Preparing for birth is mostly about knowing what to expect, so that when labour starts you are making decisions from a position of understanding rather than surprise.

During pregnancy

Attend your antenatal appointments — they are how problems are picked up early, often before you would notice anything. Eat a normal balanced diet, stay reasonably active, and avoid alcohol and tobacco.

Have your hospital bag packed by around 32 to 35 weeks. Our hospital bag checklist covers what to bring.

Signs that labour is starting

  • Regular contractions that become stronger, longer and closer together and do not settle when you move or rest
  • Waters breaking — a gush or a persistent trickle
  • A show — the mucus plug coming away, sometimes blood-streaked. This can happen days before labour
  • Persistent low backache or period-like cramping

When to go in

As a general guide, go to hospital when contractions are coming every 5 minutes, lasting about 60 seconds, and have been doing so for an hour.

Go in straight away, regardless of contractions, if:

  • Your waters break — particularly if the fluid is green, brown or bloodstained
  • You have any vaginal bleeding
  • Your baby's movements have reduced or changed
  • You have a severe headache, visual disturbance or upper abdominal pain
  • You are less than 37 weeks and think labour has started
  • Something simply does not feel right

Never feel you are making a fuss. Being sent home reassured is a perfectly good outcome.

The three stages of labour

  • First stage — the cervix thins and opens to 10 cm. This is the longest stage, often many hours in a first birth. The early part can usually be spent at home.
  • Second stage — from full dilation until your baby is born. You will feel an urge to push.
  • Third stage — delivery of the placenta, usually within an hour of the birth.

Pain relief

What is available varies between hospitals, so ask in advance at the hospital where you plan to deliver rather than assuming.

Without medication

  • Breathing and relaxation techniques — more effective than they sound, and worth practising beforehand
  • Staying upright and moving — walking, leaning, rocking; upright positions often make contractions more bearable and can help labour progress
  • Warm water on the back, and massage
  • Continuous support from a birth partner or midwife, which genuinely reduces the need for medication

With medication

  • Pain-relieving injections, commonly used and widely available
  • Epidural — the most effective form of pain relief, given into the back by an anaesthetist. It is not available at every hospital, and where it is available it depends on an anaesthetist being free. If an epidural matters to you, ask about it well before your due date so you can plan accordingly.

There is no prize for managing without pain relief, and no failure in asking for it.

Thinking about your preferences

It helps to think through what you would like — who is with you, positions, pain relief, holding your baby straight after birth, feeding. Discuss it at an antenatal visit.

Hold your preferences loosely. Labour is unpredictable, and things sometimes change for good reasons. Knowing what you would prefer makes it easier to be part of the decision if plans have to change.

Afterwards

Expect to feel sore and very tired. Bleeding (lochia) continues for a few weeks, gradually lightening.

If you had stitches, keep the area clean and dry, change pads often, and use plain warm water when washing. Tell someone if pain worsens rather than improves, or if there is offensive-smelling discharge.

Rest genuinely matters — sleep when you can, accept help, eat and drink properly. Gentle walking is good; heavy lifting is not.

Feeding

Breastfeeding is recommended and gives your baby valuable protection, but it is a skill that often takes time and can be painful at first. Ask the midwife for help early rather than struggling on. Difficulty is common and usually fixable.

How you feel

A few days of tearfulness after birth is very common. But if low mood, anxiety or a sense of detachment persists beyond a couple of weeks, please tell your doctor or midwife. This is common, it is treatable, and it is not a reflection on you as a mother.

The bottom line

Keep your antenatal appointments, pack by 35 weeks, and go in when contractions are five minutes apart for an hour — or immediately for bleeding, reduced movements or discoloured waters. Ask your hospital in advance what pain relief they offer, including whether an epidural is available. Afterwards, rest properly and speak up early about pain, feeding difficulties or low mood.

References

  1. National Health Service. Signs that labour has begun [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/signs-of-labour/signs-that-labour-has-begun/
  2. National Health Service. Pain relief in labour [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/pain-relief-in-labour/
  3. World Health Organization. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: WHO; 2018. Available from: https://www.who.int/publications/i/item/9789241550215