The stages of birth: first phase

1 & 2 Weeks Pregnant: What You Really Need to Know (March 2019).


every woman experiences a different birth. Nobody can predict how your contractions will be or how long you will have contractions. Nevertheless, there are some things that you can use to prepare for this phase of childbirth.

What happens in the first phase of labor?

In the first phase of labor, the uterine contractions gradually open the cervix (cervix). This phase is distinguished into early labor, active contractions and the transitional phase.

During pregnancy, the cervix (cervix) is closed with mucus and thus protects against infections. During pregnancy, the cervix is ​​long and firm and forms a strong support for the uterus. He is slightly tilted backwards to the back during pregnancy.

In the early stages of labor, the cervix shortens and the cervix opens to allow your baby to be born. At the end of this phase, your cervix is ​​completely open, revealing an average opening of 10 cm in diameter.

First, your cervix must come forward from the back position (Simkin and Ancheta 2011). In addition, it begins to shorten and becomes increasingly softer. For a better idea, touch the tip of your nose: it feels tight and somehow stable. Now touch your lips, they are soft and very elastic. Your cervix is ​​as firm as the tip of your nose at the beginning and gradually becomes softer, as soft and stretchy as your lips.

These changes often begin in the late weeks of pregnancy before labor begins (Murray and Hassall 2009). In the days or hours before the cervix shortens a bit, it changes its position and gradually gets softer.

While this happens, you may feel slight contractions and feel back pain or abdominal pain, or you may just feel slightly different. Stomach upset and bowel problems may be additional symptoms. This phase is also referred to as a forerunner. It could even go straight into the first phase of labor (Simkin and Ancheta 2011).

As a result of these changes, the mucus plug may detach and be excreted. This can lead to a slight so-called drawing bleeding. The mucus plug looks like jelly and may be brownish or reddish in color. If it's your first baby, it's likely to start contracting after a few hours. Have you ever given birth, so it's a sign that it is starting soon with the labor.

First Labor

During the forehead, the cervix begins to open and stretch. It opens up to 4 cm (McCormick 2009) in this phase. You probably will not notice this as the uterus contracts very gently at the beginning. It may feel like mild abdominal cramping as it does at the beginning of menstruation, or you may feel a dull ache or have back pain. Maybe your cervix has opened a few inches without you even noticing.

In many women, uterine contractions are now on the rise and are beginning to get painful. These, however, are different from the actual foreskins, which are irregular and not painful. Now you are certainly glad that it finally starts and your baby is now on the journey into the world.

Keeping track of your contractions over a 30-minute period can help you assess the status of your birth. If you or your birth partner take note of the start time at which the contraction begins, make a note of the end of the woe, then the start time and the end points again, and so on … Or you use an app or an online program. That simplifies the matter.

The frequency indicates how often the contractions come in a certain amount of time. It is always measured from the beginning of a woe to the next. For example, the first contractions can come at a distance of about 7 minutes and take about 40 seconds. If so, you have 6 minutes and 20 seconds until the next one comes.

In labor you will have your own rhythm and your own speed. As an indication: The first contractions come at a distance of more than 5 minutes and last between 30 and 40 seconds (McCormick 2009).

You may be able to talk normally during your first labor and continue as normal. It is best if you stay at home during this time instead of going to the hospital or birthplace. They are more comfortable at home and feel better and less disturbed (RCM 2012).

There are a lot of techniques that you can use with your partner. So maybe TENS and massage (RCM 2012). Do not forget to eat and drink, and just try to stay in balance and on the move - with breaks in between, of course.

Some women find the first labor to be very intense and exhausting, and it takes them over to eat or rest. But every woman is different and therefore may need something different from others at this stage. Get in touch with your midwife to get the support you need.

The first labor can be unpredictable. For some women, the frequency of contractions is the same throughout the day. In other women, the intensity increases gently (NCCWCH 2007).It depends on a variety of factors, such as the position of your baby, whether you are relaxed and how powerful the contractions are (Simkin and Ancheta 2011).

In the time of foreshadowing to active labor, the cervix changes enormously. This phase can take some time. Try to be patient and imagine that this phase is more of a marathon than a sprint.

Active Phase of Labor

The contractions of the uterus are now longer and the distances shorter. This is a sign that the active phase of labor has begun. Now the cervix opens from 3 to 4 cm up to 10 cm (NCCWCH 2007: 139).

