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Maternity Unit

Labour and birth process

If all has been well in your pregnancy and you are classed as a low risk pregnancy, it is often better to stay at home during early labour.

This increases your chances of a normal birth.

This section outlines what happens during labour and which types of birth women experience. The staff here in Newcastle will encourage you to gain enough information in order for you plan what kind of labour and birth you may wish however we recognise that labour does not always follow a set pattern. There is lots of information available on the NHS choices website including short video clips for you to view. NHS CHOICES


What should I do in early labour?

The early stage of labour can last for a number of hours while the cervix (neck of the womb) softens and starts to prepare for labour. This stage is usually longer in first time mums and this can be very frustrating, particularly if you are told you are not yet in established labour. 

This is classed as early labour or the latent phase of labour and may go on for some hours. This time is vital to allow your cervix to soften so that it then dilates more easily.

Contractions

Contractions may start very gradually and be spaced far apart. In the early stages they can best be described as strong period cramps. You may feel sick and have diarrhoea, both are signs that contractions may be on the way. As the cervix softens, thins and starts to open, you may have a 'show'. This is a mucous lightly blood-stained loss from your vagina and is normal. Sometimes you have a show before labour starts.

Established labour is confirmed when your cervix has dilated to four centimetres or more.

If you are classed as high risk, or if you go into labour early, it is wise to ring the Maternity Assessment Unit for advice on what to do next and when to come in.

At some time the membranes containing the baby and amniotic fluid may burst. When you telephone the Maternity Assessment Unit the midwife will ask you to describe what has happened and ask further questions if necessary. You may be quite certain if the waters have ‘gone’ with a gush, but sometimes it is less clear and there may only be a trickle. In this case, put on a pad and observe the loss for a while. Please phone the MAU and tell the midwife what colour the fluid is and how the baby is moving. Whether your contractions have started or not, we will ask you to come to the MAU to be checked over.

24 hour services to contact

If you think that you might be in labour we have the following 24 hour services:

  • Before 37 weeks: all enquires to the Maternity Assessment Unit - tel: 0191 282 5748
  • After 37 weeks: all enquires to the Labour line - tel: 0191 282 6363

As labour unfolds - the first stage

Your midwife will carefully record and monitor your progress. This usually includes a vaginal examination about every four hours once labour has established.

During this time, contractions become longer, stronger and closer together. Your midwife will try to ensure that your needs for support and relief from pain are met. You may want to use the pool.

Labour uses a lot of your energy, try to be well nourished before labour starts. Small, easily digested snacks are best. During labour, you may not have much of an appetite, eat and drink to satisfy your needs. If you decide to use medical forms of pain relief, we would ask you to have only water.

Be prepared

The labour rooms are warm so you and your birth companions may want to dress appropriately and bring bottled water to drink. Some women enjoy sucking on ice, so you might consider bringing a flask with ice in. Partners may bring food for themselves and there is a shop in Leazes Wing open from 8.00am to 8.00pm and a café open from 9.00am until 2.00am.

Find a comfortable position, try leaning against the windowsill, kneeling on the bed or floor, lying on your side. Use whatever is in the room to make yourself comfortable and change position as you need to. Ask the midwife if you would like to try one of the birth balls, bean bags, the pool or the shower.

The birth of your baby - the second stage

When the cervix is completely open, we say that you are 'fully dilated'. At this point there is nothing to stop the baby from being born but there is still a while to go as the baby has to move down the birth canal.

Soon, the baby's head will press downwards and stimulate the nerve endings in your bottom. These are the same nerves that are triggered when you open your bowels and the feeling is often similar. You may feel that you will open your bowels if you push now, and sometimes this happens. Please don’t be embarrassed about this, it is a common feeling and the midwife is used to this. The contractions you are experiencing now may have a different feel to those you experienced earlier in labour. You may feel more out of control. This stage is called 'transition' and is typically the time when women may become irrational or distressed. Not all women behave in this way, but what you are feeling is very intense. Let yourself go and do whatever feels natural. Midwives are used to this change in behaviour. Please don’t feel embarrassed by anything you want to do or say.

When the baby's head is visible

The midwife will tell you when the baby's head is visible. Listen very carefully to the midwife as the baby is being born. We are trying to keep the soft tissues of your perineum (the area between your vagina and bottom) from tearing and will tell you to breathe as the baby's head is born.

This slows down the force of the pushes and allows the baby to emerge gently. If you wish, your baby is placed onto your tummy so you can hold him or her next to your skin where the baby will enjoy the feeling of warmth. If you have asked to cut the umbilical cord, the midwife will help you do this now.

Please talk to your midwife if you prefer to have you baby wrapped first.

After the baby Is born

After the birth of the baby you will need to pass your placenta (afterbirth). Many women are currently requesting delayed cord clamping which can be beneficial for baby. This involves waiting for at least one minute after the birth before clamping the cord to allow extra blood to flow from the placenta into your baby. Please talk to your midwife well before the baby is born so you can discuss the method of delivering your placenta. If you wish to have this stage of your labour actively managed, rather  than expectant mangement (just waiting), the midwife will give you an injection, called Syntocinon, in the top of your leg. This causes the uterus to contract strongly and separates the placenta so that it can be delivered. This is the most common way to have the placenta delivered in the UK.

If you would rather wait for the placenta to come out naturally it may be delivered after a short length of time but can often take longer to be delivered. Providing you are not losing too much blood from your vagina, we are happy to wait for the placenta to come.  You might want to write about this in your Birth Plan.

The midwife will check that the baby is fine and that your vagina and perineum are OK. You will then be left to enjoy your new baby. This is a good time to try the baby to your breast if you plan to feed that way. Babies can be very alert just after birth and may make a good attempt at feeding. Ask your midwife if you would like help. We will bring you some tea and toast and offer you a bath or shower if you would like one. If your baby is enjoying 'skin to skin' contact, this can be continued with your partner while you go for a bath or shower.

Episiotomy and tears

An episiotomy is a deliberate cut to the perineum that may be done to help the delivery of your baby. When a baby is born it stretches the opening of the vagina and the walls and skin of the vagina will often stretch without tearing. But it can take several minutes for the vaginal tissue to stretch fully and if there is a need to urgently deliver the baby an episiotomy may be required to speed up the delivery.

To repair the cut or tear you will receive a local anaesthetic to numb the area, unless you already have an effective epidural. Dissolvable stitches are used which do not need to be removed.

Skin to skin contact

Both you and your baby will benefit from close skin to skin contact after birth. Holding your undressed baby close to your skin helps calm your baby and keep your baby feeling comforted warm and secure.

Holding your baby against your skin is a lovely way to get to know your baby. Lots of skin to skin contact in the first few days and weeks can also help with establishing breastfeeding. Skin to skin contact can start almost immediately after any type of delivery, ask your midwife about all of the benefits and how we can help you at this most important time.

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