Your Birth

There is very little space to store items on the ward so it is easier to bring the minimum and have things taken home and brought in as required.

During your pregnancy you will have been forming ideas and opinions about your labour and birth of your baby. You may find it helpful to make a birth plan. This enables you and your partner to express some of your thoughts and objectives. It is important to keep your approach flexible and your options open as every woman's labour is different. Your plan is a starting point for you and your partner to share some of your preferences with your midwife and doctors. You are welcome to make your plan in any form and this can be added to your notes.

Your partner may want a separate plan, especially if there are particular requirements.

The following list gives a brief outline of some area you may want to consider.

Your feelings about the labour and how you will cope - where you want to have your baby, your hopes and expectations for the birth, any experiences of previous deliveries.

My Labour - preferred ways of coping with contractions, different positions, breathing, being mobile, partner support. 

My Birth - position for birth, cutting the cord, skin to skin contact.

Birth of the Placenta - syntometrine, physiological

My Baby - vitamin K, feeding, sleeping

After my Baby is Born - how long you want to stay, visitors

Special Requests
Your midwife will be happy to discuss your birth plan and you can review your plan at any stage.

Remember this is a guide, no-one knows exactly what form or how long your labour will take, but you will be encouraged at all times to make informed choices.

After the birth you or your partner may want to make notes about your experience to discuss with the midwife or doctor.

What will labour feel like?

While you are pregnant, you may feel your uterus (womb) tightening from time to time. These tightenings are called Braxton Hicks contractions. When you go into labour, these tightenings become regular and much stronger. The tightening may cause pain that feels like period pain, and usually becomes more painful the further you get into labour. Different women experience labour pains in different ways. Usually, your first labour will be the longest. If medication is used to start off (induce) labour or speed up your labour, your contractions may be more painful. 90% women use a range of pain relief ways to cope with labour pain. It is a good idea to have an open mind and be flexible.

Preparing for labour

Antenatal parenting classes, run by midwives who know about the Royal Surrey County Hospital, may be helpful for you to prepare for the birth. The classes will help you understand what will happen in labour and may help you to feel less anxious. The midwife will tell you what is available to reduce labour pain. If you need more information about epidurals (an injection into your back to numb the lower half of your body), the midwife can arrange for you to meet an Anaesthetist at our Anaesthetic Clinic to discuss various aspects of this procedure. If you cannot go to antenatal classes, you should still ask your midwife about what is available to reduce the pain. You can then discuss this with the midwife who cares for you while you are in labour.

Where you choose to give birth can affect how painful it is. If you feel at ease in the place you give birth, you may be more relaxed and less anxious about labour. For some women this means giving birth at home, but other women feel reassured by the support offered at the hospital. If you are planning to give birth in our hospital, it may be helpful to look round before hand.

Simple Self-help methods

A supportive companion is invaluable. Relaxation is important so bathing in warm water, massage, particularly having your back rubbed, or the use of a birthing ball and staying active for as long as possible during labour can help, allowing labour to progress and for the pain to feel less intense. Music can also be helpful.

Calm breathing may increase the oxygen supplied to your muscles, and so make the pain less intense. Also, because you are focusing on your breathing, you may be less distracted by the pain. Some mothers find aromatherapy, hypnosis, homeopathy, herbalism, reflexology or acupuncture very helpful. Ask your midwife about these simple methods.  Midwives are trained in the use of aromatherapy.

Aromatherapy

This is available to all women giving birth at the Royal Surrey County Hospital.

It is difficult to know beforehand what will be best for you. The midwife who is with you in labour should be the best person to give you advice. Here is some information about the main methods of coping that are available at the Royal Surrey County Hospital.

Using a birthing pool during labour

We have a birthing pool available at the Royal Surrey and some women find that labour in water is less painful. The midwife will continue to monitor your progress and your baby's well-being.

Transcutaneous electrical nerve stimulation (TENS)

• A gentle electrical current is passed through four flat pads stuck to your back. This creates a tingling feeling. You can control the strength of the current yourself.
• It works by encouraging your body to produce its own natural painkillers, (endorphins) and also by blocking the pain signals, which are sent by the spinal cord to the brain.
• It is sometimes helpful at the beginning of labour, particularly for backache. If you hire one, you can start it at home.
• It has no known harmful effects on your baby.

