Types of labour...

Induction

Labour is started off if continuing the pregnancy poses a specific risk to you or your baby. It can be hard to tell a pregnancy that needs induction from one that will turn out to be problem-free, however. Induction rates vary between hospitals, from around 10% to 30%. Private hospitals tend to have higher rates.

Induction depends on the doctor and the hospital as well as your pregnancy. If you plan to give birth in a high tech hospital you're about twice as likely to be induced as if you plan to give birth a home or in GP unit. If your baby is overdue one doctor may recommend starting you off after a week while another may wait up to 3 weeks; but induction is more likely to be suggested if you're over 35 or you've previously had a difficult labour - although there's little evidence to say whether it's likely to avoid a repetition,

Some reasons for starting you off are more compelling than others. Illnesses like pre-eclampsia or diabetes can cause serious problems and the placenta may be failing if a baby isn't growing well. Your doctor might try to avoid a caesarean section by gently turning a baby who's lying in a position that makes it difficult to be born normally and inducing you before the baby can turn back.

The decision isn't always straightforward, and the advantages of induction must be balanced against the risks, such as causing foetal distress or delivering a premature baby. Every case has to be judged individually, but you can discuss how your birth is likely to be managed with your consultant.

What Happens in Normal Labour

Labour takes place in 3 linked stages, each achieved by your contractions. First the neck of your uterus, which is tightly closed during pregnancy, thins out and opens to let your baby to pass through. Then the contractions push your baby down the birth canal to be born. Finally, they expel the placenta.

During labour your midwife checks your baby's position, his heartbeat and your progress, takes your blood pressure, provides pain relief if needed and generally helps you to cope.

Early labour: Stronger, more regular contractions usually last 45 - 50 seconds. Most women have to relax consciously and breathe gently through them. You may feel calm and powerful, or edgy and afraid. If you feel you need reassurance or help contact your midwife, or phone the hospital to say you're coming in.

Established labour: The intense contractions that pull the remaining rim of cervix open so that you're fully dilated and ready to push usually last a minute or more and come every few minutes. This can be the most trying phase of labour and you may feel overwhelmed and pushed to your limits. Some women feel deeply calm and powerful, however.

Delivery: The contractions change as your baby moves down the birth canal and stretches your pelvic floor. You may get a catch in your throat or a strong urge to bear down, as though opening your bowels. Pushing usually takes an hour or two.

Afterwards: You cuddle or breastfeed your baby while the placenta arrives and stitches are inserted if necessary. You may feel overwhelmed with happiness, relieved that labour's over, or flat as a pancake in more ways than one.