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Caesarean birth video

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Baby-friendly caesarean birth | Maidstone and Tunbridge Wells NHS Trust

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Why do babies cry?

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Evidence around babies sleeping on their backs 

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Evidence around babies sleeping on their backs 

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The single most effective action that parents and caregivers can take to lower a baby's risk of SIDS is to place the baby to sleep on his or her back for naps and at night.

Compared with back sleeping, stomach sleeping increases the risk of SIDS by 1.7 - 12.9. The mechanisms by which stomach sleeping might lead to SIDS are not entirely known. Studies suggest that stomach sleeping may increase SIDS risk through a variety of mechanisms, including:

Increasing the probability that the baby re-breathes his or her own exhaled breath, leading to carbon dioxide buildup and low oxygen levels

Causing upper airway obstruction

Interfering with body heat dissipation, leading to overheating

Whatever the mechanism, evidence from numerous countries-including New Zealand, Sweden, and the United States-suggests that placing babies on their backs to sleep results in a substantial decline in the SIDS rate compared to placing babies on their stomachs to sleep. Researchers have established the link between stomach sleeping and SIDS by showing that babies who died from SIDS were more likely to be put to sleep on their stomachs compared to babies who lived.

After that discovery, public health campaigns were launched to promote back sleep position and reduce the use of the stomach sleep position. Dramatic decreases in SIDS rates were observed in all countries with these public health campaigns; these campaigns have been successful in reducing the prevalence of stomach sleep position among infants. In areas where stomach sleeping is rare (including Hong Kong), SIDS rates historically have been very low, which further strengthens the association.

Compared with infants who sleep on their backs, infants who sleep on their stomachs:

Are less reactive to noise

Experience sudden decreases in blood pressure and heart rate control

Experience less movement, higher arousal thresholds, and longer periods of deep sleep

These characteristics might put an infant at higher risk of SIDS. The simple act of placing infants on their backs to sleep significantly lowers SIDS risk.

As stomach sleeping has declined in response to back-sleeping campaigns worldwide, statistics show that the contribution of side sleeping to SIDS risk has increased. Research shows that side sleeping is just as risky as stomach sleep position and, therefore, should not be used.

Placing babies on their backs to sleep is not associated with risks for other problems. For example, there is no increase in aspiration or complaints of vomiting when babies are placed on their backs to sleep.

Moreover, babies may benefit in other ways from sleeping on their backs. A 2003 study found that infants who slept on their backs were less likely than infants who slept on their stomachs to develop ear infections, stuffy noses, or fevers.

Several studies found that back sleepers have delayed early motor skill milestones, although one recent Israeli study found no difference in gross motor developmental skills at 6 months among supine (back) and prone (stomach) sleepers.Some studies have noted that even though supine sleepers experience these early delays, there is no significant age difference in terms of when the infants learn to walk.

Multiple studies have found a positive correlation between the amount of time supine sleepers spend prone during their awake hours and motor skills development.This finding reinforces the need to educate parents about the importance of tummy time.

1. American Academy of Pediatrics, Task Force on Infant Sleep Position and Sudden Infant Death Syndrome. (2000). Changing concepts of sudden infant death syndrome: Implications for infant sleeping environment and sleep position. Pediatrics, 105(3), 650-656.

2. Carroll, J. L., & Siska, E. S. (1998). SIDS: Counseling parents to reduce the risk. American Family Physician, 57, 1566-1567.

3. Davies, D. P. (1985). Cot death in Hong Kong: A rare problem? Lancet, 2, 1346-1348.

4. Lee, N. N., Chan, Y. F., Davies, D. P., Lau, E., & Yip, D. C. (1989). Sudden infant death syndrome in Hong Kong: Confirmation of low incidence. British Medical Journal, 298(6675), 721.

5. Sahni, R., et al. (2002). Quality of diet, body position, and time after feeding influence behavioral states in low birth weight infants. Pediatric Research, 52, 399-404.

6. Kahn, A., et al. (2003). Sudden infant deaths: Stress, arousal, and SIDS. Early Human Development, 75(Suppl.), 147-166.

7. Li, D.k., Petitti, D.B., Willinger, M., et al. (2003). Infant sleeping position and the risk of sudden infant death syndrome in California, 1997-2000. American Journal of Epidemiology, 157(5): 446-455.

