Labour - the early phase

Labour - the early phase

This information leaflet has been written to help you recognise the start of your labour and to offer you advice and tips to help you through this early phase, sometimes referred to as the latent phase of labour.

You may know that labour is often described in three parts:

The first part of labour is when the neck of the womb (the cervix) opens (dilates) over a period of time to 10cm, also known as ‘fully dilated’.

The second part of labour is when the cervix has fully opened and the baby moves down through the vagina and is born.

• The third part is when the afterbirth (placenta) is birthed.

The way labour is experienced varies and sometimes it can take some time. If you think that you are in the early stages of labour, the main thing to remember is to stay calm and relaxed.

What are Braxton Hicks contractions?

Braxton Hicks contractions are the tightening and relaxing of the muscles of the uterus, which last for 30–60 seconds and may occur several times an hour, several times a day. They may be more noticeable towards the later stages of your pregnancy. They are completely normal and generally experienced as tightness. Although they may be uncomfortable, they are not usually painful.

How can I tell the difference between Braxton Hicks and real labour contractions?

As you progress into labour, contractions become noticeably longer, more regular and more frequent. They are generally much stronger than Braxton Hicks contractions. You might find that you cannot talk through them and need to concentrate to manage them.

What is ‘the latent phase’ of labour?

The latent phase is the very beginning of the first part of labour. Before labour starts, the neck of the womb (cervix) is long and firm. During the latent phase of labour, the muscles of the uterus start to contract. These first contractions, along with the Braxton-Hicks contractions that you may have already experienced, help to soften, shorten and thin the cervix and prepare your body for active labour. The cervix will begin to open (dilate).

You may feel irregular contractions that vary in strength, how often they last and how often they come. They may feel uncomfortable and last for 30-40 seconds. You may have some stronger contractions that take your breath away and others that you are able to talk through. You may have several close together and at times, have longer intervals between them. You may feel them as abdominal or period-like cramps, backache or pressure in your pelvis. They may continue for a few hours and then stop and start up again the next day. This is perfectly normal. This ‘stop-start’ pattern is common in early labour.

How long does the latent phase last?

This phase can take from a few hours to up to 2 or 3 days, although it is often shorter for second and subsequent labours. Of course, it could be much shorter, sometimes barely an hour. Nobody knows for sure why there are such big differences in labour duration between individuals.

Sometimes the latent phase blends into the first stage of labour and there is not anything specific to signify the onset of true labour.

How can I help myself through early labour?

There are many ways of helping yourself to cope through the latent phase of labour:

• It is important to try and remain relaxed.
• When the contractions start, it can be helpful to distract yourself from them and not focus on monitoring them.
• Keep your breathing deep, steady and slow during a contraction. This will prevent you from using extra energy. Try to breathe in through your nose and then longer breaths out through a relaxed and slightly open mouth. Once the contraction is wearing off, close your eyes and allow your body to rest before the next one.
• Take warm, deep baths or showers. You may find the warmth of the water soothing and relaxing.
• A hot water bottle on your lower back can help.
• Ensure you maintain your energy levels by eating small, light meals containing carbohydrates.
• Drink if you feel thirsty. Isotonic or sports drinks are a good way of boosting energy levels and keeping you hydrated during the early stages of labour.
• Make sure you empty your bladder regularly, passing urine at least every couple of hours. Try to avoid constipation. You may have loose stools; this is a normal part of the process.
• Remaining upright will assist gravity and help your baby to descend into the pelvis. Rocking your pelvis and swaying your hips can also assist you.
• Alternate active upright positions with resting, lying on your left side if this is comfortable for you. It is important to balance activity with rest to preserve energy.
• Try different positions such as standing or kneeling, leaning over a birthing ball or chair. It may be helpful if your birth partner massages your lower back and helps you relax by supporting you in any positions that you may try.
• If you intend to use approved alternative therapies such as aromatherapy or hypnotherapy, then you can use these now. The latent phase can be a good time to practise breathing techniques that will help you in active labour.
• If you have access to a TENS machine, you may wish to put it on during the latent phase.
• If you are able to take paracetamol, this may be helpful to you (take according to the instructions on the packet).
• If your contractions stop it is a good time to rest and make sure you have something to eat. Do not feel disheartened, labour naturally slows when you need to rest. The contractions will start again when your body is ready.
• Be aware of your baby’s movements. Your baby should continue to move normally throughout labour. If you think that your baby’s movements are less than you normally experience or if you are concerned, please call the assessment line01223 217217

Labour is as much a psychological process as a physical one. For your contractions to work well to birth your baby and to get the natural pain relief that the hormones of labour provide, you need to let the primitive part of your brain work well. An active thinking brain and stress all prevent the primitive brain from producing the hormone ‘oxytocin’ which is so important for normal labour and is the hormone of “calm, connection and love”. This is why physical and mental relaxation, an air of calm, being prepared and informed helps.

During the latent phase, you may be most relaxed at home with familiar surroundings and supported by people you trust and who understand the process of labour. It is important to try and remain relaxed to promote the release of oxytocin and reduce stress. If you feel that your self-coping strategies are not helping and you need further support, or if you are concerned about any of the symptoms you are experiencing, please call to arrange to come in.

Active or ‘established’ labour

In active labour, contractions occur regularly. The length and intensity of contractions increases and continues, regardless of what position you are in or what you are doing. You may find that you cannot talk through them and must concentrate to manage them. At the same time there is a progressive thinning, shortening and opening of the cervix. In this phase of labour you may have 3-4 contractions in 10 minute if this is your first baby or 2-3 in 10 minutes if you have had a baby before. The contractions are likely to last 60 seconds and will be more intense. You are advised to contact a midwife at this stage and can expect to have continuous care until your baby is born.

When to contact your midwife

• If you think you are in active labour or would like advice about when to come into hospital
• If your waters break
• If you have vaginal bleeding that is not mixed with a mucous discharge (show)
• If the pattern of your baby’s movement has changed or is less
• If you feel unwell, have severe abdominal pain or a severe headache
• If you feel you need more support and would like to come in
• If you would like advice or have any concerns

The contact numbers for your community midwifery team or the Rosie Hospital are on your antenatal handheld notes.