Labour can be divided into three main stages: Early and Active Labour, Birthing of your baby, Delivery of the Placenta

The 1st stage of Labour

When the cervix is thinning and dilating, can be divided into three different phases. These phases are: Early first phase, Active first phase and End of first phase (transition). Understanding the likely physical progression throughout the 1st stage phases can assist you, your partner, Doula, Midwife or Doctor to recognise the unique physical signs of the 1st stage, and gain an awareness of some support strategies that may be helpful at different times.

This awareness can also help you in making informed decisions about when to take a walk, have a rest or jump in the car and head to the hospital. You may benefit from staying at home as long as possible if it’s your first baby, should you be up to baby number six then it’s advisable to get going to your chosen place of birthing, after all, those babies are likely to come out after one sneeze! Not every woman will exhibit all three definite phases, but knowing them can provide you with a general guide as to what may be expected.

Throughout the early, active and transitional phases of 1st stage, the uterine muscles contract and retract (ouch) therefore, after each contraction, the uterus becomes smaller in size and pushing your baby down and out. During a contraction the uterus tilts forward and downwards. At the same time, the cervix becomes thinner, being pulled up and open (or ‘dilating’).

What it feels like?

Labour contractions normally behave in a progressive way. They usually start off in prelabour being short, mild and irregular (or more than 5 minutes apart), changing as the labour becomes more established. In the early 1st phase, the contractions tend to become longer, more intense, and usually less than 5 minutes apart.

However, some labours do not follow this pattern. Occasionally, a woman will have no build up, and at times she may labour until her baby is born with only moderate, 5 minutely contractions, that would normally be associated with prelabour, or early 1st stage. This must be very occasionally because no mother I know has ever sat back with a cuppa and casually retold the story of her ‘moderate, 5 minute prelabour contractions’ that resulted in birthing her child. This doesn’t mean it hasn’t happened of course.

Active 1st phase is viewed as the time when your labour changes again, from being in early 1st phase, and moving into a ‘strong established labour’. Again, the labour ‘ramps up’, with the contractions becoming stronger and closer together, and possibly lasting longer.

Your body is working very hard now to open up your cervix. The contractions need to be strong to achieve this. You may be wondering how much more intense this labour can get? Pain relief options may be crossing your mind. Hitting your partner may be also crossing your mind. You’ve no doubt started swearing at him or her by now. You’ll notice that you need to breathe through the contractions because the only other option is to lose your mind. When you work with the contraction and soften your mouth (mooing and ooing noises keep the mouth soft and round) your breathing becomes deeper, your awareness goes inward, there’s no more talking during a contraction and most likely the vomiting begins. This is good news. Your cervix can do a lot of dilating during involuntary actions like sneezing or vomiting. It’s all working for the same cause!

Third Phase of first stage– Transition time. Your contractions are now likely 1 to 3 minutes apart, and lasting for approximately 50-70 seconds, being ‘back to back’ with little, or no, rest periods in between. Some feel like one, continuous contraction, with lower back, hip and anal pain, never completely subsiding between the contractions, as the baby moves further down the birth canal. This is often the time when birthing mothers ‘quit’. Attempts to get up and leave, head home, demands to get the Doctor to give an epidural immediately, are all very common threads of birthing stories. Transition does that to you, along with some intense stinging and breathing changes, also making different sounds, more grunts and straining sounds during the contractions. These are sounds that many women make when they start to move into the early phase of 2nd stage.

The 2nd stage of labour

The 2nd Stage of Labour begins when the cervix is fully open and your baby’s head (known as the ‘presenting part’) moves down out of the uterus and into the vagina (or birth canal), ending with the birth of your baby. The 2nd stage can be made up of four different phases,

Most women, but not all, will experience a resting phase or ‘lull’ as they move from transition into the 2nd stage of their labour. This is when your cervix is fully dilated (about 10 cms), but the urge to push, or to ‘bear down’ is not yet felt. Some women experience mild contractions at this time, while for others the contractions fade away (or stop completely) for a short period. The next phase, pushing, is damn hard work, so if you get a resting phase, make the most of it!

The active pushing phase is usually from when you start to feel the urge to push (usually during a contraction, don’t bother pushing without one ) until most of the baby’s head can be seen at the opening of her vagina. The sensations during this phase can range from a slight urge at the peak of the stronger contractions, to an irresistible urge to push (or bear down) all the time that you may have little control over. The initial pushing is usually experienced in short bursts during some of the contractions, increasing to a tremendous need to push several times during each and every contraction as the baby comes down.

As the baby descends their head ‘moulds’ to the shape of the birth canal, hence why most newborns have very odd looking, slightly pointy heads. This is possible because your baby’s head is not solid like an adult’s, but has five separate bone plates that have not fused (or joined) as yet. As the baby is being pushed down through the vagina, the baby’s skull bones move towards each other and slightly overlap, protecting their brain. The baby’s head usually becomes longer and thinner (more so if the baby has been sitting in the vagina for some time). Your baby’s head will return to a normal shape!

Usually once the head crowns, the baby’s face and entire head slowly emerge within moments. You may need to ‘pant’ or blow, as the baby’s head comes out (similar to blowing out a candle). This may help ease your baby’s head past your perineum.

Soon after your baby’s shoulders are delivered and boom, you’ve got a slippery little piece of heaven being thrown toward you. It feels amazing in different ways for all mothers. Some experience a high, bells and fireworks kind of moment, some an intense feeling of relief and all the gooey love stuff comes a little later. Don’t feel guilty if this is you, it was me too.

The 3rd Stage of Labour

The 3rd Stage of Labour begins from the moment the baby is born until the delivery of the placenta, cord and membrane from the uterus. Let the hospital know previous to your birthing day if you’re wanting to keep any of this for storing, planting or consumption (each to their own) purposes.

In the majority of cases, the 3rd stage is actively managed by the Midwife or Doctor. This involves you being given an injection of a synthetic oxytocin hormone drug (called ‘Syntocinon’), the umbilical cord being clamped and cut usually within minutes after the birth, though delayed clamping is routinely practiced in most cases and the cord being gently pulled (while the Midwife or Doctor uses their other hand on the woman’s belly to support her uterus) to help deliver the placenta. My midwife asked me if I’d like to give a push, I looked at my baby (finally out) and just said “Not really”. I ended up having to give some assistance, begrudgingly I might add.

The fourth stage of Labour

The Fourth Stage of Labour is a special add on stage, the first hour after your baby is born is a very special bonding time, first breastfeeds happen now, only a medical emergency should interrupt it. It is the time that your body stabilises and the baby fully adjusts to life outside the womb. After, it is a time to shower rest, eat and drink for you, for your baby to be checked, weighed and measured, to ring friends and relatives and perhaps have some form of celebration.

This can be an intense period with the labour or events leading up to the birth of your child still hanging in the air. Emotions of delight, joy and love intermingle with relief as you see, hold, smell your new baby and probably change your first nappy. You start to very quickly forget or downplay how intensely painful and tiring your labour was, thinking and even saying out loud ‘Oh that wasn’t so bad, was it?’ (I got a very confused look from my husband) all because of the tiny bundle wrapped up happily in your arms.