Labour and the latent phase

This information leaflet has been written to help you recognise the start of your labour, understand the likely pathway through labour and offer you advice and tips to help you through the early phase, sometimes referred to as the latent phase of labour.

You may know that labour is divided in three parts:

The first part of your labour is when the neck of the womb (cervix) opens over a period of time to 10cms, also known as ‘fully dilated’.
The second part of your labour is when the baby moves down through the vagina and is born.
The third part is when the afterbirth (placenta) is delivered.

Remember that every woman’s labour is different and sometimes it can take some time. This is perfectly normal. If you think that you are in the early stages of labour, the main thing to remember is to stay calm and relaxed.

What are Braxton Hicks contractions?

Braxton Hicks are tightening of the muscles of the uterus which last for 30–60 seconds and may be several times an hour, several times a day. They may be more noticeable towards the later stages of your pregnancy.

How can I tell the difference between Braxton Hicks and real labour contractions?

Labour contractions are usually noticeably longer, more regular, increased in frequency and are generally more painful than Braxton Hicks contractions.

What is ‘the latent phase’ of labour?

The latent phase is the beginning of the first part of your labour. It is a period of time that will not necessarily be continuous and is unique to each woman. Some women will have backache and cramps or have bouts of contractions that may last a few hours which then stop and start up again the next day. This is perfectly normal. The duration of the latent phase of labour can be variable. It may last for 24 hours or more and can be tiring for you. It helps if you can stay as relaxed as possible during this part of your labour and remain at home in comfortable surroundings as long as you can. If your contractions stop it is a good time to rest and make sure you have something to eat.

What is happening during the latent phase of labour?

Before labour starts the neck of the womb (cervix) is long and firm. During the latent phase of labour, the muscles of the uterus start to contract. These first contractions, along with the Braxton-Hicks contractions that you may have already experienced, help to soften the neck of the womb and prepare your body for active labour.

Your contractions may feel uncomfortable and last for 30–40 seconds. They may continue for several hours and may not be regular. Sometimes they stop and start. This is normal. This ‘stop-start’ pattern is common in the latent phase.

How long does the latent phase last?

This phase can take from 6 to 10 hours to up to 2 to 3 days, although it is often shorter for second and subsequent babies. Of course, it could be much shorter, sometimes barely an hour. Nobody knows for sure why there are such big differences in labour duration between individuals.

Sometimes the latent phase tends to blend into the first stage of labour and the woman does not experience anything specific to signify onset of true labour.

How can I help myself through early labour?

There are many ways of helping yourself to cope through these first hours of the latent phase of labour.

It is important to try and remain relaxed.
Keep your breathing deep, steady and slow during a contraction. This will prevent you from using extra energy
Once the contraction is wearing off, close your eyes and allow your body to rest before the next one.
Take a warm bath or shower, at regular intervals. You may find the warmth of the water soothing and relaxing.
Ensure you maintain your energy levels by eating small,light meals containing carbohydrates.
Drink plenty of fluids. Isotonic or sports drinks are a good way of boosting energy levels and keep you hydrated especially during the early stages of labour.
Remaining upright will assist gravity and help your baby to descend into the pelvis. Rocking your pelvis and swaying your hips can also assist you.
Alternate active upright positions with resting, lying on your left side if you feel you need to rest.
If you have access to a birthing ball, use it regularly as this too can alleviate any discomfort.
You may want to call your birthing partner for added support during this time.
It will be helpful if your partner massages your back to help with any backache and help you to relax and support you in any alternative positions that you may adopt.
Your birthing partner can also make other family members aware of the latent phase of labour and encourage them to give support rather than raise concerns.
If you intend to use approved alternative therapies then you can use these now.
Some women who have hired a TENS machine put it on during the latent phase.
Be aware of your baby’s movements, your baby should continue to move throughout labour. If you think that your baby’s movements are fewer than you normally experience or if you are concerned, speak to a midwife.

Labour is as much a psychological process as a physical one and for your contractions to work well to birth your baby and to get the natural pain relief that the hormones of labour provide, you need to let the primitive part of your brain work well. An active thinking brain and stress all prevent the primitive brain from producing the hormone ‘oxytocin’ which is so important for normal labour and is the hormone of “calm, connection and love”. This is why physical and mental relaxation, an air of calm and being prepared and informed helps.

