Early labour

Early labour

Maternity

The latent phase

This information is designed to help you understand the process of labour, especially the early part of the first stage, known as the latent phase.

It includes suggestions for you and your birth partner on how to help you cope at home, or in the hospital during your latent phase.

Labour is a physical process, which can often take a long time. Everyone’s labour is different.

There are three stages of labour:

  1. The first stage, when the cervix (neck of the womb) opens to 10 centimetres 
  2. The second stage, when the baby moves down through the vagina and is born 
  3. The third stage when the placenta (afterbirth) is delivered

What is the latent (early) phase of labour?

The latent phase of labour is the very first part of your labour - the early part of the first stage when your cervix begins to soften and open until it is 4 centimetres dilated.

Before labour starts, the neck of the womb (cervix) is long, firm and closed. But even before labour begins the cervix can soften and start to get thinner.

Three diagrams. The first shows the cervix closed, the second shows the cervix drawn up and thinner, the third shows the cervix at 3 to 4cm.

The next part of labour is called the active phase or established labour. Both the latent and the active phases take place during the first stage of labour. Eventually, at the end of the first stage, the cervix has opened to 10 centimetres and is described as being ‘fully dilated’.

‘Braxton Hicks’ contractions happen throughout pregnancy. These are tightenings of the muscle of the womb (uterus) which last for about 30 seconds and are usually painless. During the latent phase, Braxton Hicks contractions may become more noticeable and more frequent, lasting between 35 and 45 seconds. However, you may not notice anything happening at all. Remember, the latent phase of labour can last a very long time, especially if it is your first birth.

Sometimes the latent phase is very quick, but it typically lasts anywhere between 4 and 24 hours. For some people it may last several days or sometimes even weeks. You may feel backache or cramps during this time. You may get contractions which last a few hours but then stop and start up again the next day. This is normal.

Signs of labour beginning

The 'show'

As the neck of your womb begins to soften and open, the mucus which has been protecting the entrance to your womb comes away. This is called the ‘show’. It is has a jelly like appearance and can often be streaked with blood, either bright red, pink or brown. It may also be clear. This is all normal.

Having a ‘show’ means that your body is starting to get ready for labour, but the actual birth of your baby is very likely to be some time away. You can have a ‘show’ several days before giving birth.

Your waters breaking

Before active labour starts, your waters may break. During pregnancy, your baby is surrounded by amniotic fluid, the ‘waters’. For about 1 in 10 people, the first sign that labour is going to start is that their waters begin to leak. It is quite common to leak a small amount of urine towards the end of pregnancy and it can sometimes be difficult to tell if your waters have broken, or if it is urine. 

If you are not sure if your waters have broken, put a sanitary pad on and call the Maternity Triage Unit for advice on 01709 427700.

If you have a definite gush of fluid, it is a clear sign that your waters have broken and you should contact the Labour Ward (01709 424491) or Triage (01709 427700) for advice.

If your ‘waters’ have broken, it is important for you to look at them:

  • The waters are often clear or ‘straw’ coloured; sometimes they change to a light pink colour. This is normal 
  • If you notice that your ‘waters’ are green, brown or heavily blood stained, you should contact the Labour Ward straight away for advice on 01709 424491
  • Monitor your baby’s movement. They should stay the same.

If your ‘waters’ break and labour has not yet begun, this is still normal. Most people (86 in 100) will go into labour within 24 hours of their ‘waters’ breaking. However, during this time you will be offered an assessment by a midwife.

Contractions

In the latent phase of labour contractions may start and stop - this is normal. Sometimes, contractions may be continuous for several hours but remain short lasting and mild. This is normal too. 

This time can be tiring, but it is important to remember that your body already knows how to give birth. When you begin to understand what helps or delays the natural process, you can create the right environment around you. If you find that labour has slowed down, this is a good time for you and your birth partner to get some rest and have something to eat. When your body has built up some energy supplies, your contractions will start again. 

As labour establishes and you enter the active phase of labour, contractions will be longer, stronger and close together. You may not be able to breathe through contractions as easily and find you become withdrawn as you focus on coping with contractions. 

It can be hard to tell when the active part of labour has begun, and you may wish to attend triage to be assessed and to be informed of your progress in labour. If you are still in the latent phase (if your cervix is less than 4 centimetres dilated and not thinned out) you will likely be advised to return home and wait for the contractions to become longer, stronger and closer together. It is safe for you to be at home in early labour.

