Vaginal birth

Labour for your first child can last from 8 to 14 hours and sometimes even longer.
For woman that have previously already given birth, labour is often shorter, from approximately 4 to 7 hours .

Signs that labour has begun

  • The mucus plug which sealed the womb comes away, with the appearance of mucus and blood.
  • There may be fewer movements and kicks from the baby.
  • Your waters breaking, sometimes it's a trickle or it can be a real gush of water. The fluid is transparent, whitish or pink in colour.
  • Your contractions are :
    • more regular, more frequent, more intense and last longer.
    • they last from 5 to 10 minutes over a period of about half an hour.
    • low down period type pains and back ache


If your waters break, any bleeding or abnormal discharge and you must immediately go to you maternity unit. </warning

<warning> A mother giving birth for the first time and feeling contractions every 5 to 10 minutes approximately for more than half an hour means that she needs to go to maternity.


There are 3 stages to labour. The first stage is where the cervix dilates. The second stage is when the baby is pushed out and born. The third stage is when the placenta comes away and is delivered.

It is helpful to keep as active and as mobile as possible during the first stage of labour. This can help you cope better with the pain.

First Stage

At the start of labour the cervix softens and gradually opens. During contractions your cervix dilates. Midwives often refer to this as established labour when the cervix has dilated to 3 -4 cm. Reaching established labour can take several hours and you are usually advised to stay at home where you can relax, enjoy a bath and be comfortable in your own surroundings.

The end of the first stage is when your cervix has dilated to 10 cm. It can take between 6 to 10 hours to achieve full dilation from established labour. It approximately

You will be monitored throughout labour. This is to check the baby's heart rate, checking for signs that the baby could be distressed. There are various ways to monitor the baby during labour
  • Ultrasound probe also called a sonicaide. The midwife can intermittently listen to the baby's heart rate
  • A belt with two sensors is placed on your tummy. One of the two sensors monitors the baby's heart beats and the other, the rhythm and the intensity of the uterine contractions.
  • A clip might be placed on the baby's head so the heart rate can be measured more accurately.
  • The last few centimetres of dilation are the most trying and the most painful, except when labour is performed under an epidural.

Second Stage (The Birth)

The cervix dilates one centimetre per hour approximately. So once fully dilated at 10cm you will feel the urge to push. Your midwife will guide you and tell you when you need to push.
  • Now is the time to try out some of the positions and techniques you learnt at your antenatal classes. You need to find a position that is comfortable and that works for you.
  • This second stage of pushing the baby out is a lot of hard work and your partner and midwife will give you a lot of support and encouragement to keep going. This stage can take an hour sometimes a little more
  • At each push, the contractions are more frequent, intensify and spread over the entire uterus and the baby moves down to the vaginal opening.
  • It is important for you to listen to your midwifes instructions as when to stop and start pushing. This is to enable the head to be born slowly allowing the skin to stretch and prevent tearing.
  • Once the head has been delivered, the shoulders and body are much easier to push out.
  • Sometimes a small cut needs to be made to make the vaginal opening wider - this is usually if the baby is getting short of oxygen and the midwife needs to hurry the birth.

The arrival of the baby

  • As soon as your baby is born he/she is lifted up into your arms and the umbilical cord is cut.
  • He/she will be dried off and wrapped to keep warm and sometimes any mucous in the baby's mouth and nose needs to be cleared away to enable easier breathing.

Third Stage

  • 15 to 20 minutes after the birth, the uterus contracts to push out the placenta .
  • Sometimes a drug is given to help speed up the delivery of the placenta either by an injection or drip.
  • The placenta is examined by the midwife who checks that it is intact and that there is nothing left inside the uterus. Any remaining fragments may cause an infection or haemorrhage.

Following birth

You, your partner and baby will remain in the delivery room for approximately a couple of hours whilst any tears are sutured up and your BP, pulse, temperature and vaginal bleeding are monitored and you can freshen up
  • Your baby will be examined, weighed, measured, have name bands place on both feet.
  • It is during these first few hours you can breastfeed your baby for the first time.

Document produced in collaboration with Claire Gabillat
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