First stage

Active labour is often said to begin when contractions are strong, regular and lasting at least 60 seconds, and your cervix is open to at least four centimetres. During the first stage of labour your contractions will continue to come regularly, and become progressively stronger. This stage of labour can last around 6-12 hours if it is your first baby, and is often quicker if it is your second or third baby. When you arrive at your maternity unit (or your midwife comes to your home) and throughout the first stage of labour your midwife will offer regular assessments of your progress and wellbeing, and the wellbeing of your baby, including:

• your observations (blood pressure, pulse and temperature)
• abdominal palpation
• listening to your baby’s heartbeat
• vaginal examination to assess the progress of labour and position of your baby.

Your midwife will support you with different positions and coping strategies, including pain relief if needed. If the midwife is concerned about you or your baby at any point, she will ask a senior midwife or obstetrician for a second opinion. This can sometimes mean transferring to the labour ward if you are at home or in a midwifery led unit. Towards the end of the first stage you may experience something known as ‘transition’ which can make some women feel scared or out of control. This is common and is soon followed by an urge to push as the cervix reaches ten centimetres dilated, and the baby moves down into the birth canal. Your midwife will support you closely during this stage.