The Three Stages of Labour

The Latent Stage: Early Labour

The latent stage is often the longest phase of labour, marking the beginning of your body’s preparation for birth. During this time, your cervix starts to soften and dilate (open) gradually, allowing your baby to move into position. This stage can last for hours—or even days—particularly for first-time mothers.

• Contractions: You may feel irregular contractions that range from mild discomfort to more noticeable pain. Unlike later stages, these contractions don’t follow a predictable pattern in frequency or duration.
• What to do:
  • Stay hydrated and eat light, energy-rich foods to maintain your strength.
  • If labour begins at night, try to rest or sleep. If it starts during the day, stay upright and gently active to encourage your baby’s descent.
  • Use breathing exercises, massage, or a warm bath or shower to manage discomfort.
• When to contact your midwife: If you’re unsure whether you’re in labour, or if contractions turn into regular (every 5 minutes or more often), reach out for guidance. NHS guidelines emphasise that listening to your body and seeking advice early can prevent unnecessary stress.

Established Labour: The First Stage

Once your cervix has dilated to about 4 centimetres and contractions become stronger and more regular, you’ve entered established labour. This stage continues until your cervix is fully dilated (around 10 centimetres).

• Contractions: These typically last 40–50 seconds at the start, with 10-minute intervals. As labour progresses, contractions grow longer (over a minute) and closer together (less than a minute apart).
• Pain management: Although contractions can be intense, the pain often subsides between them. Techniques like focused breathing, pelvic rocking, and vocalising can help. Your birth partner can support you by rubbing your back, holding your hand, or breathing with you.
• When to go to hospital: If you’re having regular contractions (every 5 minutes or more often), your waters break, or you experience vaginal bleeding, contact your midwife or maternity unit immediately. NHS advice stresses that early admission isn’t always necessary—if labour hasn’t progressed, you may be advised to stay home until contractions intensify.

The Second and Third Stages: Birth and Delivery of the Placenta

The second stage begins when your cervix is fully dilated and ends with your baby’s birth. This phase can last from a few minutes to a few hours. The third stage involves delivering the placenta, which usually takes 5–30 minutes.

• Pushing: You’ll feel a strong urge to push during contractions. Your midwife will guide you on when and how to push effectively.
• After birth: Once your baby is born, skin-to-skin contact is encouraged to promote bonding and breastfeeding. The placenta is then delivered, either naturally or with the help of an injection to speed up the process.

Understanding Contractions: What to Expect

Contractions are the rhythmic tightening of your uterus, which help your cervix dilate and guide your baby through the birth canal. Recognising the difference between true labour contractions and Braxton Hicks contractions (practice contractions) is key to knowing when labour has truly begun.

True Labour vs. Braxton Hicks

Coping with Contractions

Every woman’s experience of contractions is different—some describe them as intense period pains, while others find them more manageable. Here’s how to cope:

• Breathing techniques: Slow, deep breaths can help you stay calm and focused. Try inhaling through your nose and exhaling through your mouth.
• Movement and positions: Rocking your pelvis, swaying, or leaning forward can ease discomfort. Some women find relief in a warm bath or shower.
• Support from your birth partner: A partner or doula can provide physical support (e.g., back rubs, hand-holding) and emotional reassurance.
• Pain relief options: Discuss your preferences with your midwife ahead of time. Options may include gas and air (entonox), a TENS machine, or an epidural.

NHS England’s Latest Safety Measures for Labour and Birth

In September 2024, NHS England issued a National Patient Safety Alert highlighting the risks of oxytocin overdose during labour. Oxytocin is a hormone used to induce or augment labour, but incorrect dosing can lead to overly strong contractions, which may stress the baby or increase the risk of complications. The alert provides updated guidance for healthcare professionals, including:

• Strict monitoring: Continuous fetal heart rate monitoring is recommended when oxytocin is used to detect any signs of distress early.
• Dosing protocols: Oxytocin should be administered in low, gradually increasing doses, with regular assessments of the mother and baby’s response.
• Clear communication: Midwives and doctors are advised to explain the risks and benefits of oxytocin to women and their birth partners, ensuring informed consent.

NHS guidelines also emphasise the importance of personalised care. As noted in the North West Latent Phase Labour Guideline, “it is imperative to listen to the woman and her birth companions.” Some women may experience strong, painful contractions without significant cervical change, and their perception of being in labour should be respected.

When to Seek Emergency Help

While most labours progress safely, certain signs require immediate medical attention. Call 999 or go to the nearest maternity unit if you experience:

• A sudden, strong urge to push (which may indicate your baby is about to be born).
• Heavy vaginal bleeding.
• Your waters breaking and the fluid being green or brown (a sign of meconium, which can indicate fetal distress).
• Contractions lasting longer than 2 minutes or occurring 6 or more times in 10 minutes.
• Reduced fetal movement (fewer than 10 movements in 2 hours after 28 weeks).

Frequently Asked Questions About Labour

How long does labour usually last?

Labour duration varies widely. For first-time mothers, the latent stage can last up to 20 hours, while established labour averages 8–12 hours. Subsequent labours are often shorter. However, every birth is unique, and there’s no “normal” timeline.

Can I eat or drink during labour?

Yes, light snacks and fluids are encouraged during the latent stage to maintain energy. Once in established labour, you may be advised to stick to clear fluids or ice chips, especially if an epidural or caesarean section is a possibility.

What if my labour isn’t progressing?

If labour stalls (e.g., contractions weaken or cervical dilation slows), your midwife may suggest changing positions, walking, or using oxytocin to stimulate contractions. In some cases, a caesarean section may be recommended for the safety of you or your baby.

Is it normal to feel scared or overwhelmed?

Absolutely. Labour is a physically and emotionally intense experience. Many women feel anxious, especially if it’s their first time. Talking to your midwife, attending antenatal classes, and having a birth plan can help you feel more in control. Remember, your healthcare team is there to support you every step of the way.

Key Takeaways

• Labour is divided into three stages: the latent stage (early labour), established labour (active labour), and the delivery of the baby and placenta.
• True labour contractions are regular, increasingly intense, and don’t ease with movement. Braxton Hicks contractions are irregular and usually painless.
• Stay hydrated and eat light meals during early labour to maintain energy. Use breathing techniques, movement, and support from your birth partner to manage pain.
• Contact your midwife if contractions become regular (every 5 minutes), your waters break, or you experience bleeding. Seek emergency help if contractions are remarkably frequent or last longer than 2 minutes.
• NHS England’s safety alert on oxytocin highlights the importance of careful monitoring and personalised care during labour.
• Every labour is different—trust your instincts and communicate openly with your healthcare team.

Preparing for a Safe and Positive Birth Experience

Labour and childbirth are profound experiences, and being informed can help you approach them with confidence. By understanding the stages of labour, recognising the signs of true contractions, and knowing when to seek help, you can navigate this journey more smoothly. NHS England’s updated safety measures underscore the importance of personalised, attentive care—ensuring that both you and your baby receive the best possible support.

If you’re expecting, take time to discuss your birth plan with your midwife, attend antenatal classes, and pack your hospital bag well in advance. Most importantly, remember that you’re not alone—your healthcare team, birth partner, and loved ones are there to support you every step of the way.