Labour and birth

Where you give birth is your choice. Here at Bradford you may choose to give birth at home, at our along-side birth centre and our labour ward. Women with more complex needs may be advised to give birth on our labour ward where their care can be more specialised. Women who have midwife led care will be encouraged to consider a birth at home or on the birth centre.

Speak to your midwife about the available options.

The start of labour is called the latent phase. This is when your cervix becomes soft and thin, and starts opening for your baby to be born. This can take hours or sometimes days.

You’ll probably be advised to stay at home during this time. Please see the video with some useful tips and coping strategies.

Latent phase of labour – Punjabi

Latent phase of labour – Urdu

A birth plan is a record of what you would like to happen during your labour and after the birth. You don’t have to create a birth plan but, if you would like one, your midwife will be able to help.

Discussing a birth plan with your midwife gives you the chance to ask questions and find out more about what happens in labour and gives you the opportunity to explore your own preferences. It also gives your midwife the chance to get to know you better, and understand your feelings and priorities, and allows you to think about or discuss some things more fully with your partner, friends and relatives.

During the 1st stage of labour, contractions make your cervix gradually open (dilate). This is usually the longest stage of labour.

The 2nd stage of labour lasts from when your cervix is fully dilated until the birth of your baby.

You’ll usually be able to hold your baby immediately and enjoy some skin-to-skin time together.

The 3rd stage of labour happens after your baby is born, when your womb contracts and the placenta comes out through your vagina.

We now have a class specifically aimed at partners.

It’s helpful to know which pain relief options are available before the birth. If you know what you can have, you may find it easier to stay calm and try to relax as much as you can, which can mean an easier birth. If you are stressed and tense, your contractions may feel more painful and become less effective.

Write down your wishes in your birth plan, but remember you need to keep an open mind. You may find you want more pain relief than you’d planned.

After your baby is born, hold him against your skin as soon as possible, and for as long as you want. Skin to skin contact reduces baby’s stress level by 75%. This will calm him and give you both the chance to rest, keep warm and get to know each other.

If you want to breastfeed, this is a great time to start as your baby might move towards the breast and work out the best way to suckle for himself. Breastfeeding also releases lots of oxytocin in baby and mother, which will help you to feel close and connected. If you choose to bottle feed, giving the first feed in skin contact while holding your baby close and looking into his eyes will also help you bond.

You have lots of decisions to make during pregnancy, in labour and when you have had your baby. In order to make informed decisions about your care you can use a decision making tool like the BRAIN tool.

B Benefits. What are the benefits?

R Risks. What are the risks and considerations?

A Alternatives. What are the alternatives, and what are the risks and benefits of those?

I Intuition / information. How do you feel? Do you need more information?

N Nothing / not now. Do I need to decide now? What if I do nothing?

Sometimes a doctor or midwife may need to make a cut in the area between the vagina and anus (perineum) during childbirth. This is called an episiotomy.

An episiotomy makes the opening of the vagina a bit wider, allowing the baby to come through it more easily.

Sometimes a woman’s perineum may tear as their baby comes out. In some births, an episiotomy can help to prevent a severe tear or speed up delivery if the baby needs to be born quickly.

If your doctor or midwife feels you need an episiotomy when you’re in labour, they will discuss this with you. In England, episiotomies are not done routinely.

Up to 9 in 10 first-time mothers who have a vaginal birth will have some sort of tear, graze or episiotomy.

The National Institute for Health and Care Excellence recommends that an episiotomy might be done if:

• the baby is in distress and needs to be born quickly, or
• there is a need for forceps or vacuum (ventouse), or
• there is a risk of a tear to the anus

Around 1 in 7 deliveries in England involves an episiotomy.

If you have a tear or an episiotomy, you’ll probably need stitches to repair it. Dissolvable stitches are used, so you will not need to return to hospital to have them removed.

Massaging the perineum in the last few weeks of pregnancy can reduce the chances of having an episiotomy and perineal trauma during birth.

The type and frequency of massage varies across research studies. Most involve inserting 1 or 2 fingers into the vagina and applying downward or sweeping pressure towards the perineum.

The most benefit was in women who repeated this every day.