Labour is a series of events that brings about the dilation of the cervix, the descension of foetus down the birth canal, the delivery of the baby and finally, the delivery of the placenta.

FIRST STAGE

The first stage of labour is the thinning and opening of the cervix to approximately 10cm in diameter, which enables the fetal head (approximately 9.5cm at full term), to pass through.

The first stage can be divided into three phases:

Early phase

The early phase is the longest phase, which may vary in time from 6 hours to 24 hours or even longer.  During this phase, the cervix dilates to approximately 3cm. The intensity and frequency of the contractions may be mild and irregular - some may be so mild that you don't even notice them.  They may progressively grow stronger and intense. This phase is often longer for the first time pregnancy, compared to those who have already given birth.

Symptoms of early labour may include period-like cramps, backache, diarrhoea and a bloody 'show' when the mucous plug from the opening of the cervix dislodges.

Active Phase

During the active phase, the cervix dilates to around 8cm. The intensity, duration and frequency of uterine contraction increases. The contractions help the descension of the baby into the pelvis, forcing the cervix to open completely.

Transitional Phase

In the transitional phase, the contractions increase in duration and intensity, often with very little break in between. Some women feel shaky and sick during this phase. The cervix fully dilates to 10cm in diameter.


SECOND STAGE

The baby now descends the birth canal. Contractions are usually strong and regular with a short break in between (to allow you to catch your breath).  A semi-sitting or squatting position in this stage helps in the pushing and descension of the baby through birth canal.

If your waters have not already broken, they are likely to do so during this stage of labour. Most people get a strong urge to push - this means that the baby is ready to be born and each contraction brings that nearer!

Many experience a stinging feeling as the vagina stretches to allow the baby's head to pass through. This is called 'crowning'. Your midwife or obstetrician will be there to help the baby's head and shoulders pass through the vagina - the rest of the body then follows very quickly - and your beautiful baby is born!

THIRD STAGE

The final stage of labour is the delivery of the placenta. A few minutes after the delivery of the baby, there will be mild labour contractions, resulting in complete delivery of the placenta and other attached membranes (membranes from the amniotic sacs).  These contractions may be so mild that you don't even feel them.

After the birth

Once the baby has been born, most people feel elated and forget everything that is going on around them. As your hormones balance themselves, you may feel cold and shaky - particuarly if your labour has been quick. You will experience heavy, bloody, vaginal discharge like a menstrual flow after the child birth, which lessens over the next few hours.

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