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.

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.