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What's labour really like?

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Pregnancy video

Have a look at the NHS Choices video on pain relief options in labour

Real mum's tip

"During labour I couldn't have managed without a spray bottle of water. It was tropical on the delivery suite, but as soon as my sister started spraying me, I felt much calmer"

Mums' Choice member Annwen Ackroyd, mum to Charles, 12 weeks

Every mum's experience of labour is different; just try not to feel too anxious and remember that at the end of it all you'll get to meet your new baby!

How do I know I'm in labour?

Most labours start slowly, and you might be wondering if this is it. Signs to look out for include:

You've had a "show"

Some women lose a plug of pink mucus called a show.

You have lower back ache

Not unlike period pain.

Your waters break

When your waters break, the membrane holding the amniotic sac (which holds your baby) has started to leak. If this happens, call the hospital and speak to a midwife for advice.

Early labour (0-3cm dilated)

What's happening?

Labour can last anything from an hour to a few days. In the early stage you'll have mild contractions, which can be from 5 to 20 minutes apart.

How will I feel?

Slightly uncomfortable and perhaps a bit anxious. Try to relax – you may have a while to go yet.

What can I do?

Take your mind off the contractions – go for a gentle walk, watch TV, read a magazine – whatever works for you. A TENS machine can help early labour pain – see Pain relief in labour - Natural pain relief (below). You can hire TENS machines from Tesco Pharmacies for six weeks for £27.50. Call 0800 59 16 88 for more information on participating stores (and have your Tesco Clubcard number to hand – just think what you can use all those coupons for later!).

Active labour (4-10cm dilated)

What's happening?

At 4cm dilated your baby will start to slowly move downwards; as contractions increase and you reach 10cm, you'll begin to feel the urge to push.

How will I feel?

This is hard work – active labour can last from one to six hours, or longer. Staying upright and mobile can help labour progress. Do ask for pain relief if you need it.

What should I do?

Listen to your midwife. Once the baby's head has crowned, you may feel some more contractions. Push as if you were doing a poo. As the baby's head comes through, you'll feel huge pressure (and possibly a burning pain), followed by a rush of relief and joy as your baby is born!

Third stage of labour

What's happening?

It's nearly over – just the placenta to deliver.

How will I feel?

This is a breeze compared to giving birth!

What should I do?

You may be offered an injection to speed up this process and you'll need to push again.

Pain relief in labour

Natural pain relief

Self-help techniques can be useful in early labour to relieve pain. The advantage is they don't involve using drugs, so there are no side effects for you and your baby. However, they only help you cope with the pain – they don't take it away.

  • Active birth positions. These help to keep you moving. The more mobile you are, the faster your baby's likely to be born.
  • Breathing. Slow breathing in the early stages of labour will help you to relax, and other breathing techniques can help relieve contractions and focus attention away from the pain. Find out more about different methods at your antenatal class.
  • Complementary therapies. Massage, reflexology, acupuncture, hypnosis, aromatherapy and homeopathy may all help to relieve pain. If you're planning to give birth in a hospital, just ask permission for your practitioner to be present.
  • TENS. A transcutaneous nerve stimulation (TENS) machine delivers small electrical pulses to the body via electrodes placed on the skin. These can help some women cope with early labour pain.
  • Water. Buoyancy makes it easier to manoeuvre and water soothes and takes the edge off contractions – this is why some women use a birthing pool. If you don't have access to one, a bath can help.
  • Hypnotherapy for birth. Not generally available on the NHS, there are several types available including HypnoBirthing and Natal Hypnotherapy.

Medical pain relief in labour

If you give birth in hospital, you'll have access to a range of pain-relieving drugs. Talk your options through with your midwife, as the type of pain relief you choose will depend on how far into labour you are and how quickly labour is progressing. For a home birth, gas and, in some cases, pethidine are usually available.

  • Gas (Entonox). Often known as gas and air, this is a mixture of oxygen and nitrous oxide (laughing gas) that you breathe in through a hand-held mask or mouthpiece. Entonox takes the edge off the pain but doesn't remove it altogether. However, it can be combined with pethidine for more effective pain relief.
  • Pethidine. Injected into your thigh or bottom once labour is well established, pethidine helps reduce pain to a more manageable level. If it works well, you'll feel relaxed and sleepy, and this can ease labour if you're tense. The effect wears off after four hours.
  • Epidural. A local anaesthetic is injected into the epidural space in the lower back via a fine tube. The tube is inserted through a needle and left in place during labour so that top-ups can be given.
Take your mind off the contractions – go for a gentle walk, watch TV, read a magazine – whatever works for you.