Some pregnant mums have a short, smooth labour with just a gulp of gas and air for pain relief. But with around half of all births requiring medical intervention, many women find the birth a little more complicated. Know what might happen and you'll be well prepared.
You may be induced if your baby is in distress, you have a medical problem such as pre-eclampsia, which can cause dangerously high blood pressure, or you're overdue, as the placenta may not work as efficiently. Also, an induction may be necessary if your waters break but contractions haven't started, because of the risk of infection.
Your midwife may use prostaglandin gel or pessary to induce you at first, which she'll insert in the vagina, near the womb, to soften the cervix and stimulate contractions. An oxytocin drip, containing a synthetic version of a hormone naturally produced in labour, may also be used to stimulate contractions. Your doctor may perform an artificial rupture of the membranes (ARM) too, for which he'll insert a long probe into the vagina.
The words forceps and ventouse are enough to make any mum-to-be cross her legs, but they can be very useful aids.
Forceps, which look like large salad spoons, are used if your baby gets stuck in the vagina. They're gently inserted and cupped around your baby's head. You'll probably have a local anaesthetic.
A ventouse is used in the same situation. This is a small rubber cup that sticks to your baby's head through vacuum suction. A doctor then gently pulls on the cup during a contraction.
Your baby may be born with marks or a swelling on his head if either of these tools is used, but they're likely to disappear within 24 hours. With both methods, you may be given an episiotomy first - a diagonal cut between the vagina and the anus - to make the opening larger. You'll be bruised and sore afterwards but your midwife can suggest ways to ease discomfort.
If you're distressed due to a long or complicated labour, a Caesarean may be suggested. Also, if your baby is in distress, or unable to pass through the pelvis, a C-section can be life-saving. Other situations in which a Caesarean is vital include when the baby isn't getting enough oxygen, when the placenta is blocking the cervix or when the umbilical cord falls into the birth canal in front of the baby.
So what happens? You'll get a spinal block or epidural anaesthetic. The surgeon will then make a 20cm cut across your lower abdomen, open the uterus and deliver the baby. Once the afterbirth is delivered, the incision will be stitched or stapled.
Women who have Caesareans won't get pelvic floor damage or tearing, but they may suffer infection or blood loss. There is also a rare risk of blood clots in the legs, respiratory complications and damage to the bowel or bladder. Recovery time is longer, as is the hospital stay (three to four days on average), plus you're advised not to drive, or lift anything heavier than the baby for up to six weeks.
What real mums say...
I had to have a C-section'.
Sharon McLaughlin, 31, lives in the Netherlands with husband Robert and their daughter Robin, 9 months. "We can see the baby's in distress," said the hospital doctor. "We'll have to do an emergency Caesarean." Terrified, I started to cry. Although I was a week overdue, I thought this was a routine appointment. It was especially scary as the doctor didn't know what the problem was.
Within two hours they'd shaved my pubic area, put a catheter in and given me an epidural. Then they took me into theatre. Robert was by my side as they did the C-section. I couldn't feel anything, but my top half was shaking. Nine minutes later, our daughter was delivered but she was chalk white. Apparently, there was a leak between my blood and hers, so she had to have two blood transfusions.
Now, I'm just so relieved she's healthy. At the time I was too worried about my baby to think about the birth.'
I felt he'd never come out'
Lindsay Carruthers, 38, lives in Norwich with husband Steve, son Sam, 19 months, and her two daughters, Jessica, 12, and Rachel, 15. She's expecting her fourth child in August.
I'd had an easy, three-hour labour with my second baby and hoped that I would have a similar experience with my third. But sadly, it wasn't to be.
I was eight days overdue when I was induced with prostaglandin gel on Friday afternoon. Nothing happened for hours, so a midwife advised Steve to go home. Two hours later though, my waters broke.
After a few hours of contractions they found I wasn't dilating. The baby's head hadn't engaged either and they were having difficulty monitoring him. So on Sunday morning I was prepped for a C-section - I was distraught as I wanted to give birth myself. But in theatre I finally dilated. Three or four pushes later Sam was born. He was so exhausted he came out sleeping!'
Know the facts
Latest figures, 2003-2004, show more than 50% of women have some form of intervention.
46% of deliveries were normal.
More than 20% were induced.
About 12% were assisted with a ventouse or forceps
12% of women had an episiotomy.
23% of deliveries were by Caesarean, half of which were emergency C-sections.
SOURCE: NHS MATERNITY STATISTICS, ENGLAND