Unless your pregnancy has been identified as high risk, the best place to be in early labour is at home. Being in your home environment will help you to relax and allow the labour to establish naturally without intervention. You should consider contacting the hospital when your contractions (pains) are occurring frequently and increasing in intensity and duration. For the majority of women, the regular pains of established labour will last for 40-60 seconds and be 2-5 minutes apart. We strongly advise that you come into hospital if you think your waters may have broken, if you have a fresh, red blood loss (that is different to a 'mucous show,') if you haven't felt your baby move for a while, if you have started labour before 37 weeks or if you have any signs and symptoms that are causing worry or concern. Please call the delivery suite for advice if you are unsure when to attend the hospital.
The experience of labour is unique for every individual woman, and no two labours are the same! Nature will allow your labour to build up slowly and gently; this is often called the latent phase of labour whereby the contractions (pains) will not be powerful or frequent enough to push the baby through the birth canal. Latent labour can sometimes last for many hours before it becomes established (although you will have long periods of rest between pains.) As a general rule of thumb, particularly for first time mums, the average length of established labour (ie. when pains are frequent and powerful) lasts between 12-16 hours.
If your labour is progressing normally, it is best to allow the waters to break of their own accord. This can be at any stage in the labour, sometimes just as your baby is being born. The practice of breaking the waters or Artificial Rupture of the Membranes (ARM) may be suggested if it is appropriate to attempt to accelerate your labour or if we are concerned about the well-being of your baby.
If it is less than 24 hours since your waters broke, and you and your baby are well, it is perfectly safe to have a bath. Water may help to relax you and allow your labour to progress naturally. It is advisable just to use plain water and not add any soaps or toiletries to the bath water. If your waters have broken and you notice a green or brown colouration or an offensive smell, please come straight to the hospital for advice.
The Natural Birth Centre (NBC) is a midwifery-led, home-from-home birthing suite. There are no doctors on site in the NBC and we actively promote birth without intervention or epidural analgesia. If your pregnancy is low risk, that is, without any past or current medical complications affecting either you or your baby, and you are motivated to birth naturally, you will be suitable to use the NBC. Please speak to your midwife either during your pregnancy or when in early labour if you are unsure of your suitability for the NBC.
If your pregnancy or labour has deviated from a 'low risk' category, we will support you to give birth on our main delivery suite. The presence of medical staff and equipment does not mean you cannot birth normally and we will attempt to keep you as active as possible during your labour, whilst ensuring that safety is paramount. We have mats, bean-bags and a birthing pool on the main delivery suite to keep your experience as normal as possible and our midwifery team are encouraged to discuss all options with you. The welfare of your baby is extremely important in labour and we aim to support you as much as possible when continuous monitoring of your baby's heartbeat is advised.
For many women, only midwives will be present at the birth. Midwives who practise in the UK are highly skilled and highly trained to be the experts in supporting normal childbirth. Midwives work together with the obstetric team (high risk pregnancy) and may seek the assistance of a skilled doctor should your labour require medical opinion or assistance at any stage. It is important we work together as a team to provide a safe and quality birth experience for you and your baby. The presence of a doctor in your birthing room does not mean that you cannot achieve a normal birth!
We recognise that the birth of a child is a wonderful event for your family. It is usual to have one or two birth partners with you during your labour. Usually children are not present if you have chosen a hospital birth. If it is your wish to have your children present, please consider the hospital birthing environment and strategies for supporting children who witness difficult or traumatic births. It is advisable to speak to a senior member of the midwifery team prior to the birth.
If you have chosen to give birth to your baby in hospital, we prefer that only the woman enters the pool if the choice is to labour and give birth in water. We actively encourage partners to offer guidance, alongside emotional and physical support, while leaning over the side of the pool and this will ensure that comfort and contact are maintained.
If you have been informed that you are GBS positive in pregnancy, our recommendation is that you receive a prophylactic dose of intravenous antibiotics when in established labour. If your pregnancy is otherwise low risk, you will be able to enter the birthing pool following the administration of antibiotic and a waterproof dressing will be used.
Evidence shows that there is no benefit of continuous, electronic fetal monitoring for a healthy, low risk woman who is labouring actively. As you must be low risk to labour in the NBC, we will listen carefully to your baby, using a doppler (Sonicaid) or a Pinard stethoscope every 15 minutes during labour and more frequently just before the birth. If the midwife has concerns about your baby's heartbeat, she may suggest transferring you to the delivery suite for continuous monitoring.
If you require continuous electronic monitoring of your baby's heartrate and you wish to mobilise during the active phase of your labour, we have a special monitor that records the heartbeat without the need for you to be attached by wires. This means that you will be able to move around freely.
If your labour and birth has been straightforward, you may choose to allow the placenta to separate and deliver without the use of an oxytocic drug – this is known as a physiological third stage. The natural process can sometimes take up to an hour; we will encourage you to breastfeed to aid the release of natural oxytocin. If there are concerns, your midwife may advise that an oxytocic drug is needed and you will be offered an injection into your thigh – this is called an active third stage and the placenta will normally be delivered within 10 minutes. Whilst standard practice is to offer an oxytocin injection as routine, we are happy to support a physiological third stage.
Vitamin K is offered to all newborns and can be administered by either injection or by oral drops. Please seek support from your midwife and read the relevant literature before you make your choice. We have oral vitamin K available. Your baby will receive a dose at birth, and further doses at 7 and 21 days of age.
The Natural Birth Centre is a home-from-home birthing suite and not intended for a post natal stay. If you and your baby are well following the birth, you may go home from as little as three hours post-birth. You will be seen by a midwife the following day. If, however, we have any concerns following the birth, you will be advised to stay on our post natal ward.