The contractions become more powerful at this stage and the intensity usually peaks. Once this has been achieved, the intensity of the contraction gradually decreases. You may not be able to talk while in pain. You must interrupt your conversation to continue breathing or moaning.

It is quite normal that, as time goes by, the contractions become more painful and the child giving birth becomes louder. Relaxation techniques, such as pelvic swinging or using a ball of birth, may help to relax and keep your breathing under control.

The labor now comes about every three to four minutes and takes about 60 to 90 seconds. There is not much time left to recover between the individual contractions. This break is enough for a short communication to walk around or take a sip before preparing for the next woe.

In the phase in which the contractions are very strong, you often lose your appetite and you are sick. They feel sick. They feel the urge to go to the bathroom. Your digestive system is getting ready for the final stages of childbirth. If you are in the active labor phase, you should head to the hospital or birthing center, or call your midwife to take care of your home birth at home.

In-phase contractions tend to maintain their dynamics to expand and open the cervix faster. It can still take several hours for the cervix to fully open. Take one step at a time and always remember that with each and every pain you can come a little closer to the moment you finally see your baby.

Transitional Phase

The transitional phase is the period in which labor changes from the opening labor to the pressing labor. This is usually the case when the cervix is ​​about 8 cm open. It ends when the cervix is ​​fully opened or you feel the strong urge to squeeze.

Perhaps the incidence of contractions is decreasing, but labor is getting worse and contractions continue longer (Downe 2009).Sometimes, contractions are like a double wave. This means that the pain begins gently and rises to the first point of pain, then decreases in intensity, but increases in intensity until it finally comes to an end. This may be an indication of an imminent rupture of the membranes just before or during the transition to contractions. Bleeding may occur after the cervix is ​​fully open (McCormick 2009).

The experiences in this phase are different with the pregnant women. It can be very intense and painful. You may also be so engrossed during your woe that you can only express your needs abruptly. You may groan, scream, or be impatient with anything and everything. Or you may feel shaky, shiver and just feel sick. But maybe you do not feel any of that.

If you plan to go through childbirth without painkillers, this is certainly the best testing phase for you and your baby at birth (Downe 2009). You may reconsider your birth plan or ask for epidural anesthesia (PDA) even if you were hoping you did not need it. Or if you're planning a home birth, you might want to go to a hospital now.

Your birthing partner will help you through this phase. Sometimes, fortunately, there is a small breather at the end of the transition period, so you and your baby can recover and rest before the labor pains begin (McCormick 2009).

Tips for the First Phase of Labor

  • Listen to your body.
  • Eat and drink according to your appetite.
  • Try different positions and keep moving.
  • When your labor starts, try to rest and sleep.
  • Go to the bathroom every two hours.
  • Take a warm shower, bath or use a birth pool to relax.
  • Consider using hypnosis birth techniques and welcome any woe.
  • Take nitrous oxide when it's offered to you.
  • If you need something stronger, ask your midwife about pethidine or something similar, or ask for a PDA.
  • As the intensity of contractions decreases, check our tips for speeding up your contractions in a natural way.

Continue reading what happens in the second phase of labor.


Downe S. 2009. The transition and the second stage of labor. In: Fraser DM, Cooper MA. eds. Myles Textbook for Midwives. Edinburgh: Churchill Livingstone, 509-30 McCormick C. 2009. The first stage of labor: physiology and early care. In: Fraser DM, Cooper MA. eds.

Myles Textbook for Midwives. Edinburgh, Churchill Livingstone, 457-75 ( ) Murray I, Hassall J 2009. Change and adaptation in pregnancy.In: Fraser DM, Cooper MA. eds. Myles Textbook for Midwives. 15th ed. Edinburgh: Churchill Livingstone, 189-225

NCCWCH. 2007. Intrapartum care: care of healthy women and their babies during childbirth. National Collaborating Center for Women's and Children's Health, Clinical Guideline. London: RCOG Press.

RCM. 2012. Latent phase. Royal College of Midwives, Evidence-based guidelines for midwifery-led care in labor.

RCOG. 2011. Operative vaginal delivery. Royal College of Obstetricians and Gynecologists, Green-top guideline, 26th London: RCOG press.

Simkin P, Ancheta R. 2011. The laboratory progress handbook: early intervention to prevent and treat dystocia. 3rd ed. Chichester: Wiley Blackwell

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