You’ve been carrying a baby in your womb for almost 9 months, as your unborn baby has grown and developed. Now, it is the right time for that baby to be born, and you’re in labour.
This first stage of labour is also called the stage of Dilatation. When you start feeling contractions, it means that your cervix is gradually softening and then ‘dilating’ in order to allow the baby to pass through. You will experience additional symptoms such uterine contractions, expulsion of mucus plug and rupture of membranes.
The uterus will contract for about 45 seconds, beginning with a slow tightening of the womb that comes to a strong peak, and then slowly fades. For women giving birth for the first time, labour will usually last between 12 and 24 hours, with an average of 14 hours. However, for women who have given birth before, labour usually averages only 6 hours.
It depends on the size and position of the baby, the size of the mother’s pelvic area, and the behaviour of the uterus. In this stage, other muscles of your uterus are involuntarily working to stretch open the circular muscles of the cervix opens wider (effacement) the constrictions become stronger and regular until the cervix is fully dilated.
The mucus plug may consist of thin or thick mucus. It may be just bloodstained in some women, resulting in brownish vaginal discharge. But in others, there may be true bleeding at the time of expulsion of the mucus plug.The cervix which is the mouth of the uterus is filled with dense mucus that serves as a seal during pregnancy. As the cervix is opening and thinning to allow the passage of the baby, the mucus is expelled through the vagina.
Before the cervix has fully dilated to a full 10 centimetres to accommodate the baby’s head and allow the baby to enter the birth canal is the one that is usually to be most painful. Sometimes, it can be accompanied by back pain, leg cramps, nausea, and rupture of membranes.
The beginning of labour is signified by the rupture of membranes (rupture of the bag of waters) without any prior abdominal pain. The rupture of the membranes may start with a sudden gush of water, or with only a small drip that is just enough to soak the underwear wet. In most cases, leakage of water is more common if you are lying down. Standing or sitting up causes the head of the baby to plug the mouth of the uterus and prevents outflow of the amniotic fluids (waters).
Active labour is the period of time when your cervix dilates between four and eight centimetres. Contractions usually come between three and five minutes apart, dilating the cervix approximately one centimetre per hour. During this time, the contractions that you have been experiencing will become stronger and more intense. You will also find that as time progresses the contractions are getting closer together and lasting longer.
As much as possible, get on as normal with your daily life, ignore the sensations that you are experiencing until it completely demands your attention. Don’t worry whether or not this is actual labour. For the vast majority, labour eventually makes itself very clear.Try to be patient and have confidence that your body is doing exactly what it needs to do. When this is not possible start with some of the tips and positions that follow.
Keep changing position and walk around as you can because gentle movement encourages the uterus to contract more effectively, and gravity increases the pressure from the foetus on the cervix. If you cannot get out of bed, try to sit upright. Movements prevent over stressing one or two muscle groups by changing the way you hold your baby. Also, it allows you to respond to the changing feelings in your body caused by the baby moving through the pelvis.
Energy bars or cereal bars are good to keep your energy levels up. A prolonged labour can be exhausting and may cause dehydration. It is therefore important that you keep your fluid intake up. Aim to drink a glass of water every hour or, if you prefer, take a few sips after each contraction
The excitement of knowing that things are moving at last is a nice feeling. You are finally going to deliver your baby and it may give you a rush of adrenaline that will make you want to stay active. That’s great, but don’t overdo it; if you’re in early labour, the birth may be some time away and you need to conserve your energy. Take a rest and find a good place for you to relax.
The main focus, is to understand how long each contraction lasts and how far apart two successive episodes are. Use a stop watch or a clock with a second hand, and keep a notepad close at hand to write down the timings, or have your birth coach time them for you. Take note when the contraction begins and ends. Wait until you have 3 contractions in 10 minutes lasting 40 seconds or more before going into the hospital or calling your midwife.
Your partner can help you get through the first stage of labour by encouraging you to relax and breathe calmly, assisting you in changing positions, offering sips of water rubbing your back, cooling your face with a wet clean towel, giving you emotional support and acting as a mediator between you and the hospital staff if you are not up to it.