Labour usually starts slowly and then speeds up.

There are three distinct stages:

First stage of labour

Contractions open up the cervix.   In the very early part of the first stage you may have short contractions every 20 minutes or so. As labour progresses, the contractions will get longer, stronger and closer together and may come every ten minutes.  Towards the end of the first stage you may have contractions every four or five minutes, and, finally every two to three minutes.

Tips to cope during early labour

Stay at home as long as possible. There is a midwife on duty at the labour ward day and night, so you can ring them and talk things through.

• Keep reasonably busy and active.
• Have long relaxing baths.
• Eat little and often to keep your energy levels up.
• Try to rest and relax in different positions.
• Go for walks, watch a really funny video.
• Have a cuddle or massage with your partner.

Established labour

When your cervix has dilated to 4 or 5cm you are in what's known as established labour and it's then that you may start to think about pain relief.

Midwives and obstetricians will probably say that you’re not in labour until you have reached ‘established’ or ‘active’ labour, when the contractions are strong and frequent, and your cervix is dilating well. Anything before this is seen as the build up to labour and is called the latent phase. Established labour can take around 6-12 hours – you may feel that you have been in labour a lot longer if you count the latent phase as well.

Find out more about established labour here

The second stage of labour

Once the cervix is fully open, you can begin to push your baby out. This is called the second stage of labour. Being upright helps make this stage easier, try:

• Sitting on the bed, well propped up with pillows.
• Kneeling on the bed with your arms and shoulders on pillows over the end of the bedhead. 
• Kneeling on the floor leaning over a chair.

What to expect in birth

With every contraction, you will feel your baby move down the canal, and then, as the contraction fades, the baby slips back a bit. Most women get a strong urge to push with each contraction; try to use little breaths and little pushes so you give three to five pushes with each contraction.

If this isn’t working, or if you have an epidural set up and cannot feel to push, you may want to hold your breath for the whole contraction and push all the time. This is very tiring, though. Your partner, midwife or you, can place a hand at the top of your tummy to feel when the contractions start and finish, so you can push normally.

Your labour partner may need to encourage you if you get tired. He or she can help you sit up, sponge your face and give you a drink. They may be able to see your baby’s head at the peak of each contraction and can tell you about it.

As your baby is about to be born, your midwife will tell you not to push, but to pant. This allows the baby’s head to be born gently. Almost at once your baby will be born, with a rush of waters and a warm slithery feeling. If you wish, the midwife can lift your baby straight onto your tummy, or your baby can be wrapped first. You can then hold your baby and start to get to know him or her.  Find out more here about what happens in the first moments after birth.

Third stage of labour

This is the delivery of the ‘afterbirth’ – the placenta. You will usually be offered an injection in your thigh just as the baby is born to help deliver the placenta.

Some mothers prefer to have a natural third stage, which can be much slower and relies on being upright and the baby stimulating your natural hormones. It does increase the risk of heavy bleeding after the birth, so it’s important to discuss this with your midwife before the baby is born.

Retained placenta

Usually the placenta is delivered a few minutes after the baby is born. Sometimes it does not come away quickly, or only part of it comes away, and it has to be removed manually. You may be moved to the theatre for this and you may be given an epidural or spinal before it is done.

Cuts, tears and stitches

Pushing gently, or panting the baby out, can help the baby be born gently and give your muscles and skin time to stretch. Sometimes the perineum stretches enough to allow the baby to be born, but occasionally this area tears slightly or has to be cut to enlarge the birth outlet.

You may have:

• A cut known as an episiotomy – your midwife will do this if she thinks you will tear badly, or if the baby needs to be born quickly. The area is usually numbed first, or it can be done at the height of a contraction when it doesn’t hurt.
• A tear – your midwife may watch the area and, if she thinks it will be a small tear, let it tear 
• Stitches – a small tear may not need stitches, but a larger tear or a cut will be stitched up after the birth. You’ll need to lie on your back with your legs up in straps (lithotomy stirrups). Before your midwife starts stitching, an injection will be given to numb the area. Or, if you have an epidural in place, it will be topped up.

The total length of labour, if you count the latent and active phases, depends partly on whether this is your first baby, the position the baby is in and when you first notice contractions. Before the birth, if you manage to sleep through the first few hours of latent labour, it will seem much shorter than if you wake up at the first twinge.

Am I in labour?

Read more about the signs of labour, and get the expert view with our labour and birth faqs