BIRTH

Stages of Labour
First Stage of Labour
The first stage of labour is the longest, lasting from a few hours to a few days. This stage happens in 3 phases: early, active – usually 12 hours or less – and
transition. It begins with mild contractions and ends when the cervix is fully opened.

Early first stage of labour Active first stage of labour Transition stage of labour
What happens: What happens: What happens:
• cervix softens and opens to 3 to 4 cm • cervix opens to 8 to 9 cm • cervix opens fully to 10 cm
• baby’s head comes down in your pelvis • baby’s head continues to move down in • baby moves down further into your pelvis
• may have diarrhea your pelvis • health care provider listens to baby’s
• mucus plug falls out of the cervix; may have • “show” may become heavy, dark and bloody heartbeat every 15 to 30 minutes
pinkish discharge (“show”) • health care provider listens to baby’s
What you might feel:
• amniotic sac (“water”) may leak or break heartbeat every 15 to 30 minutes
• pressure on your bottom
What you might feel: What you might feel: • strong contractions every 2 to 3 minutes that
• backache and pelvic pressure • stronger contractions every 3 to 5 minutes last 60 seconds
that last 45 to 60 seconds • moments of panic and confusion
• discomfort in thighs, hips or belly
• doubt as to whether you can cope with • irritability, difficulty saying what you need
• contractions that feel like mild cramps, last 20 to
contractions
45 seconds, and come every 10 to 20 minutes • nausea, vomiting
• quiet focus on yourself and your labour
• a trickle or gush of fluid • trembling arms and legs, leg cramps
What you can do: • hot or cold flashes, sweating on face
What you can do:
• use relaxation techniques • constant discomfort
• carry on your usual activities, go for a walk or
try to sleep or rest • focus on breathing • strong urge to push
• breathe normally until you can’t talk through • concentrate on one contraction at a time
What you can do:
contractions, then start with slow breathing • between contractions, keep moving and sip
• picture your cervix and body opening up to
• eat a light meal and drink fluids fluids or suck on ice chips
let your baby out
• take a shower (not a bath, which can slow • pee frequently
• tell someone if you have the urge to push
your contractions during early labour) • have a warm shower while sitting on a chair
• use panting if you have the urge to push
• use a sanitary pad and call your doctor if your or leaning on your partner
before you’re fully dilated
water breaks

Baby’s Best Chance Birth • Stages of Labour 1

 What is fetal monitoring? Second Stage of Labour
Listening to your baby’s heart rate during The second stage begins with your cervix fully open and ends with the birth of your baby. It can last
active labour to see how it’s being affected from a few minutes to 2 or 3 hours.
by contractions. Usually done with a hand- What happens: What you can do:
held stethoscope. If needed, an electronic
• health care provider breaks your bag of • relax your bottom and go with the urge to
monitor may be placed around your belly
waters if necessary push; use the muscles you use for a bowel
or clipped onto your baby’s head.
• health care provider listens to baby’s movement
heartbeat every 5 minutes • use breathing techniques; drop your chin
Call your health care provider or • baby’s head pushes down against your groin; towards your chest and relax your tongue
hospital when: may tear a bit, or doctor may make a small cut • change positions as needed
• your contractions are regular and painful, (“episiotomy”) to allow more room • use relaxation techniques between
last 30 to 60 seconds and come every • vagina stretches contractions
5 minutes or less • you may poop as you push • if asked to stop pushing, use panting
• your water breaks • as head emerges, mucus in baby’s nose and • touch your baby’s head as it comes out
• you have vaginal bleeding or pinkish mouth may be suctioned out • look down or use a mirror to watch your baby
discharge (“show”) being born
What you might feel:
• you’re unsure and worried
• powerful contractions every 2 to 3 minutes
• your health care provider has advised
that last 60 to 90 seconds PARTNERS
you to call early
• strong urge to push What You Can Do
• splitting and burning feeling on your bottom During contractions, look your partner
SEEK CARE
• baby’s head slipping back in between in the eyes and help them focus on their
If your water breaks and the breathing. Between contractions, wipe
contractions
fluid is green or brown, your baby has their forehead with cool cloths and offer
pooped. This may mean that she’s • emotional, surprised, overwhelmed, anxious
sips of fluids. Stay with your partner and be
or frightened
stressed or in a breech position. Go to calm, confident and encouraging.
the hospital. • very tired but with a burst of energy

2 Birth • Stages of Labour Baby’s Best Chance

Third Stage of Labour Fourth Stage of Labour
In the third stage, your uterus contracts and the placenta comes out. This stage takes 5 to 30 minutes The fourth stage refers to the first 2 or 3 hours
or longer. after birth.
What happens: What you might feel: What happens:
• umbilical cord is cut and clamped • cramps and a gush of blood as the placenta • your body begins to recover
• health care provider checks baby over comes out • your baby may breastfeed or nuzzle your
• placenta separates from the uterus wall and • relieved, grateful, joyful or unemotional breast
is pushed out the vagina • exhausted, shaky, cold, hungry, thirsty
What you might feel:
• uterus rises in the belly; becomes size and
What you can do: • very tired, dizzy, shaky, chilled
shape of a grapefruit
• cuddle your baby skin-to-skin on your chest • difficulty peeing because of swelling
• tears or episiotomy are stitched up
• bring baby to your breast to see if she’s • discomfort
ready to suck
What you can do:
• keep your baby skin-to-skin until she
finishes her first feeding and then for as long
as you wish
• put an ice pack between your legs to
reduce swelling
• drink fluids and have a light meal
• have someone help you if you need to get up

DID YOU KNOW BE AWARE

Waiting 12 or more hours after birth If you’re sleepy, have a support
before bathing your baby will help keep person with you when you’re cuddling
her temperature steady and can help get skin-to-skin with your baby.
breastfeeding off to a good start.

Baby’s Best Chance Birth • Stages of Labour 3