Recognising labour and giving birth

Giving birth to your baby is an emotional and life changing event! It’s exciting and every experience of labour is different. Your health professionals will do everything they can to make this a positive experience.

It is important that you are involved in any decisions about your care during labour. There are lots of choices to consider, but it is good to understand what to expect from labour and plan your birthing options well in advance of your baby’s arrival.

There are 3 stages of labour:

The first stage of labour is from the onset of regular and painful contractions which become stronger and longer as time goes on.

The second stage of labour is from when your cervix dilates to 10 cm and you push your baby out.

The third stage of labour is when you deliver the placenta and membranes (the afterbirth and the bag of fluids that is attached to it).

The early stages of labour

During labour, your cervix opens (dilates) so that the baby can pass through. The first stage often starts with the early stage of labour, where you will usually feel contractions which start irregularly and mildly and build up to a more regular pattern. This softens and thins the cervix whilst also dilating.

You may begin to feel pains in your back, the tops of your legs, similar to period pain, as well as tightening, which is different from ‘Braxton Hicks contractions’. This can sometimes take a few days.

You may see a heavier discharge that is clear or yellow like jelly, perhaps streaked with blood; this is called a ‘show’. If you see fresh blood, like you would during your period, contact the hospital or maternity unit straight away.

You may be offered an early assessment to see whether you are in labour,  they will ask about your contractions. This will cover:

• how frequent they are
• how long they are lasting for
• how strong they feel

They may also discuss:

• your birth plan
• how your pregnancy has gone
• your baby’s movements
• whether the contractions are painful
• your baby’s position and heartbeat

Your waters may break either before or during labour. This should be a clear or pink fluid but if it is green or red in colour, you must contact your midwife or maternity unit immediately. Some people are unsure whether their waters have broken or not, and if this is the case, you should be seen for an assessment by your midwife. Not everyone’s waters break during labour, but if they do you should always contact a midwife for advice.

Establishing active labour

During the first stage of labour, your contractions will become stronger and more regular as time goes on, but don’t worry if it seems as though your labour has stopped. This is common and contractions can come and go over many hours. They will become more regular as labour progresses. In some cases, this is happening because the baby’s head is engaging further in to the pelvis, and getting in to the right position for labour.

During this time, remember to drink plenty of fluids as it’s very important to keep hydrated. Eating little and often can help to maintain your energy levels too. Snacking on small amounts of foods high in carbohydrates like toast, cereal and sandwiches are good options.

Keep as calm and relaxed as you can by listening to music or reading, and, if your mind is distracted, it will help with each contraction. Your birth partner can help with this. If you’re feeling tired, have a rest or even try to sleep.

Try to stay mobile during labour. Your birth partner can help you to manoeuvre into different positions. Staying upright can help the pelvis to open up and the baby’s head to fully engage into the pelvis. The use of a birthing ball can help even more with getting your baby into the right position ready for birth.

If you are able to, and your pregnancy is low risk, try to stay at home for as long as possible, contacting the midwives when the contractions establish. This is known as active labour.

Even if your waters have broken, you might be sent home if your labour has not yet started. You should definitely call the hospital when contractions are regular and powerful, coming between 10 to 15 minutes apart, and lasting at least 30 to 60 seconds to discuss the next plan of your care.

Your midwife will want to know about how you are during the contractions, but it’s also important to say when you feel you are ready to go in. You should also call the hospital if you see fresh bleeding or if you have concerns about your baby’s movements. To find out more about what to take with you for the birth, read our article on packing for labour.

Giving birth

Good birthing positions include kneeling on all fours, squatting, sitting or leaning on a birthing ball, sitting on a birth stool and also standing. When your baby is ready to be born, you will have an overwhelming and unstoppable urge to push, but try not to push until your body is pushing for you to do this. If you have an epidural, your midwife will guide you through this stage.

It is important that your baby’s head is born slowly to help minimise damage to you, so you will be asked to stop pushing and breathe or pant. Occasionally, an episiotomy might be considered. This is a surgical cut made at the opening of the vagina during childbirth. If you require stitches for any tears, these can usually be done straight after the birth.

Third stage of labour: Delivering the placenta

This is what you may know as the ‘afterbirth’. The placenta separates and is delivered within a few minutes, although it can take up to an hour to deliver. It can be delivered naturally (physiological) or with help from an injection of oxytocin (active).

A physiological delivery of the placenta is possible if you’ve had a normal birth with no interventions, and allows for uninterrupted skin-to-skin time.

If you have an injection of oxytocin, this will happen as the baby’s body is being born. The cord will be clamped within a few minutes and cut, and the placenta will then be delivered after around 15 minutes by your midwife.

Your health professionals will guide you through the process of labour. If you have any concerns, speak to your midwife or health visitor.