Labour - stage one

Labour is usually divided into three stages. The first stage is the longest for almost everyone, but its length is very variable. Anything between one hour and 20 hours is normal.

Labour begins as a response to hormonal triggers coming from the baby. The baby's adrenal gland matures and starts to secrete the hormone cortisone.

In response to this, the mother produces hormones called prostaglandins - and it's these that stimulate the uterus to start contracting.

With each contraction:

• the uterus pushes the baby down
• the cervix opens up and becomes thinner By the end of first stage, the cervix is fully open; enough to allow the baby to pass through and into the birth canal (the vagina). This is described as being 10 centimetres dilated or fully dilated. How contractions change At the beginning of labour, contractions last about 40 seconds, once every 10 minutes. By the end, each contraction lasts longer than a minute, with a gap of no more than a minute between each one. Labour tends to speed up as it progresses. It normally takes far less time for the cervix to dilate its second five centimetres, compared to its first five. How to stay comfortable Most women cope best with this stage of labour if they feel free to move into whatever position feels best. This might be
  • kneeling
  • leaning forwards on a floor cushion or your partner's lap
  • leaning against a wall
  • resting on all fours ...and anything else that helps - different positions may work better for you at different times. Caring for your baby during labour Fetal monitoring keeps a close watch on your baby's health by measuring his heart rate.

The midwife may use a Pinard stethoscope, which looks like a sort of ear trumpet. She places it against your abdomen and listens to the baby's heart

You may be linked to an electronic fetal monitor which picks up and displays the baby's heart rate as a number on a screen. Alternatively, a small electrode, clipped onto the baby's scalp picks up the heartbeat, and the result is transmitted to the machine. The heartbeat is also printed out so it can be looked at and assessed over time. This form of monitoring can be continuous.

Telemetry sends the signal of the heart rate via radio waves to the receiver. You're not actually attached to the monitor, so you're free to move around as long as you stay within range of the monitor. Again it can be continuous.

A doppler machine uses ultrasound for monitoring. A small transmitter-receiver is placed on your abdomen to pick up the heartbeat.