Prodromal labour: what it is and how to recognise it

April 4, 2024 Manuel Fernández

The birth of your baby is approaching, and you're wondering whether you're having prodromal labour or labour contractions, and whether you should go to hospital. It's a very common doubt. That's why our team of midwives has prepared the following post for you. With the latest evidence on prodromal labour.

Prodromal labour, the dilation phase

To start with, we need to distinguish the three stages that take place during the process of labour, and they are:

The dilation phase
The expulsive phase
The placental delivery phase

And as our subject is prodromal labour, we will focus more on the dilation phase. As it is the longest stage of the whole labour process, taking up to 90% of the total duration.

What is the dilation phase?

The dilation phase is the phase that goes from the start of the first contractions, known as the prodromal stage, until the full dilation of the cervix, which is 10 cm.

How does the dilation phase progress?

This phase is different for every woman, and even in each woman it can be different from one pregnancy to the next, but generally speaking it follows a series of stages.

First stage of dilation, latent phase or prodromal phase

Also known as the latent phase of labour or the prodromal phase. It is the one that begins when contractions start to appear with a mild or moderate intensity, which are normally well tolerated. And with an irregular frequency and duration.

During this period, your cervix will go through two processes: on the one hand, it will gradually shorten, which is what we call in gynaecology effacement of the cervix. And on the other hand, the dilation of the cervix itself also begins, reaching up to 4 cm.

And if we talk about the duration of this first dilation phase, it can vary depending on whether it is your first labour or whether it is a second or third one. Bear in mind that for a first labour, the first dilation phase or latent phase can last up to 20 hours, and that would be normal. And for mums who have already had a labour before, this phase can last around 14 hours.

To finish with the latent phase of dilation, we have to mention that we should not confuse it with false labour. This "false labour" is characterised by contractions that are infrequent and of irregular intensity, which will not increase and which will be focused mainly on the lower abdomen. What's more, these contractions will often ease with rest or walking around.

Second stage of dilation, active phase of labour

This second dilation phase is known as the active phase of labour. It happens when the neck of your womb reaches 4 cm of dilation, and it ends when it reaches 10 cm, in other words, full dilation.

During this phase, the contractions will become more and more frequent, with a longer duration and greater intensity. This speeds up the process of dilation, with an average of 1.2 cm per hour in mums who are in their first pregnancy and 1.5 cm per hour in mums who have had a labour before.

Although you should bear in mind that on many occasions, this progression in the dilation of the cervix, does not follow this pattern. So we should not generalise or worry if it is not the case, and it is essential to remember that this process of dilation is individual and unique for each woman.

If I have prodromes, does that mean I am in labour?

As we mentioned earlier, during the phase of prodromal labour or the latent phase, which is the first phase of dilation of the cervix, irregular contractions occur in timing and frequency, and with a moderate intensity that will be the start of the process of dilation, but it does not mean that you are in labour. Instead, you will be at a previous "preparation" stage. These are your prodromes, and now you will be closer to meeting your baby, but there are still other phases to go through.

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If I have prodromal labour, should I go to hospital?

During the prodromal phase, admission to hospital is not recommended. The recommendation that clinical guidelines give to us in labour wards is to advise pregnant women to keep active and adopt positions that can ease or control the pain.

During the active phase of labour, when contractions are longer, more frequent and rhythmic, you should go to hospital. By then, your cervix will be dilated to 3-4 cm and effaced (shortened) by 50%. This means it will be halfway to fully effaced. When you arrive at hospital, we will assess you and admit you if you are in the active phase of labour.

You will be given all the information about the situation you are in and the best alternatives to approach your labour just as you wish, and it will be interesting for you to have noted it down in your birth plan. And if you haven't done so, don't worry: we midwives and the gynaecology team are fully aware of respecting maternal wishes and we will be the best professionals to accompany you in this great moment when you are going to meet the love of your life.

Reasons to go to hospital

Below we give you a list of reasons to go to hospital:

The fact that your belly goes hard in a rhythmic way, and that it does not stop with rest, is an indication to go to hospital because labour has started.
It is recommended that admission to hospital takes place when the following criteria are met:
- Regular uterine activity (Regular contractions) Cervix (assessed at the hospital with a vaginal examination) Effacement of > 50%
- A dilation of 3-4 cm
If the waters break, even if you are not having contractions. If you have any doubts:
- Put on a sanitary pad and check that it gets slightly wet and that the loss increases with movements or coughing; however, if the colour is not clear, go as soon as possible, although without urgency, to rule out any complication.
Bleeding in an amount greater than a period.
- It should not be confused with light spotting, which is normal after a vaginal examination, nor with the passing of the mucus plug, which, as we mentioned earlier, could be bloodstained mucus.
A sudden drop in or absence of your baby's movements.

Conclusion on prodromal labour

As we always tell you, every case is unique, and you will need to adapt this information to your own individual situation. That said, if you have any doubts, go to hospital, you will not be the first or the last to go too early, and it does not matter. And whatever happens, we will always be here, happy to help you. Lots of strength for this final stage!