8. American Academy of Pediatrics, Task Force on Infant Sleep Position and Sudden Infant Death Syndrome. (2000).

9. Hunt, C. E., et al. (2003). Infant sleep position and associated outcomes. Archives of Pediatric and Adolescent Medicine, 157, 469-474.

10. Majnemer, A., & Barr, R. G. (2005). Influence of supine sleep positioning on early motor milestone acquisition. Developmental Medicine & Child Neurology, 47, 370-376.

11. Carmeli, E., Marmur, R., Cohen, A., & Tirosh, E. (2009). Preferred sleep position and gross motor achievement in early infancy. European Journal of Pediatrics, 168, 711-715.

12. Davis, B. E., Moon, R. Y., Sachs, H. C., & Ottolini, M. C. (1998). Effects of sleep position on infant motor development. Pediatrics, 102(5), 1135-1140.

13. Pin, T., Eldridge, B., & Galea, M.P. (2007). A review of the effects of sleep position, play position, and equipment use on motor development in infants. Developmental Medicine & Child Neurology, 49, 858-867.

14. Salls, J. S., Silverman, L. N., & Gatty, C. M. (2002). The relationship of infant sleep and play positioning to motor milestone achievement. American Journal of Occupational Therapy, 56(5), 577-580.

15. Majnemer, A., & Barr, R. G. (2005).

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The single most effective action that parents and caregivers can take to lower a baby's risk of SIDS is to place the baby to sleep on his or her back for naps and at night. Compared with back sleeping, stomach sleeping increases the risk of SIDS by 1.7 - 12.9.1 The mechanisms by which stomach sleeping might lead to SIDS are not entirely known.

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Top tips on helping your baby move into an optimal fetal position

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While there's definitely no right or wrong position for your baby to hang out in in your womb, labour's definitely easier if they're facing a certain way. That's head down, with their tummy facing your back.

Some babies though will lie with their back against your back, known as being in the 'occiput posterior' (OP) position.

"If they're in that position, giving birth tends to take longer - words no-one wants to hear. It's because your baby can't tuck their chin in so easily and that makes getting through the pelvis more awkward."

Giving birth to a back-to-back baby can also give you backache while you're in labour (Simpkin, 2010; RCM, 2012).

Here are some tips to help during pregnancy.

1. Lean forward

Forward-leaning positions, like getting on all fours, have often been recommended. There's no evidence that this can help turn your baby but it can reduce any backache that you're suffering because of the baby's position (Hunter et al, 2007). So it's definitely worth a go.

It can also be helpful in the first stages of labour to ease backache (Guittier et al, 2016).

2. Don't panic

In the end, your baby is very likely to end up in the occiput anterior position - one of the best positions. Only five to eight of every 100 babies end up back-to-back with you anyway (Tommy's, 2016). So try not to worry too much.

3. Get into positions where your pelvis and belly tilt forwards

Some ways to do that are:

Sit upright on a chair making sure your knees are lower than your pelvis and your torso is slightly tilted forwards.

Sit on a swiss ball.

Watch your favourite Netflix show while kneeling on the floor, over a beanbag or cushion or sit on a dining chair.

Use yoga positions, like sitting with your back upright and the soles of the feet together, knees out to the sides.

Sit on a wedge cushion in the car, so your pelvis is tilted forwards.

Sleep on your side, not on your back.

Swim with your belly downwards.

Any exercises that you do on all fours can be helpful too.

(Sutton and Scott, 1996; Andrew, 2010)

4. Avoid certain positions:

Sometimes you won't be able to but if you can, ditch:

deep squats

crossing your legs

sitting with feet raised

leaning back into a sofa or armchair.

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 pregnancy, labour and life with a new baby.

Andrew CG. (2010) Considering non-optimal fetal positioning and pelvic girdle dysfunction in pregnancy: increasing the available space. Journal of Clinical Chiropractic Pediatrics. 11(2):783-788. Available from: http://jccponline.com/jccp_v11_n2.pdf [Accessed 13th August 2018]

Guittier MJ, Othenin-Girard V, de Gasquet B, Irion O, Boulvain M. (2016) Maternal positioning to correct occiput posterior position during the first stage of labour: a randomised controlled trial. BJOG. 123;2199-2207. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132127/ [Accessed 13th August 2018]

