image courtesy of morguefile.com
What is the first stage of labour?
The first stage of labour is made up of two phases – the early, or latent, phase, and the active phase – and is the very beginning of labour. In medical terms, when the contractions that have up until now in the majority of cases only been annoying or unnoticeable start to change and become more intense and begin to actively work on bringing about the effacement (thinning) and dilation (opening) of the cervix. This stage ends when dilation is complete and pushing begins.
How can I tell if it is starting?
In most cases you won’t know exactly when the latent phase of early labour starts, especially as it can be very similar to prelabour, but it may start with a gradual change in the intensity or duration of prelabour contractions, or begin in irregular and widely spaced contractions similar to braxton hicks contractions that you may have been experiencing during pregnancy. As a general rule however the latent phase first stage of labour has begun when the contractions are regular, from 5 minutes to 20 minutes apart and lasting 30-60 seconds in duration, these times may vary between women however. The active phase of the first stage of labour generally begins when contractions are lasting 60-90 seconds and 2-4 minutes apart and a woman has dilated to 6cm, although this also varies between women and is only a general guideline as some women may experience these contractions at only 1cm dilated while others will still be having 7 minute apart contractions at 6cm dilated.
What can I expect?
In the beginning you may experience a dull ache or pain similar to period cramps, or you may experience a stronger ache that intensifies during the peak of the contraction, or you may even experience only mild discomfort or nothing at all. Your uterus will tighten with the contraction, generally starting from your back and radiating around to the front and down until your uterus is firm and round and the general size will be relatively smaller than normal with the fundus (the top of your uterus) raised up higher, and thicker, than normal. The “tightness” will slacken towards the end of the contraction and your uterus will become soft and return to its normal size with the fundus in its normal position once more (or slightly lower than normal position if baby is starting to engage and move into the pelvis).
As your labour progresses the contractions will become stronger, longer and the time between the contractions will reduce until you start to have contractions that peak two or more times before they end and only a short break between each single or group of contractions. This is the point where transition usually begins (I say usually as sometimes transition begins earlier or later than this point, it varies for everyone) and the second stage (the pushing stage) of labour follows transition.
What do I do now?
Once you are in active labour you have choices depending on where you intend on birthing – if you are intending on birthing at a hospital or birthing centre and have not already left it may be time to head in once active labour has begun/been established. If you are birthing at home with an independent midwife and you haven't called her in yet it would be a good idea to give her a heads up that active labour appears to have begun and that she should think of coming to you soon.
If you have hired a doula and haven't called him or her in yet now is the time to give him/her a call so that she/he can be prepared or can come in if you want or need him/her there, this also applies to any other birthing partners or family members that you want with you during your birth if you haven't already called them.
If you are birthing at a hospital or birth centre you can start loading your maternity bag/s into the car between contractions once active labour has begun (if you have not already done so prior to labour beginning), remember to take it easy so as not to overdo things and rest when you can, if you are able to try to eat something high in energy and nutritious to give you the energy that you will need during your labour and drink plenty of fluids (water, coconut water, lemon/lime water, gatorade etc) to keep yourself hydrated.
If birthing at home it's show time and you will most likely be finding your labour “groove” and focusing on your body and baby.
Soon you will be meeting your new baby, and then a brand new journey with many unique challenges will begin!
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