The first stage of labour is the onset of regular contractions, which cause the cervix to thin and stretch until you are 10cm dilated. This is usually the longest stage. At some point during this stage, you will go to your maternity hospital (phone them for advice if you’re not sure when to go in). Here you will be offered a vaginal examination to determine the exact stage of labour, the position of the baby and state of the membranes.
This marks the end of the first stage and the beginning of the second. By now, you will have contractions lasting 60-90 seconds at two-to-five-minute intervals. At this stage, your midwife will usually check to see if you are fully dilated. The transition stage can be very intense, both emotionally and physically, but it’s worth remembering that it’s the shortest phase of labour. While the first stage of labour is all about waiting for the cervix to dilate and coping with the pain of contractions, the second stage is much more active and physically demanding.
The second stage of labour starts when you are fully dilated and can last from 20 minutes to two hours. Following transition, you will feel an overwhelming need to push. Your midwife will guide you through this process and tell you when to start pushing. Each time you push, you are moving your baby further down the birth canal, until eventually the head will show through the vagina. This is called crowning.
During crowning, you will feel a burning, stinging sensation in your perineal area and your midwife will advise you not to push, or to push very gently as she guides the baby’s head out.
It is now only a matter of minutes until your baby is born. Panting instead of pushing allows your perineum to stretch and may help to prevent tearing. Every time you have a contraction, your baby’s head moves further out until it is out completely. Once it has fully emerged, your baby will turn his head sideways and the shoulders will be delivered during the next contraction. This is followed straightaway by the rest of the body, which slides out with a huge gush of fluid. Your midwife will hand you the baby to hold while she cuts the cord.
The third and final stage of labour is relatively straightforward, compared to what has gone before. Most maternity hospitals will offer you an injection to help the placenta to separate, and you will be asked to give a last push to deliver it. If you need stitches because of an episiotomy or tear, these will be done under local anaesthetic by your midwife. You will usually be allowed to remain in the delivery room for an hour or so while you have some tea and toast and give your baby his first feed.