What happens during the latent phase?

Towards the end of pregnancy, most expectant mothers feel their uterus contract, becoming firm for a few seconds before relaxing again. These contractions are a form of training for the uterine muscles in preparation for labour. During the latent phase, the contractions become more powerful and are then referred to as labour pains. Initially, the sensation may resemble dull menstrual cramps, but the contractions in the latent phase last longer, occur irregularly, and are more painful. Contractions can last anywhere from 15-45 seconds, with pauses between them varying from minutes to hours, often quite irregularly.

During the latent phase, you are usually at home, but you can contact the maternity unit for advice. It can be a little tricky to know exactly what is happening, especially if you are a first-time mother. It is not uncommon for expectant mothers in the latent phase to have one or more visits to the maternity unit for checks, advice, support, and possibly help with pain relief.

It is entirely normal for the body to take its time, and for the latent phase to therefore feel long. A small number of expectant mothers do not notice that the latent phase is occurring, but this is unusual. Approximately ten percent of all labours start with rupture of the membranes, meaning your waters break.

Cervical changes

Before labour begins, the cervix is immature. In a first-time mother, it is approximately three centimetres long and feels firm when the midwife examines it. The immature cervix is positioned posteriorly, but during the latent phase, as the cervix begins to soften, it turns anteriorly to start dilating and eventually effacing.

Bleeding during the latent phase

Small amounts of bleeding mixed with mucus, known as show, are completely normal throughout labour. Show is due to changes in the cervix as it softens, ripens, and dilates. If you experience heavier bleeding without mucus, accompanied by persistent abdominal pain, you should always call the maternity unit for advice. You can also call if you feel worried or are unsure whether bleeding is show.

Emotions during the latent phase

It is common to experience many overwhelming emotions during the latent phase, such as excitement, fear, anxiety, happiness, and frustration, to name a few. If you are a first-time mother, everything is new and may feel incomprehensible. If you have given birth before, you might recall difficult experiences from a previous labour. Remember that all emotions are normal; what feels easy for one person can feel very difficult for another; there are no right or wrong feelings.

When the latent phase has been ongoing for 24 hours, fatigue and frustration are common. It is important to seek support from the maternity unit to help you cope throughout the process and to receive confirmation that it is normal for the body to take its time. Everything that happens during the latent phase is individual and can be described as a maturation phase leading up to active labour.

Active labour

The next phase is active labour, when the contractions change in character, becoming more regular and even more painful. It is common to have three to four contractions every ten minutes. It is the examining midwife who determines if you are in the active phase of labour.

What can I do at home during the latent phase?

• Rest and relax – which often feels safest in your home environment
• Breathe through the entire contraction – good practice for active labour; pause and breathe calmly when a contraction occurs
• Take warm baths or showers
• Receive a massage
• Use a TENS machine
• Use a heat pack – although some prefer cold for pain
• Take paracetamol if the pain is too difficult to manage
• Eat and drink, perhaps a favourite beverage
• Practice relaxation techniques, breathing exercises, and perhaps pregnancy yoga

When should I contact the maternity unit?

• Always call the maternity unit and speak to a midwife before you leave home. You will receive support and advice on everything that is common during the latent phase, such as concerns about different types of contractions, rupture of membranes, or how the baby is moving.
• Call if you feel concerned about bleeding, for example, fresh bleeding accompanied by persistent abdominal pain.
• Call if your waters break or if you suspect they have broken.
• Call when the contractions become more painful than before and occur regularly at three to four-minute intervals.