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Kent and Medway - Bump, Birth and Beyond

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If you're six weeks or more pregnant and haven't yet made an online referral to register with a midwife, visit our ' Tell us you're pregnan t' page for more information.

Once you've completed and sent the online form, a midwife from your local team will be in contact within 10 days to arrange an appointment.

You will be mainly under the care of a midwifery team throughout your pregnancy and should have a named midwife who will support you throughout your pregnancy journey. If you have a pre-existing condition, such as asthma or diabetes, or there are other complications during your pregnancy, then you may also see a consultant. This will be explained to you by your midwife.

At each appointment, your midwife will usually offer to check your blood pressure, test your urine, and ask you questions about your growing baby. Your appointment may take place in your home, Children's Centre, GP surgery or hospital and will last for about an hour. At your first booking appointment, you will be given a set of maternity notes, which might be handheld or you will be able to access them digitally. This is where all the reports of your scans and other tests will be recorded, along with notes from your maternity team.

You will also be able to apply for a maternity prescription exemption, which entitles you to free prescriptions and dental treatment until your baby is 12 months old.

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Early pregnancy :: Kent and Medway - Bump, Birth and Beyond

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If you're six weeks or more pregnant and haven't yet made an online referral to register with a midwife, visit our ' Tell us you're pregnan t' page for more information. Once you've completed and sent the online form, a midwife from your local team will be in contact within 10 days to arrange an appointment.

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Stay organised throughout your pregnancy

You can print the list on this page to keep track of things you need to do during your pregnancy, such as book antenatal classes, tell your work you're pregnant and think about where you'd like to have your baby.

⬜ Take a pregnancy test: doing a pregnancy test

⬜ Learn about the benefits you are entitled to: maternity and paternity benefits and leave

⬜ Stay active, start exercising: exercise in pregnancy

⬜ Take folic acid: vitamins, supplements and nutrition in pregnancy

⬜ If you smoke, get help to quit: stop smoking in pregnancy

⬜ Make an appointment to see your midwife or GP: your antenatal care

⬜ Book antenatal classes: antenatal classes

⬜ Claim free milk, fruit and vegetables through Healthy Start: get help to buy food and milk

⬜ Make sure you've been offered all your screening tests: antenatal checks and tests

⬜ Make an appointment to see a dentist: dentists

⬜ Find out about your rights at work: GOV.UK: maternity pay and leave

⬜ Ask to hear your baby's heartbeat: your antenatal care

⬜ Visit the maternity unit you plan to give birth in: where to give birth: the options

⬜ Start buying the things you'll need for your baby: what you'll need for your baby

⬜ Feeling hungry? Stick to a sensible diet: have a healthy diet in pregnancy and foods to avoid in pregnancy

⬜ Start making your birth plan: how to make a birth plan

⬜ Write to your employer 15 weeks before you plan to stop work: GOV.UK: maternity pay and leave

⬜ Claim Maternity Allowance after week 26: GOV.UK: maternity allowance

⬜ See if you're eligible for a Sure Start Maternity Grant: GOV.UK: Sure Start Maternity Grant

⬜ Make sure you know the signs of labour: signs that labour has begun

⬜ Pack a bag ready for labour and birth: pack your bag for labour

⬜ For birth partners, prepare for the birth: tips for your birth partner

⬜ When in labour, phone the maternity unit before leaving home: what happens at the hospital or birth centre

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You can print the list on this page to keep track of things you need to do during your pregnancy, such as book antenatal classes, tell your work you're pregnant and think about where you'd like to have your baby.

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Personalised care means people have choice and control over the way their care is planned and received based on ‘what matters’ to them and their individual needs and preferences.

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Personalised Care and Support Planning in Maternity Services

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Can I choose where to give birth?

Yes. You have the right to choose where you give birth. You can choose to give birth in a hospital, in a birth centre, or at home. A birth centre is a maternity unit that is run by midwives. It can be part of a hospital or completely separate.

Your NHS trust may automatically book you into a hospital or birth centre. You can ask to discuss this and make your own choice.

A healthcare professional may say you 'need' or 'have' to give birth in a hospital. You can ask them why they think this. What medical reasons do they have for this advice? You do not have to agree with them.

In some cases, there may be restrictions on your right to choose a hospital or birth centre. However, no-one can make you give birth away from home if you want to stay at home.

The only time someone else can decide for you about where you give birth, or your treatment, is if you lack mental capacity. This is very rare, but we describe what mental capacity is below.

Yes. You have a right to choose where you give birth. You cannot be made to go to hospital. Healthcare professionals may want to talk to you about your plans and any concerns they have. This should be an opportunity to have an open discussion and to share information. They should always respect your views and choices.

All NHS Trusts are expected to run a home birth service. This is not guaranteed in law, but the law says that your right to choose where to give birth should only be restricted when there is a good reason to do this, and where the decision is 'proportionate'.

This means that a Trust should only pause their home birth service if they have looked at all the options for keeping it going and they are still unable to.

If you are told you cannot give birth at home because of staff shortages, remind the hospital that it must make sure there are enough staff to provide the services it has promised. They should have plans for situations such as staff shortages. This could include providing an independent midwife.

If you feel that your choice to give birth at home is not being respected, you can contact Birthrights for advice using our contact form.

Yes. The Nursing and Midwifery Council's Code says that midwives must put your interests first and make your safety their main concern. This is their professional duty.

Midwives should respect your decision to give birth outside the hospital. They should attend you at home if you ask for this, even if they don't agree with your decision.

If you are in labour and the hospital tells you there is no midwife to attend you, (and that they will send an ambulance), you cannot be made to attend hospital if you do not want to. You or your birth partner can ask to speak to the Head of Midwifery and ask them to provide a midwife.

If a midwife - or any healthcare professional - has breached their duty of care, you can complain. Duty of care means that they must care for you and keep you safe. They can be referred to their regulatory body, which will investigate.

Yes. Only you have the right to decide where you give birth. No one can overturn the decision you have made. This is the law.

The only time that someone else can make decisions about your healthcare is if you lack mental capacity to make those decisions. This is very rare.

Even if healthcare professionals advise you not to give birth at home, no one can make you go to hospital.

Your midwife and hospital consultant (if you have one) should work with you to make a care plan for giving birth at home.

When professionals give you advice and information about where to give birth, it should be based on facts, not personal opinions.

Healthcare professionals must not put pressure on you, or threaten you, when you are deciding where to give birth. They must not threaten to involve social services. If you feel this has happened, you may not have given consent to the treatment you received. This could mean that the healthcare professional can be taken to court for failing to obtain your consent.

Yes. All people in the UK have a right to maternity care in hospital.

Your GP will tell you which hospitals have maternity services in your area, and you can choose which one to use.

You can ask to use a different hospital. If your GP will not refer you to the hospital you choose, you can refer yourself. Look on the hospital's website or ask its maternity team for the self-referral form.

Yes. The government says everyone in the UK should be able to choose between giving birth in hospital, in a birth centre, or at home. You should be offered a full discussion of the risks and benefits of the options you are considering.

If there is no birth centre in your area, or you want to use a different birth centre, you can ask your GP to refer you or you can refer yourself.

Birth centres often have rules, called admissions criteria, that say people with 'high risk' pregnancies cannot use the centre.

These are not legal rules and they cannot be applied in a blanket way. The centre should use them only to guide them when making a decision about who can use the centre.

The birth centre must only refuse to allow you to use the centre if they feel they cannot provide you with safe care. The centre must have a good evidence-based reason that shows you or your baby are at high risk of harm when giving birth without the support of a hospital obstetric ward. The centre must be able to show that it cannot safely manage that risk. They should consider the risk on a case-by-case basis, looking at what the risks are in your personal situation.
For example, a birth centre might say you cannot use the centre if your labour is being induced and where medical advice strongly recommends the monitoring of your contractions.
Or the birth centre's rules might say that you cannot use the centre if your body mass index (BMI) is above a certain level. However, they should look at what the specific risks are in your case and whether they can be safely managed. They need to have evidence for what they say. They need to discuss it with you, and if they think they cannot safely care for you in the birth centre they need to discuss what alternatives they can suggest (for example, offering similar support such as a birth pool on the labour ward).

