Speeding up labour (2024)

When does active labour start?

• you are having regular, powerful contractions and
• your cervix is dilating from 4cm (1.6in) onwards (NCCWCH 2014).

How long is a normal labour?

If this isn't your first baby, you may have a shorter labour, though this isn't guaranteed. For women who have given birth before, the active first stage of labour lasts, on average, for five hours (NCCWCH 2014). It's unlikely to last for more than 12 hours (NCCWCH 2014).

The pushing phase of labour (active second stage) shouldn't usually take more than three hours, or two hours if you've had a baby before (NCCWCH 2014).

Bear in mind that a quick labour isn't necessarily better either for you or your baby (Rimmer 2014). Very fast labours can be physically and emotionally challenging (Rimmer 2014). However, a very slow labour can leave you exhausted and unwell (Harper et al 2014).

What counts as a slow labour?

A four-hourly check gives your midwife a good overview of how you're doing. Assessing you more often than that won't necessarily help her to understand more, and can lead to unnecessary intervention in your labour (NCCWCH 2014).

However, if you've had any health concerns during this or a previous pregnancy you may need continuous monitoring.

Your doctor or midwife will also want to monitor you if you've developed complications, such as meconium (your baby’s first poo) in your waters, or fresh bleeding (NCCWCH 2014).

Your midwife will place two electronic sensors on your bump, one to measure contractions and one to measure your baby's heartbeat. The sensors will remain there throughout your labour. Your midwife will still only check your cervix every four hours, though.

If your cervix isn't dilating at a rate of at least 0.5cm (0.2in) an hour over a four-hour period, speeding up your labour may be an option (NCCWCH 2014). This is also called augmentation of labour. Your midwife will discuss whether or not to speed up your labour with you and your doctor.

Each woman's labour is unique. Your wishes should be taken into account, along with what your midwife and doctor recommend is best for you and your baby (Jackson et al 2014, NCCWCH 2014).

Why might my labour be slow?

• You're dehydrated or exhausted (NCCWCH 2014).
• The position of your baby is making it harder for your labour to progress (NCCWCH 2014).
• You feel particularly scared or anxious. These emotions tend to interfere with the release of the hormone oxytocin, which can help labour along (Aral et al 2014, Simkin and Ancheta 2011).
• Your contractions are infrequent, not very strong, or staying at the same intensity rather than getting stronger (NCCWCH 2014).
• You've had interventions that have slowed your contractions. These could include having to stay still for periods of time, or having an epidural (NCCWCH 2014).

Bear in mind that the first 5cm of cervix dilation nearly always takes much longer than the second 5cm (Ehsanipoor and Satin 2019, Jackson et al 2014, Simkin and Ancheta 2011). Your cervix opens more quickly as your contractions get stronger.

How is labour speeded up?

If you agree to the procedure, here's how your midwife will do it. Once you're on the bed, she'll remove the last section of the bed so that your bottom is right at the end. She may ask you to put your legs up in stirrups, or just hold them apart.

Your midwife will then make a small break in the membranes around your baby. She'll use a long thin probe (amnihook) or a medical glove with a pricked end on one of the fingers (amnicot). She'll scratch the membrane until it bursts and the waters flow out into a tray placed underneath the bed.

This procedure isn't painful but it can be very uncomfortable. You'll probably be glad to get up again once it's over.

Your midwife will then check your baby's heartbeat using a Sonicaid or ear trumpet, to make sure that breaking the waters hasn't distressed him.

Your contractions may become much stronger after your waters have been broken (NCCWCH 2014). Be prepared to work hard with breathing and relaxation exercises. Or you can ask your midwife for some pain relief, such as gas and air, if you need extra help.

Hormone drip

If moving around or breaking your waters doesn't speed up your labour, your doctor may suggest a hormone drip to boost your contractions (NCCWCH 2014). This will contain Syntocinon, which is an artificial form of the labour hormone oxytocin.

If you have Syntocinon, your midwife will continuously monitor your baby's heartbeat by strapping electronic sensors to your tummy (NCCWCH 2014).

Your midwife may also recommend attaching a small clip to your baby's head. The clip is called a fetal scalp electrode and it may provide a more accurate reading than placing a sensor on your tummy. It also allows you to move around more easily.

Continuous monitoring is recommended because Syntocinon can over-stimulate your womb (uterus) (NCCWCH 2014). You may get very strong, frequent contractions, which could distress your baby.

You're also more likely to need help from pain-relieving drugs to cope with these artificially induced contractions. For this reason, your midwife should offer you an epidural before she starts a Syntocinon drip (NCCWCH 2014).

Can I speed up labour myself?

• If you're lying on the bed, get up! Being upright and mobile may strengthen your contractions, while also helping you to cope with them (Lawrence et al 2013).
• Take a walk to the toilet. A full bladder may slow down your labour by getting in the way of your baby's head descending (Simkin and Ancheta 2011).
• If you have access to one, get into a warm bath or birth pool. This can reduce your need for an epidural or spinal pain relief (Cluett et al 2018).
• If your baby is lying back-to-back, an experienced midwife may advise you to lie on your side or try kneeling or standing lunge positions. This may help your baby to rotate to a better position for birth (Simkin and Ancheta 2011).
• Have some private time with your partner. Turn the lights down low and have a cuddle, with some nipple stroking or breast massage. This may help your body to release oxytocin, the hormone that strengthens your contractions (Simkin and Ancheta 2011).

You can also ask your midwife whether she's certified in any complementary therapies, such as aromatherapy massage, that could help you.

What can help me to cope with a long labour?

• Use breathing and relaxation techniques to help you stay calm and focused (NCCWCH 2014). If you've been taking hypnobirthing classes, this is the time to use everything you've learned!
• Ask your birth partner to massage your back, or your feet, if you're sitting in a chair (NCCWCH 2014, Smith et al 2018).
• Listen to your favourite music (NCCWCH 2014).
• Eat and drink when you need to. Have a small snack, such as toast, and water, or an isotonic drink, to stay hydrated (NCCWCH 2014).
• Change your position. Later in labour you may not feel like walking around, but your midwife can help you to find a comfortable position (NCCWCH 2014).
• Listen to your body and try different positions (Simkin and Ancheta 2011). Move around or adopt positions that feel most comfortable to you as labour progresses (NCCWCH 2014).
• Ask your midwife to explain what's going on. If you feel involved and in control of your labour, you'll probably feel less anxious and more relaxed. This may make your labour easier to cope with, and you may find it a more positive experience (NCCWCH 2014).
• If your midwife is caring for other women as well as you because the unit is busy, continuous support from a student midwife may help your labour to progress. Your birth partner could ask if there's any extra help available (Bolbol-Haghighi et al 2016).

Learn more about what to expect from each stage of labour.