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Labour and choices available

We want to help your labour and birth to progress as naturally as possible – download our positions in labour leaflet for more information.

Active birth

At Maidstone and Tunbridge Wells NHS Trust we want to help you to have as straightforward a birth as possible, as this has been shown to be better for the health and emotional well-being of mothers and babies. Every labour and birth experience is different for each woman, baby, and birth partner, but we hope you will find some of these tips useful and that it will enable you to take a very active role in your care during labour.

Your body

It is normal for a woman to feel anxious about giving birth; however, remember that your body is designed to birth a baby and instinctively knows what to do. With freedom and privacy you will be able to follow your instincts, moving your body in the way that is most helpful for coping with your contractions and easing the birth of your baby. Your midwife will support and guide you and help you feel confident.

What can I do before the birth?

Choosing the best place to give birth

It is important that the environment feels safe and comfortable to enable a labour to progress naturally. For women with a straightforward pregnancy, this may mean choosing to have the baby at home or in one of our Birth Centres at Maidstone or Crowborough. Talk to your midwife about what might be the best option for you.

Getting the baby into the best position for labour and birth

In the last few weeks of pregnancy it is important to try and help your baby get into the best position possible. Sitting ‘slumped’ on a sofa may encourage the baby to lie with its back to your back, which can result in a much longer labour than if the baby were facing the other way around. We therefore advise that, whenever possible during this time, you try to keep your knees below your pelvis when sitting down. Talk to your midwife about this during your pregnancy and she will explain further.

Perineal massage – helping reduce tearing of the perineum

Research has found that massaging your perineum prior to giving birth may help reduce tearing and trauma.

When to come into hospital

For most women we recommend waiting until the contractions are coming in a regular pattern (roughly every five minutes, lasting for about a minute, and needing all your attention). However, this is only a guide and you also need to listen to your own instincts. If you are not sure, feel free to ring and discuss it with a midwife.

Many women come into hospital very early in labour, which is not necessary and may slow down your contractions. For this reason, we may advise women to return home for a while if labour is not properly established.

Of course, there are some situations when you would be advised to come to hospital before this point – if you have bleeding or your waters break, if you have severe pain that is not related to your contractions, or have any worries about your baby. If you have any concerns we advise that you ring Triage at Tunbridge Wells hospital and seek advice from the midwifery staff.

During labour and birth

We try to make every labour room as comfortable as possible with a range of birthing aids such as the birth couch, bean bags, rocking chairs, mats, and birth balls. Women are encouraged to be as active and upright as possible.

Using gravity – keep upright and mobile

Being able to move freely and use different positions is also likely to help keep your labour normal. There are many advantages to staying off the bed and keeping yourself upright during the first and second stage of labour:

  • It will help your baby to move down the birth passage more easily and quickly using gravity to aid descent
  • There is less pressure on the blood vessels that supply the uterus (womb) with oxygen for your baby
  • When you are upright your pelvis is able to open wider and make more room for your baby to come through
  • It may help contractions to work better, which will mean that the labour is slightly shorter
  • It may help you feel more comfortable and feel less pain
  • In the second stage of labour it may help you to be able to push more effectively

Equipment such as birth balls, mats, and rocking chairs are available for all the delivery rooms; these can help you to use a variety of good positions for labour. Ask your midwife to advise you on positions to try. One of the most important findings of research studies is that you should listen to your own body and use the positions most comfortable for you. Try changing position frequently – and if you need to lie down remember to avoid lying flat on your back as this can reduce the blood flow to your baby and may affect the baby’s heart rate as well as tending to slow labour down. If you do need to lie down you may find it helpful to try relaxing on your left side with a large pillow between your knees; it is also possible to give birth in this position.

Using water in labour

Water encourages relaxation and confidence, provides excellent pain relief, and many women enjoy the feeling of weightlessness, support and calming power. Research has found that there are significant benefits for using water during the first stage of labour and we would encourage any woman who has an uncomplicated pregnancy to try it out.

We do not recommend using the pool until labour is well established as it may slow down contractions if it used is too early. The midwives are able to support you to give birth in the pool if that is your wish and there are no complications, or you may choose to get out of the water at some earlier point.

Emotional support

Good support in labour is one of the most important factors in helping women have a normal birth. Having lots of encouragement to get through labour and feeling well cared for is known to help women cope with the pain of labour. It may also affect the length of labour and what sort of birth you have (although there are other factors that influence your labour too). You may find it helpful to have another birth supporter, as well as or instead of your partner, with you. It is a good idea to choose someone who you know will be calm, confident and supportive.