Both hospitals and birth centres must make 'reasonable adjustments' so that anyone with a long-term health condition or disability has equal access to their services. This is law, under the Equality Act 2010.

These adjustments could be in the way the hospital or birth centre provides care, accessing and navigating the buildings, providing equipment, or providing services such as British Sign Language interpreters or extra support.

The Equality Act 2010 says the midwifery team should talk to you about what adjustments you need. Your midwife can also ask for help from other teams in the hospital, such as Occupational Therapy, if necessary.

They should talk to you from the start of your pregnancy so that together you can work out the best way they can support you throughout your pregnancy, in labour, and during your post-natal care.

Having a long-term health condition, disability or sensory impairment does not take away your right to choose where you give birth.
For example, a woman who uses a wheelchair should be given a room that she can access in her wheelchair as well as a bathroom that she can comfortably access. She should also be provided with appropriate aids such as a shower stool and toilet frame. An autistic person may ask for a familiarisation tour of the ward or have sensory considerations in their birth plan to make the environment accessible.
If you need help to communicate with healthcare professionals, ask as early in your pregnancy as possible so that you can make informed choices from the beginning.

This might be support with British Sign Language interpreters, large print materials or materials in a form that is suitable for your screen reader.

This might be access to an interpreter for your appointments and care.

Yes. A birth plan lets you tell healthcare professionals about the kind of treatment and care you want.

Your midwife or doctor should help you to make a birth plan (this may be called a personalised care and support plan) that will be included within your maternity records (your digital or handheld notes). If you choose care that is 'out of guidelines' then you may find it helpful to make your birth plan with a consultant midwife or doctor. Your plan should be recorded so that any doctors or midwives who care for you can find it. You might also want to print a copy so that you can give it to your doctor or midwife when you are in labour.

This can include where you want to give birth, so thinking about your birth plan will help you to explore the options and decisions you might make.

You may find it useful to think about what is important to you before you make your birth plan. This can help you to think of the questions you want to ask the healthcare professionals who are supporting you. It can help you have a clear and respectful discussion with them about where you want to give birth and what care you want during and after the birth. You can read more about birth plans on our factsheet Consenting to treatment.

Your midwife and doctor should provide you with information and personalised discussions to help you make informed choices about your care.

When you make your decision, your midwife should support you. They should listen to you and respect what you say. They should help you to get the maternity care you choose.

If you are struggling to find this support, contact the Director or Head of Midwifery at your hospital. If you don't know the details for the Head of Midwifery, you can ask your midwife and/or the Patient Advice and Liaison service (PALS) (in England and Wales) to put you in touch. The Trust website will have a page with PALS details on it. If you are worried, you can look these details up in case you need them.

The Nursing and Midwifery Code says that all midwives must treat people as individuals and respect and uphold their rights. Your midwife is your advocate. They should support you even if your decision doesn't fit the hospital or birth centre's guidelines.

You may want to choose a hospital or birth centre in another area, for example to be near family support. Or you may need to change to a Trust if your circumstances change, for example if you move to a new area during your pregnancy.

If you move, you can book with a hospital or birth centre in your new area for care. You can do this directly by looking on the hospital's website or asking its maternity team for the self-referral form. Alternatively, your GP in your new area can help. You should be able to do this even if you are very late in your pregnancy. You can also ask to book with the home birth team, although they may have a limit on numbers of people they can book or how late they can accept bookings, depending on how they are staffed.

If you are having trouble booking for care after a move, you can contact us for support.

If you are told that you cannot choose the hospital or birth centre you want because you do not live in the right area, you can ask for an exception to be made. Ask:

Even if their policy says you cannot use the services you have asked for, you can ask them to look at the reasons why you want this hospital or birth centre. They need to give you a good reason if they say no.

Wherever you give birth, your postnatal care will be provided in your home area.

Many NHS Trusts now offer only online video tours, photographs or leaflets about their maternity wards and birth centres. These can help you familiarise yourself with the maternity unit. You do not have a right to an in-person tour.

However, if you have a disability or health condition that means you may need reasonable adjustments, ask to visit the hospital or birth centre so that you and the healthcare professionals working with you can plan ahead.

You might want to look at physical adjustments that will be needed, such as a hoist. If you have a visual impairment, the position and nature of the lighting could be important. Autistic people often want to visit ahead so that they know what to expect and can ask for changes that will make their birth experience easier. The key is that everyone is different so you need to visit in order that you and the healthcare team can plan your individual care.

You have the right to ask for a water birth. The hospital or birth centre may have rules about who can have a water birth but these are not legal rules. You can ask how many rooms have a pool in the birth centre or hospital.

If your care team has concerns about whether a water birth is safe, they should offer you a respectful discussion on the risks and benefits in your situation so that you can make an informed decision.

The hospital or birth centre should only say that you cannot access a water birth if they have a good reason based on clinical evidence.

Your midwife and doctor should also help you consider other options, such as using water for pain relief in labour but not for the birth itself.

If you choose a water birth at the birth centre or hospital, you may not be able to access a pool if there is not one free when you arrive. If you are unsure whether a pool will be available, some people decide to hire their own pool for use at home and then transfer when they are ready. If you have a home birth, you can buy or hire a pool to use at home.

Mental capacity means that you can understand the choice you need to make about treatment and can make a decision.

In law, everyone has mental capacity unless it can be shown that you do not.

Very rarely, someone may not be able to give consent to treatment because they are unable to make a decision that they need to make, even when it is very clearly explained and they are given lots of support.

It is very rare to not have mental capacity.

The people caring for you cannot say you do not have mental capacity simply because you do not agree with them.

Most people do not have to pay for their care. The NHS provides free care to those who are 'ordinarily resident' in the UK. If you are not 'ordinarily resident' then you may have to pay for your care. If this applies to you, then this includes maternity care in hospital, in the community and at home. Your NHS Trust must tell you if you will be charged for your care.

Even if you have to pay for your care and cannot afford to do so, you must still be given maternity care. You cannot be told that you have to wait until you can pay.

The rules about who has to pay for care, and how charging works are very complicated.
Guidance giving you the choice of where to give birth
The 2016 Better Births report for NHS England set out that women should be able to decide where they want to give birth; whether this is at home, in a midwifery unit or in an obstetric unit. This also applies to birthing people who do not identify as women.

The other nations of the UK have the same expectations of maternity services in their areas. Here is their guidance:
Guidance on home births
The legal position is that you have the right under Article 8 of the Human Rights Act to a private and family life which includes the right to choose where you give birth and who is present.

However, this is a qualified right which means that the rights can be restricted where there is a legitimate aim such as protecting the health of others, and the restriction is 'proportionate'.

This means that the Trust should only suspend their home birth service if they have looked at all the options for keeping it going including using local Independent Midwives or bringing back retired midwives to supplement their team, and looking at alternative ways to transfer into hospital if the ambulance service is under pressure (this last realistically applies only in times of severe crisis such as a pandemic).

The UK's guidance is set out in:

In 2016 the NHS Ombudsman accepted that an NHS Trust that suspended its home birth services and refused to make contingency plans was acting unreasonably. They were told to start providing the service again and to work with other Trusts to provide support for home birth in the meantime.
The Nursing and Midwifery Council Code
The Nursing and Midwifery Council Code sets out professional standards of behaviour for nurses, midwives and nursing associates in the UK. It says that midwives need to put the interests of people using maternity care first.
About Birthrights
Birthrights factsheets give you information about your human rights when you are pregnant and giving birth.

Birthrights champions respectful care during pregnancy and childbirth by protecting human rights. We provide advice and information to women and birthing people, train doctors and midwives, and campaign to change maternity policy and systems.

