Giving birth - first stage of labour

What is the first stage of labour?

The first of the 3 stages of labour is when your cervix (the neck of your uterus) opens (dilates) in preparation for you to give birth. Your contractions also become stronger and more frequent.

What are the phases of the first stage of labour?

Although every labour is different, there are 3 distinct phases within the first stage of labour.

The latent phase

The first phase is called the latent phase.

• It is the longest phase and can last for many hours or even days.
• Your cervix becomes thinner (called effacement) and begins to open.
• You may have regular or irregular contractions or they may not be noticeable.
• You can usually stay at home during this stage of labour.
• Try to rest and relax by doing gentle stretches or by practising mindfulness, meditation or other calming techniques.
• Eat light snacks such as fruit or toast to maintain your energy reserves, but avoid heavy meals so you don't feel nauseous later.

The active phase

The second phase is called the active phase.

• It is when your cervix is open (dilated) to between 4 and 6 centimetres.
• You may experience stronger, more painful contractions than during the first phase.
• Contractions become more regular, occurring 3 to 4 minutes apart and lasting between 30 to 60 seconds.
• You may choose to come to a hospital or your birthing centre during this phase.
• During the active phase, your cervix dilates to 8 centimetres.

The transition phase

The third and final phase of the first stage of labour is called the transition phase.

• Your cervix becomes fully dilated, opening to 10 centimetres, large enough for your baby to pass through.
• Contractions become more painful.
• You may feel pressure in your bottom or like you have a bowel movement (poo). This is due to your baby pressing on your rectum (back passage).
• Once your cervix is fully dilated, the second stage of labour begins.

How long can the first stage of labour last?

The first stage of labour is the longest but its length can vary widely between births. It usually lasts around 12 hours for your first birth, and about 8 hours if you have given birth before.

Some people do not notice contractions at the start, only realising they are in labour towards the end of the first stage.

When should I go to the hospital or birthing centre?

What support is available during the first stage of labour?

During the first stage of labour your birth partner can support you at home until you are ready to go to the hospital or birthing centre. They can try to help you relax and be as comfortable as possible. This could include:

• dimming the lights and playing calming music
• giving you a gentle massage
• bringing you light snacks and drinks
• helping you with natural pain relief methods, such as hot or cold packs or breathing techniques
• physically supporting you to maintain comfortable positions during contractions

You can also help yourself during this stage by:

• drinking water regularly to stay hydrated
• emptying your bladder regularly — this gives the baby more space to move down and will also be more comfortable for you
• standing and moving around to manage pain during contractions and to help to naturally progress labour

What happens when I arrive at hospital or a birth centre?

Once you are at the hospital, birthing centre or where you choose to give birth, your midwife will monitor you and make sure your labour is progressing as it should.

When you arrive at the hospital or birthing centre:

• A midwife will examine your abdomen to check the position of your baby.
• They will ask you about the strength and frequency of your contractions. This can help them identify how far your labour has progressed.
• They will use a deoppler or a continuous monitor to check your baby's health and listen to your baby's heartbeat.
• Your midwife will ask you about your pregnancy and general health, including what medicines you take or if you have given birth before.
• Your midwife will also check your blood pressure to make sure it is in a normal range.
• They may ask you for a urine sample to test for signs of infection.
• They may ask your consent to perform a vaginal examination to see if your waters have broken, if you are bleeding from your vagina and measure how dilated your cervix is.

It can be helpful to prepare a folder with your important medical information for your midwife.

You can discuss your birth plan with your birth team, including your preferences regarding pain relief during labour. Feel free to request pain relief at any time, and your midwife will guide you on suitable methods of pain relief for each stage of labour.

What happens if something goes wrong?

Every labour is unique, and sometimes things don't go as planned. You may have to adjust your birth plan if the situation changes. For example, there can be labour complications in which extra medical support is needed.

Your midwife will communicate with you and your doctor to guide you to make the best decisions for you and your baby.

Resources and support

• Speak to your doctor or midwife during a prenatal visit about what you should do in your first stage of labour. If you have any questions or concerns at any time, you can call your midwife, doctor or birth unit for advice.
• The Royal Australian and New Zealand College of Obstetricians and Gynaecologists provides a pamphlet on labour and birth.
• Health NSW has created a labour and birth booklet outlining the various stages, what to expect at each stage of the birthing process and as well as how you can be supported.