<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.
<div class="submenu" data-cat="submenu">

<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>

</div>
<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>

</div>

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" />
<div data-cat="submenu" class="submenu">

<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>

</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>

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>

</div>

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>
	
<div data-cat="submenu" class="submenu">

<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>

</div>





COOKIE SETTINGS

MANAGE COOKIE PREFERENCE

What to expect in labour and birth

Stages of labour