Contractions are sensations of firmness of the abdomen, followed an interval of relaxed softness like bad menstrual cramps.

Actual labour contractions begin with a gradual increase in intensity, reach a peak and then subside. They come at regular intervals and become more painful over time.

False contractions occur at irregular intervals and subside after a while.

As labour approaches or just before it, the amniotic sac ruptures leading to sensation of vaginal dampness and then a continuous leakage of clear fluid. It is strongly recommended to proceed to the hospital promptly.

A sign that the cervix has soften and started to dilate.

Duration of labour can last for short few hours till 24 hours.

First Stage of Labour:
Prepares the cervix for birth, which can last approximately 20 hours. The cervix dilates and aligns itself towards the front to facilitate a smoother delivery.

The contractions begin and gradually intensifies in both strength and frequency, till full dilatation of cervix at 10 cm is achieved.

Second Stage of Labour: From fully dilated cervix to delivery of baby:
The mother will experience the strong urge to push. This stage can last from a few minutes up to 1.5 hours. A small incision(episiotomy) may be made between the vagina and anus to widen the vaginal opening.

In event of the mother becoming exhausted or baby showing signs of distress, assisted instrumental delivery like forceps or vacuum cup may be used.

Third Stage of Labour: The delivery of the placenta or afterbirth:
Minutes after delivery of the child, the placenta separates from the uterine wall and contractions will be felt once again, prompting the mother to push. Thereafter, the doctor will repair any vaginal tears or episiotomy if one was made.

Epidural
Most effective method and last throughout from labour, delivery of baby to the repair of perineal wound.

Avoids general anaesthesia when emergency Caesarean section is required.

It needs continued surveillance during labour.

Does not cause long term back pain, though 2% of women can have a "dural tap" causing a transient severe headache.

Morphine injection
An intramuscular injection provides moderate pain relief in labour.

Causes nausea and drowsiness in the patient.

Best avoided if delivery is imminent to minimize the sedative effects on the baby.

Nitrous Oxide and Oxygen ('Entonox")
Provides partial pain relief shortly after inhalation.

Too much of Entonox can cause light-headedness and the labouring woman will not be able to cooperate and push ineffectively during second stage of labour.