The birth of a baby can be broken down into different stages. It’s important to recognise that our bodies all go through the same stages and phases of labour, but we might not all experience them in the same way.
How do you know exactly what stage you’re in? How do you know when one phase ends, and the next one begins? What happens during each one?
For a more detailed explanation on all three stages of labour, read BellyBelly’s article The Stages Of Labour – An Informative Guide.
In this article, we’ll focus on the active phase of labour, and everything you need to know.
What are the phases of labour?
During each stage of labour, your body and baby are working together to enable your baby to be born.
Labour can be broken down into three stages, as follows:
- The first stage includes the latent and the active phases of labour, and the transition phase
- The second stage is the pushing stage and the birth of your baby
- The third stage is the birth of the placenta and membranes.
Active phase of labour: definition
The active phase follows on from the latent phase. In active labour, there are regular contractions and typically the cervix dilates from 4cm to 10cm. At 10cm the cervix is described as being fully dilated or open.
During this part of the labour, true labour contractions become more regular, consistent, intense and longer in duration.
Active labour can also be referred to as established labour.
What is the active phase of labour?
During this stage, labour progression is generally more predictable, compared with the latent phase, where contractions can stop and start, or be affected by certain movements or activities.
In a normal labour, during the active phase labour progresses more quickly. This can result in either steady or rapid cervical dilation.
During this phase, it’s likely you’ll notice a change in your uterine contractions. You’ll probably experience:
- More painful contractions
- More regular contractions
- Contractions that are closer together
- Contractions that last longer.
Your waters might break at this stage (if they haven’t already). This means that the fetal membranes around your baby have torn or burst and the amniotic fluid in which your baby is floating will be released.
There’s no right time for your waters to break. For many women it will happen at some point during the active phase of labour but, for some, it could occur in early labour.
It’s more common for your waters to break during the latter phases of labour, as contractions become stronger and more intense. Imagine your waters are like a big water balloon; the harder you squeeze the balloon, the more likely it is to burst.
Latent phase of labour compared with active phase
The latent and active labour phases both fall within the first stage of labour.
There are a number of differences between the two phases – in terms of what you might experience and what’s happening in your body during each phase.
What happens in latent labour?
When latent labour begins, the tightenings that you’ll experience focus on the lower uterus and the cervix (the neck of the womb).
As the body prepares for birth, the cervix begins to change, in a process known as effacement. This process might happen over a period of a few hours or, for some, a few days. The cervix starts off long and firm and changes to become shorter and softer; this happens to enable your baby to pass through the cervix and into the birth canal.
During early labour, you’ll feel tightenings in the lower abdomen. They can feel like intense period pains that build up over time. They might stop and start, and they could be irregular in their pattern. They might also change, depending on what you’re doing or the position you’re in. For example, if you lie down or sleep, you might notice they slow down or stop. This is normal in the latent phase of labour.
Once the cervix becomes shorter and softer, then it can begin to dilate and open. As this happens, your baby can move lower and, when ready to be born (in the second stage), the baby will move into the birth canal for a vaginal birth.
What happens in active labour?
As the active phase of labour begins, your body is really working hard to prepare for your baby to be born.
In spontaneous labour, contractions will gradually intensify. Your body is moving your baby lower into the uterus and opening the cervix, so your baby can be born.
The uterus is a big muscle and now has a huge job to do. Not only will you notice your labour contractions becoming stronger, you might also feel them differently in the uterus. Early labour contractions focus on the lower part of the uterus but in active labour, contractions will start from the top.
As you reach transition towards the end of the first stage of labour, you’ll start to feel the expulsive nature of your contractions, as your body gets ready to push your baby out. Once full cervical dilation has occurred and you get to the pushing phase, this is known as the second stage of labour.
During active labour, your baby will be getting into the best possible fetal position for birth. You can also help, by changing your position regularly. This helps encourage your baby’s head and body into a good position.
Whether you’re giving birth at home, a hospital, or birth centre, your midwife will be able to help you get into a position that feels right for you.
How to identify active labour
Let’s look at the different characteristics of latent and active labour, and see how they compare.
The features of the latent phase are:
- An irregular pattern of contractions, which might stop and start
- The pattern might be changed by certain activities or positions
- It can be a slow process
- The cervix dilates from 0-4cm
- Shorter contractions that last 10-40 seconds
- Longer gaps between contractions, which might be every 5-10 minutes
- Contractions are felt in the lower abdomen and might feel like strong period pains
- You are able to breathe through them
- Loose bowel movements are common in early labour
- You might lose your mucus plug or ‘show’
- You might experience your waters breaking
- You feel able to eat and drink relatively normally
- You can talk freely in between contractions.