We are a charity, independent of the government and the NHS.
Disclaimer: Our factsheets provide information about the law in the UK. The information is correct at the time of writing (May 2021). The law in this area may be subject to change. Birthrights cannot be held responsible if changes to the law outdate this publication. Birthrights accepts no responsibility for loss which may arise from reliance on information contained in this factsheet. Birthrights has provided links to third party websites where these may help provide relevant further information. Birthrights takes no responsibility for the contents of linked websites and links should not be taken as an endorsement.
Do you work with pregnant women and birthing people?

Our training equips doctors, midwives and other birth workers with knowledge of the law and human rights principles, an understanding of how to apply it in practice, and the ability to communicate effectively with women and birthing people in a way that upholds their human rights. We offer a 10% discount to multidisciplinary teams.

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Can I choose where to give birth? Yes. You have the right to choose where you give birth. You can choose to give birth in a hospital, in a birth centre, or at home. A birth centre is a maternity unit that is run by midwives.

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The 20-week screening scan looks for some physical abnormalities in the baby. Find out what happens at this screening scan, whether you have to have it, and what to expect if the scan shows a possible problem.

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The third trimester of your pregnancy is from week 29 to week 40 - months seven, eight and nine.

Feelings at this stage of pregnancy tend to go from tiredness and worry to excitement about the baby.

Your baby continues to grow, and as the third trimester progresses they'll have a better chance if they're born early. You'll have more checks with the midwife in the third trimester, because it's important to keep an eye on your and your baby's health.

The position your baby is in becomes more important now and you may start to think about what happens during labour.

If you can, use these last few weeks to get ready for the baby and enjoy some time for yourself, especially after you start maternity leave. If you have children already, you may find it hard to keep up with them sometimes. Take any offers of help you can get.

One important thing to remember in the third trimester is that you should now go to sleep on your side at night (and during any day time naps). You can read more here about why going to sleep on your side in the third trimester is safer for your baby.

Things to think about in the third trimester of pregnancy

You can still be active during the last three months, but you'll probably find your body slowing down naturally. Walking is an ideal exercise.

You may also find that pregnancy yoga, pilates or aquanatal classes are good ways to stay active in the third trimester. Staying active doesn't have to be planned, though. We've got some good tips for staying active without going to the gym here.

If you haven't written your birth plan yet, you may wish to do it now. As part of your birth plan, it's good to think about the different kinds of pain relief that are available and what you may like to consider when you're in labour.

Bear in mind, though, that your wishes may change and you might also need some extra help during labour and birth, so keep an open mind.

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Tommy's - Third trimester: weeks 29 to 40

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The third trimester of your pregnancy is from week 29 to week 40 - months seven, eight and nine. Feelings at this stage of pregnancy tend to go from tiredness and worry to excitement about the baby. Your baby continues to grow, and as the third trimester progresses they'll have a better chance if they're born early.

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Kent and Medway - Bump, Birth and Beyond

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Pregnant women, birthing people and their partners can choose between birthing at home, within a birth centre (or a midwifery-led unit), or in hospital on an obstetric ward.

The health professionals supporting your maternity journey will support you with your options and preferences. There are a number of advantages and considerations when choosing your place of birth and wherever you choose, the place should feel right for you and you should feel supported in your decision. You can change your mind at any point in your pregnancy.

For more information on birth choice, that you may find useful, please click on the links.

To help you choose where to give birth, you can try the Which? tool.

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Birth choices :: Kent and Medway - Bump, Birth and Beyond

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Pregnant women, birthing people and their partners can choose between birthing at home, within a birth centre (or a midwifery-led unit), or in hospital on an obstetric ward. The health professionals supporting your maternity journey will support you with your options and preferences.

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Kent and Medway - Bump, Birth and Beyond

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During the first 10 weeks of your pregnancy, you will be offered a blood test for Sickle Cell and Thalassaemia. These are serious blood conditions that can be passed from parents to the baby.
If these conditions are found early in your pregnancy, then you can be offered treatment for you and your baby.
Syphilis, Hepatitis B and HIV
Between eight and 12 weeks, your midwife will offer you a blood test for three infectious diseases: Syphilis, Hepatitis B and HIV. You can choose which tests you want to have. These are serious infections, which can be passed onto your baby.
The blood test should be carried out before you are 10 weeks pregnant, so any treatment can be started to help reduce the risk of passing the infection to your baby.

More information about this test can be found on NHS.uk

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Screening tests in pregnancy :: Kent and Medway - Bump, Birth and Beyond

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During the first 10 weeks of your pregnancy, you will be offered a blood test for Sickle Cell and Thalassaemia. These are serious blood conditions that can be passed from parents to the baby. If these conditions are found early in your pregnancy, then you can be offered treatment for you and your baby.

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East Kent Hospitals University NHS Foundation Trust

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Kent and Medway - Bump, Birth and Beyond

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This page looks at the way your body gets ready for labour and how you know labour is starting. The video below from East Kent Hospitals demonstrates the changes to the neck of your womb which happen in this early part of labour.

The show, and other signs you're getting ready for labour

During the last days and weeks of your pregnancy, you may notice your baby getting lower and pressing on your bladder more, and perhaps making walking more tiring. On the other hand, this may give your lungs a little more space which can reduce breathlessness when active. A first baby is likely to move down and stay down, while if you've had a baby before there can be more movement.

Some women report 'nesting' behaviour in the days before labour starts when they have a sudden burst of energy to organise or make changes to the home. Others are happier to mostly rest. A grown baby, plus water, plus a placenta - it's a lot to carry around.

You may have a 'show'. This is where the jelly-like substance which has been plugging the neck of your womb starts to come away. You may notice a lump of mucus, which can be creamy, pale yellow, and streaked with red or brown blood. It's not beautiful but can be exciting. After a show, it could still be a couple of weeks or more before your labour starts, but it's part of the process.

Your digestive system may empty out. For some, the first sign will be loose bowels, and perhaps being sick. This can happen one or two days before labour starts. It's important to keep eating and drinking as you need your energy. You probably want to avoid large meals and rich food at this point. Of course, you may be having these symptoms for other reasons, especially if you feel unwell. Call your midwife if you are concerned.

Labour can start in different ways, and just as every baby is unique, every labour will unfold slightly differently. There are three main signs that labour is starting:

You may notice tightenings in your bump

You are probably used to practice tightenings (Braxton Hicks) from the last few weeks. These are different. Early labour tightenings develop into longer, stronger and more regular labour contractions. Some women prefer to think of tightenings and contractions as surges or waves as this makes them easier to welcome. Early labour tightenings might be:

● More like period cramps than anything you've felt in a while
● Stronger than practice tightenings
● Lasting longer than practice tightenings
● Coming predictably after a set amount of time

You may find you need to stop what you're doing when they come and just give yourself a moment. They might last a few seconds, or they might last half a minute or more. The gap between could be a few minutes, or it could be half an hour or even longer. Contraction tracker apps are useful to keep a note of the pattern.

Early labour tightenings will develop into long, strong, regular labour contractions but this can take up to a couple of days, especially with a first baby. It is also normal for the early labour tightenings to ease off.

This is not unusual, and the important thing is to remind yourself that it won't last forever. Concentrate on saving your energy for when things do move to the next phase.

The waters may be released

In a film, mothers always seem to know instinctively when this is happening. In reality, you may be uncertain. The fluid may come out in a gush, or it is often a trickle. A gush makes it obvious, but with a trickle, it is much harder to know. Some women feel or hear a 'pop', while many don't. Watery vaginal discharge is normal for many women in late pregnancy, which can make it harder to be sure.

You may get a backache

Early labour contractions sometimes feel more like waves of backache, and less like tightenings in the bump. This is more common when the baby's back is lined up with your back, rather than curling into the front of your bump. Forward leaning positions are fantastic in early labour. You might want to be on your hands and knees for the contractions or sitting and leaning. A birth ball can be ideal, with something sturdy such as the back of the sofa in front of you to hold. If you feel tired, you can lie down on your side with your bump, tipped down towards the cushions or mattress.

