Latent Stage

The latent stage is when the cervix begins to soften and open, and can take many hours or even days before labour is fully established — it's usually the longest stage overall. Contractions during this time are irregular and range from mildly uncomfortable to more painful. Eating and drinking for energy, staying relaxed at night, and staying upright and gently active during the day (which helps the baby move down and the cervix dilate) can all help, alongside breathing exercises, massage, or a warm bath or shower.

Established Labour (1st Stage)

Established labour begins once the cervix has dilated to around 4cm with stronger, more regular contractions. Your midwife will check on you periodically, offering support and pain relief as needed, along with regular vaginal examinations to track progress (which you can decline if you'd prefer). The cervix needs to reach around 10cm — fully dilated — for the baby to pass through; in a first pregnancy, this typically takes 8 to 18 hours from established labour, often quicker (5 to 12 hours) in later pregnancies.

Monitoring You and Your Baby

Your midwife will regularly check your baby's heartbeat, usually with a small handheld device every 15 minutes, while you remain free to move around. Electronic monitoring — using two pads strapped to the bump, or occasionally a small sensor attached to the baby's scalp for more precise readings — may be suggested if there are any concerns, or if you have an epidural, though this can somewhat limit movement; you can request it even without specific concerns, and it can often be removed again if everything looks normal.

If Labour Is Slow to Progress

If contractions aren't strong or frequent enough, or the baby is in an awkward position, your midwife or doctor may suggest breaking your waters (artificial rupture of the membranes) to help strengthen contractions, or, if that doesn't work, an oxytocin drip into a vein to make contractions stronger and more regular — both usually mean discussing pain relief options and needing closer monitoring of your baby.

2nd Stage: Pushing and Birth

The 2nd stage runs from full dilation to your baby's birth. Your midwife will help you find a comfortable position — sitting, lying on your side, standing, kneeling, or squatting — with kneeling on all fours sometimes helpful for backache. As your baby moves down the birth canal, you may feel an urge to push, similar to needing to pass a stool; if you've had an epidural, this urge may be reduced or absent. Pushing usually lasts up to 3 hours in a first birth, or up to 2 hours in subsequent births.

As the baby's head is close to being born, your midwife will guide you to pause pushing and breathe gently, allowing the perineum time to stretch. Sometimes an episiotomy (a small cut to the perineum, done under local anaesthetic) is suggested to prevent a tear or speed up delivery, with any cut or tear stitched afterwards. Once the head is born, the rest of the body usually follows within the next contraction or two, and you'll typically be able to hold your baby straight away for skin-to-skin contact, with breastfeeding possible as soon as you're ready — ideally within the first hour.

3rd Stage: Delivering the Placenta

The 3rd stage happens after birth, as the womb contracts to deliver the placenta. There are two approaches: active management, where treatment speeds this up, or physiological management, where it happens naturally without intervention — your midwife will discuss both with you in advance so you can decide your preference, and let you know if physiological management isn't advisable in your specific situation.

With active management, an oxytocin injection is given into the thigh to help the womb contract, the umbilical cord is usually clamped between 1 and 5 minutes after birth (sooner if needed for medical reasons), and the placenta is guided out via gentle traction on the cord, usually within 30 minutes. This speeds up delivery and lowers the risk of heavy bleeding afterwards, though it can increase nausea and afterpains.

With physiological management, no injection is given, the cord isn't cut until it stops pulsing (usually 2 to 4 minutes), and you'll push the placenta out yourself once it separates — this can take up to an hour overall, though pushing itself is usually quick. You can switch to active management at any point if the placenta doesn't come away naturally or you begin bleeding heavily.