The early phase of 1st stage is usually when the contractions start to become regular and more painful. Some women will need to stop and breathe with some of the stronger contractions in the early phase. During this time the cervix is very thin and opens (or dilates) to about 3- 4cm or more.
Image 3-03 shows the thin cervix now opening (or dilating) to about 3 to
4 cm.
Active phase of 1st stage or established labour
The active phase of 1st stage is when the contractions become stronger, and closer together. Most women need to breathe and work with them now, (perhaps pain relief is crossing their mind). During this time the cervix is opening (or dilating) from about 4 cm to around 7- 8cm. The terms 'active 1st stage' and 'established labour' essentially mean the same thing. Established labour is the term predominantly used by most caregivers.
Image 3-04 shows the cervix now open to about 7 to 8 cm.
End of 1st stage or 'transition'
Towards the end of the 1st stage or 'transition', the contractions generally become very strong, close together (or for some women back to back, with little to no rest in between). Many women experience vague urges to push, or feelings of pressure in their bottom, as the baby's head moves lower down into their vagina.
The woman can often experience feelings of being 'out of control' or not wanting to 'do it anymore'. Some women make lots of noise, or will moan or grunt at this time. The woman may seriously contemplate pain relief in transition, but often when they know they are nearly there, they are motivated to keep going. During transition the cervix opens from about 7- 8cm to 10 cms (or 'fully dilated').
Image 3-05 shows the cervix almost fully open, with the bag of waters bulging down in front of the baby's head.