I'm getting a lot of tightenings but then they stop - is it early labour?

Sometimes it is difficult to know if tightenings are early labour tightenings or just practice tightenings when they come and go for several days or more. It can be confusing and frustrating.

It can be helpful to concentrate on eating healthily, occasional activity and lots of distraction. This might be chatting to friends, films, videos, podcasts, or whatever works for you. If you have been using hypnobirthing soundtracks, these can be very useful at this stage.

This video from East Kent Hospitals University Foundation Trust takes you through what happens in the early stages of labour.

When do we call a midwife

Call the number you have been given when:

The contractions are getting longer, stronger and more regular

or your waters are leaking

or you have any concerns

Going to a birth centre or obstetric unit too early can raise the chance of needing more interventions. For this reason, while the pattern of labour indicates the early stage, you are likely to be advised to continue at home. It is useful to have the call though, to let the team know how you are getting on.

If your waters are leaking, you will be invited for an assessment. If the waters are clear and your baby is moving well, this is reassuring. You can discuss the best timing for the assessment with your team.

If you're having contractions without water leaking, you will be asked to call back once contractions are long, strong and regular. This is the sign that you are reaching 'active labour', also called 'established labour'. In active labour, the neck of the womb is opening. This is the stage where regular or continuous monitoring of the baby is advised and your midwife will travel to you for homebirth, or you will travel to the birth centre or obstetric unit.

When you have had a baby before, it is possible that things can start very quickly, and you may have little warning before being in active labour. It is, of course, very normal for things to start slowly too. Labour is well-known for being unpredictable!

Signs you are in 'active' labour:

Contractions generally last 45 seconds to one minute or more

It is usually difficult to talk during a contraction

From the start of one contraction to the start of the next will generally have shortened to be just a few minutes

Call or call back if you think it is 'active labour' or if you have any concerns. If you experience any of these, then call your unit urgently:

Signs of labour before you reach 37 weeks of pregnancy

Bleeding from the vagina that is not a show

Waters leaking before you reach 37 weeks of pregnancy

Waters leaking at any time which have a green or brown tint

Pain from your bump which is constant, not coming and going

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Early signs of labour :: Kent and Medway - Bump, Birth and Beyond

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This page looks at the way your body gets ready for labour and how you know labour is starting. The video below from East Kent Hospitals demonstrates the changes to the neck of your womb which happen in this early part of labour.

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First stage of labour: a definition

As labour can be a long, complex process, it's handily referred to as happening in three stages (NICE, 2017).

"The first stage of labour is made up of contractions that will get longer, stronger and more frequent."

These contractions will help to push your baby down and your cervix to open (dilate) so that your baby can come into the world. When your cervix has dilated to about 4cm, you're in 'established labour' (NICE, 2017).

If this is your first baby, the first stage of established labour usually lasts between eight and 18 hours. If it's not, it's more likely to be around five to 12 hours (NICE, 2017).

What do contractions feel like?

Ah, the big question. Trouble is, contractions can feel completely different from woman to woman and even in different pregnancies. So the way your friend describes hers may be a world away from your own experience.

Some ways you might describe the feeling are:

discomfort or a dull ache in your back or lower stomach

pressure in the pelvis

stomach becoming hard, then soft again

wave-like motion from the top of the uterus to the bottom

similar to period pain.

If you're wondering what early labour feels like, watch our video where new mums talk about what it felt like for them.

The good news is that contractions will come and go so - if you can - try and relax in between them (WebMD, 2018).

Contractions versus Braxton Hicks contractions

The contractions you'll experience during established labour are different from the Braxton Hicks contractions (false contractions) that you probably felt while you were pregnant. Unlike Braxton Hicks, they don't go away when you change your position or relax.

Early labour pain management and calling your midwife

Your midwife will know how far on you are and whether you need to be in hospital or at your birthing centre yet. So before you head off anywhere, give them a call.

Your midwife will then ask questions and assess you based on your:

movements

breathing

ability to hold a conversation

emotional state.

Call your midwife or a doctor straight away if:

you have a heavy 'show'

your waters break

your baby's moving less than usual

you're less than 37 weeks pregnant.

(NHS Choices, 2017)

First stage of labour: managing pain at home

In the early part of labour, you're likely to be at home. Try the following if you can:

walk or move around

drink a lot of fluids and healthy snacks

have a warm bath

do some relaxation or breathing exercises

ask your birth partner to rub your back

manage the pain with paracetamol (if needed)

stay in an upright position.

When your contractions start coming every five minutes and last at least 60 seconds, give your midwife a call (NHS Choices, 2017).

Early labour and your birth partner

Having a supportive birth partner can give you a sense of control, comfort and competence and make complications less likely (Hodnett et al, 2013). So (no pressure), choose carefully...

Things your birth partner can do to help you are:

Speaking to midwives or doctors if you're not able to.

Encouraging you (especially through contractions...) and reassuring you.

Massaging your back (if you can bear it... some women can't).

Getting you those crucial energy-boosting drinks and snacks.

Speaking to you about pain-relief options.

Helping you with relaxation and breathing techniques.

Supporting you while you try different positions.

First stage of labour: how it will progress

When you meet your midwife, they will:

Ask you about the length, strength and how often your contractions are coming.

Possibly conduct a vaginal examination and record your pulse, blood pressure and temperature.

Ask about your baby's movement in the last 24 hours.

Examine your stomach.

Monitor your baby's heart rate.

(NICE, 2017; Which?, 2018)

First stage of labour: what happens at the end

Toward the end of the first stage of labour, your cervix will be about 7cm to 8cm dilated.

A lot of women find this the hardest, most painful part of giving birth and you might feel like you are out of control. If this happens to you, don't worry: it's totally normal.

If you want to give birth without pain relief, this might also be the part when you find it the trickiest to stick to your plan. It's absolutely fine, of course, if you do change your mind but if you do want to still avoid pain relief, it is possible to use self-help methods like hypnobirthing instead.

Then you'll be on to the second stage of labour, which will last until you have your baby, normally for two to three hours at the most. (NICE, 2017)

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth and life with a new baby.

You will also find useful information on NHS Choices in a guide to labour.

More information on stages of labour can be found in NICE guidelines.

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. (2013) Continuous support for women during childbirth. Cochrane Database Syst Rev.(7):CD003766. Available from: http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD003766.pub5/pdf [Accessed 3rd August 2018].

NHS Choices. (2017) Signs that labour has begun. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/labour-signs-what-happens/ [Accessed 3rd August 2018].

NICE. (2017) Intrapartum care for healthy women and babies. Available from: https://www.nice.org.uk/guidance/cg190/ifp/chapter/what-happens-during-labour [Accessed 3rd August 2018].

RCM. (2012) Evidence based guidelines for midwifery-led care in labour: assessing progress in labour. Available from: https://www.rcm.org.uk/sites/default/files/Assessing%20Progress%20in%20Labour.pdf [Accessed 3rd August 2018].

WebMD. (2018) Pregnancy and signs of labor. Available from: https://www.webmd.com/baby/labor-signs#1 [Accessed 3rd August 2018].

Which? (2018) Stages of labour. Available from: https://www.which.co.uk/birth-choice/getting-ready-to-give-birth/stages-of-labour [Accessed 3rd August 2018].

WHO. (2013) Counselling for maternal and newborn health care: a handbook for building skills. Available from : https://www.ncbi.nlm.nih.gov/books/NBK304186/ends [Accessed 3rd August 2018].

Further reading

Lawrence A, Lewis L, Hofmeyr GJ, Dowswell T, Styles C. (2013) Maternal position and mobility during first stage labour. Cochrance Database Syst Rev.(8):CD003934. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164173/ [Accessed 3rd August 2018].