Breathing and relaxation

This is a skill best learnt and practised before labour begins, so please ask your midwife to explain it to you. Focusing on your breathing, particularly breathing out slowly; this will help you remain as calm and relaxed as possible during each contraction. You may find it helpful for your partner or your midwife to remind you to do this throughout the labour.

Enjoy massage, aromatherapy and reflexology

Some of our midwives have had extra training and experience in using complementary therapies in labour. These include aromatherapy and reflexology, which can help reduce pain and fear, increase energy, and stimulate hormone release (which boosts your strength and ability to give birth). If you would like to try any of these therapies please ask your midwife.

Other complementary or alternative therapies

Visit our complementary therapy page.

TENS machine (Transcutaneous nerve stimulation)

Some women find a TENS machine helpful in labour, especially in helping to cope with backache in the early part of labour. It works in a way that is similar to acupuncture. A set of electrodes, attached to sticky pads on your lower back and linked to a battery powered unit, send impulses to the nerve endings in your skin that help prevent pain signals travelling from the womb to the brain. There are a limited number of TENS machines available to loan from the Birth Centre at Maidstone – or you may wish to hire one from an outside company.

Other methods of pain relief

Every woman will approach giving birth in a different way and you may of course change your opinion regarding pain relief on the day itself. You will be best prepared if you are aware of all the options available and then ‘go with the flow’ on the day. A separate leaflet about methods of pain relief such as an epidural, pethidine injection or gas and air (entonox) can give you further information on these choices and is available from your community midwife.

Monitoring the baby’s heart

A straightforward pregnancy…

If you have no complications in pregnancy we recommend that your midwife listens to your baby’s heartbeat with a hand held device once labour is properly established. Continuous electronic monitoring (belt monitoring) for women without a medical reason is not recommended as it increases the risk of medical intervention and caesarean section, but does not mean that babies are born in better condition. It will also decrease mobility.

If there are medical problems or complications…

If there are medical complications electronic monitoring is usually recommended. This does not necessarily mean that you have to stay on the bed for the whole of your labour, however if you need to be on a monitor it is important that we have a reading at all times. For many women it is still possible for the heart beat to be monitored whilst sitting on a birth ball, standing or using other positions. It is important that you discuss with your midwife how best to stay upright and mobile throughout your labour.

See separate leaflet ‘Positions in labour’ for further information

What else can help?

  • Feel confident in your ability to give birth. Listen to your body – usually our instincts are right in helping us know what to do to cope.
  • Try to go with each contraction – allow it to take over, surrender to its intensity and breathe through it, moving your body and feeling comfortable to ‘be yourself’ (including making any sounds you want).
  • In between contractions try to rest and relax as much as you can and breathe normally.
  • Think about your preferences for labour and birth and talk them through with your partner or other supporters. You may like to write these down in a ‘birth plan’ to help your midwife understand how you would like her to support you in labour.
  • Talk to your midwife about your preferences, hopes and fears. She will support you as much as she can.
  • You will have your own room when you are in labour, so feel free to bring in any reminders of home that may make you feel more at home e.g. pictures or photos.
  • Dim the lighting. Ask your midwife if you can move the furniture around to make the room feel more comfortable.
  • Some women like to bring their own pillows, or even an old duvet they can use as a mat (which can be thrown away afterwards).
  • Music – each birthing room has a portable CD player so bring in some music that makes you feel relaxed and happy.
  • Snacks and drinks – these may be helpful in labour – and your partner may also need some refreshment too.
  • Decide what you would like to wear. For some women this may be a night gown or a shirt or you might like to wear your normal clothes. In the pool, some women prefer not to wear anything – others prefer a t-shirt or bikini top.

Complications and assistance at birth

Most women will experience a smooth labour, free of problems. However, some women and babies do occasionally require a helping hand. This can range from assisting a prolonged or difficult labour that then results in a normal birth, to intervention to aid the safe delivery of the baby using medical methods. In the event of problems, your midwife will consult the obstetrician (doctor) on call and discuss with you any suggestions for medical help. At all times we want to ensure that you are fully informed and involved in any decisions about your care. We are at all times committed to honouring your wishes throughout labour and birth while maintaining maximum safety for you and your baby.

Our commitment to you:

  • You will be involved in all decisions
  • You will be treated with care, consideration and respect
  • Wherever possible we provide 1:1 care in labour
  • We will help you to be as mobile as possible throughout labour
  • You can choose any pain relief ranging from water, massage to TENS, gas and air, pethidine injection and epidural

And finally…..

We hope this information will help you feel more prepared for labour and birth. Please ask your midwife for any further information and also details of parent education sessions that you can attend during your pregnancy