<h1>Induction of labour</h1>
<img class="alignnone size-full wp-image-1139" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.3.2.jpg" alt="Pregnant woman in hospital room sits on an exercise ball supported by her birth partner and a midwife" width="650" height="406" />

<span style="font-weight: 400;">Inducing labour will always be discussed with you, to ensure you fully understand the risks and benefits and your consent will be gained prior to anything happening.</span>

<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/17/why-i-might-be-offered-an-induction-of-labour/">Why might I be offered an induction of labour?</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/how-is-labour-induced/">How is labour induced?</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/frequently-asked-questions/">Induction of labour: Frequently asked questions</a>

</div>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/induction-labour/" type="nhs">Induction of labour</a>

<a href="https://www.tommys.org/pregnancy-information/labour-birth/induction-labour-information-about-having-labour-induced" type="tommy's">Having labour induced</a>

<a href="https://www.nice.org.uk/guidance/ng207">Inducing labour</a>

<a href="https://www.buzzsprout.com/961453/6636310-episode-35-induction">Induction - The Obs Pod, Episode 35</a>

</div>

Induction of labour

<h1>Interventions in labour</h1>
<img class="alignnone size-full wp-image-1145" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.3.3.jpg" alt="Pregnant woman reclines on a hospital bed while a midwife feels her bared bump" width="650" height="406" />

<span style="font-weight: 400;">During labour, sometimes things can slow down or concerns can arise with your or your baby's well-being. If this happens your midwives and/or doctors may recommend certain options  to help you to give birth to your baby safely.</span>
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/17/breaking-your-waters-amniotomy/">Breaking your waters (amniotomy)</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/606/">Oxytocin (known as synto or syntocinon)</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/610/">Episiotomy</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/ventouse-forceps/">Ventouse or forceps</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/caesarean-birth-2/">Emergency caesarean birth</a>

</div>

Interventions in labour

<h1>When pregnancy goes beyond your due date</h1>
<img class="alignnone size-full wp-image-1135" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.3.1.jpg" alt="Close up of pregnant woman with a pen crossing off days on a wall calendar" width="650" height="406" />

<span style="font-weight: 400;">If you have had a healthy pregnancy without complication and haven’t gone into labour by 41 weeks you will have a routine appointment with your midwife to discuss the next steps.  </span>

<h2>What happens at your 41 week appointment?</h2>

<span style="font-weight: 400;">You will be offered a membrane sweep, which is an internal examination of the cervix. During this examination your midwife will insert the tip of her finger into your cervix and sweep around the bag of membranes that cover your baby’s head. This has been shown to release hormones that may encourage labour to start within 24 hours. Sometimes the cervix isn’t yet open, and a sweep isn’t possible. You may be invited to return for more sweeps.</span>

<span style="font-weight: 400;">
</span><span style="font-weight: 400;">Your midwife will also offer you a date to have your labour induced. This is normally recommended by 41 weeks and three, four or five days (depending on your maternity units guidelines and availability). Some maternity units are able to offer complementary therapy to encourage labour to start naturally. Ask your midwife about this.</span>
<div class="relatedlinks" data-cat="relatedlinks"><a type="nhs" href="https://www.nhs.uk/conditions/pregnancy-and-baby/over-40-weeks-pregnant-overdue/">If your baby is overdue</a></div>

When pregnancy goes beyond your due date

<h1>Assisted birth</h1>
<img class="alignnone size-full wp-image-1146" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.3.jpg" alt="Smiling pregnant woman in hospital bed has her hand held by a midwife" width="650" height="406" />
<span style="font-weight: 400;">Assistance with labour and birth may be recommended either:</span>
<ul>
<li>prior to your due date</li>
<li>for medical reasons</li>
<li>when you go beyond your due date; or</li> 
<li>during labour.</li>
</ul>
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/23/when-pregnancy-goes-beyond-your-due-date/">When pregnancy goes beyond your due date</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/induction-of-labour/">Induction of labour</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/interventions-in-labour/">Interventions in labour</a>

</div>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.tommys.org/pregnancy-information/labour-birth/assisted-birth" type="tommy's">Assisted birth</a>

<a href="https://www.which.co.uk/birth-choice/safety-and-interventions/inductions-and-interventions-in-labour" type="which">Induction and interventions</a>

<a href="https://www.birthrights.org.uk/factsheets/consenting-to-treatment/">Consent: the key facts - Birthrights</a>

</div>

Assisted birth

<h1>Early signs of labour</h1>
<img class="alignnone size-full wp-image-1110" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.1.jpg" alt="Close up of a pregnant woman propped up in bed holding her the sides of her bump" width="650" height="406" />