Hunter S, Hofmeyr GJ, Kulier R. (2007) Hands and knees posture in late pregnancy or labour for fetal malposition (lateral or posterior). Cochrane Database Syst Rev.(4):CD001063. Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001063.pub3/full [Accessed 13th August 2018]

RCM. (2012) Evidence based guidelines for midwifery-led care in labour: persistent lateral and posterior fetal positions at the onset of labour. Available from: https://www.rcm.org.uk/sites/default/files/Persistent Lateral and Posterior Fetal Positions at the Onset of Labour.pdf [Accessed 13th August 2018]

Simkin P. (2010) The fetal occiput position: state of the science and a new perspective. Birth. 37(1):61-71. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20402724 [Accessed 13th August 2018]

Sutton J, Scott P. (1996) Understanding and teaching optimal foetal positioning. Tauranga: New Zealand.

Tommy's (2016) Getting your baby into the best birth position. Available from: https://www.tommys.org/pregnancy/labour-birth/baby-best-position-birth [Accessed 13th August 2018]
Further reading
Andrews CM, Andrews EC. (1983) Nursing, maternal postures and fetal positions. Nursing Research. 32:336-341. Available from: https://www.ncbi.nlm.nih.gov/pubmed/6567853 [Accessed 13th August 2018]

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Tips: how to get your back-to-back baby into position for birth | Labour & birth articles & support | NCT

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If your midwife's said your baby is back-to-back, there's still a big chance that they'll move. In the meantime, here are some ideas to help them shift...

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Explanation of what is happening in labour, timing ideas and positions that will help 

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Explanation of what is happening in labour, timing ideas and positions that will help 

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Great information - hopefully good as a recap from what was covered in classes

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The myths about postnatal mental health 

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The myths about postnatal mental health 

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Postnatal depression and mental health as a parent: 10 myths | NCT

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Myth 1: Pregnant women are deliriously happy and never get depressed

There's no doubt that pregnancy is an exciting time of life, but it's also a hugely challenging one. It's hardly surprising that mental health problems at this time are common (RCM, 2015). About 10% to 15% of pregnant women are affected by mental health problems, such as anxiety, tokophobia and depression, during pregnancy (RCM, 2015).

If you feel worried, anxious or low, you could talk to someone you trust, whether it's your partner, friends, family, midwife or GP.

Myth 2: It's just the 'baby blues', I'm fine

Many women get the 'baby blues' during the first week after childbirth, when they feel down or depressed. But such symptoms can continue for longer, get worse or appear at a later stage up to a year after you have your baby. If so, it can be a sign of something more serious like postnatal depression, birth trauma or post-traumatic stress disorder (PTSD) (NHS, 2018).

There's a danger symptoms can still be labelled as the 'baby blues', which means a lot of mums don't seek help and get the support and treatment they need for their mental health.

Myth 3: If I'm diagnosed with a mental health issue, my baby will be taken away from me

Sadly, this is a huge misconception and it's why a lot of people suffer in silence (Boots Family Trust Alliance, 2013). However, what will actually happen is that the new parent will be given medication and/or counselling to help them feel better. The aim is to provide treatment that will support you, your baby, your partner and your families (NICE, 2014).

If you are seriously ill, you may need psychiatric inpatient care and be admitted into a mother and baby unit, where you can stay together with your baby (NHS, 2021).

Myth 4: If I tell anyone about my mental health worries, they will think I'm a failure, a bad parent or that I don't love my baby

Experiencing a mental health problem does not mean you are a failure or a bad parent (NHS, 2021). In fact, seeking medical help and treatment means you are doing the best for your baby so it's actually a sign of good parenting (NHS, 2021).

Myth 5: Mental health problems only affect certain people

It's untrue that mental health problems affect only people of certain ages, social backgrounds or relationship statuses. On the other hand, some parents are at a higher risk of perinatal mental health problems, such as those with previous mental health illness.

Whatever your situation, always talk to your midwife, health visitor or GP if you don't feel well emotionally (RCOG, 2017).

Myth 6: I will be forced to take medication

You will never be forced to take medication if you are diagnosed with mental health problems. Instead, you'll discuss the benefits and downsides of different treatment options with your healthcare provider. That way, you and your healthcare provider will find what'll work best for you (NICE, 2014; NHS, 2021).

You can always try different options too: just speak to your GP or psychiatrist if you want to continue, change or stop your medication (NICE, 2014).

