You will probably be the first person to really know that you are in labour. Now is a good time to check that you have everything you need packed for hospital. The first stage of labour can take a very long time, and it is best if you can stay at home in familiar surroundings for as long as possible. The first stage can start differently for different people. Some might notice contractions starting, others might have their waters break. If your waters break, it is sensible to inform your hospital or midwife as they may wish to see you if your contractions do not start. Early contractions are often said to be like period pains, but accompanied with a tightening of your stomach. These may or may not be particularly uncomfortable, but paracetamol can be taken to ease them in the early stages. Most will be at around 15-20 minute intervals. It's a good idea to time your contractions, so you know what your body is doing.  The beginning stage is called pre-labour, or the latent stage.   As time goes on, you should notice that the contractions are becoming more regular and more uncomfortable, and also lasting for longer. You should make your way into hospital once they are 5 mins apart (for a first baby) or 10 mins apart for second or other babies. If you are in too much pain, and want some pain relief, then call your hospital, and head in when you need to. The first stage of labour is preparing your body for the second stage, which is when your baby will be born. With each contraction your cervix is beginning to dilate , and thin out (efface) Midwives measure dilation in centimetres - fully dilated is 10cm. With each contraction, your cervix thins and opens more and it is often that a women will have a show (a pink or blood stained mucous plug come out).  Once you reach 3cm dilation you are considered to be in active labour.

What to expect.

When you arrive at hospital you will be met by one of the midwives, who will talk to you, read your notes, take your temperature, blood pressure and pulse too. You will have an abdominal examination, and some hospitals like the woman to be placed on a CTG to trace contractions and the baby's heart rate.  At this point the midwife will probably want to do a vaginal examination. This is to see how labour is progressing, see which way the baby is lying and to check your waters. If you have written a birth plan, now is a good time to let the midwife see it, or to discuss anything that you feel needs to be brought up.

Positions for the first stage of labour

The best thing you can do to help speed things along, and to aid with the pain is to keep upright and mobile. Being upright means gravity is working with you, pushing down on your cervix helping it to dilate. If you are being monitored you will still be able to move around a bit, so talk to your midwife about this if you're worried.

Complications

Fetal distress -   This happens when the baby is not getting enough oxygen. This will be picked up very easily by the CTG which will be monitoring the baby's heart rate. Sometimes, if midwives want to make sure that the baby is in distress, they may break your waters. This will often have meuconium (first poo) present if the baby is distressed.  If they want to continue to keep a better eye on the baby, a foetal head monitor may be placed on the baby's head. This gives a much better indication of how the baby is feeling. Sometimes a doctor may want to take a blood sample from the baby too. This also gives them a clearer idea of how baby is doing.

Failure to dilate -   Sometimes a woman's contractions might not be strong enough, or contracting in the correct way for dilation to be happening either at all or as quickly as it should. In this instance, a doctor might make the decision that your waters should be broken for you, and possibly to have a syntocinon drip. Both of these things should increase the strength and regularity of contractions until you are dilating well.

Your rights

It is always the womans right to refuse medical intervention, examinations etc and to have the kind of birth she wants.