Which? (2018b) Choosing your birth partner. Available from: https://www.which.co.uk/birth-choice/getting-ready-to-give-birth/choosing-your-birth-partner [Accessed 3rd August 2018].

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First stage of labour: signs, coping and when to go to hospital | Labour & birth articles & support | NCT

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The first stage of labour - when things start happening - can be daunting. Here's you're guide to everything from contractions to when to call the midwife.

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All parents are offered a thorough physical examination for their baby within 72 hours of giving birth.

The examination includes screening tests to find out if your baby has any problems with their eyes, heart, hips and, in boys, testicles (testes).

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All parents are offered a thorough physical examination for their baby within 72 hours of giving birth.
The examination includes screening tests to find out if your baby has any problems with their eyes, heart, hips and, in boys, testicles (testes).

What is the newborn physical examination?

The newborn physical examination is usually carried out in hospital before you go home.

Sometimes it's done at a hospital or community clinic, GP surgery, children's centre or at home. Ideally, both parents should be there when the examination is done.

The healthcare professional doing the examination should explain what it involves. This could be a doctor, midwife, nurse or health visitor who's been trained to do the examination.

Some parts of the examination may be a bit uncomfortable for your baby, but it will not cause them any pain.

The aim is to spot any problems early so treatment can be started as soon as possible. Usually, nothing of concern is found.

If the healthcare professional doing the examination does find a possible problem, they may refer your baby for more tests.

You'll be offered another physical examination for your baby at 6 to 8 weeks, as some of the conditions it screens for can take a while to develop.

This 2nd examination is usually done at your GP surgery.

How is the newborn physical examination done?

The healthcare professional will give your baby a thorough physical examination.

They'll also ask you questions about how your baby is feeding, how alert they are, and about their general wellbeing.

Your baby will need to be undressed for part of the examination.

During the examination, the healthcare professional will also:

look into your baby's eyes with a special torch to check how their eyes look and move

listen to your baby's heart to check their heart sounds

examine their hips to check the joints

examine baby boys to see if their testicles have descended into the scrotum

What does the newborn physical examination check for?

The examination includes an overall physical check, plus 4 different screening tests.

Eyes

The health professional will check the appearance and movement of your baby's eyes.

They're looking for cataracts, which is a clouding of the transparent lens inside the eye, and other conditions.

About 2 or 3 in 10,000 babies are born with cataracts in one or both eyes that need treatment.

But the examination cannot tell you how well your baby can see.
Find out more about childhood cataracts
Heart

The healthcare professional will check your baby's heart. This is done by observing your baby, feeling your baby's pulses, and listening to their heart with a stethoscope.

Sometimes heart murmurs are picked up. A heart murmur is where the heartbeat has an extra or unusual sound caused by a disturbed blood flow through the heart.

Heart murmurs are common in babies. The heart is normal in almost all cases where a murmur is heard.

But about 8 in 1,000 babies have congenital heart disease that needs treatment.
Find out more about congenital heart disease
Hips

Some newborns have hip joints that are not formed properly. This is known as developmental dysplasia of the hip (DDH).

Left untreated, DDH can cause a limp or joint problems.

About 1 or 2 in 1,000 babies have hip problems that need to be treated.
Find out more about developmental dysplasia of the hip
Testicles

Baby boys are checked to make sure their testicles are in the right place.

During pregnancy, the testicles form inside the baby's body. They may not drop down into the scrotum until a few months after birth.

Around 2 to 6 in 100 baby boys have testicles that descend partially or not at all.

This needs to be treated to prevent possible problems later in life, such as reduced fertility.
Find out more about undescended testicles

Does my baby have to have the examination?

The aim of the examination is to identify any of the problems early so treatment can be started as soon as possible.

It's strongly recommended for your baby, but not compulsory.

You can decide to have your baby examined and screened for any or all of the conditions.

If you have any concerns, you should talk to your midwife or the healthcare professional offering the examination.

When will we get the results?

The healthcare professional who does the examination will give you the results straight away.

If your baby needs to be referred for more tests, they'll discuss this with you there and then, too.

The results will be recorded in your baby's personal child health record (red book).

You'll need to keep this safe and have it to hand whenever your baby sees a healthcare professional.

If you have any concerns, you can discuss them with your midwife or the healthcare professional who does the examination.
Download a leaflet about screening tests for you and your baby from GOV.UK

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All new parents are offered a newborn physical examination for their baby. Your baby's eyes, heart, hips and, in boys, testicles will be checked.

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Kent and Medway - Bump, Birth and Beyond

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If you are a first-time parent then you may be feeling a little nervous about caring for your baby, especially if you haven't changed a nappy before or bathed a baby. It is quite common to feel this way in the early days until you've got to know your baby and how to care for their needs.

Don't be afraid to speak to your midwife if you have any worries or concerns about your newborn. They are there to support you in the first 10-14 days after birth. Afterwards, you can contact your health visitor or your GP with any concerns.

In this section, you will find lots of information about caring for your newborn.

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Caring for my baby :: Kent and Medway - Bump, Birth and Beyond

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If you are a first-time parent then you may be feeling a little nervous about caring for your baby, especially if you haven't changed a nappy before or bathed a baby. It is quite common to feel this way in the early days until you've got to know your baby and how to care for their needs.

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A LWAYS sleep your baby

on their B ACK

in a C LEAR cot or sleep space

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The safest cot is a clear cot

The safest cot for a baby is a clear cot. That means removing anything that isn't essential. Babies need just two items in their cot:

It's important to remove anything that isn't essential because items such as toys, blankets and bumpers could cover their face and obstruct their breathing.

When preparing your baby's sleep space, remember:

No pillows or duvets

No cot bumpers

No soft toys or comforters

No weighted or bulky bedding

No products designed to keep your baby in one sleeping position, such as wedges or straps

No pods or nests, rolled up towels or anything soft placed on top of the mattress.

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Safer sleep overview - The Lullaby Trust

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An easy guide to practicing safer sleep for your baby and reducing the risk of sudden infant death syndrome (SIDS, or cot death).

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The baby blues

During the first week after childbirth, many women get what's often called the "baby blues".

Women can experience a low mood and feel mildly depressed at a time when they expect they should feel happy after having a baby.

"Baby blues" are probably due to the sudden hormonal and chemical changes that take place in your body after childbirth.

Symptoms can include:

feeling emotional and bursting into tears for no apparent reason

feeling irritable or touchy

low mood

anxiety and restlessness

All these symptoms are normal and usually only last for a few days.

Is it postnatal depression?

Depression after a baby is born can be extremely distressing. Postnatal depression is thought to affect around 1 in 10 women.

Postnatal depression can start at any point in the first year after giving birth and may develop suddenly or gradually.

Symptoms such as tiredness, irritability or poor appetite are normal if you've just had a baby. But these are usually mild and do not stop you leading a normal life.

When you have postnatal depression, you may feel increasingly depressed and low. Looking after yourself or your baby may become too much.

Emotional signs of postnatal depression may include:

loss of interest in the world around you and no longer enjoying things that used to give you pleasure (like you "cannot be bothered")

feelings of hopelessness

not being able to stop crying

feelings of not being able to cope

not being able to enjoy anything

memory loss or being unable to concentrate

excessive anxiety about your baby

Other signs of postnatal depression may also include:

sleeplessness

extreme tiredness

feeling generally unwell

loss of appetite

Getting help for postnatal depression

It's important to seek help as soon as possible if you think you might be depressed, as your symptoms could last months or get worse and have a significant impact on you, your baby and your family.

With the right support most people make a full recovery.

If you think you may be depressed, talk to a GP, midwife or health visitor as soon as possible so you can access the support you need.

Treatment for postnatal depression

The 3 main types of treatments for postnatal depression are:

self-help - for example, talking to your family and friends about your feelings, making time to do things you enjoy, getting as much sleep as you can at night, exercising regularly, and eating a healthy diet

psychological therapy - a GP may be able to recommend a self-help course or refer you for a course of therapy, such as cognitive behavioural therapy (CBT)

antidepressants - these may be recommended if your depression is more severe or other treatments have not helped; your doctor can prescribe a medicine that's safe to take while breastfeeding

Talk to a GP about the pros and cons of different treatments so you can decide together what's best for you.