Myth 7: I'm the only one who feels this way

It's very common for women to experience mental illness after giving birth but, sadly, many still keep quiet about it (NHS, 2021).

You might feel as though you're alone but you're absolutely not. It is important to talk about your condition to your GP and those close to you. This will help you get treatment as soon as possible (NHS, 2021).

There are many ways to connect with other mums who are also dealing with mental health problems. Ask your midwife or health visitor about any local support groups or see this link.

Myth 8: There's only one kind of mental health illness that affects parents

You may only have heard of 'the blues' or 'postnatal depression' and these are often thought to be the same thing. But there is a wide range of ways mental ill health can present in different people.

So just because your symptoms don't seem to match what you've heard from other people, it doesn't mean you're ok. Read more in our articles on perinatal mental health.

Myth 9: Only mums suffer from mental health issues

A significant number of dads and other co-parents also struggle emotionally with the transition to parenthood (Kim and Swain, 2007). In fact, in a study of new fathers with children aged 0-18 months, 27% of them reported symptoms suggestive of depression (Psouni et al, 2017). Read more here about postnatal depression in dads and co-parents.

Witnessing a traumatic birth can leave partners feeling distressed and, for some, may result in them experiencing ongoing trauma symptoms or post traumatic stress disorder (PTSD) (Daniels et al, 2020).

Myth 10: I'm never going to feel better

Recovery can be a slow process but it does happen. Many things can contribute to stages of recovery. This includes an accurate diagnosis, effective medication, supportive psychotherapy, and your own growing knowledge of your condition and how to live with it (NHS, 2021). So speak to your midwife, health visitor, or GP as soon as you can to start your journey to recovery.

Some other things that might help your wellbeing are eating a healthy diet, having plenty of rest and finding time to do what you enjoy. Exercising and getting regular sleep are also helpful (NHS, 2021; Mental Health America, no date).

Experiencing mental health symptoms can be overwhelming but help is available so speak to a trusted healthcare professional, such as a midwife, health visitor, or GP. If you feel at risk of harming yourself or others, call 999, attend an emergency department, or call the Samaritans on 116 123.
This page was last reviewed in January 2022.
Further information

Mind, a leading mental health charity, provides information on a range of mental health topics including postnatal depression and has an infoline for support: 0300 123 3393.

Tommy's, a charity that fund research into stillbirth, premature birth and miscarriage, has information about mental health in pregnancy as well as a Wellbeing Plan to help parents talk more openly.

The Royal College of Psychiatrists has information on mental health in pregnancy.

The NHS website has more information about mental health and some helpful tips on how to improve your mental wellbeing.

If you want to explore private therapies, it is important that the person offering you care and treatment is appropriately qualified and insured. For help finding a qualified therapist with professional accreditation see this link. It may be beneficial to speak to your GP first about the type of private therapy you are considering.

Treatment for any mental health problem should always start with a clear assessment of your mental health to ensure the techniques the therapist will use will be helpful. With any type of therapy, it is important that you feel comfortable and safe with the therapist and with the therapeutic techniques they use. If you are not comfortable for any reason, you should consider moving therapists, which is possible even within the NHS.

Our support line offers practical and emotional support with feeding your baby: 0300 330 0700.

You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

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Mental health as a mum: 10 myths | Life as a parent articles & support | NCT

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There's no doubt that pregnancy is an exciting time of life, but it's also a hugely challenging one. It's hardly surprising that mental health problems at this time are common (RCM, 2015). About 10% to 15% of pregnant women are affected by mental health problems, such as anxiety, tokophobia and depression, during pregnancy (RCM, 2015).

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Virtual tour of UHCW including labour ward, Lucina and other areas (scan rooms etc)

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Virtual Tour of the Maternity Departments at UHCW NHS Trust

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Information about inconsolable crying

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Adam Miconi, Ryan Steinbeigle, National Center on Shaken Baby syndrome, Period of PURPLE Crying

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The Period of PURPLE Crying is the phrase used to describe the time in a baby's life when they cry more than any other time.

