At the end of your pregnancy your body gets ready to go into labour.  Some women may feel sick and have diarrhoea. This is nature's way of emptying out your digestive system so that it can begin the work of labour. Some women may experience a 'nesting' urge or have a rush of energy - these are signs that contractions may be on the way and the energy is for labour.

As the neck of the womb or cervix, thins and starts to open, you may have a 'show'. This is a mucousy, blood-stained loss from your vagina and is normal.

Contractions may start very gradually and be spaced far apart. In the early stages, they can best be described as strong period cramps. They may be felt in your abdomen, back and/or down your legs.

Keep a note of the timing of contractions, they may be further apart that you think and they may disappear altogether. This part of your labour can be very frustrating.

At some time during your labour, the membranes containing the baby and amniotic fluid may burst. When you telephone the Maternity Unit, the midwife will ask if you think this has happened. If the waters have ‘gone’ with a gush, you may be quite sure they have. But sometimes it is less clear and the waters may trickle from your vagina. In this case, put on a pad and observe the loss for a while. Please phone the Maternity Unit and tell the midwife what colour the fluid is and how the baby is moving. The midwife will ask you to come to the Maternity Assessment Unit to be checked over.

During early labour it is good to stay at home.  We ask you to come to the Maternity Unit when you feel you need the support of the staff there and need to think about pain relief.

The midwife will monitor your progress by keeping a careful record of how you and your baby are. 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.  If all is well, you may want to use the pool or our Snoozlum Room. Ask your midwife about how you can use these.

Labour uses a lot of your energy, try to be well nourished before labour starts. Small, easily digested snacks are best, such as fruit, pasta, cereal etc. During labour, you may not have much of an appetite. Eat and drink to satisfy your needs – your body will let you know if it doesn’t want anything. If all is progressing normally, you can continue to eat and drink as you wish. If you decide to use medical forms of pain relief, we would ask you to have only water.

The labour rooms are hot. You and your birth partner 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 need some food for themselves during labour. (The shop in Leazes wing is open from 8.00 am to 8.00 pm and the café is open from 9.00 am until 2.00 am.) 

Think about what position you will be most comfortable in. 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.

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. The baby has to move down the birth canal. Contractions may slow down or stop for a while.

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 exactly the same. 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 your midwife is used to this.

The contractions you are experiencing now may have a different quality to them than 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.

The midwife will tell you when the baby's head is visible. Listen very carefully to your 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 'pant' or 'blow' as the baby's head is born. This slows down the force of the pushes and allows the baby to emerge gently.

Sometimes, we cannot prevent a tear from happening. More rarely, the midwife may need to make a cut, called an episiotomy, to help the baby to be born. In both cases, the midwife will check carefully after the birth and you may need stitches.  Some tears heal well without stitches.

The midwife will help your baby to be born and place the baby onto your abdomen so you can hold him or her next to your skin, if this is what you have agreed to do. The midwife will dry the baby and you and your partner can hold the new arrival against 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.

If you prefer to have the baby wrapped before you hold her or him, please talk to your midwife.

Next you have to deliver the placenta and membranes. In most cases, the midwife will give you an injection, called Syntocinon, in the top of your leg after the baby is born. This causes the uterus to contract strongly and detaches the placenta so that it can be delivered. If you would rather not have this injection, the placenta will 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. Please talk to your midwife well before the baby is born and you can discuss the method of delivering your placenta. 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 the pay phone and 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