<span style="font-weight: 400;">In the week building up to your labour starting you might experience some of the following:</span>
<ul>
 	<li><span style="font-weight: 400;">increased clear vaginal discharge</span></li>
 	<li><span style="font-weight: 400;">mild upset stomach or diarrhoea</span></li>
 	<li><span style="font-weight: 400;">feeling energetic or restless</span></li>
 	<li><span style="font-weight: 400;">frequent practice contractions, or tightenings of the uterus known as Braxton Hicks, and/or backache.</span></li>
</ul>
<span style="font-weight: 400;">Some women won’t notice any of these signs, and it is nothing to worry about if you don’t feel any different towards the end of pregnancy.</span>

<span style="font-weight: 400;">As your labour starts you may notice some of the following signs which can be explored here.</span>
<div class="submenu" data-cat="submenu"><a href="https://admin.mumandbaby.uk/2018/08/14/the-show/">The show</a>
<a href="https://admin.mumandbaby.uk/2018/08/14/contractions/">Contractions</a>
<a href="https://admin.mumandbaby.uk/2018/08/14/your-waters-breaking/">Your waters breaking</a>
<a href="https://admin.mumandbaby.uk/2018/08/14/514/">When to call your midwife/maternity unit</a></div>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>
<div class="videoplayer" data-cat="video">How will I know I am in labour?
<iframe width="560" height="315" src="https://www.youtube.com/embed/jkL1DhAsr_0?rel=0&amp;showinfo=0" frameborder="0" allowfullscreen="allowfullscreen"></iframe></div>
<div class="relatedlinks" data-cat="relatedlinks"><a href="https://www.nhs.uk/conditions/pregnancy-and-baby/labour-signs-what-happens/" type="nhs">Signs that labour has begun</a>
<a href="https://www.tommys.org/pregnancy-information/labour-birth/how-will-i-know-when-labour-has-started" type="tommy's">More on signs labour has started</a></div>

Early signs of labour

<h1>If your baby is too unwell to survive</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/08/If-your-baby-is-too-unwell-to-survive-300x200.jpg" alt="Premature little baby in an incubator" width="300" height="200" class="size-medium wp-image-17551" />
<span>Sometimes babies are born so early or so unwell it is very hard for them to survive despite having intensive care. This will be a very difficult time for you and your family. Your baby will have fought so hard to have met you and spend time with you since their birth.</span>

<span>Whilst your baby is still alive, you may wish to make memories with them such as making prints of their hands and feet, taking photos and videos of you all together, introducing them to siblings and family they may not have met yet, reading them your favourite books and having a ceremony to celebrate their life. The neonatal team helping you to care for your baby will be able to assist you with all these things and any other requests you may have.</span>

<h2>End of life care for your baby</h2>
<span>If the neonatal team has spoken to you about your baby dying, they may start to change the focus of their care from active care to focusing more on maximising their comfort. This may involve doing fewer painful procedures on your baby or starting your baby on some medicines to keep your baby comfortable.</span>

<span>The team will discuss with you, whenever possible, about where you would like to be with your baby when they stop receiving active treatment and transition to receiving comfort-focused care. This is usually in hospital, but may be in a hospice, or even at home. The neonatal staff will support in making these decisions. The neonatal team may also introduce you to the palliative care team, who are experts in caring for babies with life-limiting conditions.</span>

<span>The team will also discuss with you whether you would like your baby to have a postmortem examination to find out more about the problems that have made your baby so ill. There are also some instances where the coroner may make this decision.</span>

<h2>After your baby has died on a neonatal ward</h2>
<span>The neonatal unit staff will support you to be able to provide care for your baby around the time of death. They will issue you with a death certificate and provide you with all the information you need about registering your baby’s death. You will be offered a bereavement appointment to talk about your baby’s care a few weeks after their death. A bereavement nurse will be in regular contact with you too.</span>

<div data-cat="relatedlinks" class="relatedlinks">
<a href="https://www.sands.org.uk/">Sands support</a>
</div>


If your baby is too unwell to survive

<h1>Meeting your baby for the first time</h1>
<img class="alignnone size-full wp-image-1147" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.4.1.jpg" alt="New mother in a birthing pool holds her newborn baby for her birthing partner to hold" width="650" height="406" />

<span style="font-weight: 400;">Meeting your baby for the first time can cause many different emotions in new parents. After months of build up to the birth, you may feel elation and an instant rush of love but don’t be concerned if you initially feel dazed and disconnected, or have concerns over whether the baby is alright. Making an emotional connection with your baby can take time. It is important to remember that there is no right or wrong way to feel about your newborn and that for some parents it can take quite a while to adjust to the fact that labour is over and their new baby has arrived.</span>
<div data-cat="video" class="videoplayer">

