Giving birth - first stage of labour

What is the first stage of labour?

The first stage of labour is when your cervix (the neck of your uterus) opens (dilates) in preparation for birth. During this stage, your contractions become stronger, longer and more frequent as your body helps your baby move down through the birth canal.

The first stage ends when your cervix is fully open at 10 centimetres — this means you are ready to begin pushing in the second stage of labour.

What are the phases of the first stage of labour?

While every labour is different, the first stage of labour is divided into 2 distinct phases — the latent phase and the active phase. Most people in labour and midwives recognise the ‘transition phase' as the end of the active phase, just before the second stage of labour begins.

The latent phase

The first phase is called the latent phase, and can last for many hours or even days.

Your cervix moves forward, shortens and becomes thinner (effaced) and begins to open. Contractions may be regular or irregular.

You can usually stay at home during this stage of labour.

Tips for this phase:

• Try to rest or sleep and relax by doing gentle movements or stretches, or by practising mindfulness, meditation or other calming techniques.
• Eat light snacks such as fruit or toast to maintain your energy.
• Drink water to stay hydrated
• Rest and save your energy for the active phase ahead.

The active phase

The second phase is called the active phase.

• It is when your cervix is completely shortened/thinned (effaced) and open (dilated) to 4 centimetres.
• You may experience stronger, more painful contractions than during the latent phase.
• Contractions become more regular, every 3 to 4 minutes, and may last around 60 seconds.
• You may choose to go to hospital or your birthing centre during this phase.
• Contact your doctor or midwife if you are having a homebirth, Birthing on Country or in a rural or remote setting.
• Your cervix becomes fully dilated, opening to 10 centimetres, large enough for your baby to pass through.

The transition phase (at the end of the active phase of the first stage).

The transition phase is a period between the first stage of labour and the time when active pushing begins. In the transitional phase your cervix will be around 8 to 10 centimetres dilated.

You may feel:

• your contractions become faster and more intense
• irritable, loss of control or like you ‘can't do it anymore'
• that it is difficult to communicate
• shaking legs
• nauseous
• pressure in your bottom or the urge to push

During this time, your partner, midwife or doctor can help by offering calm reassurance, encouragement and staying close to support you through this intense phase of labour.

Once your cervix is fully dilated, the second stage of labour begins.

How long can the first stage of labour last?

The first stage of labour is the longest, but its length can vary widely between births. It usually lasts longer for your first birth, and shorter if you have given birth before.

Some people do not notice contractions at the start, only realising they are in labour towards the end of the first stage — this is not common.

You can usually stay at home while you are in the latent or early stages of labour. This applies whether you are planning to birth in a hospital, with a private midwife, in a birth centre, on Country, or in a rural or remote setting.

You can contact your midwife or doctor at any time if you are unsure, need support, or want advice about when to travel to your chosen place of birth.

When should I go to my planned place of birth?

What support is available during the first stage of labour?

During the first stage of labour your birth partner, family, friends and care team can help you feel supported and comfortable.

At home or in your birth setting, they can help you by:

• dimming the lights and playing calming music
• giving you a gentle massage
• bringing you light snacks
• helping you with natural pain relief methods, such as hot or cold packs or breathing techniques
• offering water regularly to keep you hydrated
• physically supporting you to maintain comfortable positions during contractions

Tips to help yourself during this stage include:

• emptying your bladder regularly — this will help you move into different positions and can be more comfortable for you
• standing and moving around to manage pain during contractions and to help naturally progress labour
• let your support person know what they can do to help you, especially as your preferences may change at different times in labour

What happens when I arrive at hospital or a birth centre?

Once you are at the hospital, birthing centre or where you choose to give birth, your midwife will monitor you and make sure your labour is progressing as it should.

When you arrive at the hospital or birthing centre, these things may happen:

• A midwife will examine your abdomen to check the position of your baby.
• They will ask you about the strength and frequency of your contractions. This can help them know how far your labour has progressed.
• They may use a doppler or continuous monitoring to check your baby's health and listen to your baby's heartbeat.
• Your midwife will ask you about your pregnancy and general health, including what medicines you take or if you have given birth before.
• Your midwife will also check your blood pressure to make sure it is in a healthy range and may ask you for a urine sample.
• They may ask your consent to perform a vaginal examination to measure how dilated your cervix is or a speculum examination to see if your waters have broken or if you are bleeding from your vagina.
• You may need a cannula inserted in your arm and bloods taken.

It can be helpful to prepare a folder with your important medical information for your midwife.

You can share your birth preferences with your birth team, and discuss your options for pain relief during labour. You can request pain relief at any time, and your midwife will guide you on suitable methods of pain relief for each stage of labour.

What complications can happen?

Every labour is different. Sometimes things don't go as planned and you may have to adjust your birth preferences if the situation changes. Your care team may recommend extra monitoring or medical support for possible labour complications such as:

• contractions slowing down or labour not progressing
• fetal distress (a drop in your baby's heart rate)
• heavy bleeding or signs of infection
• meconium in the amniotic fluid

If this happens, your midwife or doctor will explain what's happening, discuss your options, and involve you in decision-making. The goal is always to keep you and your baby healthy and safe.

How can I prepare for labour and birth?

You can prepare for labour in many ways to feel more confident and informed:

• attend antenatal classes
• discuss your birth preferences with your midwife or doctor
• discuss your birth preferences and note your values and wishes for labour
• learn about your healthcare rights including shared decision-making and giving informed consent to any procedures or interventions
• talk with your support person or partner about how they can help you during each stage of labour

Resources and support

If you'd like more information or support, these organisations and services can help:

• The Australian Government has a range of pregnancy information resources.
• The Queensland Government has fact sheets about early labour.
• The Royal Australian and New Zealand College of Obstetricians and Gynaecologists provides a pamphlet on labour and birth.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Information for Aboriginal and/or Torres Strait Islander peoples

• Birthing on Country supports culturally safe, community-led maternity care for First Nations families.
• Find an Aboriginal Community Controlled Health Organisation (ACCHO) near you.

Languages other than English

• The Multicultural Centre for Women's Health offers a library of pregnancy, birth and postpartum resources in many languages.
• Monash Health has health information translated into many languages, including pregnancy care topics.

Information for sexually and gender-diverse families

• Rainbow Health Australia has a library of practical resources on services for LGBTIQ+ and gender-diverse families.
• QLife is a free, national phone and webchat service that provides anonymous peer support and referrals for LGBTIQ+ people and their families.