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Short video on importance of early nurture on brain development 

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Short video on importance of early nurture on brain development 

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Center on the Developing Child at Harvard University

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This video from the InBrief series addresses basic concepts of early childhood development, established over decades of neuroscience and behavioral research, which help illustrate why child development-particularly from birth to five years-is a foundation for a prosperous and sustainable society.
View this video in Spanish

InBrief: The Science of Early Childhood Development

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The Science Behind Early Childhood Development

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This video addresses basic concepts of early brain development established over decades of neuroscience and behavioral research. Learn more about why child development-particularly from birth to five years-is a foundation for a prosperous and sustainable society.

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This is a great pack of sounds, and advice on preparing a dog for the new arrival- passed on by a dog behaviourist!

https://www.dogstrust.org.uk/help-advice/dog-behaviour-health/sound-therapy-for-pets

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Local project for parents who require some additional support with the emotional well being and mental health

https://cwmind.org.uk/mums-in-mind/

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Guide on how to tell if your baby is poorly

https://www.nhs.uk/conditions/pregnancy-and-baby/spotting-signs-serious-illness/

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Introduction to Attachment and Brain Development 

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Introduction to Attachment and Brain Development 

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Good article gives an introduction and historical thoughts and research around attachment, early learning and brain development

https://www.verywellmind.com/what-is-attachment-theory-2795337

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Latest research and commentary from Sara Wickham. It is complicated and the risks do indeed outweigh the benefits. It’s very tricky though. According to one of our practioners involved in this area there is a trial about to happen
In the GBS3 trial there will be three groups of women. One group will follow the current NICE guidelines which is the more expensive, more accurate test that most women currently have to pay for, at 36 weeks if in a high risk category.
In the second group all women will be able to have the expensive test at 36 weeks.
In the third group women will be tested in labour if they want to be using PCR technology to get a result in less than an hour.
As well as looking at rates of infection in babies, the trial will also be following up on adverse outcomes for women who have abtibiotics and their babies. The feelings of parents around the decisions they are making will also be studied.
It’s a very well thought out trial which will tell us how to sort this current shambles out. Hardly any uk trusts are currently following the NICE guidelines and offering the expensive test. Lots of women are being categorised as high risk because they test positive at 36 weeks but are negative before labour starts. Giving antibiotics just in case is not a benign act and it can’t go on

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A review published in the British Medical Journal has concluded that, based on current evidence, routine screening for group B streptococcus colonisation in late pregnancy should not be introduced in the UK, as the potential harms of unnecessary treatment with antibiotics may outweigh the benefits.

Farah Seedat et al (2019) explain the background to their review:

"The media and politicians regularly call for universal antenatal screening for GBS as an alternative means of selecting women for prophylaxis. Advocates point to countries across Europe and North America where screening is recommended and where reductions in early onset GBS infection have been observed. But the evidence shows that the effectiveness of screening, using established screening criteria, is uncertain and that screening has potential harms. Here, we explain why the UK National Screening Committee decided not to introduce routine screening in the UK-namely, high levels of overtreatment, unknown potential hazards from screening and intrapartum antibiotic prophylaxis treatment, and uncertain benefit." (Seedat et al 2019).

There is particular concern about overtreatment and this is something of deep concern to many women and those who care for them during pregnancy and childbirth. I have recently been updating my book on this topic and, as always, have sought input from women, midwives, doctors and other birth workers. Although I heard from a few people who feel strongly in favour of increased screening and treatment (often based on their own experiences of having a baby with GBS disease), the overwhelming majority of comments received were from people who feel that taking the universal screening approach is "too much". Some women who are offered antibiotics because they have risk factors do not want them in those circumstances either, because they are concerned about side effects and the impact of this treatment on a number of aspects of the woman's and baby's health and experience.

Many of those who have contacted me about this topic are also aware that the chance of a baby getting GBS disease is very small, which means the chance of overtreatment is extremely high. The new analysis shows that, "in 2014-15, under risk based prevention, 138 933 term pregnant women were colonised with GBS, but only 350 term neonates developed early onset infection, meaning screening would have led to overtreatment of 138 583 (99.75%) women in labour." (Seedat et al 2019).

This is of particular concern given what we know about the importance of a baby's microbiome. Giving antibiotics to women in labour can interfere with the development of a baby's microbiome and, as I note in the new book, "Recent research shows that not only are bacteria beneficial, but they need to be passed on to the baby during birth via its mother's vagina and have an important part to play in future health, especially relating to the gut and digestion, but in many other areas of wellbeing as well." ( Wickham 2019, forthcoming).

The BMJ review also contains a couple of useful infographics which illustrate the problem of overtreatment.

