The first stage of labour

You’ve been pregnant for months, as your unborn baby has grown and developed. Now, it’s time for the baby to be born, and you’re in labour. The first stage of labour involves dilation (opening) and effacement (thinning and shortening) of the cervix, as your body prepares for the baby’s birth.

First stage – 7 to 8 hours

During early or first-stage labour, the cervix dilates three to four centimetres.

You may:

• Be excited, anxious, energetic, confident.
• Be more comfortable at home until labour becomes active.
• Eat lightly.
• Wonder if ‘this is it.’
• Do calming activities in the daytime, or go back to sleep if it’s nighttime.

Your contractions:

• Usually result in cervical dilation, to three to four centimetres, and partial effacement.
• Build to a peak and recede.
• Are mildly to moderately painful and begin in the lower back. (May feel like menstrual cramps.)
• May be light enough that normal breathing is comfortable.
• May become strong enough that you pay attention to your breathing and/or begin relaxation exercises.
• May be five to 20 minutes apart, becoming more intense, longer and closer together.
• May be 30 to 45 seconds long (but not more than 60 seconds).
• Result in baby beginning to bring chin to chest so the smallest diametre of the head can start to pass through the pelvis.

Your doctor or midwife may:

• Suggest coming to hospital if membranes rupture (the water breaks) or contractions are five minutes apart.

Nancy Levy, RN, MS, is a former childbirth educator at Women’s College Hospital in Toronto and York Central Hospital in Richmond Hill, Ont.