The features of the active phase are:
- A regular pattern of contractions, which are unlikely to stop and start
- It is less likely to be altered by change of positions or activities
- The cervix dilates from 4cm-10cm
- Contractions will be closer together – maybe every 3-4 minutes
- They are felt from the top of the uterus
- Contractions feel stronger and more intense
- You need greater concentration and support to breathe through them
- You might lose a ‘bloody show’ as the cervix begins to open more
- You might experience your waters breaking, if they haven’t done already
- You might feel nauseous
- You are less likely to want to eat
- You might feel rectal pressure or a need to open your bowels as the baby gets lower
- You might become more withdrawn or feel the need for quiet in between contractions.
Duration of active phase of labour
It’s natural to wonder how your long labour will be. It’s a question that’s very difficult to answer, as no one can predict exactly what will happen during labour.
For more information, you can read How Long Does It Take To Dilate From 4cm to 10cm?
There are certain factors that will influence the length of labour, including whether or not you’ve had a baby before, and the position of your baby’s head.
However, according to NICE guidance in the UK, active labour for nulliparous women (women giving birth to their first baby) will last, on average, anywhere between 8 and 12 hours, and is not likely to go longer than 18 hours.
Women who have had a baby before (multiparous) will most likely have a much shorter labour. Labour typically lasts around 5 hours, and is unlikely to go beyond 12 hours.
To find out more, read BellyBelly’s article How Long Does Early Labour Last? What You Should Know.
How can I keep labour progressing?
Typically, once the active phase of labour has begun, for most women labour will keep progressing naturally without the need for them to do anything particular.
However, it’s important to try to keep labour as undisturbed as possible. This enables a number of important birthing hormones to work their magic and keep everything moving along.
For more about this, read: Undisturbed Labour – What Is It And Why Aim For One?
For some women, labour might need a little encouragement to keep things moving.
Here are some things you can try:
- Eat. Fuelling your body is important to keep it working efficiently
- Stay hydrated. Dehydration can affect the pattern of labour contractions
- Empty your bladder. A full bladder can stop your baby from getting into a good position
- Change positions. This will encourage your baby into a good position, and changes the dimensions of the maternal pelvis, creating more space for your baby to be born
- Try some relaxation techniques or breathing exercises. Taking a few minutes to focus on your breathing and staying as calm as possible will help reduce adrenaline, which can slow your labour
- Use physical touch. Kissing, cuddling, or massage techniques all help release the hormone oxytocin, which is responsible for labour contractions
- Water Birth. Evidence suggests the use of water in labour and birth reduces the need for pain relief medication or epidural analgesia, which can slow labour progress
Arrested active phase of labour
Unfortunately for some, the things mentioned above will not be enough to keep their labour progressing. If labour gets ‘stuck’ at a certain point, without progression, or with very little progression, this is known as a stalled or arrested labour, or labour dystocia.
There might be maternal or fetal indications as to why labour has stalled.
In that case, women will require some form of clinical management, or labour augmentation and close monitoring, in a birth centre or hospital, to improve their labour outcome. Close attention will be paid to the mother’s observations such as blood pressure, temperature and pulse, as well as the baby’s heart rate, to ensure the safest possible maternal and neonatal outcomes.
Can I be 4 cm dilated and not be in labour?
It’s possible for the cervix to be 4cm dilated, but for a woman not to be in labour. This is particularly true for women who’ve had babies before. After a woman has had a baby, the cervix often remains slightly open, even years later. This can mean that it could already be dilated, even before any labour contractions begin.
It’s also possible to be 4cm dilated, but not be in active labour. Even if the cervix is open to 4cm, you might not be experiencing a regular pattern of contractions yet. Again, this is more common in women who have had babies before.
How much time do I have after my waters break?
For most women, labour will begin with contractions. For some, though, the waters breaking will be the first sign of labour beginning.
For more information, you can read Waters Breaking – What To Do When Your Waters Break.
If your waters break before your contractions have started, this is known as Premature Rupture Of Membranes (PROM). This occurs in about 8-10% of full-term pregnancies.
About 60% of women will begin the labour process within 24 hours of their waters breaking. 95% of women will go into labour within 4-5 days of their waters breaking. However, the risk of infection increases the longer this time frame goes on.
Once the waters break, your baby is no longer in a sterile environment; therefore, there is an increased risk of developing an infection, known as chorioamnionitis.
If your waters break after 37 weeks, research suggests it could be safe to wait up to 48 hours; however, some health care providers might follow different protocols – for example, waiting up to 24 hours, or offering an induction or augmentation of labour straight away.
If labour hasn’t begun naturally after this time, you might be offered labour induction, to speed up the process and to reduce the risk of you or your baby developing an infection.
Are babies active during contractions?
Your baby should still be active during labour, whatever stage or phase you are in.
Feeling your baby’s movements is a reassuring sign of her overall well-being, which should continue as she makes her way into the world.
You might not feel the baby move during contractions as space and movement will be slightly limited; however, it’s normal to feel movements in between contractions.
If ever you have concerns about your baby’s movements, speak to your care provider straight away, as this could be an early indication of fetal problems.