Fourth trimester – Birth and Post-birth
How to prepare for labour
There are many ways to prepare for labour, and doing some research beforehand can help you gain a general understanding of what to expect. Keep in mind that every birth is unique, so even the most thorough research may not fully prepare you for your own experience. However, there are plenty of online resources available that cover good birthing positions, breathing techniques, and relaxation tips. Additionally, you can always consult your doctor or midwife for more personalized advice.
It's also a good idea to pack a hospital bag in advance. The last thing you want to do when labour begins is scramble around the house gathering items. Having your bag ready to go will make the process smoother when the time comes. Here are a few essentials you should consider:
- Your birth plan and maternity notes
- A warm dressing gown
- Slippers or comfortable shoes
- T-Shirts that you don’t mind getting a little messy
- Warm socks
- Toiletries, including moisturiser, toothbrush and paste and lip balm
- High-energy snacks and drinks
- Hairbands
- Nappies, blanket and clothes for your baby to wear
- Spare clothes for leaving the hospital
- Try positions that may help with labour.
- Do perineal massage to reduce the risk of damage to your perineum area during birth.
- Keep active to help your baby's position.
- Learn ways to help deal with labour pain.
For more information, great tips, and advice please visit the websites below.
You’re going into labour, what do you do?
If you have any concerns—such as being unsure if you are in labor, noticing a change in your baby's movements, or suspecting that your water has broken—you can always reach out to a midwife. Use the contact numbers provided in your maternity notes to get in touch.
Some of the signs and symptoms of going into labour may include:
- Period-like cramps.
- Backache.
- Diarrhoea.
- An urge to pee, caused by your baby's head pressing on your bowel.
- A small, bloodstained discharge may occur as your cervix thins, and the mucus plug is expelled (this is called a 'show').
- A gush or trickle of water as the membranes break.
- Contractions or tightening’s.
Have a look at the video from the NHS below to find out more about the early signs of labour.
There are 3 different stages in labour:
- The First stage – Begins with regular contractions and cervix dilation, ending at 10cm.
- The Second stage – The 'pushing' stage begins when the cervix reaches 10 cm and ends with the birth of the baby.
- The Third stage – This is from the birth of the baby to when the placenta is delivered.
First stage of labour
Latent Phase
The latent phase of labour marks the beginning of the first stage, during which the cervix softens and starts to open (dilate) for the baby’s birth. Contractions will begin, which can be irregular in intensity and frequency; some may feel like strong period pains.
Your cervix is typically sealed with mucus during pregnancy, but when labour starts, the mucus plug may come out, often referred to as your “show.” This may appear as a small mucus discharge, sometimes with a bit of blood, which can be red or brown. If you notice excessive bleeding, contact your hospital or midwife.
The length of the latent phase varies for each woman, often lasting hours or even days, particularly for first-time pregnancies. Staying calm and comfortable is essential. If you're over 37 weeks with a healthy pregnancy, your midwife may advise you to stay home until labour is “established,” meaning your cervix has dilated to at least 4 centimetres and contractions are stronger and more regular.
What can I do to ease the pain?
The goal during the latent phase of labour is to remain as calm and comfortable as possible. You may find it beneficial to:
- Keep mobile
- Rest and sleep between contractions, especially if labour starts at night or you are feeling tired.
- Stay hydrated by drinking fluids, such as water. Isotonic sports drinks may also help maintain your energy levels.
- Consume small, regular snacks like toast, biscuits, or bananas; however, be mindful that many women may not feel very hungry, and some might experience nausea.
- Try any relaxation and breathing exercises you've learned.
- Consider getting a massage; your birth partner can assist by rubbing your back.
- Follow the instructions on the packet when taking paracetamol; it is safe to use during labour.
- Have a warm bath or shower.
- Gently bounce or rock on a birthing ball.
- A TENS (transcutaneous electrical nerve stimulation) machine can be used to alleviate pain. It attaches to your back using sticky pads and sends small electrical impulses that help block pain signals from your body to your brain. This reduces your awareness of the pain.
Contact your midwife or maternity unit if:
- Your contractions are regular and coming about 3 times in every 10 minutes
- Your waters break
- Your contractions are very strong, and you feel you need pain relief
- You have any bleeding
- You're worried about anything
Your baby’s movements
You should continue to feel your baby move as usual right up until you go into labour and throughout the labour process. If you have any concerns about your baby’s movements during the early stages of labour, please contact your midwife or maternity unit.
Established Labour
The next phase of the first stage of labour is referred to as established labour. This occurs when your cervix has dilated to at least 4cm, and your contractions become stronger and more regular.
Throughout this stage, your midwife will communicate with you about how you’re feeling and whether you require any pain relief. They will also:
- Listen and monitor your baby's heartbeat every 15 minutes
- Check how often you are having contractions
- Measure your pulse every hour
- Measure your temperature and blood pressure every 4 hours
- Check how often you empty your bladder
Your midwife will be there to conduct regular vaginal exams to track your labour’s progress, but remember, you always have the option to decline if that feels right for you. If everything is moving along well, additional monitoring may not be necessary, allowing your midwife to focus on providing valuable emotional support.
For first-time moms, the first stage typically takes about 8–12 hours, while those with previous births may experience it in 5–12 hours. As you get closer to full dilation at 10 cm, your contractions might become more intense, which is perfectly normal. You might not even realize when you enter the second stage, but you'll likely feel the natural urge to push when it's time!
The second stage of labour
The second stage of labour starts when your cervix is fully dilated to 10 cm, and your contractions remain strong and regular.
Initially, you may not feel the urge to push, known as the passive second stage. This can last up to 2 hours for first-time mothers and up to 1 hour for those who have given birth before. The active second stage begins when you feel the urge to push and continues until your baby is born.
Your midwife will monitor both you and your baby closely during this stage and will help you find a comfortable position, whether sitting, lying on your side, standing, kneeling, or squatting. If you experience back pain, kneeling on all fours may help. It's a good idea to try different positions before labour and discuss them with your birth partner for their support.
Your midwife will now:
- Listen and monitor your baby's heartbeat every 5 minutes
- Continue to check how often you are having contractions
- Measure your pulse every 30 minutes
- Measure your temperature and blood pressure every hour
- Continue to check how often you empty your bladder
- Your midwife will offer you a vaginal examination every hour during the active second stage of labor. If you prefer not to have this procedure, you can decline. Your midwife can discuss the reasons for these examinations with you.
Every labour is unique, but generally, you can expect to deliver within 3 hours if it’s your first baby and within 2 hours if you’ve had a baby before. The second stage of labour can be challenging, but your midwife will provide support and encouragement, and your birth partner can help as well.
At birth, babies typically weigh between 6 pounds 2 ounces and 9 pounds 2 ounces, and measure 19 to 21 inches long. Most full-term babies fall within these ranges, but healthy babies can vary in size.
The third stage of labour
The third stage of labour happens after your baby is born. During this time, your uterus contracts to deliver the placenta and the membranes that held your baby. You might not notice what's going on as you'll be focused on bonding with your little one, and that’s perfectly normal. Take a moment to cherish this special experience; you’re doing an amazing job!
There are 2 ways to manage this stage of labour:
- Active – When you receive treatment to speed up the process.
- Physiological – When there is no treatment, and you choose for this stage to occur naturally.
Your midwife will explain both options to you while you're still pregnant or during early labor, so you can choose the one you prefer. There are certain situations where physiological management may not be advisable. Your midwife or doctor can clarify if this applies to your situation.
For more information about this stage of labour please click on the link below.
For More Information and advice about labour, birth and beyond please check out the links below for a selection of website, videos and flyers.