Meeting your baby for the first time

<iframe width="560" height="315" src="https://www.youtube.com/embed/0vzW9qPz3So" frameborder="0" allowfullscreen="allowfullscreen"></iframe>

</div>

Meeting your baby for the first time

<h1>You: straight after birth</h1>
<img class="alignnone size-full wp-image-1149" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.4.2.2.jpg" alt="Close up of new mother sitting up in a hospital bed and holding her new born baby" width="650" height="406" />

<span style="font-weight: 400;">After your placenta has been delivered, your midwife or doctor will ask to check and see if you have any tears to the perineum and/or vagina that might require stitches. If you do need stitches, your midwife or doctor will explain this to you.</span>

<span style="font-weight: 400;">Before stitching your midwife or doctor will ensure the area is numbed with local anaesthetic, or if you have an epidural already, this will be topped up. Most tears will be repaired in your birthing room, more significant tears require repair in an operating theatre. Tears are repaired using dissolvable stitches and normally heal within a month of birth.</span>

<span style="font-weight: 400;">All women will lose some blood after giving birth, this happens because the area of the womb where the placenta was attached takes time to heal. Bleeding may be heavy immediately after the birth, but will reduce significantly over the next few days and weeks. Bleeding will normally last between two and six weeks. Your midwife will check on your bleeding regularly straight after birth.</span>

<span>If there is significant bleeding this is called a postpartum haemorrhage (PPH). Your midwife and doctor will take prompt action to stop ongoing blood loss.</span>

<div data-cat="submenu" class="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/21/understanding-perineal-tears/">Understanding perineal tears</a>

</div>


<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/you-after-birth/" type="nhs">You after birth</a>

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/third--or-fourth-degree-tear-during-childbirth/" type="rcog">Third and fourth degree tears</a>

<a href="https://www.rcog.org.uk/en/patients/patient-leaflets/heavy-bleeding-after-birth-postpartum-haemorrhage/" type="rcog" >Heavy bleeding after birth (postpartum haemorrhage)</a>

<a href="https://www.buzzsprout.com/961453/8348398-episode-53-tears-and-stitches">Perineal tears and stiches - The Obs Pod, Episode 53</a>

</div>

You: straight after birth

<h1>What happens straight after birth</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.4.2.jpg" alt="New mother holds her new born baby to her bare chest under a sheet" width="650" height="406" class="alignnone size-full wp-image-1153" />

<span style="font-weight: 400;">Explore what will happen once your baby has arrived.</span>
<div data-cat="video" class="videoplayer">

What will happen after my baby is born?

<iframe width="560" height="315" src="https://www.youtube.com/embed/hao7l1iTFNo?rel=0&amp;showinfo=0" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen="allowfullscreen"></iframe>

</div>
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/17/626/">Skin-to-skin contact</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/you-straight-after-birth/">You: straight after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/your-baby-straight-after-birth/">Your baby: straight after birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/vitamin-k-for-newborn-babies/">Vitamin K for newborn babies</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/identification-for-your-newborn-baby/">Identification for your newborn baby</a>

</div>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/what-happens-straight-after-the-birth/" type="nhs">What happens straight after birth</a>

<a href="https://www.nct.org.uk/birth/after-your-baby-born" type="nct">More on after your baby is born</a>

</div>

What happens straight after birth

<h1>Immediately after giving birth</h1>
<img class="alignnone size-full wp-image-1154" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.4.jpg" alt="Mother in hospital bed holds her baby to her chest" width="650" height="406" />
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/17/meeting-your-baby-for-the-first-time/">Meeting your baby for the first time</a>

<a href="https://admin.mumandbaby.uk/2018/08/17/what-happens-straight-after-birth/">What happens straight after birth</a>

</div>

Immediately after giving birth

<h1>Preterm labour and birth</h1>
<img class="alignnone size-full wp-image-1123" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.6.jpg" alt="Preterm baby sleeps inside an incubator" width="650" height="406" />

<span style="font-weight: 400;">A baby that is born before 37 weeks gestation is considered to be ‘premature’ or ‘preterm’. There are different categories of prematurity:</span>
<ul>
 	<li><span style="font-weight: 400;">extremely preterm (less than 28 weeks)</span></li>
 	<li><span style="font-weight: 400;">very preterm (between 28 and 32 weeks)</span></li>
 	<li><span style="font-weight: 400;">moderate to late preterm (between 32 and 37 weeks).</span></li>
</ul>
<span style="font-weight: 400;">In the UK, roughly eight one in every 100 babies will be born prematurely. Extremely preterm birth is less common with less than one in 100 babies being born between 22 and 28 weeks gestation.</span>