If you'd like to receive updates about the book when it is published, the best way to stay in touch is to be on my newsletter list and, if you are already on it, to keep an eye out for our emails in your inbox. We'll let you know as soon as it's ready!

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Potential harms of GBS screening "outweigh benefits"

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A review published in the British Medical Journal has concluded that, based on current evidence, routine screening for group B streptococcus colonisation in late pregnancy should not be introduced in the UK, as the potential harms of unnecessary treatment with antibiotics may outweigh the benefits.

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Car seats: The facts and details about studies behind the headlines (from the nhs)

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"Long periods sleeping in car seats may be dangerous for young babies," the Daily Mail reports.

The results of a small study suggest spending long periods of time in a car seat may lead to babies having breathing difficulties.

But the researchers pointed out "we cannot be certain of the clinical significance or potential risks".

This novel study used a vehicle simulator to look at the effects of placing a newborn baby in a car seat at the 40⁰ angle required for travelling.

Researchers tested 40 newborns, who were a mix of preterm and full-term.

They found that while sat at this angle for 30 minutes - either stationary or when in motion - the babies' heart and breathing rate increased, and their blood oxygen levels were lower compared with lying flat in a cot.

The difficulty is knowing whether this would put the infants at serious risk - for example, whether their risk of stopping breathing goes up.

We don't know how many harmful effects may occur while a baby is travelling in a car seat, so a larger study is now needed.

Until then, the safety of a baby travelling in a moving vehicle is paramount. It's important to continue to use car seats as instructed for any journeys - and is also required by law.

Francine Bate, chief executive of the Lullaby Trust, the charity who funded the study, advised parents to keep a watchful eye on babies travelling in a car seat, and to also avoid driving long distances without taking a break.

Where did the story come from?

The study was carried out by researchers from Great Western Hospitals NHS Foundation Trust, Swindon, the University of Southampton and the University of Bristol.

It was funded by the Lullaby Trust and published in the peer-reviewed journal, Archives of Disease in Children: Fetal and Neonatal Edition. The article is openly available to access online.

The Mail gives fairly balanced coverage of this study, including making the recommendation that babies should travel in a properly secured child seat during car journeys, as required by law.

What kind of research was this?

This experimental study involved using a simulator designed to reproduce the vibration a baby experiences when placed in a rear-facing car seat in a car travelling at 30mph.

Car seats are used for infants from birth up to 10kg, but may be too big to secure low birthweight or preterm infants who weigh less than 2.5kg.

There are concerns that the prominent back of the head seen in babies may push the head forwards when they sleep in these seats, and possibly obstruct the airway.

There are said to have been isolated reports of deaths while infants have been sleeping in these seats, either while travelling or when being used as an alternative to a cot or pushchair.

A BMJ study from 2006 found that in the 18 months between July 1999 and December 2000, a total of 43 babies who had been travelling in car seats required admission to hospital for serious breathing difficulties.

There have never been any studies that have actively monitored infants in moving vehicles before, so this moving simulation aimed to better establish how safe car seats are for babies while travelling.

What did the research involve?

The study aimed to assess the effects of placing healthy full-term and preterm infants in a car seat positioned at an angle of 30⁰ or 40⁰, either while static or moving.

The intention was to replicate the normal routine of parents preparing for and then taking their baby on a car journey.

Mothers of 40 infants - 19 full-term and 21 preterm - were recruited when the babies were ready for hospital discharge.

The babies were monitored continuously for their breathing rate, heart rate, blood oxygen levels and carbon dioxide levels on breathing in and out while spending 30 minutes in three different positions.

Half the infants were randomly allocated to be tested in the following order (protocol A):

on a horizontal surface, seated angle of 30⁰ (static)

on the simulator, seated angle of 40⁰ (static)

on the simulator, seated angle of 40⁰ with movements to simulate being in a car travelling at 30 mph (motion)

The other half received this sequence in a different order (protocol B): static 40⁰, moving 40⁰, then static 30⁰.

The babies' breathing and heart measures when they were lying in a cot (baseline) were compared with those during the tests.

The static 30⁰ positions were tested using the babies' own car seats, as they were ready to go home. The 40⁰ tests used the same seat placed on a motion simulator in the lab.

What were the basic results?

