Stage One Labor - The Latent Phase*

Welcome the latent phase of Stage One Labor.

I think the terminology around “early labor” is confusing. Medical caregivers, texts and some childbirth educators refer to the period of labor that you have been working through by varying terms: pre-labor, false labor, practice labor and early labor.

Those sensations were most definitely part of the labor process and why I think these contractions deserve credit for the relatively painless hard work of readying your baby and cervix that they perform, so I label this period as Early Labor.

However, most texts and childbirth educators refer to the beginning phase of Stage One Labor as Early Labor which I think is confusing as you have already been in Labor for some time at this point.

So I have decided to use a more medical term “latent” for the first phase of Stage One Labor. At this point progressive contractions are present but labor is not fully developed. I feel this definition is a more accurate description of this this first phase.

It gives better markers between determining non-progressive contractions from the contractions that are making progress. It also gives a good marker in distinguishing Latent from Active.

The latent phase is characterized by persistent contractions takes your cervix from 3cm-5cm, these contractions effect measurable change albeit sometimes this change is slow and subtle.

Those early contractions that you have been experiencing sure feels like labor to your body, but you need to realize that your caregiver is likely looking for signs and symptoms other than the presence of contractions.

The most reliable sign that your labor is progressing is the steadily increasing of cervical dilation.

Your medical staff will not label your labor active until after you pass the 5cm benchmark.

Stage 1 Labor is determined by these three markers:

The regular progression of uterine contraction.
The effacement and progressive dilation of the cervix.
The progress in descent of the presenting part.

During Latent phase your body will make more progress in the effacement and dilation of your cervix, descent, while occurring, will remain slow. This is the longest phase of Stage One labor.

This phase of labor according to Friedman’s curve averages out at about 6-8 hours in length. This is the old rule of thumb, no longer officially recognized by ACOG but it very well may still be the clock that your caregiver is using to time your labor.

These contractions will feel even more intense, something in the range of a mild to moderate menstrual cramp and you may begin to feel more pressure as your baby moves down into your pelvis. They may even remain irregular at this point, ranging from 5-30 minutes apart and last around 30-45 seconds. They are annoying but not exhausting.

Hormones will be flooding your system which will help you disconnect from the real world. You will start to loose track of time and this is a positive appropriate response to labor.

As your detachment increases with the progress of your labor you will find yourself in a flow-like state. Exactly where you want your mind to be, in the moment, with your experience.

Women who ambulate and assume upright positions and change positions frequently during labor tend to experience a shorter first stage. Positive Appropriate Action.

Another appropriate response to these contractions is to apply counter pressure. Counter pressure relieves pain just as stepping on a stubbed toe does, it deadens nerve pain signals. Lower back massage and the squeezing in of the hips also are beneficial here.

Your breathing is likely to change dramatically, Labor requires long slow deep breathing. You will find a dramatic difference between contractions you “fight” and contractions you “release” into.

The instinct to tense up and fight contractions will rise up again and again. Notice the contractions that you “fight” by tensing up around them—they feel worse and more painful.

Notice the contractions that you surrendered into relaxing around them—you will no doubt have found the pain more manageable and the contraction bearable.

The positive affirmative action is to develop a little ritual that helps you find your rhythm, your focus and helps you to remain relaxed. Your birth team can all assume roles at the beginning of contraction so that you can remain comfortable and focused. It is the difference between coping and suffering.

As your labor intensifies you may find it helpful to use the Yoga Based Birth Skill of Vocalization. It is appropriate and positive to give voice to the sensations you are feeling, but you need to let go of high pitched sounds. Upper register sounds draws your body in and up, modulate your sounds to your lower range as they typically release your body down and out.

Find the sounds and phrases that work for you, prepare before labor and practice becoming comfortable of making these types of sounds in front of others. It is not so much what you choose to say that is important it is instead the repetitive nature of the sounds that makes it helpful.

Alternatively you may find yourself becoming more meditative, taking a concentrated journey inwards, your support people may have less to do but no doubt you will find their presence vitally important.

It is vital that they are the people that you make you feel safe, they “hold the space” and therefore you are free to let go, surrendering yourself totally to the process.

As labor is now taking the majority of your focus, you will find yourself getting annoyed by questions that require thought. If you have prepared your birth coaches well then this is the time they will begin offering you hydration, and comfort measures without asking if you want them. Think sticking a straw between her lips and modeling breath patterns.

In Stage One Labor you cannot make “real” choices. Prepare your support team so that they know your preferences and can answer on your behalf, you simply need to nod your consent.

This is the moment that women find themselves getting trapped into interventions that they neither need or particularly want by being forced into responses that require rational thought, at precisely the moment you need to surrender into the Labor process and let go of thinking.

You may even find yourself giving an unintended response, just so they will stop talking, just attempting to answer these types of questions interferes with the natural process. Your birth team should know your answers and if they do not, prime them to ask for a private moment to discuss your options, before any real decision is made.

I attended a birth just the other day, the doctor asked a question of my client during an intense moment in her labor, if she wanted him to check her progress. It became apparent after he left the room that she had been completely unable to focus on his question and gave an answer about pain relief (which was at the top in her mind), not what her doctor was asking at all.

The latent phase of Stage One labor is the longest part, it takes the most time.

You will find that things typically move a little faster once you pass 6 cm and you are officially classified as a woman in Active Labor, the second phase of Stage One.

So we progress…

*Childbirth Physiology Resources for this post