Physiotherapy
Pregnancy hormones
In the last few weeks of pregnancy, your hormones are preparing your pelvis for labour by softening the ligaments at the front of your pelvis and in the lower back region. Be mindful of this whilst doing daily tasks. It is best to avoid extra stress and strain on your back and pelvis by only doing light duties and changing your posture regularly.
Start to use the gym ball as an alternative to sitting on the sofa and gently massage the lower back muscles as they may start to ache.
Ready?
Your hospital bag for labour should be packed and ready from about 36 weeks. Involve your birthing partner in this process, so that they know what is in the bag. Remember nappies, cottonwool or water-wipes, newborn to 0 to 3 months vests and baby grows, as well as muslin cloths and scratch mittens. Please also pack changes of clothes for yourself, toiletries, breast pads, sanitary pads and plenty of spare underwear.
Other top tips: hair bobble, lip balm, handheld fan, energy bars and juice cartons (look on-line NHS for more extensive lists). https://www.nhs.uk/start-for-life/pregnancy/preparing-for-labour-and-birth/hospital-bag-checklist/
Early signs
As labour approaches you may experience loose stools, (runny poos) as baby positions deeper into the pelvis, putting pressure on the bowels as well as increasing your hormone levels. You may notice a mucus plug discharge, called the ‘show’, from your vagina. This is a thick whitish colour or may have a pink tinge from spots of blood, but it is not necessary to inform the hospital of the ‘show’ unless it is fresh red blood (or a greenish colour discharge). If this happens, telephone the urgent advice line (24 hour): 01642 854206.
You may also notice a mucus plug discharge, called the ‘show’ and this is a thick whitish colour or may have a pink tinge from spots of blood, but it is not necessary to inform the hospital of the ‘show’ unless it is a bleed (or a greenish colour discharge) then phone the advice line.
Otherwise early signs of labour may be felt as waves of discomfort in your lower back or tummy area, similar to that of ‘period’ type discomfort or pain.
Plan to stay at home
During the early stages of labour, the best place to be, is at home. Make sure you have paracetamol pain relief at home (and can progress to co-codamol if available to you). Please make a note of what you have taken and when.
Other alternative pain relief options at home include: a warm bath (max 37°), gentle heat pack, back massage, aromatherapy, deepfreeze gel, gym ball (sitting and gently rocking the pelvis, or standing with the ball behind your back against a wall, or leaning over it on a table) and possibly using a TENS machine as an alternative form of pain relief (a TENS machine will need to be bought or hired).
Active labour
Time the length of your contractions (when you feel discomfort or pain) and the gap of time between your contractions. You will notice the contractions becoming stronger and longer (30 to 40 seconds) and the gap between them becoming shorter.
Try stay active during this first stage of labour by walking or adopting upright and forward positions, for example, sitting on a ball and resting forward onto a table, or kneeling on the floor or sofa and resting forward. Keep breathing through the discomfort and pain and make sure you do not hold your breath.
Listen to some relaxing music and take slow deep breaths in, concentrating on expanding your ribcage, and even longer breaths out. Try tuning out and ignoring the pain, by remaining calm and staying positive.
Ring the hospital
If you are high dependency, please ring the advice line as advised by your consultant or midwife. Otherwise, if you are low dependency, it is a good time to phone the advice-line when your contractions are about 5 minutes apart, to discuss whether it is advisable for you to come into hospital or stay at home a bit longer (until you are experiencing 3 contractions in a 10-minute period).
Arriving at hospital
After phoning the advice-line and being advised to come into hospital, arrive through the Maternity or the Women and children’s entrance and head towards Maternity Triage immediately on the right.
After an internal examination, monitoring your contractions, as well as baby’s heart rate, it will be decided if you are in ‘established first stage of labour’ It will also be assessed as to whether you are still ‘low’ or ‘high’ dependency for labour, and you will then be taken to the appropriate labour ward.
When you are in your labour room, it is important that you and your birthing partner ‘settle in’ and make it feel homely and comfortable. Feel free to dim the lights, use battery candles, run yourself a bath and play soothing music on your phone. Ask for a birthing ball, beanbag and possibly a birthing stool. The midwife will assist you in re-arranging the pillows and bed height to allow you to find comfortable active birthing positions.
The midwife will come into the room periodically to monitor you and baby, as well as offer different forms of pain relief.
Transition
As your cervix is dilating and your body is preparing for the second stage of labour, you may feel slightly irritable during this transition phase, as you experience a deep stretching sensation in your pelvic floor and a pressure towards your back passage (like you need to have a poo).
In tune with midwife
During this important second stage of labour, the midwife will stay with you and guide you through step by step, to help you push baby out. It is better to be in a more upright position during the pushing stage, as this will allow gravity to help both you and baby. Try to remain calm and breathe slowly and deeply.
The midwife will guide you to use a long breath out, to push or bear down and work with your uterus during contractions, so listen carefully and stay tuned to your midwife’s instructions. The painful contractions will only last for about a minute long, then they will relax until the next one.
Each contraction is bringing you closer to meeting your baby, so try to focus on that and stay positive. As the head starts to crown, you may feel a burning or stinging sensation. This is your body’s signal to deliver your baby slowly and gently, as your midwife guides you through delivering your baby.
Only the placenta left
Once your baby is born, the third stage of labour is to deliver the placenta. The midwife will usually wait a minute for baby to receive all the nutrients and blood from the placenta before clamping and cutting the cord. The placenta can be ‘actively managed’ by having an injection to speed up this stage and reduce bleeding or it can be an ‘unaided’ delivery whereby your body does this process naturally.
New bonding
The best part is when you get to hold and cuddle your newborn baby and enjoy
‘skin to skin’ bonding time. This precious time of mum and baby being wrapped up together helps to regulate baby’s heartbeat, temperature and breathing. It also encourages the baby’s natural urge to feed (breast or bottle), helps you release hormones related to breastfeeding and to emotionally bond with your baby. It is also possible for your birthing partner to experience ‘skin to skin’ bonding time as well.
Contact us
If you require further information, please contact us on:
Telephone: 01642 854453
Email: [email protected]
Patient experience
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T: 01642 835964
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