<span style="font-weight: 400;">Preterm birth carries risks because babies who are born too soon may not be fully developed, and need specialist help for life outside of the womb. Preterm babies are also at risk of longer term health problems, including learning disabilities and visual and hearing impairment.</span>
<h2>Call your midwife or maternity unit if you are less than 37 weeks pregnant and you have:</h2>
<ul>
 	<li><span style="font-weight: 400;">regular period type pains or contractions</span></li>
 	<li><span style="font-weight: 400;">constant abdominal pain</span></li>
 	<li><span style="font-weight: 400;">a "show" – the mucus plug that sits inside the cervix during pregnancy. This can be clear or blood stained</span></li>
 	<li><span style="font-weight: 400;">fresh red bleeding from the vagina (take a photograph to show the midwife)</span></li>
 	<li><span style="font-weight: 400;">a gush or trickle of fluid from your vagina – this could be your waters breaking (place a sanitary towel (pad) inside your underwear to show your midwife)</span></li>
 	<li><span style="font-weight: 400;">backache that is not usual for you, or pressure in the vagina or rectum.</span></li>
</ul>
<span>In most cases of preterm birth contractions and labour start spontaneously. Sometimes preterm birth happens when obstetricians or fetal medicine specialists intervene because of concerns about your health or the health of your baby.</span>

<span>You may find this range of videos about premature birth from Best Beginnings helpful:</span>
<div data-cat="goto" class="goto"><a href="https://www.bestbeginnings.org.uk/watch-small-wonders-online">Premature birth videos</a></div>
<div data-cat="goto" class="goto">

<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

</div>
<div class="submenu" data-cat="submenu">

<a href="https://admin.mumandbaby.uk/2018/08/14/causes-of-preterm-birth/">Causes of preterm birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/what-happens-if-i-go-into-preterm-labour/">What happens if I go into preterm labour?</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/what-happens-if-my-baby-is-born-prematurely/">What happens if my baby is born prematurely?</a>

</div>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/premature-early-labour/" type="nhs">Premature labour and birth</a>

<a href="http://www.bliss.org.uk">Bliss: for babies born prematurely or sick</a>

<a href="https://www.tommys.org/pregnancy-information/premature-birth/organisations-support-around-premature-birth" type="tommy's">Preterm birth</a>

<a href="https://www.tommys.org/pregnancy-information/premature-birth/my-prem-baby-app" type="tommy's">My prem baby app</a>

</div>

Preterm labour and birth

<h1>Tips for birth partners</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/08/Tips-for-birth-partners-300x200.jpg" alt="Man massaging his partner's belly during labour at an unassisted home birth" width="300" height="200" class="size-medium wp-image-17586" />

<span>Supporting your partner during labour and birth can be a rewarding and bonding experience for both of you. Use the Personalised Birth Preferences plan in the app to help you think about both of your needs and choices for labour and birth.</span>

<span>Staying well-hydrated and nourished during the labour will help you to stay alert, so come prepared with non-perishable snacks and drinks. It is also okay to take a break occasionally, especially if labour is long. Chat about this with your partner before labour so everyone's expectations can be met.</span>

<span>If you have helped to pack the hospital bag, you will know where to find a hat and nappy for your newborn baby, as these are the first things the midwife will ask you for.</span>

<span>Depending on hospital policy it may be possible to have more than one birth partner during labour. It is wise to check with your midwife ahead of time.</span>

<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/pregnancy/labour-and-birth/what-happens/tips-for-your-birth-partner/" type="nhs" >Tips for your birth partner</a>

<a href="https://www.nct.org.uk/labour-birth/dads-and-partners/ten-tips-for-birth-partners" type="nct" >Ten tips for birth partners</a>
<div>


Tips for birth partners

<h1>Antibiotics in labour</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2021/09/Antibiotics-300x200.jpg" alt="Cannula in back of hand" width="300" height="200" class="size-medium wp-image-17890" />
<span>There are two reasons why you might be given antibiotics during labour:</span>