What can I do in the latent phase of labour?

It is not possible to say when active labour will begin. It could start within a couple of hours of the latent phase starting, or in several days. So try to stay as relaxed as you can, and distract yourself from focussing only on the contractions. It helps if you avoid stimulating the ‘rational’ part of your brain during labour. This can override the 'primitive' part which produces endorphins (your own natural pain-relievers) and oxytocin (the hormone which stimulates contractions). 

Try to avoid: 

  • bright lights 
  • people talking to you during contractions and asking you questions
  • feeling as if people are watching you or judging you

Other things you can do to help yourself:

  • go for a walk
  • watch a programme or film  
  • have a warm bath or shower
  • have a nap (lying on your left side is often best)
  • do some relaxation
  • keep your breathing quiet and slow, breathe in gently, sigh out slowly
  • have a massage - ask your birth partner to do this for you
  • put a hot water bottle on any areas that ache - your lower back, tummy (under your bump) or between your thighs. Wrap it in a small towel first to avoid it getting too hot
  • try sitting on your birthing/gym ball if you have one
  • keep moving around, whilst remembering to save your energy for the active phase of labour
  • drink plenty of fluids - water, sports drinks and apple juice are all good
  • eat little and often - carbohydrates (bread, pasta, rice and cereal) for slow releasing energy, plus sugary food for quick releasing energy
  • put on your TENS machine if you have one
  • experiment with different positions that you find comfortable, such as standing, sitting, squatting, kneeling and walking around. Staying upright and moving around encourages gravity to help your baby descend (go down) into your pelvis
  • you can take Paracetamol at regular intervals, following the instructions on the packet.

When should you contact triage delivery suite / continuity of care team?

  • If your waters break
  • If your contractions last 40 to 60 seconds and are strong and regular
  • If you need support or reassurance from a midwife
  • If you have an urge to push - you may also need to consider calling an ambulance
  • If you have any fresh red bleeding
  • If your baby is not as active as normal, or very active
  • If you want advice about how your labour is progressing. 

Remember: although you may feel excited and want confirmation that your labour has started, coming into hospital and having vaginal examinations during the latent phase may cause labour to slow down or stop. It is normally better to speak to a midwife on the telephone for advice. If everything sounds normal, you will be encouraged to remain at home for as long as possible to help your labour progress.

You may be more relaxed at home in the latent phase of labour and we will encourage you to remain at home in comfortable surroundings for as long as you can. Studies have shown that if you attend hospital in established labour, you are more likely to experience a normal labour and birth with less intervention. You can use the tips from this information to help you manage this part of your labour at home with your birth partner.

Advice for birth partners for the latent phase (early labour)

Labour can be quite an anxious time as well as exciting for you. Seeing the person you love in pain can make you feel like you cannot help them, but be assured that it is all a natural process and there are plenty of things you can do to help to relax them and make the early stage of labour more comfortable and less stressful.

  • Listen to what they want, some people will want lots of affection but others will want to be given some space
  • Make sure they have a good meal in early labour to provide energy for the rest of labour.  Also, make sure you offer drinks to keep them well hydrated
  • Rubbing the lower back can be really soothing and helpful
  • Help to apply a TENS machine if you have one or run a nice warm bath
  • Time contractions as they become more intense to have an idea of when to call Triage. Try not to mention the times unless asked though, saying ‘That was only 30 seconds!’ after each contraction is not very helpful!
  • Use lots of encouragement and reassurance, make sure they know how well they’re doing
  • Run a warm bath or shower as water can be an amazing form of pain relief

Make sure all the bags are packed for when you do go to the hospital so there is not a big rush when you do go. If things are well prepared and relaxing at home with good support then these things can really help to make labour shorter and easier.

How to contact us

Labour Ward

01709 424491

Triage

01709 427700
7am to 7pm

Your local midwife and GP contact numbers will be on your handheld maternity notes.

Remember - labour is a journey, and the early part of the first stage can take a long time. This is normal.

We hope that using some of the tips in this information will help you through your labour.


Source URL: https://www.therotherhamft.nhs.uk/patients-and-visitors/patient-information/early-labour

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