There are three stages of labour

 the first stage, when the cervix (neck of the womb)

opens to 10 centimetres

 the second stage, when the baby moves down

through the vagina and is born

 the third stage when the placenta (afterbirth) is

delivered.

‘Braxton Hicks’ contractions can occur throughout

pregnancy. These are tightening of the uterus and are

usually painless. During the latent phase Braxton Hicks

may become more noticeable and more frequent, lasting

35-45 seconds. However some women may not notice

anything happening at all.

What is the latent phase or early labour?

The latent phase of labour is the very first part of your

labour, the early part of the first stage

Before labour starts the cervix is long, situated towards

the back of your pelvis, firm and closed.

During the latent phase the muscles of the uterus

(womb) contract and make the cervix become thinner

and softer. This is called effacement or thinning. During

the latent phase the cervix thins out and opens up to 3-

4cm.

The next part of labour is called the active phase, when

labour has become established. Midwives may refer to

this as established labour.

Both the latent and the active phase are part of the first

stage of labour.

At the end of the first stage, the cervix will have opened

to 10cm and is known as being fully dilated.

The latent phase can last several days or weeks before

active labour starts. Some women can feel backache or

lower period type pain cramps. The pains can be

irregular with no particular pattern to them, and it is quite

common for the pains to last for a few hours and then

stop altogether. Contractions may continue for several

hours, but not become stronger or longer. This is

normal.

A ‘start-stop’ pattern of contractions is common in

the latent phase. Remember! The latent phase of

labour can last a very long time, especially for first

time mums.

Once you are in the active phase of labour, your

contractions will be regular and continue until your baby

is born. Your contractions will get stronger, longer and

closer together.

Many women are unsure of when the active part of

labour has begun, and may wish to attend triage to be

assessed and to be informed of progress in labour. If

you are still in the latent phase (if your cervix is less than

4cm dilated and not fully effaced) you will be advised to

return home and wait for the contractions to become

longer, stronger and closer together. Most women will

be more comfortable at home in the latent phase. There

is evidence to suggest the longer you stay at home the

more likely you are to have a normal birth. This leaflet

should help you find ways to cope with this.

What can I do in the latent phase of labour?

It is not possible to say when active labour will begin. It

could start in a couple of hours, or several days, so try to

stay as relaxed as you can, and distract yourself from

focussing only on the contractions. There are things you

can do to distract yourself, such as,

 pottering around the house

 taking a walk

 watching a DVD

 taking a warm bath, putting a bath towel in the

water with you to cover your tummy and keep it

warm

 using a hot water bottle on any areas that ache

such as your back, tummy, under your bump, or

between your thighs

 having a nap

 doing some relaxation

 massage

 keep your breathing quiet and relaxed, breath in

gently, and sigh out slowly

 keep as mobile as you can, while remembering to

rest when needed to save energy for active labour

 try out different positions to become comfortable

such as

standing, squatting, kneeling using pillows, bean

bags and birthing balls

 drink plenty of fluids; water, sports drinks and juice

are good

 eat little and often, carbohydrates (bread pasta,

rice and cereal) for slow release of energy, plus

sugary foods, such as sweets or glucose tablets

for quick release energy

 listening to calming and relaxing music

 You can safely take paracetamol or co-codamol 6

hourly within the recommended dose.

 You may find it helps to have sex. This causes

your body to produce oxytocin, this is a hormone

which is also produced in labour and which makes

the uterus contract.

 TENS machines can be used in the latent phase.

Your birth partner can help with the latent phase with

things such as

 massage

 keeping you active

 getting you drinks

 praising and encouraging

 giving you cuddles

 Keeping you company and distracting you from

focussing on the pain.

You can help your labour to carry on smoothly by

avoiding stimulating the ‘rational’ part of your brain.

You need peace, quiet, and a feeling of safety to help

you relax and so increase the levels of your own

natural pain relievers called endorphins.

During labour you can take measures such as avoiding;

 bright lights

 people asking you questions which you have to

think to answer

 people talking to you during contractions

 feeling as if people are watching you or judging you.

If your waters break before labour

 during pregnancy, your baby is surrounded by

amniotic fluid (the waters)

 before active labour starts, your waters may break

 for some women 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 if it is

urine

 If you are not sure if your waters have broken, put a

sanitary towel on and lie down for about 30 minutes.

If you have a definite gush when you stand up, it is

a clear sign that your waters have broken and you

should telephone triage.

 If not, then you can assume your waters have not

broken.

 It is advisable once you think your waters have

broken to contact triage to be informed of what

happens next.

 If your water is any colour other than clear you

must contact triage immediately.

 It can be common for your waters to break and for

you not to go into labour, if this happens you will be

assessed in triage and sent home, and advised to

return 24 hours after your waters have broken to

have labour induced.

The ‘show’

The show is a mucous plug that sits in the cervix during

pregnancy, as the cervix begins to soften and shorten,

the show can come away.

It can be clear mucus, lightly coloured with blood or

quite heavily stained with blood. Any form of the show is

normal, and individual to each woman. As long as this is

mucousy, thick and sticky in appearance you do not

have to inform triage until you have any further signs of

labour.

If you experience what you think may be labour

before 37 weeks, you must contact triage for advice.

Things you can do to help yourself before labour

starts

Remember your body knows how to give birth. When

you can understand what helps and hinders the natural

process you can create the right environment for

yourself.

 Communicate with your midwife during

pregnancy; make sure you find out as much

information as you can from her.

 Attend antenatal classes and active birth

workshops

 Some women find it helpful to read The

Pregnancy Book free to first time mums

 Other women use the internet. Try the National

Childbirth Trust website www.nct.org.uk

 You can write a birth plan so we can understand

your needs and feelings about labour.

 Think positively about the strength and reliability

of your body.

University Hospital of South Manchester

Southmoor road

M23 9LT

http://www.uhsm.nhs.uk

Triage telephone number 0161 291 2724

Editorial Board No : 1152/14

Review Date : September 2016

Coping with the latent phase of

labour Advice for women