<h2>1)	Known risk of an infection</h2>
<span>Antibiotics in labour will be recommended if there is an increased risk of infection to the baby by bacterium called Group B Streptococcus (GBS). This could be indicated in labour if:</span>
<ul>
<li>a) results in your current or previous pregnancy have detected GBS in vaginal or urine testing; or</li>
<li>b) labour starts prior to 37 weeks and is associated with rupture of membranes prior to the onset of labour.</li>
</ul>
<span>The team will check your allergies and available results to determine which antibiotics to give you until your baby is born. When antibiotics are administered for this indication only, you will be able to walk around in labour.</span>

<h2>2)	Signs of a possible infection</h2>
<span>Infection in labour may be suspected based on symptoms like fever, or signs like a higher than expected heart rate in you or baby in the womb.</span>

<span>Infection can occur in any part of your body. If we can’t identify where the infection is, we work on the assumption that it could be in the womb, and this may be difficult to confirm until at least a few days later.</span>

<span>Untreated infection can sometimes spread to the blood and if not treated it may have serious consequences. Given the risk that an infection may pose, the medical team will undertake a detailed assessment of you and your baby. They will conduct a range of tests on you to help establish the type of infection. This will include blood tests, urine tests and vaginal swabs. The tests include full blood count, C-reactive protein (CRP), blood/urinary/vaginal culture and sensitivity. The team will recommend starting antibiotics through a cannula (a very fine, flexible plastic tube) directly into your vein.</span>

<span>You will need to be monitored closely and this will involve continuous monitoring of you and the baby, which may limit you from walking around in labour. We will continue to support your birth preferences as best as possible and discuss all options and recommendations so that you can make informed choices about your care. We will help you adopt positions that are comfortable for you and that are known to support vaginal births.</span>

<span>Some of the blood results will be available within a few hours and some tests (microbiological cultures and sensitivity) may take up to 3 days.</span>

<span>Your team will continue to monitor you and your baby closely through your labour and will keep you informed of their findings and recommendations. You are encouraged to ask any questions or share concerns you may have.</span>

<h2>What will happen after the birth?</h2>

<h3>1)	Known risk of an infection</h3>
<span>If you received antibiotics in labour only because of the known risk of GBS infection, this will be stopped at the time of the birth. For 12-24 hours after the birth, your team will monitor you and the baby for anything concerning, including signs of infection. The monitoring aims to identify early warning symptoms and signs. For the baby, this will include overall assessment and regular measurement of heart rate, respiratory rate, colour, temperature and feeding. The baby will stay with their mothers on the postnatal ward.</span>

<h3>2)	Signs of a possible infection</h3>

<span>Your antibiotics will be continued through the cannula until your temperature has been normal for at least 24 hours after the birth, you feel well and the infection results indicate an improvement.</span>

<span>Based on your recovery and test results, you may need to continue the antibiotic course as tablets. The total duration of antibiotics can vary but they will be safe to take if you are breastfeeding.</span>

<span>If you have a urinary infection, you will need to repeat a urine test (culture and sensitivity) a week after you complete your antibiotics course to make sure the infection has been treated fully.</span>

Antibiotics in labour

<h1>Birth with twins or more</h1>
<img class="alignnone size-full wp-image-1119" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.5.jpg" alt="Close up of new born twins lying together" width="650" height="406" />

<span style="font-weight: 400;">During pregnancy you will have an appointment to discuss your options for the birth of your twins. More than 40% of twins are born vaginally with the remainder being born by either planned or emergency caesarean. </span>

<span>The most common way for twins to lie is both with their heads down. It is common for one or both babies to be feet or bottom down (breech). Some babies lie across your womb (transverse lie) and if this is the case with the first twin to be born, you’ll need a caesarean section. If you’ve had a vaginal birth for the first twin but the second is lying across your womb, they may need help to turn so they can be born.</span>

<span style="font-weight: 400;">In some cases a planned caesarean will be recommended, for example, if your babies share one placenta, or the first baby is in the breech (bottom first) position. </span>

<span style="font-weight: 400;">During labour, it is recommended that your babies have continuous electronic fetal monitoring, as the risk of complications during labour is higher for twins. It may also be recommended that you have an epidural, in case you require an emergency caesarean birth quickly. There will be more people at the birth of twins, often two midwives, two obstetricians and two neonatal doctors.</span>

<span style="font-weight: 400;">If you have triplets or more, planned caesarean birth would be recommended for you as the safest way to deliver your babies.</span>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/giving-birth-to-twins/" type="nhs">Giving birth to twins</a>
</div>

Birth with twins

<h1>Coping strategies and pain relief in labour</h1>
<img class="alignnone size-full wp-image-1132" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.7.jpg" alt="Close up of heavily pregnant woman leaning forwards with her birth partner standing behind her and touching her waist" width="650" height="406" />