You may also find it helpful to contact the Association for Post Natal Illness or the National Childbirth Trust.

The mental health charity Mind provides useful resources for people affected by postnatal depression.

Your local children's centre can put you in touch with your nearest postnatal group.

These groups provide contact with other new mothers and encourage mums to support each other. They also offer social activities and help with parenting skills.

Avoiding alcohol

Alcohol may appear to help you relax and unwind. In fact, it's a depressant that affects your mood, judgement, self-control and co-ordination.

It has even more of an effect if you're tired and run-down.

Be careful about when and how much you drink, and do not drink alcohol if you're taking antidepressants or tranquillisers.

Postpartum psychosis

Postpartum psychosis, which is also called puerperal psychosis, is rare. Only 1 or 2 mothers in 1,000 develop a severe psychiatric illness that requires medical or hospital treatment after the birth of a baby.

This illness can develop within hours of childbirth and is very serious, needing urgent attention.

Other people usually notice it first as the mother often acts strangely.

It is more likely to happen if you have a severe mental illness, a past history of severe mental illness or a family history of perinatal mental illness.

Specialist mother and baby units can provide expert treatment without separating you from your baby.

Most women make a complete recovery, although this may take a few weeks or months.

Postnatal post-traumatic stress disorder (PTSD)

Postnatal post-traumatic stress disorder (PTSD) is often the result of a traumatic birth, such as a long or painful labour, or an emergency or problematic delivery.

It can also develop after other types of trauma, such as:

a fear of dying or your baby dying

life-threatening situations

The symptoms of postnatal PTSD, such as re-experiencing aspects of the traumatic event, can occur alone or in addition to the symptoms of postnatal depression.

The symptoms can develop straight after the birth or months afterwards.

It's extremely important to talk to someone about how you're feeling. Your midwife, GP or health visitor will be able help you.

If you're worried about talking to a health professional, consider asking a close friend or family member to come with you for support.

There are effective treatments available, such as cognitive behavioural therapy (CBT) and medicines.
Read more about treatments for PTSD

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Find out about feeling down after giving birth, including how to tell the difference between the "baby blues" and postnatal depression.

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Postnatal depression (PND) is a type of depression that many parents experience after having a baby. It can affect any parent, regardless of whether they've suffered from a mental health condition before. Postnatal depression is linked directly to giving birth and is a common problem, affecting 1 in 10 women within a year of giving birth.

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Skip to content

Kent and Medway Talking Therapies is a free and confidential NHS service offering mental health support across Kent and Medway.

Our talking therapies are available to anyone over 17.5 years old, living in the Kent and Medway area.

Our services include talking and listening therapies, like counselling and cognitive behavioural therapy, to help you feel like yourself again.

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Talking therapies in Kent and Medway | We Listen

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Kent and Medway TalkingTherapies is a free and confidential NHS service offering mental health support across Kent and Medway.

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Welcome to Perinatal Pathways, a quick and simple questionnaire to help you, your family and health professionals find services and helpful information for your mental health.

The following questionnaire will only take a few minutes to complete. The answers will help you to find what your next steps are and give you some helpful information but remember it is not a diagnostic tool and if you have any concerns you should discuss these with a health professional.

Ready to start? Press the start button below

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This website has been developed by the NHS Southeast Perinatal Mental Health Clinical Network to help midwives, health visitors and other health professionals working with families in the Perinatal period to identify which service and interventions would be most helpful.

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From 35 weeks onwards, you or your partner can use daily perineal massage until your baby is born which may reduce your risk of tearing.

This is particularly beneficial for first-time mothers. You may choose to ask your partner to help you with this.

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Reducing your risk of perineal tears | RCOG

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The following animation explains what an OASI is, the four components of the OASI Care Bundle and how women can reduce their risk of sustaining an OASI in childbirth.

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A birth plan is a record of what you would like to happen during your labour and after the birth. You don't have to create a birth plan but, if you would like one, your midwife will be able to help.

Discussing a birth plan with your midwife gives you the chance to ask questions and find out more about what happens in labour.

It also gives your midwife the chance to get to know you better, and understand your feelings and priorities, and allows you to think about or discuss some things more fully with your partner, friends and relatives.

You can change your mind about your wishes for labour and birth at any time.

Your personal circumstances

Your birth plan is personal to you. It depends on what you want, your medical history, your circumstances and what is available at your maternity service.

You might be given a special form for your birth plan, or there may be room in your notes. It's a good idea to keep a copy of your birth plan with you.

The maternity team who care for you during labour will discuss it with you so they know what you want.

Be flexible

You need to be flexible and prepared to do things differently from your birth plan if complications arise with you or your baby, or if facilities such as a birth pool aren't available.

The maternity team will tell you what they advise in your particular circumstances. Don't hesitate to ask questions if you need to.

Things to consider

You can find out more about the things you need to think about when making a birth plan, such as:

You can work out whether there's anything you feel strongly about and might wish to include.

You can also show your birth partner these tips to support you.

Download a birth plan template

You can download a birth plan template (Word document 65KB, opens in a new window) to fill in and save.

Get Start4Life pregnancy and baby emails

Sign up for Start4Life's weekly emails for expert advice, videos and tips on pregnancy, birth and beyond.

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Find a birth plan template and learn about making a birth plan, including where to give birth, pain relief options, who to have with you and your feelings on intervention.

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Babies do things in their own time, and only 1 in 20 will arrive on their due date.

It might be a good idea to get your hospital bag packed at least 3 weeks ahead of the due date, so that you're all ready to go if your baby decides to make an early appearance.

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Find out what to pack in your bag ready for labour and birth, including essentials for you and the baby, plus suggestions for your birth partner, if you have one.

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Vaccinations that are offered during pregnancy have been shown by research to help keep you and the baby safer. You will be offered free vaccinations for whooping cough and flu during pregnancy. You may also be offered the COVID 19 vaccine.

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Whooping cough vaccine in pregnancy

What is whooping cough?

Whooping cough (pertussis) is a respiratory infection that develops into severe coughing fits. This illness can be very severe, especially in very young babies. The number of cases of whooping cough in the UK has risen among babies who are too young to have had their vaccinations.

Because of this, the Department of Health developed a vaccine for pregnant women to protect their babies against this illness until they are old enough to have their first vaccinations.

When should I be offered the whooping cough vaccine?

You will be offered the whooping cough vaccine by your GP or midwife.

All pregnant women should be offered the whooping cough vaccine between 16 and 32 weeks of pregnancy, although it can be given right up until you go into labour.

You will be offered this vaccination to boost your antibodies. These antibodies will be passed to your baby through the placenta.

As there is no whooping cough-only vaccine, the vaccine you'll be given also protects against polio, diphtheria and tetanus. The vaccine is called Boostrix IPV.

Comprehensive research into the vaccine has shown that it's very safe, with no ill-effects for pregnant women or their babies.

Is the whooping cough vaccine safe?

Comprehensive research into the vaccine has shown that it's very safe, with no ill-effects for pregnant women or their babies.

Flu vaccine in pregnancy

If you're pregnant in winter, you will be offered a flu vaccine. There is evidence that pregnant women can be more at risk of developing complications if you get flu during pregnancy. To cut this risk for you and your baby's health, women are offered a free flu jab, usually sometime between September and February.

The vaccine doesn't contain any live viruses, so it can't cause flu. Some people get a slight temperature and aching muscles for a couple of days afterwards. You may also feel a bit sore at the injection site.

In some areas, midwives can give a flu vaccine at the antenatal clinic. In others, you will need an appointment at a GP practice. Some community pharmacies also offer flu vaccination on the NHS.

Is the flu vaccine safe?

