Your first stage of labour explained

Waters Breaking

The amniotic sac that your baby has developed inside breaks open and the fluid he’s been surrounded by escapes. It’s not as dramatic as it sounds so don’t worry. It usually happens in established labour and often at the height of a contraction. Some women’s waters break before the contractions start.

The sensation is usually subtle and often the first sign is simply the fluid escaping – usually in a trickle rather than a gush. The fluid is straw-coloured, rather like urine, but with a slight almond smell. There’s usually the equivalent of a wine bottle full.

You should contact your midwife, who can verify that your waters have broken. But there isn’t necessarily a rush, because labour might not start for another 36 hours.

Stage One – contractions and dilation

When the first stage begins, you tend to know about it as real contractions start! That’s when the womb contracts and relaxes in a rhythmic pattern – imagine a balloon inflating and then letting a bit of air out over and over. Just like you’ll be imagining, the contracting is tightening and cramping, whilst the relaxing is when you get a break to recover.

Contractions do two main things: push your baby deeper into the pelvis and open the cervix until it’s what is called ‘fully dilated’, which is the equivalent of 10cm open.

Essentially, your cervix is the ‘door’ where your baby will come from the womb into the world. Before labour starts, the cervix has a small opening, but it needs to get wider so you can give birth. So, as the contractions continue it ‘dilates’ at around 1cm an hour with a first baby, although it will be quicker with subsequent labours. When you’re fully dilated, the first stage is complete.

Pain during contractions

At risk of being shot down in flames for saying this, labour does hurt, so instead of trying to find a cure, you should think about ways of coping.

The pain hits at the peak of each contraction and subsides between each contraction. The pauses between each contraction decrease as labour progresses, from around 20 minutes early on to two minutes as the birth nears.You need to make the most of the breaks to relax your body. Measured breathing is one of your best tools.

3 things that could stop your pregnancy going to plan:

• Contractions going ‘off the boil’:

This often happens when you’re feeling tired or worried. Once you’ve had some rest or drinks and snacks, the contractions return. Sometimes an artificial hormone called oxytocin is given, which gets the uterus contracting again.

• The baby getting stressed:

Your midwife will be watching you every step of the way, so that if your baby is stressed she can act accordingly. Sometimes you might be advised to have a c-section, or have assistance with the use of forceps or ventouse.

• Meconium:

Some babies open their bowels before they are born which is sometimes, but not always, a sign of distress. This becomes apparent when your waters break and the water (liquor/amniotic fluid) is green, and you will need closer monitoring.

A mum’s point of view: “I didn’t understand about dilation”

“My midwife laughed when I asked her if she used a tape measure to see how many centimetres dilated my cervix was. She explained that it’s just an estimation on what her fingers can feel when doing an internal examination,” said Marie Ray, 26, from West Norwood, mum to Isobell, 5 weeks.

Anne’s top tip:

“Focus on a deep breath in and a long breath out. Also, think about keeping your face relaxed. This might sound daft, but if your face is relaxed then everything else will relax too.”

Read more...

• Ways to bring on labour
• Intervention in labour and birth
• Birth hypnotherapy - could it work for your labour?