First stage of labour
The process often starts out slowly with short, infrequent contractions of the uterus. Over a period of hours or days, the contractions become stronger and come closer together.

Labour is by definition the presence of regular uterine contractions, leading to the progressive effacement and dilation of the cervix and ultimately to the delivery of the baby. The diagnosis is usually self-diagnosis, made by the mother on the basis of painful and regular contractions and other factors such as a show of mucus or blood and rupture of the membranes.

Labour is a time of intense physical activity, stress and pain and the care that a woman receives during her labour should help her to cope with this as well as minimise any potential risks to herself and her child. It is important for the mother to prepare herself not only physically,but also with knowledge to give her confidence and courage to deal with the changes to her body. Every woman experiences labour differently; however, there are common changes that occur throughout the stages and phases of labour.

Effacement/early labour

Thinning out(effacement) and opening (dilation) of the cervix: Dilated 0-4 cm; baby’s head starts to descend behind the pubic bones.

Contractions are:

  • Mild
  • 20 – 40 seconds long
  • from 5-10 minutes apart.

Appropriate techniques to employ:

  • Relaxation
  • Slow abdominal breathing
Mother's reaction:
  • Elation
  • Excitement
  • Apprehension
Mother should do the following:
  • Time the contractions
  • Call her doctor or caregiver
  • Conserve energy
  • Pack the last of her hospital bag if a hospital delivery isplanned and prepare the last minute things for the baby

Father/birth partner can do the following to help:

  • Help partner relax and check her breathing
  • Keep the environment pleasant and calm - possibly encourageher to listen to some classical music
  • Assess the situation and be supportive
  • Time the contractions
  • Put a pillow and blanket in the car for partner

Dilation/active labour

  • Dilated 4-8 cm
  • Membranes may rupture or be ruptured by the doctor
  • Further descent of the baby’s head behind the pubic bones

Contractions are: Stronger; 40 - 60 seconds long; 2-5 minutes apart

Appropriate techniquesto employ:

  • Relaxation
  • Slow chest breathing

Mother's reaction:

  • Growing serious
  • Increased need to concentrate
  • Restlessness
  • Desire for companionship and increased dependency

Mother should do thefollowing:

  • Go to hospital
  • Consciously relax
  • Concentrate on her breathing
  • Empty her bladder regularly
  • Find the most comfortable position. Changing positions,walking, rocking or moving will help labour progress

Father/birth partner can do the following to help:

  • Drive slowly to the hospital
  • Check in while the partner is being prepped
  • Check the relaxation of the partner
  • Help to find the most comfortable position
  • Be supportive
  • Locate emesis basin
  • Give back pressure or rub the lower back if she needs it


  • The cervix finishes dilating and begins making the transition from opening to pushing
  • Dilated 8-10 cm
  • The baby’s head starts to press on the pelvic floor and an urge to bear down is experienced

Contractions are:

  • Very powerful and efficient, thus this phase may be quite short
  • 40-60 seconds long
  • From 1-3 minutes apart

Appropriate techniques to employ

  • Pattern/candle breathing (pant-blow)

Mother's reaction:

  • Possible urge to push
  • Restless
  • Hard to concentrate
  • Nausea or vomiting
  • Hiccups or burping

Mother should do thefollowing:

  • Try to relax
  • Keep eyes open during a contraction
  • Rest between contractions


Father/birth partner can do the following to help:

  • Alert nurse in charge of intensity in contractions
  • Help partner to deal with the contraction
  • Reassure partner that the end is near
  • Help partner to relax between contractions
  • Stay calm
  • Pace her with her breathing


More about the stages of labour:

The second stage

The third stage

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