B] First Stage of Labour

The first stage of labour begins with the onset of regular painful contractions. During this stage, the cervix dilates from 0 to 10 cm. The first stage of labour consists of latent, active and transitional phases.

1. Latent Phase
The latent phase is the early and slow part of labour which begins with the onset of regular painful contractions and lasts until the cervix is dilated by 4 cm. It usually takes 8 hours. During this phase of labour, most women are relatively comfortable and walking around should be encouraged, since it naturally stimulates the process. For a first-time mother, the cervix must be completely effaced before dilatation continues. Effacement is reported in percentages as 50 to 100 percent. The membranes should not be ruptured until the woman is in the second stage in order to prevent infection. The role of the midwife during this phase is to monitor and observe maternal and fetal well-being and the progress of labour.

2. Active Phase
The active phase of labour is faster and more efficient than the latent phase. In this phase, contractions are longer, more regular and painful, usually occurring about every two to five minutes. Ambulation should be encouraged until the woman is uncomfortable and/or membranes have ruptured.

3. Transitional Phase
This is the last phase of the first stage of labour. Cervical dilatation continues at a slower rate (8-10 cm). Contractions become more frequent, stronger and last longer. During this phase the woman may exhibit a decreased ability to cope with the contractions. She becomes restless, changes positions and may feel abandoned. As the fetal head continues to descend, the woman begins to feel the urge to "push" or bear down. Active pushing by the mother should not begin until the second stage is confirmed. Pushing too early can cause the cervix to swell or to tear and bleed.