While you may manage your labour with only the help of TENS, it is more likely that you will need some other sort of pain relief later on in labour. To hire a TENS machine please ask your midwife for a leaflet.

Entonox (50% nitrous oxide and oxygen, sometimes known as gas and air)

• You breathe this through a mask or mouthpiece.
• It is simple and quick to act, and wears off in minutes.
• It sometimes makes you feel light-headed or a little sick for a short time.
• It does not harm your baby and it gives you extra oxygen, which may be good for you and your baby.
• It will not take the pain away completely, but it may help.
• You can use it at any time during labour.

You control the amount of Entonox you use, but to get the best effect timing is important. You should start breathing Entonox as soon as you feel a contraction coming on, so you will get the full effect when the pain is at its worst. Do not use it between contractions or for long periods as this can make you feel dizzy and tingly.

Pethidine:

• Usually given by a midwife as an injection into a large muscle in your leg.
• The pain relief is often limited. It starts after about 10-15 minutes and may last a few hours.
• Although it has less effect on pain than Entonox, many mothers find it makes them more relaxed and less worried about the pain.
• Other women are disappointed with the effect of pethidine and say they feel less in control.
• Pethidine may make you feel sleepy.
• It may make you feel sick, but you are usually given an anti-sickness medication to stop this.
• It delays stomach emptying, which might be a hazard if you need a general anaesthetic.
• It may slow down your breathing. If this happens, you may be given oxygen from a facemask and have your oxygen levels monitored.
• It may make your baby slow to take its first breath, but an injection can be given to your baby to stop this. It may make your baby drowsy, and this may mean that it cannot breast feed as well as normal.

Epidurals and spinals

Epidurals and spinals are the most complicated but most effective method of pain relief and are carried out by an anaesthetist, who is a doctor who is specially trained to provide pain relief and to give drugs that make you go to sleep.

• Epidurals are given into a very small tube that the anaesthetist places in your back.
• They have little effect on your baby.
• There is a small risk of a headache.
• They may cause a drop in blood pressure.
• They increase the probability of having a forceps or ventouse delivery.

Who can and cannot have an epidural?

Most people can have an epidural, but certain complications of pregnancy and bleeding disorders may mean that it is not suitable for you. Other conditions such as previous back operations or if you are overweight may make an epidural more difficult and take longer to put in place. However, once it is in you will have all the benefits. The best time to find out about this is before you are in labour and we run an anaesthetic clinic if you wish to see and discuss this with an anaesthetist.

What if I need an operation?

If you need an operation such as a caesarean section or forceps delivery, you may not need a general anaesthetic. In you already have a good working epidural in place then this can be topped up with a much stronger local anaesthetic. If you do not already have an epidural, a spinal will often be used. A spinal is similar to an epidural in terms of insertion and effects, although it does work much quicker.

After your baby has been born, you will be encouraged to spend some time with your baby lying against your skin.

This skin-to-skin contact has been shown to be helpful for warming babies and helping them maintain their body temperature.

For those who are going to breastfeed, it is an important first step towards establishing successful breastfeeding.  Babies are alert at this time and will often start looking for the breast.

The skin-to-skin contact can continue for as long as you want, but at least 30minutes is recommended.

If you need stitches after birth, they can be put in without having to move your baby.

Your baby can also be weighed and checked and returned to you without being dressed if you like, so you can continue this close contact.

If you have a caesarean section, you may be able to have skin-to-skin contact while the operation is being completed.  Otherwise, your baby will remain wrapped up while you are in the operating theatre, but will be unwrapped to be with you when you return to your room.

Dads can also have skin-to-skin contact, but if your baby is going to breastfeed, then time with the mother is most important initially.

Most babies will stay with their mothers on the postnatal ward.  However, some babies need extra care when they are born.  This may be because they are premature or because they have a problem at birth.   These babies will require admission to a Special Care Baby Unit.  The Royal Surrey County Hospital has a Special Care Baby Unit (SCBU) on Level G, next to the Maternity Unit.