Stages and Signs of Labour: Understanding Childbirth

As a first-time mom, Riddhima was filled with anticipation and uncertainty as her due date approached. Every twinge made her wonder if she was going into labour. Like many expectant mothers, she searched online to understand whether her pains were Braxton Hicks or the start of true labour.

In this article, we’ll outline the key differences between false and true labour, helping you feel more prepared and confident as you approach this milestone in your journey to motherhood.

Labour is typically divided into three main stages, each with unique characteristics and challenges. Here's a breakdown of what you can expect during each phase:

First Stage of Labour

This is the longest stage, starting from the onset of labour until the cervix is fully dilated to 10 centimetres. It consists of two phases:

1. Early Labour

• Contractions are mild and irregular, lasting 30-45 seconds and occurring 5-20 minutes apart
• Cervix begins to thin (efface) and open (dilate) to about 3-4 cm
• Can last anywhere from a few hours to a few days
• Ideal time to rest, eat, and prepare for active labour

2. Active Labour

• Contractions become stronger, longer (45-60 seconds), and more frequent (3-5 minutes apart)
• Cervix dilates from 4 cm to 7 cm
• Typically lasts 3-5 hours, but can vary
• Time to head to the hospital or birthing centre

Second Stage of Labour

This is the transitional stage, which begins when the cervix is fully dilated. It involves pushing and culminates in the birth of the baby. The duration can vary significantly, lasting from a few minutes to several hours.

• Contractions are intense and closely spaced (2-3 minutes apart)
• Cervix dilates from 8 cm to fully dilated at 10 cm
• Shortest stage, usually lasting 30 minutes to 2 hours
• Strong urge to push as baby descends into the birth canal

Third Stage of Labour

This final stage occurs after the baby is born and involves the delivery of the placenta, typically within 20 to 30 minutes after birth.

Understanding these stages can help you better interpret the signs of labour at 37 weeks and beyond. However, it's important to remember that every labour experience is unique, and there's no one-size-fits-all timeline.

So, how can you tell the difference between false labour pain symptoms and the real deal? Here are some key indicators that you may be experiencing true labour:

• Regular, progressively stronger contractions that don't ease up with movement or rest
• Contractions that start in the lower back and radiate to the front of the abdomen
• Bloody show (mucus tinged with blood) as the mucus plug dislodges
• Water breaking (rupture of membranes)
• Nausea, vomiting, or diarrhoea as hormones shift

Contractions During True Labour

One of the most telling signs of true labour is the nature of your contractions. During true labour, contractions will:

• Occur at regular intervals, gradually increasing in frequency and intensity
• Last about 30-70 seconds each
• Become more painful and harder to talk through
• Continue even if you change positions or activity level

Other Physical Signs of True Labour

In addition to contractions, there are other symptoms few days before delivery that can signal the onset of labour:

1. Dropping/Lightening: You may notice that your baby has dropped lower into your pelvis, making breathing easier but increasing pressure on your bladder.
2. Effacement and dilation: As labour approaches, your cervix will begin to thin out (efface) and open (dilate). Your healthcare provider can check for these changes during a pelvic exam.
3. Increased back pain: Many women experience lower back pain and cramping as labour nears, often radiating to the abdomen and thighs.
4. Loose bowel movements: Hormonal changes and uterine contractions can stimulate the bowels, leading to diarrhoea or more frequent bowel movements.

Don't forget that not all women experience these signs and symptoms!

As your due date approaches, you may experience contractions that make you wonder if you're going into labour. However, not all contractions signal the start of true labour.

Braxton Hicks contractions, also known as false labour, are common during pregnancy. These irregular, often uncomfortable contractions prepare your body for delivery but don't indicate that labour is starting.

Typically occurring in the second or third trimester, Braxton Hicks contractions are usually painless and can be triggered by factors like dehydration, a full bladder, physical activity, or baby movements. Staying hydrated, emptying your bladder, and taking breaks can help reduce their frequency.

Characteristics of False Labour Contractions

When you're experiencing contractions, it's crucial to understand the difference between true and false labour pain. Here are some key characteristics of Braxton Hicks contractions that can help you distinguish them from the real thing:

• Irregular intervals: False labour contractions don't follow a regular pattern or get closer together over time.
• Weak and unpainful: Braxton Hicks contractions are usually mild and not very painful, although they can cause discomfort.
• Variable duration: These contractions can last from 15 to 30 seconds, sometimes up to 2 minutes, but they don't increase in duration as time goes on.
• Effect of movement: False labour pain symptoms often subside or change when you walk, rest, or change positions.
• No cervical dilation: Braxton Hicks contractions do not cause your cervix to dilate, which is a telltale sign of true labour. 

As Riddhima neared her due date, she felt mild contractions that came and went, making her think she was going into labour. However, after timing them, she realised it was false labour.

The key to understanding true labour pain lies in the contractions' timing, intensity, and regularity. False labour contractions are irregular and painless and stop with a change in position. In contrast, true labour contractions are stronger and more regular and increase in intensity and frequency over time.

Timing and Intensity of Contractions

A key sign of labour is the timing and intensity of contractions. In early labour, contractions are mild, lasting about a minute and occurring every 5 to 15 minutes. As labour progresses, they become stronger, longer, and closer together.

In active labour, contractions typically occur every 3 to 5 minutes and last around 45 seconds. They are intense enough to make talking or walking difficult. Timing your contractions helps you track progress and decide when to head to the hospital or birthing centre.

Changes in Cervical Dilation and Effacement

Another crucial indicator of labour progression is the change in your cervix. During labour, the cervix dilates (opens) and effaces (thins out) to allow your baby to pass through the birth canal. In early labour, the cervix may dilate to about 3-4 centimetres and become significantly effaced.

As you transition into active labour, the cervix dilates more rapidly, reaching 10 centimetres by the end of this stage. Your healthcare provider will monitor your cervical changes during regular check-ups and can help you understand how your labour is progressing. 

If you experience any of the following signs of true labour, it's time to contact your doctor or midwife:

• Regular contractions that become stronger and more frequent
• Water breaking (rupture of membranes)
• Bloody show (mucus discharge tinged with blood)
• Persistent lower back pain or cramping

Trust your instincts and don't hesitate to reach out if something doesn't feel right.

Trust your instincts and listen to your body. By understanding the difference between true and false labour, you can better prepare yourself for the arrival of your little one.

Suppose you experience any key signs of labour, such as contractions, backache, or water breaking, especially around 37 to 38 weeks of pregnancy. In that case, contacting your midwife or maternity unit for guidance is crucial.