STAGES OF LABOUR
| Latent Phase
| Active Phase
| How do you feel
does the doctor do | | Do's and Don'ts
is the beginning of labour. It commences with the
onset of true pain and uterine contractions, which
bring about gradual opening up of the cervix. The
opening of cervix is assessed in terms of “centimeters”
When the cervix is fully opened or dilated as it is
medically referred to, it is approximately 10 cms
This is so because the diameter of the foetal head
(biparietal diameter) is approximately 9.5 cms at
first stage is divided into two parts:
What do you feel
This is the
beginning of the end part of your pregnancy. Very
soon you will be the proud mother of an adorable little
one. During this stage you may experience pain
in the abdomen and back. This may even go on to the
thigh and leg. Initially it may start off with
a vague backache or lower abdominal pain (like menstrual
pain). Gradually it will increase in intensity, duration
You will be able to appreciate the hardening of the
uterus.The movements of the foetus may also be slightly
reduced during labour.The pain may initially come
once in ˝ - 1 hour lasting for few seconds and by
the end of this stage it will peak and you may experience
a contraction every 2 – 3 minutes and the contraction
itself may last for ˝ - 1 minute. With the
onset of pain you will have show .
Sometime during the first stage of labour, the bag
of waters may burst releasing watery fluid. This is
This water is usually clear. If it is yellow, brown
or green, then it suggests that your baby may be having
some problem inside and it is an indicator to immediately
inform your doctor.
If the bag of waters burst before onset of labour
pain, it is wise to report immediately to your doctor
so that steps for early delivery can be taken to avoid
infection setting in.
In case the bag of waters does not burst by
itself, your Doctor may do so when you are in the
active phase .
This tells him/her about the colour of amniotic fluid
and also accelerates the labour pain.
What Does Your
Once you have been admitted and all the
routine procedure like shaving, enema, etc. have been
done, you may be assigned a room or may be kept in
the labour ward (depending upon the hospital protocol
and your doctor’s judgement).
Subsequently, your doctor and the nurse will be constantly and
closely monitor you. Monitoring is done to follow
the course of labour (whether you are progressing
normally) and to find out the status of the foetus
during labour. An obstetrician is always worried
(sometimes more than you) till the delivery takes
place as he/she is in charge of two lives during labour.
She / he can relax only after the delivery has been
Your doctor / nurse will
be monitoring the following things:
- Your general condition, pulse rate, B.P and other parameters.
- Your labour pains – whether
they are adequately in need or need any external
support to increase their intensity (with the help
of tablets / I.V.drugs).
- The heart rate of your baby-- whether it is normal/abnormal.
This is checked by using a stethoscope or a Doppler
machine. These 2 parameters may be checked every
˝ hour or even more frequently as per your conditions.
- Internal examination: Your
doctor may do an internal examination as required,
though not as frequently, as he/she checks you pulse,
blood pressure and your baby’s heart rate. Internal
examination (P.V. – Per vagium) is done to assess
the progress of labour.If your bag of waters is
not burst, the doctor may do so if your cervix is
dilated to about 3 – 5 cms. This procedure is absolutely
pain less. You may feel some warm fluid trickling
down your vulva and buttocks and nothing more than
that. If you are moving around, then you may need
to wear sanitary pads to prevent soiling/ leaking.
- If necessary and if facilities are available,
you may be attached to a monitor / instruments to
record your baby’s heart rate. This may be done
intermittently or continuously.
If necessary, an IV line may be taken to administer
IV fluids or other medications.
commonly given may be:
to prevent / decrease pain.
increase uterine contraction.
facilitate dilatation of the cervix.
medicines as indicated by your medical / obstetrical
to reduce acidity and vomiting.
- Pain relief during labour
/ Painless labour
If consent is given, you may be subjected to some
form of therapy to reduce pain felt during labour.
Role – Do's & Dont's
this stage you can be either ambulatory
or lie in bed at rest. Abulation helps to
take your mind off the discomfort and gravity
aids in proper dropping down of the foetal
far as the pain is concerned you may try
a variety of methods like relaxation, deep
breathing etc. or request your doctor for
labour analgesia. More details on techniques
of the pain relief during
During labour it is preferable to be
on a liquid diet. One thing you can do is
to have a light snack before you leave from
home for the hospital.
During labour you must have adequate fluids to prevent
In case you are asked to be fasting by your doctor (in
anticipation of some problem during labour
or for surgery) an I.V. drip will be started
to take care of your nutrition and hydration.
It is a good idea to keep some hard boiled sweets to
suck on during labour to counter you thirst,
though ice chips are the best for this purpose.
Pass urine frequently as a full bladder may impede labour.
Only rarely you will require catheterisation
to empty your bladder.
can time your contraction and if you are
on a foetal monitor, you can monitor the
foetal heart rate yourself. The normal range
is between 110 – 160 beats/minutes.
Keeps your spouse / partner with you as long as allowed
to by the doctor. It is a great physical
as well as moral support to have someone
besides you during labour. The partner /
spouse can massage you, distract you and
provide comfort and reassurance. This can
be a great help in calming you down and
actually enjoying your labour.
During the first stage remember not to push /
strain during any time. Always make a conscious
effort and tell yourself to relax in between
your contration. Pushing during this stage
will not help in anyway. Infact it can lead
in formation of a swelling on your baby’s
scalp (although, quite harmless, called
“the caput”) and also predisposes you to
prolapse of the uterus in later years.
Your 1st stage will last for an average
of 8 – 10 hours from onset of labour. So
remember that you will not deliver as soon
as you are in the hospital. Be patient.
Don’t forget to add to your labour list,
things like a walkman, cards, cassettes,
story books, etc. to help you kill time.
things which you may find comforting and relaxing
- Take a warm bath just before
leaving for the hospital.
around in the hospital as much as possible.
yourself adequately hydrated.
relaxation, breathing techniques, etc. to reduce
your companion to massage your abdomen and back.
a damp cloth to wipe your face and body. It is very
between contraction and don’t push unless told to.
about the wonderful baby that you are going to have
soon. Its worth all the trouble and discomfort that
you are going thru.