During the latent phase, your midwife may encourage you to remain at home. Research has shown that fear and anxiety very often inhibit labour and when in hospital, this in turn can encourage a cascade of interventions. The best place for most women in this stage of labour is at home with familiar surroundings and supported by people she trusts and who understand the process of labour. You should however contact your midwife, the Birth Centre or Delivery Unit at any time if you are concerned about any of the symptoms you are experiencing.

Active or ‘established’ labour

In active labour contractions occur regularly. The length and intensity of contractions increases and continue regardless of what you are doing. At the same time there is a progressive thinning, shortening and opening of the cervix (neck of the womb). Below is an outline of what to expect in the active first and second stage of labour and after the birth of your baby.

What to expect in the different stages of labour

First stage	Second stage
Expected length	First stage First baby: 6-20 hours. Second or subsequent baby: 2-10 hours (this is a general time frame and is individual to each woman).	Second stage First baby: 1-2 hours. Second baby or subsequent baby: 10 minutes to 1 hour (again this is individual to each woman).
Support	First stage You are advised to contact a midwife at this stage. A midwife will care for you throughout labour.	Second stage Your midwife and birth partner(s) will encourage you with your pushing.
Contractions	First stage Contractions are coming regularly about every 3-5 minutes (or more frequently) and lasting 60 seconds.	Second stage Contractions are very strong and close together with strong urges to push down.
Monitoring	First stage The midwife will ask permission to listen to the baby’s heartbeat every 15 minutes; your blood pressure and temperature will be taken every 4 hours and your pulse every hour.	Second stage The midwife will request to listen to the baby’s heartbeat every five minutes.
Cervical Dilation	First stage The cervix gradually dilates up to about 10cms or ‘full dilatation’.	Second stage The cervix is fully dilated.
Working with pain	First stage Being active and having a bath/shower can help and has no side effects. Painkilling drugs are available; please ask if you would like to discuss your pain relief options.	Second stage
Vaginal Loss	First stage The midwife will monitor the vaginal loss; your ‘waters’ may break.	Second stage Your waters may break at this stage if they haven’t already; the midwife will monitor the vaginal loss.
Meals	First stage Lots of fluids help; you may not feel like eating much.	Second stage Sips of fluid can help your mouth from drying out.
Activity	First stage Remaining upright and active can mean less need for pain relief and a shorter first stage of labour.	Second stage Movement and changing position can help.
How you may feel	First stage At the end of the first stage the labour might ‘step up intensity’. You may feel that you can’t cope. This is a good sign; you are nearly there.	Second stage Varying sensations, overwhelming urge to push; you sense the birth is close.

Active labour – third stage	After the birth
Expected length	Active labour – third stage On average 20 minutes to 1 hour, or 5 to 15 minutes with an injection of synthetic oxytocin.	After the birth
Contractions	Active labour – third stage You may feel a strong urge to push your placenta out.	After the birth ‘After pains’ may make your womb tender.
Monitoring	Active labour – third stage	After the birth Your temperature, pulse and blood pressure will be taken.
Activity	Active labour – third stage Being upright can help your body expel the placenta. You will be encouraged to have your baby skin-to-skin with you.	After the birth You have earned a good rest!
Support	Active labour – third stage Continuous care of the midwife.	After the birth The midwife will leave you only when you are happy to be left.
Vaginal Loss	Active labour – third stage A small gush of blood usually passes before the placenta comes out.	After the birth The vaginal loss can be like a heavy period for a few days.
Cervical Dilation	Active labour – third stage	After the birth The cervix closes after the placenta and membranes are delivered.
Working with pain	Active labour – third stage	After the birth If you need stitches, local anaesthetic will be used.

When to contact your midwife

If you think you are in active labour or would like some advice about when to come into hospital.
If your waters break.
If you have vaginal bleeding.
If the pattern of your baby’s movement has changed or is less.

The contact numbers for your community midwifery team or the Rosie Hospital are on your antenatal ‘handheld’ notes.