Labour 101: From Early Labour to Established Labour

If your waters break

Call your midwife straight away, day or night, if your waters are green, brown, or blood-stained, or if you have any concerns about your baby's movements. If your waters are clear, your baby is moving normally, and it happens overnight, you can usually wait and call us first thing in the morning. If you're unsure whether your waters have broken, please call. We can talk through your symptoms together.

Latent (early) labour

The latent phase is when your cervix begins to soften, shorten, and gradually open. It can last anywhere from a few hours to several days, and it's common for contractions to start and stop or vary in intensity. This is normal, but it can be tiring.

Coping at home:

• Rest when you can, and conserve energy for active labour.
• Stay hydrated and eat regular, nourishing snacks.
• Use a TENS machine, paracetamol, or a wheat bag/heat pack if helpful.
• Spend time in a warm bath or shower.
• Use massage, movement, and encouragement from your support people.

Call when contractions are regular, strong, and occurring every 2–3 minutes, lasting around 60 seconds, for 1–2 hours, or immediately if your waters are green/brown/blood-stained, your baby's movements change, you have bright red bleeding beyond light spotting, or you feel labour is progressing quickly.

Established labour

This is when your cervix is fully effaced and dilating, usually from around 4–6cm onwards. Contractions become stronger, longer and more regular. Usually 60–90 seconds, coming every 2–3 minutes for 1–2 hours, is when it's time to call. Talking through contractions becomes difficult, and comfort measures like breathing, movement and water become increasingly important. Together, we'll decide whether it's time to meet at home, or head to the birthing unit or hospital.

Transition

The final part of the first stage, as the cervix dilates from around 8cm to fully dilated (10cm). It's often the most intense part of labour, but usually the shortest. You may feel strong, frequent contractions, shaking, feeling hot or cold, nausea, and self-doubt. Feeling overwhelmed here is a very common sign that birth is getting close.

Second stage: birthing your baby

This begins once your cervix is fully dilated and ends with your baby's birth. You'll be encouraged to find positions that feel effective for you: standing, kneeling, leaning forward, using a birth ball, or being in water. As the head crowns, we may encourage slower breathing to let tissues stretch gradually, sometimes with a warm compress for comfort. Shortly after birth, your baby will be placed skin-to-skin with you.

Third stage: birth of the placenta

There are two approaches:

• Physiological (natural): waiting for the placenta to separate and be born naturally, usually within 30–60 minutes, supported by your body's own oxytocin release through skin-to-skin and breastfeeding.
• Active management: an oxytocin injection shortly after birth to help the uterus contract firmly, reducing the risk of heavy bleeding. This may be recommended if there are specific risk factors.

We'll talk through both options with you well before your birth, so you feel confident in whichever you choose.