All pregnant women worry and feel nervous about how they will cope with labour and birth, but one of the best ways to overcome your fears and anxieties is to find out as much as you can about what’s going to happen before labour starts.

NCT antenatal teacher Ruthie Pearlman answers the pressing questions lingering on most pregnant women’s minds.

Is it really possible to prepare yourself for labour and birth?

While no one can fully prepare themselves for something they have never experienced before, antenatal classes, talking to your midwife and reading up on labour and birth can give you an overview of all the possibilities, as well as techniques to use to cope with what’s going to happen such as; breathing techniques, using different positions during labour, and relaxation skills.

Knowing what’s going to occur when will give you the added advantage of recognising events, which will make labour less fearsome all round. However it’s important to keep an open mind, as things don’t always go to plan, or happen in the order they’re meant to!

Am I really in labour?

Braxton Hicks contractions that you may have been experiencing during late pregnancy, can feel very similar to real labour contractions, so the only way to know you’re in proper labour is to wait and see how your contractions develop. Labour contractions (unlike Braxton Hicks), occur at regular and increasingly shorter intervals and become longer and stronger in intensity. Other clear signs you’re in labour are your waters breaking, backache, menstrual like cramps and/or a slightly bloodstained mucous discharge known as a "show", (although a show doesn't necessarily mean labour is imminent).

The good news is if you’re a first time mother you will have plenty of time to watch the signs of labour and deal with them as they occur (a first labour usually lasts between 12 to 16 hours), as contractions are just the start of labour. If you have any worries/concerns contact your midwife or the delivery ward at the hospital and they will advise you further.

Find out more about the stages of labour here.

How do I know it is time to go to hospital?

This is the question I get asked the most in NCT classes. The truth is many women go to hospital too early, and find themselves in a strange environment where the comforts of home are no longer available to them.  Research has proven that women need to feel safe and comfortable for labour to advance well. So time your contractions, as the duration (how long they last) is more important than the frequency (how often they come). Wait until your contractions are 45 seconds to a minute each, and have been doing that regularly for at least an hour. At this point they will almost certainly be coming at least every five minutes.  Find out when to call the midwife here.

If you are not in what is considered to be "established labour" when you arrive in hospital (4 cm dilated) you may not get a labour room and if you don’t want to go home again, you might be asked to wait in a day room or postnatal ward until your cervix is dilated to 4cm. However, if your waters break, or you’re worried in any way phone the delivery/labour ward and ask for advice.

How much does labour hurt?

This is another big question that women ask and the truth is, everyone's perception of pain is different so it’s difficult to say. What is important to know is that we are designed to be able to give birth and our bodies are made for it. If you remember this and use all the strategies at your disposal to cope with the pain, be it submersion in warm water (a hugely effective pain relief), breathing or pain medication you will get through it. If birth was truly unbearable no one would have more than one baby.  You can find out more about the pros and cons of pain relief here - and see how real mums coped with the pain in our real birth video diaries.

What pain relief will be available to me?

It depends where you opt to give birth. If you’re opting for a home birth or a birthing unit the midwife will offer you gas and air (Entonox) and other non medical pain relief such as breathing, massage, a water pool, TENS machine and relaxation, all of which can be hugely effective in reducing pain. However, if you want medical pain relief such as Pethedine, or an epidural you have to give birth in a consultant led unit at a hospital, where these options can be administered by a doctor and an anesthetist.

Will I tear when I give birth?

The most crucial factor in preventing tears is to listen to your midwife/doctor during labour and stop pushing when they tell you to and just pant. This slows down the birth and allows your midwife/doctor to guide the baby out which lowers your chance of tearing. If you do tear despite all of this, you will be quickly stitched up with the aid of a local anaesthetic and most women recover well and quickly from stitches.

What if I just can’t do it?

Many women worry that they won’t be able to cope and manage during labour and birth, which is why it’s important to remember you can do it! You need to have confidence in your body's ability and remember it is doing what it is designed to do. To help yourself use all the strategies you learn about in antenatal classes and get informed about all the coping strategies that work via books, your midwife/doctor and friends who have already given birth. Knowing what’s going to happen and when, is your guide to getting through labour and giving birth.