As labour progresses, there are plenty of options available to help you manage the sensation of the contractions as they get stronger and more intense.
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<a href="https://admin.mumandbaby.uk/2018/08/14/coping-in-early-labour/">Coping in early labour</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/self-hypnosis-deep-relaxation-techniques/">Self-hypnosis/Deep relaxation techniques</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/complementary-therapies/">Complementary therapies</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/tens-transcutaneous-electrical-nerve-stimulation/">TENS (transcutaneous electrical nerve stimulation)</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/gas-and-air-entonox/">Gas and air (Entonox)</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/water/">Water</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/opioids/">Opioids (pethidine/diamorphine/meptid)</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/epidural/">Epidural</a>

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<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/pain-relief-labour/" type="nhs">Pain relief in labour</a>

<a href="https://www.labourpains.org">Pain relief information in English and other languages</a>

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Coping strategies and pain relief in labour

<h1>Emergencies</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2018/10/1.1.10.jpg" alt="Woman looking concerned while making a mobile phone call" width="650" height="406" class="alignnone size-full wp-image-2893" />
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<a href="https://admin.mumandbaby.uk/2018/08/08/before-18-20-weeks-gestation/">Before 18-20 weeks gestation</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/after-18-20-weeks-gestation/">After 18-20 weeks gestation</a>

<a href="https://admin.mumandbaby.uk/2018/08/08/after-37-weeks-gestation-when-expecting-labour/">After 37 weeks gestation/when expecting labour</a>

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<a href="https://admin.mumandbaby.uk/2018/08/06/maternity-units/" internal="true">Contact my maternity unit</a>

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Emergencies

<h1>Monitoring your baby</h1>
<img src="https://admin.mumandbaby.uk/wp-content/uploads/2020/05/Monitoring-baby-650x406.jpg" alt="Heavily pregnant woman lies on her side while a fetal monitor is attached to her abdomen" width="650" height="406" class="alignnone size-full wp-image-11861" />

<span style="font-weight: 400;">During labour, your midwife will listen to your baby’s heartbeat to check his/her wellbeing, and to ensure he/she is coping well with labour. </span>

<span style="font-weight: 400;">There are three different ways your midwife can check this, by using either:</span>
<ul>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">a hand-held machine</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">a Pinard stethoscope; or </span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">continuous electronic fetal monitoring.</span></li>
</ul>
<span style="font-weight: 400;">If you have had a normal and healthy pregnancy, and your labour started naturally after 37 weeks, you will normally be offered monitoring using a small-hand held machine which produces the sound of your baby’s heartbeat. This is the same machine that your midwife/doctor used to listen to your baby’s heartbeat during pregnancy. </span>

<span style="font-weight: 400;">Your midwife will listen to your baby’s heartbeat intermittently and regularly throughout labour. Your midwife may offer to listen to your baby's heartbeat with a Pinard stethoscope. Like a traditional stethoscope you will not be able to hear the heartbeat but the midwife will hear it clearly. </span>

<span style="font-weight: 400;">Continuous electronic fetal monitoring (sometimes called a CTG) is a machine which is used to record your baby’s heartbeat and the contractions of your womb constantly throughout labour. It may be recommended that you have this type of monitoring if you’ve had any complications during pregnancy or labour and if you are using an epidural for pain relief. Midwives and/or doctors will look at this recording regularly throughout labour. You will need to wear two belts around your abdomen to keep the monitors in place. In some units a wireless machine may be available (this is known as telemetry), which means you may be able to move around more freely. </span>

<span>It is helpful to discuss the benefits of the different methods of monitoring prior to going into labour.  The method recommended by the midwife or doctor will depend on the health of you and your baby at the onset of labour.</span>

<span style="font-weight: 400;">Additional monitoring may be recommended if your midwives or doctors are concerned about your baby’s heartbeat during labour, this could be either: </span>
<ul>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">a fetal scalp electrode (FSE) which is attached directly to your baby’s head</span></li>
 	<li style="font-weight: 400;"><span style="font-weight: 400;">a fetal blood sample (FBS). This test involves taking a very small sample of blood from your baby’s head to check how they are coping.</span></li>
</ul>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/what-happens-during-labour-and-birth/" type="nhs">What happens during labour</a>

<a href="https://www.tommys.org/pregnancy-information/labour-birth/monitoring-your-baby-labour" type="tommy's">Monitoring your baby in labour</a>

