In active labour, the contraction pattern becomes established and the body responds in a more coordinated way. Active labour is not assessed by how contractions feel, but by how they affect the cervix and how they develop over time. Contractions can be painful and regular without indicating active labour.

The midwife assesses the contraction pattern: whether contractions are regular, last for a similar duration and return at consistent intervals. In active labour, contractions gradually increase in intensity, duration and begin to affect the cervix. A vaginal examination may then show that the cervix is opening, softening and changing position. It is the effect on the cervix – not the level of pain – that defines active labour.

The baby’s position may also be assessed, as descent of the presenting part can indicate that the body is working more effectively. The condition of the pregnant person is also observed to see how the body responds to labour.

Active labour therefore means that contractions do not only cause pain, but lead to measurable changes in the uterus.

Alma’s tips 🌿

• During active labour, some choose to move between contractions, change position or stay upright if it feels manageable.

• Warmth, such as a shower or bath, is sometimes used to help cope with contractions in the active phase.

• Some find it useful to have a support person nearby who maintains contact with the midwife.

• A calm environment with reduced disturbance or dimmed lighting may help some people manage between contractions.