Research shows that the flu vaccine is safe from the first few weeks of pregnancy right up to your due date. You can read more about the research and safety behind the flu vaccine.

Travel vaccinations in pregnancy

Some vaccines that use live bacteria or viruses are not recommended during pregnancy because of concerns that the virus or bacteria in the jab could harm the baby in the womb.

It's best to avoid visiting countries or areas where you'll need to have vaccinations before you travel.

If for any reason this isn't possible, talk to your GP or midwife. They can outline any risks and benefits of the vaccinations you need. If there is a high risk of infection in the place you're going to, it's often safer to have a vaccine rather than travel unprotected.

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Whooping cough (pertussis) is a respiratory infection that develops into severe coughing fits. This illness can be very severe, especially in very young babies. The number of cases of whooping cough in the UK has risen among babies who are too young to have had their vaccinations.

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By quitting smoking when you're pregnant, you're taking care of yourself and your baby

Tobacco smoke contains thousands of chemicals, and many are toxic. They can pass through the placenta to the baby and affect his or her development

A small baby who doesn't grow healthily has an increased chance of being stillborn. Smoking also increases the likelihood of a baby being born prematurely, and that he or she will have health and development problems in childhood and later life

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Smoking in pregnancy is harmful for you and your baby and stopping at any stage is helpful - advice on what to do and where to find more information and support

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Tobacco smoke contains thousands of chemicals, and many are toxic. They can pass through the placenta to the baby and affect his or her development

By quitting smoking when you’re pregnant, you’re taking care of yourself and your baby.

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If you use or have used street drugs or recreational drugs or other substances, it’s important to tell your midwife. The more she knows about your general health, the better she’ll be able to help you and your baby

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Midwife Sonia explains how street drugs can harm your baby and how important it is to get support with giving up.

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Advice about alcohol in pregnancy can get confusing. But we know that drinking alcohol during pregnancy can harm your baby, with the more you drink, the greater the risk.

That is why the NHS recommends not to drink alcohol in pregnancy. This keeps any risk to your baby at a minimum.

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To reduce the risk of sudden infant death syndrome (SIDS) the safest place for a baby to sleep is in their own clear, flat, separate sleep space, such as a cot or Moses basket. However, we know that many parents find themselves co-sleeping whether they mean to or not. Wherever you’re planning for your baby to sleep we recommend making your bed a safer place for baby. Our advice on co-sleeping with your baby will tell you how.

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Protein provides the building blocks for your baby to grow. Foods in this group include:

Fish

Have no more than 2 portions of oily fish each week. Make one of them an oily fish like salmon, sardines or mackerel.

There are some types of fish you should avoid (raw shellfish, shark, swordfish and marlin) if you're pregnant or trying to conceive.

Eggs

Hen eggs produced under the British Lion Code of Practice (stamped with the red lion) or produced under the Laid in Britain scheme, are considered very low risk for salmonella and safe to eat raw or partially cooked.

Any hen eggs that are not British Lion eggs or produced under the Laid in Britain scheme, should be well cooked. Other types of eggs, including duck, quail and goose eggs, should also be well cooked.

If you have a severely weakened immune system or are on a medically supervised diet prescribed by health professionals, you should cook all eggs thoroughly.

Read about the healthy way to eat eggs.

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Healthy eating in pregnancy - Start for Life

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Having a healthy diet is important in pregnancy, find out which foods to include in your pregnancy diet.

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Even before they are born, your baby is listening and getting to know you.

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Even before they are born, your baby is listening and getting to know you.

When they hear you speak, they settle and their heartbeat slows. This helps them to recognise you and to begin to learn about relationships and language.

And paying attention to the baby inside the bump helps you to learn about them and notice things about them, such as what they respond to, when they are more active or settled.

Involving other loved ones in speaking, reading or singing to baby can also help them connect.
Watch this short video for some helpful tips and techniques on bonding with your unborn baby:

Video Transcript:

You don't need to wait until your baby is born to bond with them. Pregnancy is the perfect time to start getting to know them, and for them to start getting to know you.

Visualise what they will be like. Will they have curly or straight hair, how will their laugh sound?

At around 18 weeks your baby starts to hear sounds like your tummy rumbling.

At 26 weeks, they may start to recognise and be soothed by the sound of your voice.

This is a really good time for you and other significant people to start talking to your baby or even reading to them. Try telling about your day.

You can sing too! Music that mimics a heartbeat can be calming, which is actually most lullabies.

Babies respond to what they hear. Pay attention to their movement and their rhythms and respond back.

Talking, touching and being musical will help you and those around you to connect with your baby. And your baby will get to know you and the world outside of your tummy.

Further resources:

Further support:

Every mum, dad or co-parent faces the approaching birth of a baby with a mixture of feelings - with excitement and hopes, as well as fears and worries, about what might lie ahead. The birth of a baby stirs up powerful emotions from a parent's own early experiences.

Research tells us that more than 1 in 5 mums and around 1 in 10 dads will experience a mental health problem during pregnancy or in the first years. Many of these difficulties go unseen, undiagnosed, or untreated. It is important to seek help and support if you or your partner is struggling.

You can speak to your GP, midwife or health visitor.

You can also find some additional information, advice and further signposting from these organisations:

Crisis Support:
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If you or someone you care about is in crisis, or feeling suicidal and needs urgent help you can access support in the following ways:

Go to A&E at your local hospital

Phone emergency services on 999

Call Samaritans on 116 123 (free to call and will not appear on your phone bill), or email [email protected]

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You don't need to wait until your baby is born to bond with them. Watch Home-Start's video on bonding with your unborn baby. #HomeStartTipsForParents

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When babies cry it can be stressful and overwhelming. Help is out there and all you need to do is ask.

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Babies cry, you can cope When babies cry it can be stressful and overwhelming. Help is out there and all you need to do is ask. Latest news Testimonials

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Having strong pelvic floor muscles means you’ll be less likely to have issues like stress incontinence after your baby’s born.

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Having strong pelvic floor muscles means you'll be less likely to have issues like stress incontinence after your baby's born.

What pelvic floor muscles do

Your pelvic floor muscles:

help control your bladder and bowel

hold your bladder, womb and bowel in place

are important for your sex life

They form a broad supportive sling from the front to the back of your pelvis.

How these muscles change during pregnancy

Your pelvic floor muscles support your growing baby during your pregnancy. They then stretch during labour. This can make them weaker and they may not work as well as they did before your baby was born.

Weaker pelvic floor muscles can cause:

stress incontinence, which is when urine leaks out when you cough, sneeze, run or laugh

less sensation when you're having sex

a prolapse, which is when one or more of the organs can press against the vaginal walls causing a bulge

Exercising these muscles can make them stronger, and you'll be less likely to have issues like stress incontinence after your baby's born.

Pelvic floor muscle exercises

You can do pelvic floor exercises anywhere and no one will know.

You might have heard you can do pelvic floor exercises while you're passing urine. This can stop you from emptying your bladder properly, so don't do them when you're on the toilet.

Pelvic floor muscle contraction

A pelvic floor muscle contraction is a squeeze and lift feeling, closing and drawing up the back and front passages.

To do this exercise:

lie, sit or stand with your knees slightly apart

tighten up your back passage as though you're trying to stop yourself passing wind

tighten the muscles that you would use to stop yourself passing urine

Don't clench your buttocks, hold your breath or squeeze your legs together when you're doing them.

Quick and slow contractions

For slow contractions:

1. Squeeze and lift your pelvic floor muscles as hard as you can and try to hold for up to 10 seconds - if you can't do 10 seconds, do as much as you can and build up to it

2. Relax fully for 4 seconds

3. Repeat up to 10 times

For quick contractions:

1. Quickly tighten up your pelvic floor muscles and hold for 1 second

2. Relax fully for 4 seconds

3. Repeat up to 10 times

Do some slowly and some quickly to get the most out of these exercises.

When to start these exercises

Now's a great time to start these exercises if you haven't been doing them.

