The First Stage of Labour

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The first stage of labour happens when you are having regular contractions and your cervix is open 4cm or more. The first stage ends when your cervix is fully open.

What is happening during the first stage of labour?

We call the first stage the active stage of labour. Contractions move your baby down into your pelvis, and help your cervix to stretch and open. The contractions also encourage the release of the hormone oxytocin which causes more contractions and allows labour to progress.

How do I know if this is labour?

During this stage, you will be experiencing contractions that are really regular, usually 3-4 in a 10 minute period, and they will last for at least a minute. You will start to feel contractions slowly build to their peak and relax back down again.

If this is your first labour, it can take a while to reach this stage, but with subsequent births this can happen more quickly. If you are ever unsure, or are planning to make your way to the hospital, call your maternity unit first to talk to someone. You can then make a plan together.

Your care during Labour

As the first stage progresses you will be cared for by a midwife. They will carry out an initial review of how your pregnancy has progressed, look at your personalised care plan, and ask about your labour so far.

This includes if your waters have broken, if you have had any bleeding, and how your baby is moving. They will then offer to monitor your blood pressure, pulse, temperature and check your urine.

Your Contractions

Your contractions will gradually increase in frequency and strength. Contractions are influenced by hormones and respond to other influences that you might not have expected. For example, contractions need energy! This means eating and drinking is essential. Feel free to bring any food you’d like with you.

Contractions also respond to the environment. They like a quiet, warm, dark space that feels safe and comfortable. Think about low lights, soft music and home comforts, even in a hospital environment.

Sometimes contractions slow down or reduce. A change of position, eating or drinking or being more mobile may help increase their frequency and strength. You can use birthing balls, beanbags and water to support you in more upright positions. Your birth partner or midwife can remind you to eat and drink throughout labour to keep your energy levels up.

Listening to your baby’s heartbeat

Labour can be tiring for both you and your baby. So once you’re in active labour, you’ll both be monitored more closely.
In straightforward labour this would mean offering to listen to your baby’s heartbeat every 15 minutes, for a full minute following a contraction. This enables you to move around freely in between.

In some circumstances, your midwife may monitor your baby’s heartbeat continuously. You might already know to expect this, or sometimes concerns arise in labour and your midwife will explain why continuous monitoring is now recommended.

Although this type of monitoring can limit how mobile you are, you don’t need to stay on the bed. Discuss using a birthing ball with your midwife, or trying different positions on the bed or floor. You may wish to ask if cordless monitoring is available.

What can I do to help myself in labour?

Being in an upright position and being mobile will help labour to be quicker and easier.

Going for a walk, using a birth pool or using a birth ball are all options too.

Keep your energy levels up with food and drink. Your body works hard during your labour and you will need your energy.

The more relaxed you feel the easier first stage of labour will be. Things such as massage and breathing techniques make a real difference to how you feel on the day.

Your midwife will remind you to pee regularly, as it can be difficult to feel your bladder, but it is important as a full bladder can slow labour. Occasionally your midwife may offer to empty your bladder with a temporary catheter.

You may have thoughts on whether you use pain relieving drugs in labour. This of course is not set in stone and plans can change. Your midwife will be guided by your wishes.

The labour journey is often one that has many twists and turns, your midwife is there to support you, your family and your choices. You and your baby are unique, and your maternity care providers will work together to create your best birth on the day.

More information can be found on nhs.uk/pregnancy

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