Early Stages of Labour

When you believe you are in early labour it is important that you make sure you have everything prepared, including:      

• Bag packed (including hand held notes and birth preferences) and made easily accessible https://www.nhs.uk/pregnancy/labour-and-birth/preparing-for-the-birth/pack-your-bag-for-labour/
• Childcare arranged and availability confirmed
• Transport arranged

We recommend trying the following strategies before coming to the hospital which all aim to increase your levels of natural oxytocin (see section Why is Oxytocin important?). Stay as relaxed as you can and try to distract yourself from focusing on the contractions.

The following strategies have been found to help during the early stages of labour and may need to be repeated or continued:

Make yourself comfortable - Start by making your surroundings comfortable - you could try dim lighting, candles ( not a naked flame if in hospital), blankets, music, your favourite snacks.

Keep upright and mobile - Take a leisurely walk and keep mobile. Upright positions (such as standing, squatting and kneeling) use gravity to encourage your baby to descend into your pelvis.

Watch television or films This acts as a distraction and gives you something else to think about. Something that makes you laugh is best as this will increase your endorphins and help you relax. You can sit on a birthing ball to encourage your baby to descend, if you have one.

Take a warm bath or shower. Warm water can help to reduce the sensations of discomfort and help you to relax throughout labour. Make sure you are keeping hydrated if you are in warm water for long periods of time. You could also consider using a hot water bottle.

Rest when you can. If contractions are irregular, slow down or stop, have a short nap or a lie down. Although upright positions are excellent, this stage of labour can take time, therefore it is important to try to sleep when you are able to do so. You may find it challenging to sleep during contractions but try to rest in between. Side-lying positions can be more comfortable as they also take pressure off your back. You can place a pillow or cushion between your legs to help make you more comfortable, and help keep your pelvis open for baby to navigate whilst you rest.

Try relaxation techniques. Keep your breathing quiet and sigh out slowly during contractions. Breathing techniques can be effective to focus your attention and make the sensation more manageable. When you feel a contraction, focus on slowing your breathing and relaxing any tension in your muscles. Drop your shoulders, relax your jaw, slowly breathe in through your nose and out through your mouth. It can help to have a birth partner to gently remind you to do this. If you have done any antenatal hypnobirthing classes you may wish to use these techniques.

Try massage or heat. Ask your birth partner to give you a massage. Use your TENS machine if you plan to use one. They can be purchased or hired and may be effective at relieving the sensation of pain. Put a heat source, wrapped in a small towel on areas that ache. Be careful not to burn yourself through direct application of heat onto your skin.

Try a birthing comb. A birth comb can be an excellent coping strategy to help distract you from the contractions and focus on a different sensation. It works on acupuncture points and is especially effective as it can be used in combination with other therapies such as water, mobilisation and massage at the same time.

Consider alternative therapies Our Midwifery Led Unit staff can discuss the use of aromatherapy with you.

Change your position frequently. You can use items such as birthing balls, pillows and bean bags to find positions that are most comfortable for you. Try doing circular movements whilst sitting on the ball.

Remember to eat, drink and pass urine regularly. Drink plenty of fluids. Especially water or squash. Occasional isotonic drinks and caffeinated drinks are fine but too many can cause dehydration and nutritional imbalance. Eat little and often – carbohydrates like bread or pasta and sugary foods are best. There’s no strong evidence to indicate that certain foods are more effective at speeding up labour, however you can eat whatever you prefer at this stage. Remember to go to the toilet regularly to pass urine, as a full bladder can slow down labour by obstructing your baby as it tries to enter your pelvis.

Consider taking pain relief. Paracetamol can help relieve some of the pain in the early stages of labour. However, there is a suggestion that paracetamol may slow your labour progression, as it can hinder production of prostaglandins which help to dilate the cervix.

You can take paracetamol according to the instructions on the packet.

If you weigh >50kg you should take 1000mg (1 gram) of paracetamol every four to six hours. You can take a maximum of 4 grams per day. If you weigh <50kg you should take 500mg (½ a gram) of paracetamol every four to six hours. You must not take Ibuprofen when you are pregnant/ in labour.    

Birth Partners- It is helpful if you have a supportive birthing partner with you. This should be someone who is happy to be with you throughout your labour. Choose someone who has a positive attitude about birth and who you feel totally relaxed, confident and comfortable with. We welcome two birthing partners to Labour Ward and the Midwifery Led Unit.

Our staff are available 24 hours a day to offer advice and reassurance so you can call us anytime you feel you need to. If the strategies above are no longer working, you have any questions or concerns or you would like to be seen, you can telephone Maternity Triage 01270 273116 or you are welcome to attend the maternity unit for assessment. If you have planned a homebirth the midwife will come out to your home to do this assessment. A Midwife will look at your maternity records but please let them know if you have experienced any problems or complications during your pregnancy.

If you have any additional needs or require reasonable adjustments, please let us know when you call.

Examples of reasonable adjustments can be found at birthrights.org.uk/factsheets/disability-and-long-term-health-conditions-and-maternity-care/

Oxytocin is known as the ‘love hormone’ - it is one of the main hormones responsible for uterine contractions and is released when you are relaxed and happy, as well as during sexual arousal. If you are stressed or scared other hormones can inhibit oxytocin which can prevent progress in labour. To promote oxytocin, focus on relaxing as much as possible. This will look different for every person. Some people may be more relaxed at home, but others may prefer the reassurance of being in the maternity unit. You could also consider hand expressing / colostrum harvesting as oxytocin is the hormone responsible for the release of milk.

Please be aware that sometimes moving from your home to the hospital can temporarily slow down labour progress. This can be perfectly normal as you adjust to your new surroundings.

When you become tense and anxious your body can respond by thinking there may be something wrong. It responds by releasing a hormone called adrenaline which can slow labour and your body also sends blood to the arms and legs and not as much to the abdomen. This can make it harder for the muscles of the uterus to do their job during contractions and again it can slow the process down.

The increase of adrenaline can cause your stomach to not work as efficiently, which reduces the amount calories you absorb. This can lead to you running out of energy, which can slow the labour process down. So, by feeling anxious and stressed the contractions often feel more intense but they may be less effective.

When you are relaxed and breathe contractions through, the good labour hormones are released to keep the labour going and help you to manage.