Preparing for Birth: The Three Stages, When to Go In, Pain Relief and Your Hospital Bag

Much of the fear around birth comes from not knowing what will happen. Breaking the process into pieces shrinks the anxiety considerably.

Real contractions vs practice ones

| | Braxton Hicks | True labour | |---|---|---| | Pattern | Irregular, comes and goes | Increasingly regular | | Interval | Doesn't shorten | Gradually shortens | | Intensity | Doesn't build | Gradually builds | | Moving around | Often relieves them | No effect | | Location | Usually front of the bump | Often wraps from the lower back around |

When to go in: the 4-1-1 rule

A common guide for first births: contractions 4 minutes apart, lasting 1 minute each, sustained for 1 hour. Subsequent births often progress faster, so leave earlier.

Regardless of dilation, go in immediately if:

• Your waters break (note the time, colour and smell — mention green or foul-smelling fluid)
• Heavy vaginal bleeding (more than a period)
• Noticeably reduced or absent fetal movement
• Severe constant abdominal pain, fever, blurred vision or a severe headache

The three stages

First stage (the longest): from regular contractions to full dilation at 10 cm.

• Latent phase (0–6 cm): can be very long — a dozen-plus hours isn't unusual for a first birth. Walk, take a warm shower, eat something to conserve energy
• Active phase (6–10 cm): strong, close contractions — the phase where pain relief matters most

Second stage: full dilation to birth. Usually anywhere from tens of minutes to 2–3 hours for a first baby. Follow your midwife's guidance: push with the contraction, release completely between.

Third stage: delivering the placenta, typically 5–30 minutes. Most people are looking at their baby and barely notice.

Pain relief: the honest differences

• Epidural: the most effective labour analgesia available — substantial pain relief while staying awake. The common myths are debunked: it doesn't cause long-term back pain and doesn't affect your child's intelligence. It can cause leg numbness, brief low blood pressure, and needs a urinary catheter
• Nitrous oxide (gas and air): fast onset, self-administered, clears quickly. Less powerful than an epidural but flexible
• Non-drug methods: breathing, continuous doula support, position changes, heat, water. Research shows continuous support reduces both analgesia use and caesarean rates — worth preparing seriously
• Injected opioids: used in some hospitals; timing relative to birth matters to avoid affecting the newborn's breathing

There is no bravery prize for enduring pain. Whether to use pain relief is personal preference plus medical assessment — not a moral question.

Hospital bag (the short version)

Documents: ID, insurance card, pregnancy notes, any required paperwork — keep them in one folder, they're the most-forgotten item.

For you: maternity pads, disposable underwear, nursing bras, a front-opening nightgown, slippers, toiletries, a straw cup (so you can drink lying down), a long charging cable, snacks.

For baby: newborn nappies, 2–3 bodysuits, a swaddle, muslins, baby wipes, a going-home outfit for the season.

Don't over-buy: hospitals supply a lot, and most things can be bought after you're home.

Write down your preferences

It doesn't need to be a rigid birth plan — just note your preferences: pain relief, birth partner, delayed cord clamping, skin-to-skin and early feeding. And accept it may change: the goal is a safe mother and baby, and medical indications outrank plans. A birth where you were informed and respected predicts a positive experience far better than one that went exactly to plan.

Hospital protocols vary by region — follow your own maternity unit's guidance and your doctor's advice.