Labour is a warning to a mother to get to a place of safety- for her and baby.
Every woman's child birth experience is unique, but all women giving birth will go through three distinct phases. The whole process will take, on average, up to 18 hours for a first babyand up to 12 hours or less for s second baby.
The first stage of labour is divided into these three phases: early or latent labour, active or established labour and transition or hard labour.
Your cervix will begin to soften and open slightly. Contractions are short, mild and irregular and may be felt as a little backache or as a 'period pain' low down in the abdomen. They may be increased vaginal discharge and nagging backache.
You may sense that something is different, but often denying that it may be the start of labour. You may feel a nesting instinct kick in, and start to clean, paint or wash baby clothes, or you may find that you become more lethargic and sedentary wanting to rest more.
First stage of labour: Early or latent labour phase
While usually the longest part of labour, this is generally the easiest. During this time your cervix continues to thin out (efface) and open up (dilate). Contractions are 5-20 minutes apart and lasts from 20-50 seconds. They are usually not painful, but they do get your attention. Vaginal discharge increases and you may have a mucous show tinged with a bit of blood. Your bag of waters may break now or later. Lower back pain may persist or increase with contractions, but are usually manageable. You may experience mixed feelings at this point. You are excited that labour has started in earnest, but also apprehensive that labour may be harder than you anticipated. You may feel excitement and anticipation, restlessness and nervousness and want to walk around, make eye contact, need companionship and distraction.
Unless there's a medical reason for you to go early to hospital, you'll be much more comfortable staying at home in early labour.
Active/Established labour phase:
Contractions become noticeably more intense. Your cervix is completing thinning out and continues to open. Contractions are getting longer, stronger and closer together- five to seven minutes apart, lasting 45-60 seconds.
Vaginal discharge becomes more profuse. Your bag of waters may break now if it has not already done so. Your labour may experience a plateau, which means contractions continue, but dilation may cease or pause for a while.
You will be alert and concentrating during contractions and sleepy and tired between them. Your endorphin levels are very high at this stage. You may feel frustrated that labour has slowed, but try and relax- your body is taking a breather before taking the next step.
You will want to avoid conversation, rest quietly between contractions and find your own position, often sitting with your head on your arms needing non-disruptive support from your birth companions. The sheer physical effort of labour can lead to increased breathing, heart rate, perspiration and even nausea which may be due to high endorphins.
Transition/Hard labour phase:
This is labour's most difficult and demanding phase and can last from 30 minutes to 2 hours. Your cervix is almost fully open. Contractions are close now- 2-4 minutes apart lasting 50-90 seconds. You will sense a change in the feel of contractions as their functions changes from pulling open the cervix to pushing down to get the baby out.Oxytocin (the hormone that causes contractions) levels are very high.
You may start to feel the urge to push ( this does not happen to every women though). You will feel pressure and fullness in the vagina, rectum and groin area. It is common to shiver and shake and feel nauseous, this is due to high adrenaline and endorphin levels.
Adrenalin gives you your second wind and enhances your concentration now. It also makes you very aggressive to others and protective towards the baby that is about to be born. Some women become grouchy and confused and extremely discouraged. At this stage it is normal for a women to express fear of dying or becoming injured. You may feel out of control and unable to cope. Remember that this is the darkest time before the dawning of the second stage.
Pushing or second stage
Once you are through the transition period the time has come to push your baby out. The second stage usually takes an hour, but can be as short as 10 minutes. The character of the contractions changes and feels more manageable. They are two to five minutes apart lasting 50-60 seconds. The uterus pushes down with each contraction you have. The baby moves down the birth canal and pressure and burning is felt in the perineum as the head stretches the vagina. The uterus takes time to rest between the first and second stage. This is normal and may take up to 30 minutes before getting going in earnest again.
The contractions of the second stage are often referred to as the 'Mother Making' contractions.
You become calmer as your 'second wind' kicks in and a sense of purpose takes over. You experience intense concentration- alert and eager as the birth of your baby approaches. You may feel tired and discouraged if pushing is taking a long time.
Third/Placental stage of labour
The third stage of labour sees the complete end of pregnancy and the delivery of the placenta. As soon as the baby leaves the uterus, the uterus continues to contract causing a massive decrease in volume, which usually shears the placenta from its walls. Further contractions push the placenta out. You may be asked to help with a few more little pushes to get the placenta out.
The breasts become loaded with colostrum, ready to feed baby and your skin temperature rises in order to keep your baby warm on your body. You may feel cramping as the uterus contracts and it is common to shake or experience chills.
You will feel relieved and happy, wanting to hold your precious baby. Don't be surprised by the utter exhaustion (physical and emotional) that you will feel. Endorphin levels and oxytocin levels are still very high. Take this opportunity to place your baby skin to skin on your body.
Classic signs of labour
The blob of mucous that has sealed off your cervix from the vagina for the entire pregnancy dislodges itself and may come away. It may even have a streak of blood in it. It may occur over a few hours or a few days. It is not a definite sign of labour, but watch out for something else to happen along with it.
These will get stronger, longer and closer together as labour gets going. Under the influence of the hormone oxytocin the uterine muscle will start contracting. What causes this to happen is still unknown. These contractions will cause the top of the uterus to become thicker while the cervix becomes thinner and shorter.
Breaking of waters
This may occur before labour, during labour, and some babies have been born 'in the bag'. There can be a break in the bag at a low point when there is a large gush of fluid, or the break can be higher, when there is more of a trickle of fluid. Amniotic fluid has a sweetish smell and is straw coloured. It is important that you are admitted to hospital or that you call your midwife immediately if this happens.
Other signs of labour include
You should be on your way to the hospital by the time you are having three to four contractions in ten minutes.