A guide to the first stage of labor: symptoms, signs, and how to manage them

Warning: The information in this article is for educational purposes only and is not a substitute for consulting a qualified physician.

Important medical notice

This content is for general health education purposes only and is not a substitute for professional medical advice. You should always consult your doctor or midwife regarding your pregnancy and childbirth. The information provided here is based on general medical guidelines, and the details of your personal experience may vary.

Understanding the first stage of labor

The first stage of labor is the period when your body prepares for childbirth, starting from the onset of early signs until the cervix is fully dilated (about 10 cm). This stage typically lasts 6 to 12 hours in a first pregnancy and may be shorter in subsequent pregnancies.

Key signs of the onset of labor

1. Regular and increasing contractions

Description: Uterine contractions begin regularly and increase in strength and frequency over time.
Distinguishing between Braxton Hicks contractions and true labor:
- Braxton Hicks: Irregular, usually painless, and disappears with a change of position.
- True labor: regular, increasing in intensity and duration (lasting more than 30-40 seconds), and does not stop with rest.
When should you call your healthcare provider? When contractions become regular every 4-5 minutes and last for about a minute, for at least an hour.

2. Excretion of the mucous plug

Description: A small amount of thick mucus, which may be clear, pink, or mixed with light streaks of blood.
Meaning: It indicates that the cervix has begun to thin and widen.
Important note: This may occur days or hours before active labor begins and does not require going to the hospital on its own.

3. Rupture of membranes (rupture of membranes)

Description: A sudden flow or continuous leak of a clear, odorless liquid.
What needs to be done immediately:
1. Note the color of the liquid (it should be clear or light pink).
2. Record the time of the tear
3. Contact your healthcare provider immediately.
Urgent medical warning: If the fluid:
- Green or brown: This may indicate the presence of meconium (fetal stool).
- Bright red: Contains a large amount of blood
- Odor: May indicate infection
- In all the above cases, call emergency services or go to the hospital immediately.

Stages of the first stage of labor

Early stage (latency)

Expansion time: 0-3 cm
Contraction duration: 30-45 seconds
Repetition: Every 5-30 minutes
Tips for dealing with it:
- Try to relax and sleep if it's nighttime.
- Eat light, easily digestible meals
- Drink fluids regularly
- Take a warm bath to relax
- Engage in light activities such as walking

Active phase

Expansion time: 4-7 cm
Contraction duration: 45-60 seconds
Repeat: Every 3-5 minutes
Tips for dealing with it:
- Go to the hospital or birthing center
- Use breathing techniques (deep inhalation and slow exhalation)
- Change your positions (walking, sitting on a birthing ball, kneeling)
- Ask your birth partner for help with massage.

Transition phase

Expansion time: 8-10 cm
Contraction duration: 60-90 seconds
Repeat: Every 2-3 minutes
Common symptoms:
- Strong desire to pay (tell the midwife and only pay on her instructions)
- High temperature
- Nausea or vomiting
- leg tremors

General tips for dealing with the first stage

Self-support:

Movement: Regularly changing positions helps the baby descend and advances labor.
Hydration: Drink water and natural juices regularly.
Energy: Eat snacks rich in simple carbohydrates
Relaxation: Use breathing techniques, meditation, or calming music.

Support from the birth partner:

Providing emotional support and ongoing reassurance
Assistance with breathing techniques
Back massage, especially in cases of back pain
Helping to change situations

When should you seek immediate medical help?

Contact your healthcare provider or go to the hospital immediately if:

Bright red vaginal bleeding occurred (not just pink discharge).
The amniotic fluid (water on the head) was green, brown, or cloudy in smell.
You felt fewer than 10 fetal movements in two hours.
You had a severe headache, visual disturbances, or upper abdominal pain
Your temperature has risen above 38°C
You had very painful contractions with no rest in between.

Monitoring the fetus during labor

The healthcare team will do the following:

Regular fetal heart rate monitoring using Doppler or electronic monitoring
Regular cervical dilation checks
Assessing the strength and frequency of contractions
Monitor your vital signs (blood pressure, pulse, temperature)

Dealing with slow labor

In some cases, labor may need to be accelerated (hastened) by:

Artificial rupture of membranes: if the amniotic sac does not rupture spontaneously
Instillation of synthetic oxytocin: to increase the strength and frequency of contractions
Changing positions: To help the baby descend

The decision to expedite is made after a thorough assessment by the doctor or midwife, with a full explanation of the risks and benefits.

Reliable medical sources and references

This guide was prepared based on medical advice from the following sources:

World Health Organization (WHO)—Recommendations for birth care for a positive birth experience
American College of Obstetricians and Gynecologists (ACOG) - Prenatal Care Guidelines
National Institute for Health and Clinical Excellence (NICE) in the United Kingdom—Maternity Care Guidelines
International Council of Midwives (ICM) - Standards of Practice for Midwives
Centers for Disease Control and Prevention (CDC) - Maternal and Fetal Health Guidelines

Conclusion and reminder

Remember that every birth is a unique experience. Listen to your body, trust your healthcare team, and don't hesitate to ask questions. Focusing on breathing and relaxation can make a big difference to your experience.

For information tailored to your specific situation, always consult your doctor or direct midwife.

Medical disclaimer: This content is for educational purposes only and is not a substitute for consulting a doctor or nutritionist, especially for patients with high blood pressure.

🔗 Reliable Medical Sources & References (With Direct Links)

1. World Health Organization (WHO)

Intrapartum care for a positive childbirth experience
https://www.who.int/publications/i/item/9789241550215

WHO—Pregnancy, Childbirth and Postpartum Care
https://www.who.int/health-topics/maternal-health

2. American College of Obstetricians and Gynecologists (ACOG)

How Labor Progresses: First Stage of Labor
https://www.acog.org/womens-health/faqs/how-labor-progresses

Labor and Delivery Overview
https://www.acog.org/womens-health/topics/labor-and-delivery

3. National Institute for Health and Care Excellence (NICE—UK)

Intrapartum Care for Healthy Women and Babies
https://www.nice.org.uk/guidance/cg190

Stages of Labor—NICE Clinical Guidance
https://www.nice.org.uk/guidance/qs105

4. International Confederation of Midwives (ICM)

Essential Competencies for Midwifery Practice
https://www.internationalmidwives.org/our-work/policy-and-practice/essential-competencies.html

Midwifery Care During Labor and Birth
https://www.internationalmidwives.org

health topics

A guide to the first stage of labor: symptoms, signs, and how to manage them