Having Your Baby
When you think you are in labour
If you are planning to have a home birth your community midwife will have explained to you how to contact a midwife when you go into labour. There is a midwife available 24 hours a day to support you to birth your baby at home.
If you are planning to have your baby in hospital please call the Delivery Suite:
- when your contractions are regular, at least ten minutes apart and painful. A good indication of this is when you cannot talk when you have them and you really have to concentrate on your breathing;
- when you think your waters may have broken;
- if you have any bleeding;
- if your baby's movements are different to normal
The midwife will ask you some questions about your pregnancy to date. She will listen to you when you have a contraction as this will help her know how you are coping and assess which stage of labour you are in. The midwife may be able to advise you on how to cope at home until your labour is well established. Some women call several times before they come in to the hospital.
Why you might be advised to stay or go back home
When you call, the midwife will talk to you about how your labour is progressing. As long as all is normal, you may be advised to stay at home until labour becomes established. If you come into hospital the same process will be carried out. You may be advised to go home to wait for labour to become more established. If you are unhappy with this advice please discuss this with the midwife.
When you come to the hospital in labour the midwife will monitor your contractions. You may be offered an internal examination to see how far your labour has progressed. If this shows you are still in the early stages of labour, it is often better for you to be at home where you can be more active and relaxed.
If you go home, the midwife will give you advice which will help you cope with your labour.
When you are in established labour
You will be assessed by the midwife. If your labour is advanced you will be shown to your delivery room. The midwife will discuss your birth plan with you and support you during your labour and birth.
Meadow Birth Centre
On 30 March 2015, Meadow Birth Centre, a brand new midwife-led birth centre opened at Worcestershire Royal Hospital, giving you more choice over where your baby is delivered.
The centre, run by experienced midwives, offers a comfortable environment where birth is treated as a ‘normal’ process (without intervention), rather than a medical one.
The four-room centre (each with an en-suite) is near to the current delivery suite, but not a part of it. It looks and feels homely – not like a hospital – helping you to feel comfortable and relaxed.
For more information visit the Meadow Birth Centre page.
Home is an ideal place to have your baby
You are likely to be more relaxed within your own familiar surroundings, with family close at hand.
You can consider a home birth if you:
- are having a straightforward pregnancy
- have no medical problems
- have had nocomplications with a previous birth
If you are interested in having a home birth please discuss it with your community midwife as soon as possible. Be assured that a local community midwife is on call 24 hours a day to help you birth your baby at home.
A good tip!
Many mums like the idea of a birthing pool to use at home. You can choose from many suppliers. Have a look on line and/or speak to your community midwife for tips on getting the right one for you.
Do you fancy relaxing in water during you labour?
Using a birth pool to have your baby can be a really positive experience. Many mums who have given birth that way say the warm water relaxed them and helped them cope with labour. If you want to give birth in water, research so far suggests that it is just as safe as giving birth in air. It may also make your baby's journey into the world a calmer one.
Birthing pools are available in most of our birthing rooms.
Nobody knows exactly how labour will feel until it starts. Some mums find that labour is bearable with little or no pain relief. However many are likely to want help at some point. Whichever way it is for you, take a look at the options for pain relief. It's useful to read up about your choices early on. You can also discuss the options with your community midwife.
We offer a wide selection of pain relief. This gives choice to all of our clients whether having your first baby or your fourth!
When your labour starts, you'll probably feel quite restless. You'll want to move around and keep busy. Just take care that you don't get over tired before your labour is properly underway. Have short rests, in a chair or lying down. If your contractions start at night, try to stay in bed and relax for as long as possible.
When you come into hospital we have a number of ways of helping you manage your pain.
Aromatherapy is the use of essential oils for therapeutic effects and are derived from plants and flowers. They have various properties derived by their chemical make up and can help:
- To reduce anxiety and fear
- Alleviate pain
- Assist contractions thereby accelerate labour
- Alleviate nausea and vomitting
- Enhance maternal well being during labour
Administration can be from inhalation, footbaths or massage. Administering oils in the form of a massage can convey pain reducing messages, stimulating deep sensory receptors. The Midwife may be able to demonstrate massage and the birth partner would be able to continue thus enhancing the birth experience.
In promoting the use of non pharmacological substances women are mobile longer and therefore aiding optimal fetal positioning for labour. Women are more in control during their labour and bond with baby quickly afterwards.
Not all of the midwives are trained to use aromatherapy, but ask the midwife when you come into labour ward.
A birth ball is a standard physiotherapy ball used in physical therapy departments all over the world. These balls are great for relieving discomfort during pregnancy and also labour. It provides a firm yet soft place to sit. It also helps you to get into a good position during labour and so helping to stop you from straining your muscles.
