Your birth

There are a variety of ways you may experience the beginning of labour and birth. Please read the information below — consider what will help you cope while at home and discuss these with your midwife using your personalised care plan.

You may call us at any time but we particularly recommend getting in touch if:

• You think your labour has started and it is establishing into regular and powerful contractions occurring every 2 to 3 minutes
• Your waters have released
• You have any vaginal bleeding
• You are worried your baby is not moving as much as normal
• You have any other concerns or anxieties

Pain relief in labour
There are several ways in which we can help to relieve your pain and discomfort during labour, including relaxing in water, walking, specialist equipment, gas and air, and medication.

It is important to note that everybody is different, and one method of pain relief may work well for one person, and not for others.

You will be given an information leaflet that details all pain relief methods and will be discussed with your midwife, doctor or anaesthetist.

Transcutaneous electrical nerve stimulation (TENS)
TENS is a safe method to relieve pain by attaching four specialist pads to your back that are attached by wires to a small battery-operated control box, to release continuous electrical impulses. This helps to minimise the pain signals to your brain and stimulates your body to produce endorphins.

The facts about TENS

• There is no evidence of risk to the woman, birthing person, or baby
• TENS is most useful in early labour and allows you to move around freely
• TENS is less effective during active labour
• You can control the rate and strength of the electrical impulses
• TENS can be used in combination with other methods of pain relief but is unable to be used in water

You can read more about TENS and how it works via this link.

Hydrotherapy
Hydrotherapy is the use of water to treat a variety of medical conditions and is often used during labour.

The facts about hydrotherapy

• It can be used in early labour at home, in a warm bath or shower
• It can be very relaxing and support mobility
• We have birthing pools for women who wish to continue their labour and/or give birth in water – the water is kept at a comfortable temperature just below 37.5°C

You can read more about hydrotherapy via this link.

Paracetamol and co-codamol
Paracetamol is used to relieve mild to moderate pain and helps to lower a raised temperature or fever.

Paracetamol is safe to use in early labour and during postnatal care. It is a common method of pain relief and is available from all pharmacies, in tablets, capsules and liquid form, without the need for a prescription.

Co-codamol contains two painkilling ingredients, paracetamol and codeine. It is usually taken in tablet form to relieve short-term pain where paracetamol alone is not sufficient.

Co-codamol is safe to use in early labour and during postnatal care and is available from pharmacies without the need for a prescription.

You can read more about paracetamol and co-codamol via this link.

Entonox
Entonox, also referred to as gas and air, provides pain relief when inhaled and is often used by women to ease their pain in labour.

The combination of nitrous oxide gas and oxygen is breathed in through a mouthpiece during contractions in established labour to relieve pain.

The facts about Entonox

• There is no evidence of risk to the woman, birthing person or baby
• It can be used in combination with any other method of pain relief
• The effects are rapid and wear off quickly
• You can control how much you want to use and when
• It can be used as a pain relief method for home births
• It can make some women feel light-headed and sick
• Prolonged use can make you tired and thirsty – continue to drink plenty of fluid

Diamorphine
Diamorphine is a pain-relieving drug that is administered by injection into the thigh or buttock area.

It takes about 20 minutes to come into effect, and can last between two and four hours.

The facts about diamorphine

• It can make you feel nauseous – a further drug is then given to combat sickness and vomiting
• You cannot use a deep bath or birthing pool after taking diamorphine until the effects have worn off
• Diamorphine crosses the placental barrier in labour, meaning it can remain in the baby’s system for up to 72 hours after birth; this is not dangerous to the baby, however it may interfere with the first feed

Epidural
An epidural is a type of local anaesthetic which numbs the nerves that carry the pain impulses from the birth canal to the brain.

An epidural gives complete pain relief for the majority of women and birthing people and it can be especially helpful for women who are having a particularly long or painful labour, or who are becoming distressed.

During the procedure, you will have an intravenous drip put into your arm, followed by a small plastic tube threaded through a needle into your back. Once the tube is in place, the needle is removed and you can move around freely.

You can trigger a pump to deliver a top up of the epidural if the pain level increases. Throughout the process, a midwife will monitor your baby’s heartbeat and your blood pressure.

The facts about epidurals

• It does not make you feel drowsy or sick and you may still have some feeling in your legs
• It can be topped up to give complete pain relief
• Not everyone can have an epidural – you should discuss this with your midwife and anaesthetist
• You may feel shivery for a time but this stops quickly
• There is a 1 in 100 chance of experiencing a severe headache, which can be treated
• It may cause a sudden drop in your blood pressure and your baby’s heart rate – extra fluids will be given through your drip to correct this
• You may need to have the epidural adjusted or re-sited if you still experience contractions
• You may be unable to pass urine and need to use a catheter for a minimum of six hours following the birth of your baby
• Serious epidural related problems are extremely rare and areas of numbness, pins and needles, or weakness are usually a result of the childbirth itself, not the epidural 

You can read more about epidurals via this link.

If you have chosen to have a home birth, a community midwife will provide your care. The community midwife can also advise whether this is a suitable option for you, depending on your needs.

If you decide to have a home birth, your midwife will discuss this again with you when you are 34 to 36 weeks pregnant, to ensure that this is the most suitable and safest option for you and your baby.

If you would like to have a home birth or find out more, please discuss this with your midwife.

What equipment is available during a homebirth?

Our community midwives have a range of equipment to support you during your labour, including a birthing pool.

If you would prefer, you can also provide your own equipment.

Gas and air is also available during a homebirth and can be used alongside other natural pain relief methods to help you stay relaxed and calm during labour.

Please note epidurals are not available to use during a home birth.

Who will attend a home birth?

Two midwives will attend your home birth to support you throughout your labour and to ensure that you are comfortable.

The midwives are able to suggest a variety of techniques throughout your labour, to ensure that you have a positive and comfortable experience.

Our Labour Ward is where you and your baby will be cared for during your labour and birth.

If you have experienced complications during pregnancy, it is likely that you will give birth in the Labour Ward; however, you can still choose to have your baby in the Labour Ward if you have not experienced complications during your pregnancy.

We have a dedicated team available to support you and nine comfortable and relaxing rooms, including a separate room should you present any high risk factors during your labour, and a birthing pool room.

All of our birthing rooms are equipped with birthing aids such a birth balls, stools and bean bags to encourage an active labour.

We also provide a full range pain relief of options to support you during your labour, including gas and air, diamorphine, and an epidural. 

Our Birth Centre offers a warm, friendly and home-like environment for healthy pregnant women and birthing people.

All of our birthing rooms are equipped with birthing aids such as fixed birthing pools, birth stools, a sling and birthing balls to encourage an active labour.

We also provide a range pain relief options to support you during your labour, including the use of a birth pool, gas and air, and diamorphine.

Epidurals are not available to use for pain relief within the Birth Centre.

If you have experienced complications during your pregnancy, we may recommend that you give birth to your baby in the Labour Ward. However if you would like to discuss your birth place options further, please discuss this with your community midwife who may refer you to our consultant midwife for a birth options appointment.