The kind of pain you’ll experience during contractions can vary. It may feel like a thick band being squeezed around your abdomen as the uterus hardens and tightens for several seconds before relaxing. Some women compare it to severe menstrual cramps, others experience backache, but there may be a combination of sensations as the contraction peaks and then subsides.

Individual response

You may prefer not to use certain drugs during your labour as they can dim your awareness of what is happening; however, it is very difficult to know the level of pain you can manage without relief, particularly if this is your first baby. Some women are surprised by the overpowering intensity their contractions, others may find their pain worsen through fear and anxiety.

Analgesia, such as epidural anaesthesia can offer complete relief of pain, while gas and oxygen and narcotics help reduce pain to bearable levels. Many opt for no drugs in the early part of the first stage, then have gas and oxygen towards transition. Don`t be self-critical if you do need drugs for pain relief it isn’t a sign of cowardice. Remember, labour isn`t a test, and drugs may even be essential to deliver your baby.

If you wish to have full participation in your baby’s birth without dimming your consciousness of the physical and emotional sensations, there are alternatives to drugs for pain relief.

A clear choice

Find out as much as possible about the types of pain relief that will be available. Have a discussion with your doctor, midwife and hospital attendants, and then outline your choices in your birth plan. Be prepared for your plan to change if any complications arise.

How drugs affect you

Apart from offering pain relief, drugs can affect your experience of childbirth in other ways. Make sure you opt for the type that will help enhance, rather than detract from, the pleasure of your baby’s birth.

Drowsiness

This is a common side-effect of gas and oxygen, tranquillizers and narcotics. Some women enjoy the sensation of drifting, but sometimes this can make mothers feel they lack control A few women have become so lightheaded they were unaware of what was happening around them, and gave birth without realizing it had happened.

Dizziness

Pethidine and other narcotics can sometimes induce a feeling of confusion, or disorientation, and some mothers have even had hallucinations.

Nausea

The sensation of nausea is usually slight with gas and oxygen, but is quite common after using pethidine and other narcotics, and a few mothers may suffer attacks of vomiting.

Your state of mind can have a major effect on the intensity of pain experienced in labour. So if the use of drugs will make you less anxious and more relaxed, there is no point in depriving yourself since excessive tension can affect the uterus, increase your perception of pain, and lengthen labour.

Women at high risk, and those women with an existing condition such as diabetes or having a Rhesus negative blood group, are carefully monitored so that the baby’s welfare is never in jeopardy.

You will attend an antenatal clinic at either the hospital where you will have your baby or at your doctor’s surgery. Most of the women attend once a month or so up until 7 months of pregnancy, every two weeks up to 9 months of pregnancy, and then once a week for the last month.

You will need to attend mo/e frequently if any complications develop, such as your expecting more than one baby, if you have a pre-existing medical condition, or if you are at risk.

Attending an antenatal clinic in a hospital can be intimidating and frustrating: there may be a large number of staff coming and going, and you may be kept waiting for some time. Many women describe it as a cattle market. Negative feelings can be made much worse by the discontinuity of care — it’s quite possible to see different nurses and doctors at every visit. Much of this can be avoided if you opt for shared care, a GP unit, or the “domino” system where you mainly see your doctor or your midwife for check-ups, with occasional visits to the hospital antenatal clinic.

When you go, try to make the best of your time at the antenatal clinic by taking along something to read or to do, and some food and drink just in case the food trolley doesn’t come by while you are there. Take a friend or your partner with you for company and moral support.

Ideally, your partner should attend at least one antenatal clinic with you so that he is familiar with what you go through and can sympathize. He can also have his questions answered and, most importantly, give you moral support. If you already have young children, arrange for them to be looked after if at all possible because they can be quite a handful in a confined space with little to interest them.

On your first visit to the antenatal clinic, you will be asked various questions on the following subjects:

- Your personal details and circumstances including age, marital status, next of kin and religion.

- Childhood illnesses or serious illnesses you have had.

- Serious illnesses that run in your family or in your partners family

- Whether there are twins in your family

- What symptoms of pregnancy you have, and the state of your general health.

- Details of previous births, pregnancies or problems in conceiving.

- Whether you are taking any prescription medication or whether you suffer from any allergies.

- your menstrual history — when you started, how long your average cycle is, how many days you bleed, and the date of your last menstrual period (IMP).

- From the above information, your estimated delivery date (EDD) will be calculated.