Labour and the birth of your baby is one of the most exciting journeys that you will ever go through.   After all the weeks of anticipation and planning, your big day is finally here. At the end of this journey you will get to hold your baby that has been kicking away inside you for months and months.

Labour is different for every woman, every time.  It is difficult to anticipate exactly what your journey will be like, but in this section we will cover:

• birth plans;
• packing your bag for labour;
• the signs of labour;
• how to cope at home in the early stages of labour; and
• when and how to contact the hospital.

This section serves as a guide only.  Your midwife or doctor will give you more individual advice towards the end of your pregnancy.

A birth plan is a way for you to highlight particular requests that you may have for your labour and birth. You do not have to have a birth plan – our aim is for you to have as natural a birth as possible. However, once you have completed your parent education classes, you may wish to make a birth plan. 

It is very important that you discuss your birth plan with your midwife or doctor well in advance of your labour. This discussion will give everyone a chance to go through your requests and agree them with you. If there are any areas where the hospital may be unable to meet a particular request, then you will be given an explanation for this. Once the discussion is completed, your midwife or doctor will sign your birth plan and a copy will be put in your healthcare record. We aim to work in partnership with you and to keep you informed and involved in your care during labour and birth.

Once you have reached the final month of pregnancy, we advise you to have a bag packed and ready for the big day. You need to decide what to pack for yourself and your baby. Please remember that there is limited space available on the wards, so pack lightly. Some women have a bag for labour and birth and another bag for their stay in hospital after birth. Remember that if you forget anything, your partner can get it for you at one of the shops nearby. 

• Loose fitting nightdress or an old long t-shirt;
• Disposable underwear;
• Warm socks, slippers and a light dressing gown;
• Hair bobbins and brush;
• Wash bag with toiletries – shower gel, sponge, toothbrush and toothpaste,  deodorant and so on;
• Maternity sanitary pads;
• Large, dark-coloured towel;
• Fresh night clothes to wear after the birth, (ideally front opening for breastfeeding) and a nursing bra;
• Babygro, vest, cardigan and baby hat and nappies for baby;
• Money for parking meters.

For mother 

• Fresh pyjamas/nightdress for every day
• Disposable underwear 
• Maternity sanitary pads 
• Bras and breast pads
• Panties 
• Wash bag with toiletries
• Large, dark-coloured bath towel 
• Loose-fitting clothes for going home 

 For baby

• • Babygros or sleep suits
  • Nappies
  • Vests
  • Cardigan
  • Cotton wool
  • Bath towel
  • Baby hats and bibs
  • Outfit for going home

Most women will go into natural labour between 37 and 42 weeks of pregnancy. There is no way to accurately predict when labour will actually start. If your pregnancy goes past your expected due date, there is nothing to worry about as long as you are feeling well and your baby is moving and kicking. Be sure to attend all your antenatal appointments especially towards the end of your pregnancy.

Right up to the moments before birth, your baby will be moving around inside you. At the end of pregnancy the type of movements may change and they may feel more like pokes, prods or wriggles. Babies do not stop moving before labour! They may have sleep periods but these will last for no longer than 45 minutes to one hour.

If you are unsure about your baby’s movements, there are a few things you can do to wake your baby up:

•  gently rub your tummy and talk to your baby;
• drink some cold water or eat something sweet; or
• have a warm bath or shower.

These things will often wake your baby up and normal movements will start again. You will be very aware of your own baby’s pattern of movement. If you have any concerns about the amount or type of movements you are getting, please contact your midwife, doctor or the emergency and assessment unit. Your awareness of your own baby’s movements is very important, particularly at the end of pregnancy.

Waters breaking

For some women, the very first sign that anything is happening is that their waters break. Sometimes, it is obvious that the waters have broken by the fact that you soak your underwear or bed. (In fact, it is a good idea to sleep with a towel under you towards the end of your pregnancy to avoid damage to your mattress.)

However, for a lot of women it may be difficult to be sure if the waters have broken. Many women describe feeling ‘damp down below’ due to the increased amount of vaginal discharge that is normal at the end of pregnancy. If you find that you have to wear a sanitary pad due to the amount of fluid you are losing, you need to consider if your waters could have broken. One way for you to check is to have a shower, dry the vaginal area well and put on a maternity sanitary pad. If that pad quickly becomes damp or wet, it is likely that your waters have broken. 

When the waters break, the fluid may be clear or slightly straw coloured. Sometimes there may be a vague tinge of pink in the waters. This is normal and should not alarm you. If your waters have broken, you should come in for a check-up to ensure all is well with you and your baby. If the fluid is green or green/brown in colour or heavily blood stained, you should come into the emergency and assessment unit immediately. 

Show

As the cervix (neck of the womb) starts to stretch, a plug of mucous may be released. Typically, this plug or ‘show’ is bloodstained and sticky. This bloodstaining will be old brown blood or light pink. Many women describe a show as being like the very beginning or very end of their period. You should not see bright fresh blood. Not all women will have a show before labour starts and a show is not a sure sign of labour.

Pain

Very early in labour, you may experience irregular cramping pains, like period pains. You may also have backache and a heavy sensation in your pelvis. This is all completely normal and is an encouraging sign that your body is getting ready for labour.

Restlessness

Not being able to focus on one thing, or being unable to sit still but not really being sure what you want to do. Not all women feel like this.

The Rotunda has a FREEPHONE telephone service – 1800 522 687, which provides information to women throughout their pregnancy, including at the onset of labour.  You will also have the option to speak to a midwife, if necessary.

You should attend the emergency and assessment unit if you have:

• been advised to come straight to hospital once labour starts by your doctor or midwife;
• contractions every 5 – 7 minutes, with pains lasting more than 45 seconds;
• any vaginal bleeding that is not a ‘show’;
• concerns about your baby’s movements;
• severe, lasting abdominal pain;
• headaches or blurred vision;
• been feeling generally unwell;
• your waters have broken; of if you have
• any concerns about yourself or your baby.

Once you arrive in the Rotunda you will be taken to the emergency and assessment unit. The midwife will take a history from you and carry out some observations and assessments on you and your baby.

As part of the assessment, the midwife will:

• take your temperature, pulse and blood pressure and do a urine test;
• palpate (feel) your tummy to check the position of your baby and listen to your baby’s heartbeat;
• examine you internally (vaginal examination) to check how much your cervix has opened.

The midwife will discuss this assessment with you and your partner and plan the next stage of your care. If you are in established labour you will be transferred to the delivery suite. If you are in early labour and the observations are all normal, you may be advised to return home.  If there are any concerns about you or your baby or if you require pain relief, you will be admitted to our ʿearly labourʾ ward.