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Monitoring your baby

<h1>My team for labour and birth</h1>
<img class="alignnone size-full wp-image-1133" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.8.jpg" alt="Midwife touches the control of a monitoring machine" width="650" height="406" />
<h2>Midwives</h2>
<span style="font-weight: 400;">Midwives are your main carers in labour, whether you choose to have your baby at home, in a midwifery-led birth centre or on an obstetric labour ward. Women in established labour will normally receive one-to-one care in labour from a named midwife. Your midwife will support you during labour, ensuring you and your baby are well and safe.  </span>
<h2>Obstetricians</h2>
<span style="font-weight: 400;">An obstetrician will be involved in your care if any complications or more complex needs arise during labour and/or birth. If an induction of labour is recommended for you, or if your labour and/or birth slow down it is likely that you will be seen by an obstetrician. If there are concerns with your health,  the health of your baby or if an assisted or caesarean birth is recommended you will also be seen by and cared for by an obstetrician who will work in partnership with your midwife. </span>
<h2>Maternity support workers</h2>
<span style="font-weight: 400;">These may work under the direct supervision of your midwife to provide you with support during labour.  They may also help you with feeding your baby immediately after birth.</span>
<h2>Anaesthetist</h2>
<span style="font-weight: 400;">If you have an epidural during labour, this will be put in by an anaesthetist. If you require a caesarean birth, you will also be cared for in theatre by an anaesthetist, in partnership with an obstetrician and your midwife. Anaesthetists may also become involved in your care if you have any complications or need a higher level of care due to medical conditions.</span>
<h2>Theatre team</h2>
<span style="font-weight: 400;">If you have a planned or emergency caesarean birth, there will be staff in the theatre to assist the anaesthetist, obstetrician and midwife who are caring for you. You may also be in theatre if an assisted birth is recommended, or if you have any complications after the birth that require more intensive care. </span>
<h2>Student midwives/doctors</h2>
<span style="font-weight: 400;">During labour and birth, there may be a student midwife or doctor working with your named midwife. Student midwives or doctors may provide you with care and support under direct or indirect supervision of the midwife, depending on their stage of training. Care will only be provided with your consent, and your midwife will discuss this with you.  </span>
<h2>Admin/clerical</h2>
<span style="font-weight: 400;">The team of midwives and doctors in birth centres and labour wards are supported by a team of reception, clerical and administrative staff that you may meet. Please ensure you inform the clerical team if you have any changes to your contact number, address or GP to ensure that information is recorded correctly on key documentation.</span>
<div data-cat="relatedlinks" class="relatedlinks">

<a href="https://www.nhs.uk/conditions/pregnancy-and-baby/antenatal-team-midwife-obstetrician-pregnant/" type="nhs">Your team for labour and birth</a>

<a href="https://www.nct.org.uk/pregnancy/your-care-through-pregnancy-labour-and-birth" type="nct">Midwife-led care in labour</a>

</div>

My team for birth and labour

<h1>Planned (elective) caesarean birth</h1>
<img class="alignnone size-full wp-image-1118" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.4.jpg" alt="Baby delivered by caesarean birth in an operating theatre being held while the umbilical cord is clamped" width="650" height="406" />
<span style="font-weight: 400;">
Just over one in ten women will have a planned caesarean birth. This is due to a variety of factors, and the decision will be made together with your obstetric and midwifery team.</span>

<span>Some people start labour or break their waters before the planned caesarean date.  If this happens, you should contact your maternity unit straight away.</span>

<span style="font-weight: 400;">
The day before your caesarean you will be asked to take some medications. These should be taken the night before and also on the morning of your operation, as directed. You should not eat any food after midnight but may drink water until 6am on the morning of your operation.
</span>
<span style="font-weight: 400;">
On the day of your caesarean you will normally arrive at your maternity unit early in the morning. Sometimes if the labour ward is busy, you may have to wait for a period of time before your operation can start. In the operating theatre, your chosen birth partner can normally accompany you and can stay by your side throughout the surgery, unless, for medical reasons, you require a general anaesthetic.
</span>
<span style="font-weight: 400;">
The majority of women have a spinal anaesthetic or combined spinal epidural which causes the body to go numb from the abdomen to the feet. A catheter will be inserted into your bladder, and this will normally be removed the following day. Once the operation starts, the baby is normally born within 10 minutes, and all being well you can have skin-to-skin contact with your baby in the operating theatre while the operation is completed. If your waters have broken, a gentle vaginal cleansing solution will be used to reduce the risk of infection.</span>

<span style="font-weight: 400;">After the surgery you will spend a few hours in a recovery area, and a nurse or midwife will check your observations regularly. You can start bonding with and feeding your baby during this time. Your anaesthetic will wear off after a few hours.</span>

