Coping Advice for Women in early labour

Congratulations !  You have been waiting for the last nine months, with lots of thoughts and preparation for this moment. Your body is starting to get ready to birth your baby.

Labour has three stages:

• the First Stage (including Latent Phase) - when the neck of the womb (cervix) opens to 10 centimetres
  
  
• the Second Stage - when the baby moves down through the vagina and is born
  
  
• the Third Stage - when the afterbirth (placenta) is delivered

The Latent Phase of Labour is the very first part of your labour - the early part of the first stage.

Before labour starts, the neck of the womb (cervix) is long and firm. During the latent phase, the muscles of the uterus (womb) contract and make the cervix become flat and soft, at the same time as opening it to 4cm.

The Latent Phase can last several days or weeks before active labour starts (cervix 4cm and above). Some women can feel backache or cramps during this phase. The pains can be irregular with no particular pattern to them. Some women have bouts of contractions lasting a few hours which then stop and start again the next day. This is normal.

Labour is a normal event in a woman's life and varies for each individual. Your body has to prepare for active labour which is where your cervix (the opening to the womb) opens to 4cms and beyond.

Labour is a journey, which can take a long time ........ every woman's labour is different.

This information gives you lots of suggestions to help with labour, especially the Latent Phase.

Many women experience what is known as a 'show' from the vagina. This is due to the cervix beginning to thin out and open which releases the mucus plug which seals the opening of the cervix. The mucus may be tinged pink or brown from blood or it could appear as a single blob of pinkish jelly - this is all normal.

Having a show means that your body is starting to get ready for labour - but the actual birth may be some time away. Some women have a 'show' several days before labour starts.

Having a show means that your body is starting to get ready for labour - but the actual birth may be some time away. Some women have a 'show' several days before labour starts.

If there is bright red blood, you should phone the labour ward on 01896 826897.

Before active labour starts your waters may break. During pregnancy, your baby is surrounded by amniotic fluid - the 'waters':

• for some women (about 1 in 10), the first sign that labour is going to start is that the waters begin to leak
  
  
• it is quite common for women to leak a small amount of urine at the end of pregnancy and it can be difficult to tell if your waters have broken or not
  
  
• if you are not sure, put a sanitary pad on and lie down for about 30 minutes. If you have a definite gush of fluid when you stand up, it is a clear sign that your waters have broken
  
  
• look at the colour of the fluid - the colour may be clear, pink, green or yellow. It is important to note this as you will be asked when you call

If you think your waters have broken, or you are unsure, you should phone Labour Ward for advice on 01896 826897

Contractions are the regular tightening of the uterus (womb), working to dilate the neck of the womb (cervix) and to push the baby down the birth canal. They may feel like a tightening sensation across your tummy or period type cramps, which in some cases are also felt in your back and thighs. each one usually begins gently, builds up to a peak and then tails off.

Contractions in the latent phase of labour may start and stop. They may continue for several hours but not become longer or stronger and last no more than 30-40 seconds. This is normal.

Contractions should gradually become closer together and get stronger, last longer than 40 seconds and become more rhythmical as labour begins.

Remember - a 'start-stop' pattern of contractions is common in the latent phase. 

'Braxton Hicks' contractions occur all through pregnancy. they are usually painless. They are tightening of the muscle of the uterus (womb) and last for about 30 seconds. They do not increase in length intensity or frequency, but can be easily mistaken for labour.

They tend to be short and come and go intermittently - time them; this will help you decide if this is labour or not. If in doubt, call Labour Ward on 01896 826987.

Many women have a vaginal examination during the latent phase which may find the cervix to be 1-2cm dilated. Their contractions may then stop for a few hours.

This is a good time to rest and make sure you have something to eat. When your body has built up some energy supplies your contractions will start again.

If you are in hospital when you have this examination, the midwife may suggest you go home and wait for contractions to get longer, stronger and closer together.

Most women are more relaxed at home in the latent part of the first stage.

• Remain calm!
  
  
• Stay relaxed - take long deep breaths during your contractions
  
  
• Have a warm bath or shower - you may find the warmth of the water very soothing
  
  
• Use a hot water bottle on areas that ache
  
  
• Take regular Paracetamol - no more than two tablets every four hours, up to a maximum of eight in 24 hours
  
  
• Attach a TENS and get familiar with it, if you have one at home
  
  
• Use your birthing ball if you have one - this helps get your baby into the correct position and also lets gravity work
  
  
• Go for a walk with your partner again allow gravity to help
  
  
• Watch a movie - try and distract yourself and take your mind off contractions
  
  
• Maintain a normal rest pattern - although it is good to remain upright, it is also important to rest and conserve your energy
  
  
• Continue to eat and drink normally - Isotonic drinks such as Lucozade^® and Powerade^® will also help with your energy needs

It is very important for your birthing partners and family members to be supportive. A prolonged latent phase can often be discouraging and an exhausting experience and women benefit from good psychological support

once you have carried out all of the above checklist and you feel you are reaching the stage that you require stronger pain relief than you can access at home, it might be time to come into hospital.

Remember there will always be a midwife available 24/7 in Labour Ward to give telephone support & advice. Please don not hesitate to call on 01896 826987