In the full sample of 40 babies, the average pregnancy duration was 36 weeks (range 31 to 39 weeks) and the average birthweight was 2.5kg (range 1.5 to 3.2kg). Babies were tested an average of 13 days after birth.

Looking at the static 30⁰ positions, the only difference compared with baseline was more occasions where the blood oxygen levels were less than optimal.

There were, however, more changes when the babies were angled at 40⁰ and in motion. Babies in these positions had significantly higher heart and breathing rates, and lower blood oxygen levels. Their carbon dioxide levels rose slightly, but not significantly so.

There were also more episodes where blood oxygen levels were notably lower than normal - less than 85% saturation, when normal would be in the high 90s.

Comparing the preterm babies with the full-term infants, the changes were still in the same direction, but were less so than with the preterm infants.

The order of testing (protocol A or B) made no difference.

How did the researchers interpret the results?

The researchers concluded that: "Term and preterm infants showed significant signs of potentially adverse [heart and breathing] effects in the upright position at 40⁰, particularly with simulated motion."

They went on to say a larger study is required to investigate the significance of these results.

Conclusion

This valuable pilot study is said to be the first to have assessed the effects of a newborn baby sitting in a car seat in the more upright position needed to safely secure them inside a moving vehicle.

The findings suggest spending 30 minutes sat in a car seat while stationary at the lower angle of 30⁰ has minimal effects.

But being placed in a car at the necessary 40⁰ angle, static and in motion, can have significant effects on the newborns' breathing and heart rate.

It's difficult to say whether the findings seen when a baby was positioned at the 40⁰ angle could be harmful and put them at potential risk of stopping breathing, for example. We also have no information on the effects of spending longer than 30 minutes in this position.

And although minimal effects were seen when the babies were placed at a 30⁰ angle, we don't know whether it could start to have an effect if the baby was left in the seat in this position for longer.

Because no studies have been done before in moving cars or simulators, the possible nature, frequency and magnitude of any adverse effects are unknown.

This makes it difficult to know the optimal sample size that would be needed to reliably capture any harmful effects - studies in a larger sample of babies are therefore needed to confirm these results.

The authors say the American Academy of Pediatrics currently recommends that all preterm infants should undergo monitoring in a car seat before discharge to check for low breathing or heart rate, or low oxygen saturation.

They say many UK neonatal units also follow a "car seat challenge" before discharging preterm babies from hospital. Even so, this doesn't take into account the effects of motion.

Further studies are needed to ensure the safety of newborns travelling in car seats. But for now, car safety remains paramount - parents and carers should continue to use car seats according to their instructions.

Dr Renu Arya, consultant paediatrician at Great Western Hospitals NHS Foundation Trust, who led the research project, said: "Parents should not stop using car safety seats to transport their infants. Infants must be protected in moving vehicles, and UK law requires car seats be used whenever infants travel in cars."

But it may be a good idea to rethink leaving a baby in a car seat for prolonged periods when they're not travelling.

Taking regular breaks when driving long distances is also recommended. As well as giving a baby a chance to move out of their car seat, it will also help keep the driver alert and reduce the risk of accidents.

The Royal Society for the Prevention of Accidents recommends taking at least a 15-minute break every two hours.

Analysis by Bazian
Edited by NHS Website

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Warning over babies sleeping in car seats

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"Long periods sleeping in car seats may be dangerous for young babies," the Daily Mail reports. The results of a small study suggest spending long periods of time in a car seat may lead to babies having breathing difficulties. But the researchers pointed out "we cannot be certain of the clinical significance or potential risks".

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Copy of activity done in the session on what to do in different situations if you think labour might have started

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Again, a good article from the NHS on colic in babies and what is normal/ management ideas

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Colic | Breastfeeding Challenges | Start4Life

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Read more about common breastfeeding issues such as colic. If you have any concerns, it's important to talk to your health visitor.

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A great picture and info from BASIS on sleep positions for twins

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Configurations

If parents decide to sleep their babies together, another dilemma arises - which sleeping positions are safe and comfortable?

Studies carried out by Ball ( 2006) showed that in the first month most co-bedded infants slept side-by-side. By the third month there was more variability, and those still co-bedded were positioned side-by-side, head-to-head and feet-to-feet. No evidence was found that any of these arrangements is more or less safe, comfortable, or connected with sleep duration.

