The big variable in labour is the length of the Latent Phase of labour. This is often determined by the position of baby rather than size. In some cases, the latent phase can go on for a day or two. For most women this will be very manageable, and in some cases you may not even know you are in latent labour – you may just feel more frequent and stronger Braxton Hicks than normal.
About 20 percent of women will have a painful extended labour because of the position of baby – the most common of which is called Occipito-Posterior, also known as back to back, or OP which means the baby is positioned on its back with its head facing skyward rather than facing down in the ideal position. OP can be diagnosed by careful examination of the tummy or a scan, or when in labour, by an internal examination. It is sometimes not diagnosed until labour begins. This OP position of the baby can lead to a long and painful latent labour which can really demoralise and discourage many women because they do not realise or had not anticipated being in such pain before active even labour begins. They may feel like they are in so much pain that they must be in active labour, but in fact it is just the softening and thinning of the cervix which is happening.
Even if this latent phase is painful you are not likely to be given an epidural until labour is fully established. The worry is that by giving an epidural too early, labour can stop and start and extend the latent phase even further, exhausting the mother and baby even further.
If you are risk free and the midwife or doctor is not concerned about your condition, you will be advised to stay at home until you are in established labour. If you have gone into the hospital you may get sent home, again, depending on any risk factors and how much pain you are in and how you are coping.
Try to sleep and eat if you can. If you can manage to nap or eat then it is not likely that you are in established labour. If you are hungry, a light meal is better than a three-course banquet, as your digestion will slow down as labour progresses and when active labour begins, your body will be keen to rid itself of excess food it is carrying! It will look for the quickest way to do this, and in some cases women find them selves vomiting during the active stage.
You can take oral painkillers such as Paracetamol, or your midwife may offer you Cocodramol. This may give a little relief to your pain. If you can, it is a good idea to stay active. Walking around can help with the pain and is a good form of distraction. It has been suggested that keeping upright and mobile can help labour to progress.
If you are at home a bath might help with the pain. If you are in hospital and your waters have not broken, you may get a chance to go in a Birthing Pool for a while. This can be a wonderful experience for some women and the pain relieving effects seem to be significant for many. (See Section on “Pain Relief during Labour”)
Using a TENS machine at this stage can also bring some relief. See our Section on Pain Relief.
Pethidine or Diamorphine may be offered to you if you are in hospital and in a lot of pain. See our Section on Pain Relief.
Gas and Air is not such a good idea for the latent phase of labour, it is more effective for the active phase.
Read about the next stage of Active Labour