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How to keep calm and carry on in the different stages of labour...

What is happening at each stage of labour and what can we do to stay calm?


It is certainly not a 'one size fits all' process and every woman experiences it differently, but here are some of the things you may experience, along with tips to keep relaxed at each stage. You have got this!


THE FIRST STAGE OF LABOUR

The first stage of labour has three phases: early, established and transition. It starts with contractions that continue to increase in length and intensity, and ends when the cervix is fully dilated (~10 cm).


EARLY LABOUR

What is happening?

In early labour, the cervix starts to soften and then gradually opens. At this stage you will probably still be at home. How do you know it has started? Labour is different for different people but signs that labour is starting include:

💙 A show, which is the plug of mucus, often pinkish and jelly-like, coming away from the cervix. This can happen a few days or even 1-2 weeks before labour begins. It may come out as a single blob or in smaller pieces (BabyCentre has some graphic pictures if you are interested!). 💙 Waters breaking. This can be a trickle or a sudden gush. Contrary to what we see on TV, only ~10% of women experience waters breaking before labour begins. For most of us, this will happen during or even towards the very end of labour. 💙 Contractions which build gradually in intensity and frequency. You may not notice them to begin with, they may feel like period pains or cramps, and you may feel them more in the lower abdomen and pelvis or in your lower back (depending on your baby’s position). They may also (frustratingly) stop and start, and you will most likely wonder: IS THIS IT? The midwives generally want to hear from you when your contractions are getting more regular and intense: the general rule of thumb is 3 in 10 minutes lasting about 1 minute each - though trust your instinct and if you feel like you need to go in, do so.


3 Tips to keep calm in early labour:

💙 There is plenty of time - it is SO exciting but try to rest and conserve energy as much as you can (perhaps don’t even say anything to your partner and let him/her sleep)! If you can’t sleep, even lying on the sofa with a great movie is resting. 💙 Make yourself a little den of calm and relaxation at home, with your favourite candles, essential oils, snacks, your birth ball, yoga mat or duvet on the floor. Hydrate and fuel up in preparation for the marathon ahead! 💙 Take a warm bath with relaxation music or your hypnobirthing tracks.


ESTABLISHED LABOUR (also called active labour)

What is happening?

At this stage you will probably be on your way to, or at the hospital/birth centre already (or at home if you’re having a home birth). When you are about 4 cm dilated, with regular contractions [~ 3 in 10 minutes] lasting around a minute each you would normally be considered to be in ‘established labour’ BUT trust your instinct: if you feel like going in or calling the midwives at any point, do so. By no means does everyone fit that pattern, especially if this is not your first birth. In the established phase of labour, your cervix will dilate to about 10cm.


3 Tips to keep calm (and carry on):

💙 This is the time for your birth partner to make your hospital/birth centre nest by creating a quiet and calm environment, with low lighting, candles, essential oils, your favourite tunes or hypnobirthing relaxation tracks (if you are at home, then you’ll have this all sorted already!) 💙 Breathe deeply during each contraction: a long, slow, relaxed inhale through the nose, followed by a long, slow, relaxed exhale through the mouth. Gentle back stroking (with back of the hands) can also work a treat at this stage. 💙 A birth pool or warm bath can be an amazing oxytocin booster, help ease the intensity of the contractions and make you feel more comfortable. Lots of mums love the feeling of weightlessness and ease of movement of the birth pool. Your very own safe space.



TRANSITION OF LABOUR


What is happening?

Transition is the end of the first stage of labour, when your cervix dilates from ~7 to 10cm and your body is getting ready to push your baby down the birth canal. It can be intense, challenging and emotional. For many women, this is the toughest part of labour as contractions are intense and close together, but it is also the shortest part. Birth partners, be aware that this is where your partner may doubt her ability to go on and feel like she needs all the pain-reliefs. She may have a wobble or full-on panic. She may be restless, irrational or withdraw into herself. I have heard of women putting all their clothes back on and making their way to leave the hospital at this stage! All of this is completely normal but it is good to be prepared, so you know what to expect and what can help. Rest assured that transition is over very quickly, usually within minutes, and it is a sign that you will meet your baby very soon.


3 Tips to keep calm (and carry on):

💙 Focus on your birth partner’s voice. Birth partners, don’t underestimate the power of your reassuring words and supportive presence at this stage. Tell her how well she is doing and that she is close to meeting your baby. Words such as these can be really helpful: ‘I love you’; ‘You are so close now’;‘ You will be meeting our baby soon’; 'You are doing it, right now’; ‘You are doing so well’; ‘You are safe’. I remember saying over and over, I can’t do it anymore - and my midwife repeating 'You are doing it right now!' which I found so encouraging. 💙 Focus on your breathing, simply breathing in and out, one contraction at a time. Birth partners, try breathing with her and reminding her to breathe with every contraction. 💙 Change positions, often - you could try for example standing and leaning into a bed or your birth partner, squatting, sitting on the loo or birthing ball. Birth partners, she may need to use you to hang from or lean on!


THE SECOND STAGE OF LABOUR


What is happening?

The second stage of labour is when your cervix is fully dilated and your baby moves down through the vagina (birth canal) and is born. This stage usually lasts 1- 2 hours but can be over in minutes. You are so nearly there! You may feel a strong urge to push straightaway - which might feel very similar to needing to poo! - or you might experience a short resting phase before the urge to push*. The contractions will feel different too: less frequent and more ‘involuntary’, like you have little control over them. As your baby’s head is born, you might feel a stinging or burning sensation called ‘crowning’. With the next few contractions, the shoulders and then the rest of your baby’s body will emerge into the world, ready for their first cuddle. You have done it!


*If you have an epidural, you may not feel the urge to push in which case your midwife will guide you ❤️


3 Top Tips to keep calm (and carry on):

💙 Focus on your breathing during each contraction: A short breath in through the nose, and a long breath out through the nose, nostrils pointing down slightly (in hypnobirthing this is called ‘down breathing’ ). You can actually practice this one on the loo in the last weeks of pregnancy! As your baby’s head is born, your midwife might encourage you to ‘pant’ or ‘blow’ like you would a candle, and push more gently and slowly, to protect the perineum from tearing. Birth partners, gently remind your partner to breathe during each contraction. 💙 Follow your body’s lead, and push when you feel a strong urge. You will instinctively know what to do at this stage. 💙 Try adopting an upright position so gravity can help bring your baby down, e.g. positions like squatting, kneeling upright, leaning over a bed, ball or birth partner, though follow your instinct and get into whatever position feels comfortable for you.


What is your go-to relaxation technique for labour? ❤️

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