The early stage of labour

The early stage is also called 'the latent first stage of labour'.

Information

If this is your first baby, you should be given information at antenatal appointments about what to expect in the early stage of labour, including:

  • how to tell the difference between Braxton Hicks contractions and proper labour contractions

  • how often contractions are likely to happen and low long they will last

  • how to tell if your waters have broken (see below)

  • what type of vaginal discharge to expect

  • ways to work with any pain you are having

  • how to contact your midwife and what to do in an emergency.

If you think you might be in labour

You may be offered an early assessment to see whether you are in labour. If this is your first baby, this might be a face‑to‑face meeting with a midwife, either at home (even if you are not planning a home birth) or at your planned place of birth. Or you might be offered a phone assessment, whether this is your first baby or not.

In all early assessments, the midwife should:

  • ask how you feel, and about your birth plans, hopes and any concerns

  • ask about your baby's movements, and especially about any changes in this

  • explain what you can expect in the early stage of labour, including things you can try to help with pain

  • offer you support, and pain relief if needed

  • encourage you to stay at home, or return home, until your contractions start coming more often

  • tell you who to contact next and when

  • give advice and support to your birth companion (if you have one).

Pain relief in the early stage

Breathing exercises, massage and being in water may help to ease pain during the early stage of labour. There is not much evidence that aromatherapy, yoga or acupressure work to relieve pain, but you can use them if you want to.

See the pain relief section for more information.

What if my waters break before I go into labour?

Your waters may break before you go into labour. If you or your midwife thinks your waters might have broken but are not sure, you should be offered an internal examination with a device called a speculum. You shouldn't have this type of examination if it is obvious that your waters have broken.

Most women (6 out of 10) whose waters break go into labour on their own within 24 hours. But if this doesn't happen, your midwife should offer to start your labour artificially – this is called inducing labour (which is covered in a separate NICE guideline; see other NICE guidance). This is because your waters breaking before labour starts increases your baby's risk of serious infection (from a chance of 5 in 1,000 to a chance of 10 in 1,000 births).

While waiting to be induced, or if you choose not to be induced, you will be advised to take your temperature every 4 hours while you are awake. You should get in touch with your midwife if you develop a high temperature. You should also tell your midwife straight away if you notice any change in the colour or smell of your vaginal discharge, or if your baby is moving less. Your baby's heartbeat should be checked every 24 hours by your midwife. Having a shower or a bath won't increase the risk of infection, but having sex might.

If you don't go into labour within 24 hours of your waters breaking, you should be advised to give birth in an obstetric unit, so that if there is any infection it can be treated quickly.

See also care of your baby if your waters broke before labour started.

Questions about the early stage of labour

  • When should I contact my midwife?

  • Why is it best if I stay at home even though I'm having contractions?

  • What can I do to help ease labour pain?

  • How can I tell if my waters have broken, and what should I do?

  • Information Standard