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The Latent Phase of Labour

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‘If you believe you will receive’

Having a baby is a unique moment in your life.  Women’s experience’s regarding the start of labour differ, and this will start in a variety of  ways (Gross et al. 2006). Gross et al.’s (2003) study suggested that for many women the onset of regular contractions does not coincide with what they perceive to be their onset of labour. Cervical changes at the start of labour vary from woman to woman (Albers 2001). The way in which women experience early labour has not been found to be associated with the duration of labour following admission to labour ward (Gross et al. 2010).
The latent phase of labour and its impact on labour as a whole, has until recently been poorly understood (Enkin et al. 2000), and the duration of this phase is very difficult to measure (Albers 2001). No two labours are the same.cervical dilatation
Women and their chosen birthing partners should be offered good education about the
latent phase during pregnancy. Furthermore its is well documented that Antenatal education can increase women’s likelihood of arriving in hospital in established labour (Maimburg et al. 2010).
Some women will experience a long latent phase that can be very overwhelming, these women will need extra encouragement and emotional support from their birthing partners and care givers in order for them to comfortably enter the first stage of labour.
The National Institute of Clinical Excellence (NICE) 2007 defines the latent phase as; period of time, not necessarily continuous, when there are painful irregular contractions; there is some cervical change, including cervical effacement and dilatation up to 4cm. Once a woman reaches 4cm dilatation it is recognised that she has reached the active stage of labour.
Understanding the latent phase and its impact on labour, will help you avoid early hospital admission. Studies have shown that women admitted to hospital in the latent phase have higher rates of obstetric intervention (Bailit et al. 2005).
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Here I explain the process of the Latent phase of labour Before labour starts, the neck of the womb (cervix) is long, firm and closed. Even before labour begins, the cervix can be drawn up and get thinner The ‘latent’ phase of labour is the very early start of childbirth. During the ‘latent’ phase the neck of the womb thins and opens up to about 3 – 4 cm. During this phase, the muscles of the uterus (womb) contract and make the cervix become flat and soft. This flattening is called ‘cervical effacement’ or thinning.The latent phase can last several days or weeks before active labour starts. Some women can feel backache or cramps during this phase. Some women have bouts of contractions lasting a few hours which then stop and start up again the next day. This is normal. Many women will not even notice the latent phase, others like myself will clean the house, top to bottom 3 times in one day and do all the washing and ironing like a crazy bird feathering its nest! After all labour is a primal experience and women traditionally would want to make a comfortable space to give birth.due date‘Braxton Hicks’ uterine activity occur’s all through pregnancy. They are tightening’s of the muscle of the uterus and last for about 30 seconds. They are usually painless. During the latent phase Braxton Hicks activity may become more noticeable and more frequent, lasting between 35 and 45 seconds; these will be infrequent with large gaps apart sometimes up to an hour, sometimes as close as ten minutes apart.  Some women like myself may experience the latent phase for a few days prior to the onset of labour this is especially true for your first baby.Remember your body already knows how to give birth. When you understand what helps or hinders’ the natural process you can create the right environment around you. Aim to visualise a positive outcome to your labour, such as holding your baby in your arms. Think positively about the strength and reliability of your body. Positive thoughts and meditation can really improve your ability to cope with this stage.

It helps if you avoid stimulating the ‘rational’ part of your brain during labour. This can override the ‘primitive’ part which produces endorphin’s (your own natural pain-relievers) and oxytocin (the hormone which is produced when you go into labour). in other words, focus on creative activities. Staying calm and feeling love and warmth are essential.  Oxytocin the love hormone enhances labour and keeps it going so keep your mind on all things love and all things baby.

Nutrition is very important the uterus is a very big muscle and muscles need energy in order to work efficiently so plenty of healthy snacks, and small meals. Muscles also require hydration many women make the mistake of not eating or drinking enough to keep topped up.

There are things you can do to help yourself, such as:

  • Pottering around the house
  • Taking a walk
  • Watching that film you’ve been meaning to watch
  • Taking a warm bath relax for at least 20 mins with soft lights and music
  • Keeping your breathing quiet and fluid – ‘breath in gently, sigh out slowly’
  • Trying massage – ask your partner or labour supporter to do this for you
  • Putting a hot water bottle on any areas that ache – your lower back, your tummy (under the bump) or between your thighs. Wrap it in a small towel first
  • Trying a soft gel sports injury pack which you have cooled in the freezer – this can help with backache
  • Use a Tens Machine
  • Always ensue that you keep hydrated and that you eat even if its small snacks the uterus is a muscle and muscles need food to work properly.

If your pains become stronger and you feel concerned then ring the delivery suite number given to you by you midwife.  As the next part of labour is called the ‘active’ phase. This is when labour has become established.Both the ‘latent’ and the ‘active’ phases take place during the 1st stage of labour.Eventually, at the end of the 1st stage, the cervix has opened to 10cm and is described as being ‘fully dilated’. [adtoappearhere]

You are a step closer to meeting your baby, Understanding that your emotions can effect labour will definitely improve your mindset and possibly the outcome for more info see my Fear Tension Pain Cycle blog. Remember your body is built to cope and staying relaxed really does help! Good luck you can do it..

If you liked this blog or have something to add then please leave your comments below we would love to hear from you.

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References
Albers L (2001) Rethinking dystocia: patience please MIDIRS Midwifery Digest 11 (3): 351-353
Bailit JL, Dierker L, Blanchard et al. (2005) Outcomes of women presenting in active versus latent
phases of spontaneous labour. British Journal of Obstetrics and Gynaecology 105 (1): 77-79.
Enkin M, Keirse M, Neilson J et al. (2000) A guide to effective care in pregnancy and childbirth
3rd ed. Oxford: Oxford University Press
Evidence Based Guidelines for Midwifery-Led Care in Labour ©The Royal College of Midwives 2012
8 Latent Phase
Gross MM, Petersen A, Hille U, et al. (2010) Association between women’s self diagnosis of labour
and duration after admission.Journal of Perinatal Medicine38: 33-38
Gross M, Hecker H, Matterne A, et al. (2006) Does the way women experience the onset of labour
influence the duration of labour? British Journal of Obstetrics and Gynaecology 113 (3): 289-94
Maimburg R D, Vaeth M, Durr J, et al. (2010). Randomised trial of structured antenatal training
sessions to improve the birth process. British Journal of Obstetrics and Gynaecology 117 : 921-928.

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