How to know you're in established labour?

Understanding Early Labour: What to Expect Before Active Labour

Becoming a mother was a journey that intertwined with my career as a midwife, but it wasn't until the birth of my second son, Sebastian, that I truly understood the intricacies of labour. As a mother before I became a midwife, I had the theoretical knowledge but lacked the personal experience of labour pains. Sebastian's birth, a VBAC (vaginal birth after cesarean), bridged that gap for me and illuminated why many women are uncertain if they're truly in established labour. The ambiguity often stems from the unexpected duration of early labour, also known as the latent phase.

The Long Road of Early Labour

Early labour, or the latent phase, is a crucial but often overlooked stage in the birthing process. It's a period of gradual progress before active labour sets in, and it can be the longest part of the labour journey, lasting an average of 12 to 24 hours. However, it's not uncommon for early labour to start and stop over several days or even weeks.

During this phase, the cervix remains firm, long, and typically closed, especially for first-time mothers. However, if you've previously given birth vaginally, the cervix may be slightly open. It's during early labour that the cervix begins its transformation, softening, shortening, and gradually opening in preparation for childbirth.

Recognizing Established Labour

Established labour, on the other hand, marks a significant milestone in the birthing process. As a general rule of thumb, it's characterized by regular contractions occurring every 3-5 minutes, lasting 60-90 seconds each, and the cervix dilating to around 5 centimeters. Contractions during this phase are strong, frequent, and consistent, indicating progressive dilation of the cervix.

Once established labour sets in, you'll likely notice a quicker progression as your cervix continues to dilate. Contractions become more intense, making it difficult to talk through them, and you'll need to focus on managing the pain by controlling your breathing. Deep, slow breaths not only distract from the discomfort but also ensure an optimal supply of oxygen for both you and your baby.

When to Seek Assistance

When your contractions become regular, strong, and occur every two to three minutes for one to two hours, it's time to contact your midwife. She will assess your symptoms and may recommend a visit to determine if it's time to head to the hospital, birth center, or continue labouring at home if you're planning a home birth.

For those planning a hospital or birth center birth, it's advisable to stay home for as long as possible until established labour begins. Admission to the delivery suite typically occurs once active labour is confirmed, ensuring a smoother transition into the next stage of childbirth.

By understanding the nuances of early labour and recognizing the signs of established labour, you can navigate the birthing journey with greater confidence and clarity. Remember, every labour experience is unique, and trusting your instincts is key to a positive birthing experience.

Photo credit: my friend Dayna Henley