Try to get into the habit of doing these exercises every day. To make it easier, try to link them with something you do regularly, such as brushing your teeth or watching TV.

If you find them difficult or you need advice, speak to your midwife or an obstetric physiotherapist, or contact your local maternity hospital.
Read more about pelvic health
Further information, other languages and alternative formats

Translations and alternative formats of this information are available from Public Health Scotland.

If you need a different language or format, please contact phs.otherformats@phs.scot.

Last updated:
8 August 2024

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What your pelvic floor muscles do and how they can change during pregnancy. You can start these pelvic floor exercises at any time.

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It’s normally perfectly safe to have sex when you’re pregnant.

Any sexual activity that doesn’t harm you, won’t harm your baby as they’re protected in the womb by the amniotic fluid (bag of waters). They may feel the movements when you have sex, but they won’t be harmed.

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It's normally perfectly safe to have sex when you're pregnant.

Any sexual activity that doesn't harm you, won't harm your baby as they're protected in the womb by the amniotic fluid (bag of waters). They may feel the movements when you have sex, but they won't be harmed.

When you are pregnant is an ideal time to start thinking about what method of contraception you may want to use after your baby is born.

Your midwife can talk to you about this.
Read more about contraception
Having sex in pregnancy

You and your partner might find your desire for sex changes. Either or both of you may want it more, or you might go off it completely. If sex played an important role in your lives before, then the feelings are likely to come back in time.

You may become less keen on penetrative sex, although there are other options which can give you pleasure and closeness.

Other ways to be intimate

If you don't feel like sex, you can find other ways of being intimate.

Keep your closeness:

with lots of warm, physical contact that doesn't have to lead to sex

by talking about how you're feeling with each other

Sex later in pregnancy

Later in your pregnancy, you may find sex with your partner on top uncomfortable. It's important to say what you feel comfortable with.

You can get around this by:

the person on top bearing their weight on their arms

trying side-by-side positions

Later in pregnancy, an orgasm or sex itself can set off Braxton Hicks contractions. If this happens, you'll feel the muscles of your womb go hard. Don't worry, this is normal and it isn't the start of labour.

More about Braxton Hicks

Sex and miscarriage

There's no clear evidence that having sex and miscarriage are linked. But, if you've had several miscarriages your doctor may suggest you don't have sex:

around the time your period would have been due

during the first 3 months of pregnancy

Get advice from your midwife or GP about your situation.

Sex and labour

Having sex won't start your labour early.

But if your labour was going to begin anyway, then sex may help. This is because:

semen contains natural hormones that can help your cervix to ripen

your body releases a hormone called oxytocin which is released in labour too

Sexually transmitted infections (STIs)

Being pregnant doesn't prevent you getting a sexually transmitted infection (STI).

If left untreated, STIs can cause serious harm to your baby and long-term health issues for you, including infertility.

Protecting yourself and your baby

If you think you might be at risk of an STI, use condoms to protect yourself and your baby. If you have unprotected sex (not using a condom) with someone you think may have an STI:

talk to your midwife or GP

get tested at a local sexual health clinic

Find a sexual health clinic in your area
Cold sores and genital herpes

Don't have oral sex if you or your partner has a cold sore as the same virus also causes genital herpes.

If you have genital herpes during pregnancy, there's a risk your baby could develop a serious illness called neonatal herpes.

More about genital herpes

If you think you have an STI

If you think you might have an STI, you can get tested at a local sexual health clinic.

All pregnant women are offered blood tests to check for certain STIs, including HIV, at their first antenatal appointment. Being tested won't harm your baby.

Some STIs, such as chlamydia and gonorrhoea, can be easily treated with antibiotics.

More about sexually transmitted infections

Further information and other languages and formats

Translations and alternative formats of this information are available from Public Health Scotland.

If you need a different language or format, please contact phs.otherformats@phs.scot.

Last updated:
8 August 2024

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How to have sex or be intimate throughout your pregnancy and protect yourself against sexually transmitted infections

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There are no rules about when to start having sex again after you have given birth.

You can start using some types of contraception immediately after giving birth. For some other types, it’s recommended to wait for a few weeks.

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There are no rules about when to start having sex again after you have given birth.

You'll probably feel sore as well as tired after your baby is born, so don't rush into it.

If sex hurts, it won't be pleasurable. You may want to use a personal lubricant, available from pharmacies, to begin with.

Hormonal changes after birth can make your vagina feel drier than usual.

You may be worried about changes to your body or getting pregnant again. Men may worry about hurting their partner.

It might be some time before you want to have sex. Until then, both of you can carry on being loving and close in other ways.

If you or your partner have any worries, talk about them together. You can talk with your health visitor or GP if you need some more help.

Tips for starting sex again after birth

If penetration hurts, say so. If you pretend that everything's all right when it isn't, you may start to see sex as a nuisance or unpleasant, rather than a pleasure. You can still give each other pleasure without penetration - for example, by mutual masturbation.

Take it gently. Perhaps explore with your own fingers first to reassure yourself that sex won't hurt. Hormonal changes after childbirth may mean you may need to use lubricant to help make sex more comfortable.

Make time to relax together. You're more likely to make love when your minds are on each other rather than other things.

Get help if you need it. If you're still experiencing pain when you have your postnatal check, talk to your GP.

Contraception after having a baby

You can get pregnant 3 weeks after the birth of a baby, including if you're breastfeeding and your periods haven't started again.

You need to use contraception every time you have sex after giving birth unless you want to get pregnant again.

Your midwife will discuss contraception with you after your baby is born.

You can talk to your GP, health visitor or sexual health clinic (sometimes called a family planning clinic) about contraception at any time.

Your contraception choices

You can start using some types of contraception immediately after giving birth. For some other types, it's recommended to wait for a few weeks.

Contraception choices straight after birth

You can start these types of contraception straight after the birth, including if you're breastfeeding:

If an IUD or IUS is not fitted within 48 hours of giving birth, it's recommended to wait until 4 weeks after the birth.

Contraception choices 3 weeks after the birth

If you're not breastfeeding and a healthcare professional has checked you have no risk factors for a blood clot, you can start to use these methods 3 weeks after the birth:

If you're breastfeeding, you'll usually be advised to wait until at least 6 weeks after the birth before starting the combined pill, ring or patch.

Contraception choices 6 weeks after birth

You can usually start using a diaphragm or cap around 6 weeks after the birth.

If you used a diaphragm or cap before the birth, see a doctor or nurse at a contraception clinic to make sure it still fits correctly. You may need a new size.

If you're breastfeeding, you should discuss whether the combined pill, vaginal ring or patch is suitable for you with your nurse or doctor.

Contraception and breastfeeding

You're unlikely to have any periods if you breastfeed exclusively (give your baby breast milk only) and your baby is under 6 months old.

Because of this, some women use breastfeeding as a form of natural contraception. This is known as the lactational amenorrhoea method, or LAM.

Find out about natural family planning, including LAM.

It's important to start using another form of contraception if:

your baby is more than 6 months old

you give them anything else apart from breast milk, such as a dummy, formula or solid foods

your periods start again (even light spotting counts)

you stop night feeding

you start to breastfeed less often

there are longer intervals between feeds, both during the day and at night

The effect of expressing breast milk on LAM isn't known, but it may make it less effective.

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Find out about sex and contraception after birth, including contraception you can use while breastfeeding.

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Consenting to Treatment throughout Pregnancy and Birth

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Consenting to Treatment throughout Pregnancy and Birth

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Consent means saying yes

When you are pregnant you have the right to make your own decisions about your body, just as you do at any other time.

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DadSpace | Supporting Mens Mental Health

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DadSpace facilitates Brotherly Support Between Fathers by providing opportunities to talk, listen and share personal experiences of fatherhood.

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Copy of Neonatal antenatal poster FINAL (A4 - Portrait).pdf 3

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Neonatal Antenatal information Presentation slides 3