Information for the public
During labour, your cervix dilates (opens) so that your baby can pass through. When it has dilated to about 4 cm, you are said to be in established labour. Your contractions will come more often and get stronger as time goes on.
For women having their first baby, the first stage of established labour usually lasts about 8 hours and is rarely longer than 18 hours. For women who have had a baby before, the first stage of established labour usually lasts about 5 hours and is rarely longer than 12 hours.
Your midwife should talk with you throughout the first stage about how you are feeling, and ask whether you need pain relief. The midwife will carry out a number of checks, including:
measuring your baby's heartbeat every 15 minutes
checking how often you are having contractions every 30 minutes
measuring your pulse every hour
measuring your temperature and blood pressure every 4 hours
checking how often you empty your bladder
offering vaginal examinations every 4 hours, or more often if there are any concerns or if you want this.
If your labour is going well, you shouldn't need any medical procedures or equipment, such as having your waters broken or being connected to an electronic monitor to check your baby's heartbeat.
See later for what should happen if there is delay in the first stage of labour.
Once your cervix is fully dilated, your baby's head will start moving down through your vagina. This is called the second stage of labour. Even when your cervix is fully dilated, you may not have an urge to push with your contractions straight away – this is called the passive second stage.
The active second stage is when you have an urge to push with most contractions, and ends when your baby is born. The birth is expected to take place within 3 hours of the start of active pushing in most women having their first baby, and within 2 hours for most women who have had a baby before.
Your midwife will help, encourage and talk to you, and monitor both you and your baby closely. You should be guided by your own urge to push. Your midwife should encourage you not to lie on your back but instead to find another position that is comfortable. If pushing doesn't seem to be working well or you are feeling tired, your midwife may advise you to change position, and to empty your bladder if needed.
See later for what should happen if there is delay in the second stage of labour.