There is a birth ball available for you to use in your delivery room. These are sometimes more comfortable than a bed and will help to keep you active and mobile during your labour.
Gas and air
Entonox, or gas and air, is a colourless and odourless gas. It is made up of half oxygen and half nitrous oxide, or laughing gas, as it is commonly known. It has a calming effect and takes the edge off labour pain, rather than blocking it out completely. Gas and air is available in all our delivery rooms.
This is a painkilling drug and it can also help you to relax. This drug is given to you using an injection. However it does have several side affects which your midwife can discuss with you.
TENS stands for transcutaneous electrical nerve stimulation. A TENS machine consists of a small box with a clip on the back that you can attach to your clothing. The machine gives out little pulses of electrical energy. Leading out of the box are four wires connected to sticky pads. Your birth partner can place the pads on your back for you.
TENS seems to work best and give you the most effective pain relief if you start using it at the very beginning of your labour. If you want to use this method of pain relief we advise you to hire or buy a TENS machine. You can use it at home before you come into hospital, if you are having a hospital birth.
It takes about an hour for your body to respond to the electrical impulses by releasing endorphins, so start using it when you're getting regular contractions or backache. You may find your machine works better at relieving your backache than abdominal pain.
TENS units are available to hire from the hospital. To make sure you can have one when you want it we recommend you hire your own and bring it in with you.
An epidural is a small plastic tube that sits in the space surrounding your spinal cord. The plastic tube is fed through a needle placed in your back to make sure it is in the correct position and then the needle is removed, leaving only the plastic tube itself taped to your back.
A local anaesthetic called Bupivacaine and a very small dose of a morphine-like drug called Fentanyl are injected through the plastic tube and act by numbing the nerves which pass out from your spinal cord and travel to the areas causing pain such as your womb, cervix and vagina. At Worcestershire Royal Hospital we use a system called PCEA (patient controlled epidural analgesia). This means you have a button to press when you require pain relief, giving you more control over how much drug relief you receive and the ability to try and reduce side effects such as heavy legs.
Planned C-sections at Worcestershire Royal Hospital
A caesarean section is an operation performed to deliver the baby through a cut in your lower abdomen (usually just below your bikini line).
There will be several people looking after you during your planned procedure:
- An operating obstetrician with an assistant
- One consultant anaesthetist
- One junior anaesthetist
- One midwife
- A variety of operating theatre staff
There may be more if the procedure is predicted to be complicated.
Available pain relief
There are three different ways that you can be anaesthetised for an elective caesarean section:
- a spinal anaesthetic,
- an epidural anaesthetic
- or a general anaesthetic.
At Worcestershire Royal Hospital the preferred method is to use a spinal for most mothers but the ultimate choice of how you are anaesthetised lies with you after a discussion with an obstetric anaesthetist about the pros and cons of the different anaesthetic options.
A spinal uses a very fine needle to inject a mixture of local anaesthetic and a morphine-like drug (diamorphine) into the sack of fluid that surrounds your spinal cord. The drugs then act to numb the nerves directly, as they pass out from your spinal cord to other areas of your body. The injection itself is performed in your lower back at about the level of your hips and will affect all sensation from your toes up to your chest. This will last around two - three hours and then gradually wear off.
Delivering your baby
For planned caesarean sections at Worcestershire Royal Hospital your baby is left attached to your placenta for two minutes after he or she is delivered (delayed cord clamping).
Your baby is then passed to your midwife who will check they are warm, well and breathing adequately. She will then pass your baby to you so that you can establish skin to skin contact if you wish.
Your baby will normally be weighed during the course of the procedure as well. The remainder of the operation normally takes approximately 30 to 45 minutes during which time the surgeon will make sure there is no bleeding from your wounds and sew you back together.
After the operation
Usually your partner will be asked to wait in the recovery area with your baby whilst we clean and transfer you to your bed at the end of the operation. At this stage we can position you for breastfeeding in bed because your legs will still be very numb and heavy; we can also perform any extra pain relief procedures at this stage if required and agreed between you and your anaesthetist.
You will then be moved next door to our recovery area where we will observe you for at least 30 minutes to ensure you have no ongoing bleeding or problems with your blood pressure. At this stage you may breastfeed, have a drink or something to eat if you feel like it and have individuals come and visit you and your baby for a short time. You will usually be transferred back to the postnatal ward when you are medically stable enough to go.
Problems after your c-section
The most common problems that mothers may have after spinal or epidural anaesthesia are likely to be headaches or prolonged patches of numbness or weakness in their abdomen or legs.
While these problems can be caused by a wide variety of reasons, as well as your anaesthetic, you should still speak to your midwife or hospital maternity triage service to get anaesthetic advice in the first instance. It may well be we can help you over the phone but we also have an obstetric anaesthetic clinic where we can meet with you to discuss any more complicated problems.