a. Latent or Prodromal Phase (Early).

In this phase, the mother feels slow, rhythmic contractions radiating from the lumbar region to the anterior portion of her abdomen. The contractions last from 30 to 45 seconds with the intensity gradually increasing.

The frequency of contractions is from 5 to 20 minutes. There is some cervical effacement. Dilation is from 0 to 3 cm. “Bloody show” is usually present. The mother is usually able to walk, talk, or laugh some during this phase. Diversion is usually welcomed during this time. This phase may not be included as part of the first stage of labor since it is before the onset of true labor.

True labor is considered to be at 4 cm. Duration of this phase varies, sometimes as long as 24 hours and is referred to as the “prolonged latent” phase. The mother may sometimes make some progress dilating from 1 to 2 cm and will then stop. She is usually not admitted to the hospital at this point unless the membranes are ruptured.

b. Active or Accelerated Phase.

In this phase, the contractions become stronger and last longer, usually 45 to 60 seconds. The frequency is from 3 to 5 minutes. The cervix dilates from 4 to 7 cm. This phase is considered the onset of true labor. The mother is admitted to the hospital at this point. She, then, becomes involved with bodily sensations and tends to withdraw from the surrounding environment. She is not able to walk, but, desires companionship and encouragement.

c. Transient or Transitional Phase.

In this phase, the contractions are sharp, more intensified, and last from 60 to 90 seconds. The frequency is from 2 to 3 minutes. The cervix dilates from 8 to 10 cm. Completion of this phase marks the end of the first stage of labor.

The mother may express feelings of frustration, loss of control, and/or irritability. Her focus becomes internal. She has difficulty comprehending surroundings, events, and instructions. There is an increase in bloody show as a result of the rupture of capillary vessels in the cervix and the lower uterine segment. The mother feels an urge to push or to have a bowel movement. This is considered the most severe and difficult phase for the mother.