While consulting your notes, the midwife will ask you questions about your labours progress — whether your waters have broken and how often your contractions are coming.

You will be asked to undress and put on a hospital gown or your own T-shirt or nightdress.

You will then be examined; the midwife will palpate your abdomen to feel the baby’s position; she will listen to the fetal heartbeat, take your blood pressure, pulse and temperature and give you an internal examination to see how jar your cervix has dilated.

You will be asked to give a urine sample to test for the presence of protein and sugar.

You 11 be asked when you last had a bowel movement and it may be suggested that you have an enema or a suppository (although this is no longer routine in many hospital).

You then have a shower or bath and are shown to the first stage labour room. If you have any questions or you want to make your feelings known to the staff, now is the time to remind them of your birth plan.

Every woman’s experience of labour is unique, and the time span can’t be predicted. However, an average labour lasts about 12—14 hours for first-time mothers, and about seven hours for subsequent labours. If your first labour lasts longer than 12 hours, or in subsequent labours nine hours, your obstetrician may intervene.

The first stage of labour can be regarded as having three separate phases. The early, or latent, phase is the longest, lasting about eight hours for first babies, during which the cervix is softening and you will feel contractions occurring with increasing frequency and length. Try to conserve your energy during this time.

The next, active phase when the cervix is dilating, is shorter, lasting from three to five hours, and this is when your contractions become more painful, and you may want pain relief. The final phase of dilatation (sometimes called transitional) is the shortest and most intense, usually lasting under an hour, and comes just before you begin to push.

Your Cervix Dilates

The normally tough cervix must be stretched thin and opened wide before your baby`s head can pass through. The contractions of the first stage of labour achieve this.

Before labour

Your cervix is normally thick and closed, but has been softened by hormones during pregnancy.

Early (Latent) phase

Your cervix begins to thin (efface) before it can stretch and dilate.

Active dilatation

When your cervix is about 5cm (2in) wide, it is halfway to full dilatation and delivery.

End of the first stage

Your cervix is fully dilated when it is about 10cm (4in) wide. Now the head can descend.

However anxious and overwhelmed you are, you must stay calm and reassure her – she needs to feel confident and relaxed. Encourage her to take up any positions in which she feels most comfortable and to eat and drink if she feels like it. Speak quietly and keep any onlookers at bay.

Between contractions

Turn up the heating in the room if at all possible. Wash your hands thoroughly in soap and water, and then fetch several clean bath towels and place them conveniently to hand. Fold one and put it on the bed or floor so that you have something soft on which the baby can be laid.

Then fill several bowls with hand-warm water, and collect as many clean hand towels, face flannels or tea-towels as you have; immerse these in the water and use as wipes for mother and baby during and after delivery.

The birth

Your partner will know when the baby is coming because she will feel a stinging or burning sensation as the baby stretches her vagina. After washing your hands thoroughly again, look to see if you can see the top of the baby’s head in the vaginal outlet. Remind your partner to pant or blow, so that her vagina and perineum have time to thin and stretch, which may enable her to avoid tearing.

The baby’s head will probably be born in one contraction and the rest of his body in the contraction afterwards. When the head is born, wipe each of the baby’s eyes from inside to outside with separate pieces of moist linen, and then feel round his neck to see if the cord is present. If it is, crook your little finger underneath it and pull it very gently over the head, or lift it so that the body can be born through the loop.

Do not cut the cord because it may go into a spasm and deprive your baby of oxygen. If the membranes (called the caul) are still present over the baby’s face, you must gently tear this off so that the baby can breathe.

Delivery of the Placenta

If the placenta is delivered before an attendant arrives:

Never pull on the cord or cut the cord.

After the placenta comes out, massage the mother’s abdomen firmly, with a deep circular motion, gently pushing downwards 5-7cm (2-3in) below the navel. This is important to make sure the uterus contracts and stays hard after the birth without hemorrhaging.

Its normal for a couple of cups of blood to be delivered when the placenta comes out.

Getting the mother to nurse her baby immediately will help contract the uterus and minimize blood loss.

AFTER THE BIRTH

Be careful to hold the baby firmly as he is born, because he will be slippery with blood, mucus and a waxy substance called vernix caseosa. Once he is born, he will probably give a couple of gasps, a cry, and then start to cry properly If he doesn’t cry immediately, place him across your partner’s thigh or abdomen, with his head lower than his feet, and then gently rub his back. This helps any mucus drain away and usually causes a change in blood pressure, which will bring about his first breath. Talk to him lovingly.