<span style="font-weight: 400;">You will normally stay on a postnatal ward for one to three nights, depending on your recovery. You will be given regular painkillers. You will be helped to become mobile once the anaesthetic wears off. Early
mobilisation and pressure stockings are recommended for all women to reduce the risk of developing blood clots after surgery. Some women are offered blood thinning injections.</span>
<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.nhs.uk/conditions/caesarean-section/what-happens/" type="nhs">Caesarean birth: what happens</a>
<a href="https://www.nct.org.uk/labour-birth/different-types-birth/caesarean-birth/having-caesarean-what-expect" type="nct">More on caesarean birth</a>

<a type="rcog" href="https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/considering-a-caesarean-birth-patient-information-leaflet/">Considering a caesarean birth patient informaton leaflet</a>

<a href="https://www.birthrights.org.uk/factsheets/right-to-a-c-section/">Your right to a caesarean birth</a>

<a href="https://www.birthrights.org.uk/factsheets/consenting-to-treatment/">Consent: the key facts - Birthrights</a>

</div>

Planned caesarean birth

<h1>Positions for labour and birth</h1>
<img class="alignnone size-full wp-image-1117" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.3.jpg" alt="Heavily pregnant woman stands bent forward at right angles with her elbows resting on the back of a sofa" width="650" height="406" />

<span>During labour, it is good to stay as active as possible, and to try different positions. By doing this you will encourage your baby through the birth canal in the best position for birth, whilst also helping your own comfort and coping ability. Staying active and upright is also known to shorten the length of labour.</span>

<span>You can try:</span>
<ul>
 	<li>walking</li>
 	<li>standing with support from your birth partner</li>
 	<li>going up and down stairs</li>
 	<li>rocking/swaying</li>
 	<li>using a birthing ball</li>
 	<li>sitting upright or squatting</li>
 	<li>all fours position (on your hands and knees) or kneeling</li>
 	<li>lying on your side, supported by pillows (when you want to rest).</li>
</ul>
<span>During birth, your midwife will support you to try different positions. It is important to listen to your body, and try whatever feels right for you. The positions you can adopt may depend on whether you’ve chosen to have a water birth, or if you have an epidural.</span>

<div class="videoplayer" data-cat="video">Positions for birth
<iframe src="https://www.youtube.com/embed/gDZ3PfCD7Go?rel=0&amp;showinfo=0" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe></div>

<div class="relatedlinks" data-cat="relatedlinks">

<a href="https://www.babycentre.co.uk/l25025610/16-birthing-positions-for-labour-images">Birthing positions for labour</a>

<a href="https://www.buzzsprout.com/961453/8528365-episode-57-upright-birth">Upright birth - Episode 57, The Obs Pod</a>
</div>

Positions for labour and birth

<h1>Stages of labour</h1>
<img class="alignnone size-full wp-image-1115" src="https://admin.mumandbaby.uk/wp-content/uploads/2018/09/2.2.1.jpg" alt="Heavily pregnant woman sits on a exercise ball in her hospital room and is held from behind by her birth partner" width="650" height="406" />

<span>Labour is divided into four stages:</span>
	
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<a href="https://admin.mumandbaby.uk/2018/08/14/early-labour-latent-phase/">Early labour/latent phase</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/first-stage/">First stage</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/second-stage/">Second stage</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/third-stage/">Third stage</a>

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Stages of labour

What to expect in labour and birth

<h1>Labour and birth</h1>
<div class="submenu" data-cat="submenu"><a href="https://admin.mumandbaby.uk/2018/08/14/early-signs-of-labour/">Early signs of labour</a>
<a href="https://admin.mumandbaby.uk/2018/08/29/what-to-expect-in-labour-birth/">What to expect in labour and birth</a>
<a href="https://admin.mumandbaby.uk/2018/08/17/assisted-birth/">Assisted birth</a>

<a href="https://admin.mumandbaby.uk/2018/08/14/preterm-labour-and-birth/">Preterm labour and birth</a>

<a href="https://admin.mumandbaby.uk/2018/09/03/immediately-after-giving-birth/">Immediately after giving birth</a>

<a href="https://admin.mumandbaby.uk/2021/08/31/tips-for-birth-partners/">Tips for birth partners</a>

<a href="https://admin.mumandbaby.uk/2020/06/10/what-if-my-baby-needs-additional-support/">What if my baby needs additional support?</a>

<a href="https://admin.mumandbaby.uk/2021/08/27/if-your-baby-is-too-unwell-to-survive/">If your baby is too unwell to survive</a>
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COOKIE SETTINGS

MANAGE COOKIE PREFERENCE

Labour and birth