General safety tips

While there is no strong evidence supporting co-bedding over separate bedding, or vice versa, general safe sleep advice applies to twins as well as singletons:

Room-share until 6 months of age: Sleeping babies alone in a room before the age of 6 months increases the risk of SIDS. There are a number of ways in which families with twins can arrange to room-share with both babies: both parents and both co-bedded babies in one room, both parents and babies sleeping in separate beds in one room, one parent and both babies in one room or one parent with baby in one room and other parent with other baby in another room.

Makeshift barriers separating co-bedded babies are unnecessary and can present a risk of accidental injury or suffocation.

Positioning twins diagonally across the cot may be dangerous as there is no safe way of securing a blanket around one or both babies. If using sleeping bags make sure babies' heads are far apart to ensure they don't get covered by one another's sleep bag.

Both co-bedded and separate sleeping twins should be put down to sleep on their backs, as this reduces the risk of SIDS compared to side or tummy sleeping.

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Configurations If parents decide to sleep their babies together, another dilemma arises - which sleeping positions are safe and comfortable? Studies carried out by Ball ( 2006) showed that in the first month most co-bedded infants slept side-by-side. By the third month there was more variability, and those still co-bedded were positioned side-by-side, head-to-head and feet-to-feet.

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A good article about reflux and what is normal from the NHS

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Reflux is when your baby brings milk back up during, or just after a feed. Read about reflux symptoms and how to help your baby

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Read more about common breastfeeding issues such as reflux. If you have any concerns, it’s important to talk to your health visitor.

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Personally I think the template doesn't work brilliantly as the document to give to your midwife for labour as it has pre-labour information on which isn't relevant at that point- but great discussion points and a good way to start the conversations

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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 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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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.

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NHS explanation on when induction may be offered, how it is undertaken and what to expect

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An induced labour is one that's started artificially. Every year, 1 in 5 labours are induced in the UK.

Sometimes labour can be induced if your baby is overdue or there's any risk to you or your baby's health.

This risk could be if you have a health condition such as high blood pressure, for example, or your baby is not growing.

Induction will usually be planned in advance. You'll be able to discuss the advantages and disadvantages with your doctor and midwife, and find out why they think your labour should be induced.

It's your choice whether to have your labour induced or not.

If your pregnancy lasts longer than 42 weeks and you decide not to have your labour induced, you should be offered increased monitoring to check your baby's wellbeing.

Why you might be induced

if you're overdue

if your waters have broken

if you or your baby have a health problem

If you're overdue

Induction will be offered if you do not go into labour naturally by 42 weeks, as there will be a higher risk of stillbirth or problems for the baby.

If your waters break early

If your waters break more than 24 hours before labour starts, there's an increased risk of infection to you and your baby.

If your waters break after 34 weeks, you'll have the choice of induction or expectant management.

Expectant management is when your healthcare professionals monitor your condition and your baby's wellbeing, and your pregnancy can progress naturally as long as it's safe for both of you.

Your midwife or doctor should discuss your options with you before you make a decision.

They should also let you know about the newborn (neonatal) special care hospital facilities in your area.

If your baby is born earlier than 37 weeks, they may be vulnerable to problems related to being premature.

If your waters break before 34 weeks, you'll only be offered induction if there are other factors that suggest it's the best thing for you and your baby.

If you have a health condition or your baby is not thriving

You may be offered an induction if you have a condition that means it'll be safer to have your baby sooner, such as diabetes, high blood pressure or intrahepatic cholestasis of pregnancy.

If this is the case, your doctor and midwife will explain your options to you so you can decide whether or not to have your labour induced.

Membrane sweep

Before inducing labour, you'll be offered a membrane sweep, also known as a cervical sweep, to bring on labour.

To carry out a membrane sweep, your midwife or doctor sweeps their finger around your cervix during an internal examination.

This action should separate the membranes of the amniotic sac surrounding your baby from your cervix. This separation releases hormones (prostaglandins), which may start your labour.

Having a membrane sweep does not hurt, but expect some discomfort or slight bleeding afterwards.

If labour does not start after a membrane sweep, you'll be offered induction of labour.

Induction is always carried out in a hospital maternity unit. You'll be looked after by midwives and doctors will be available if you need their help.

How labour is induced

If you're being induced, you'll go into the hospital maternity unit.

Contractions can be started by inserting a tablet (pessary) or gel into your vagina.

Induction of labour may take a while, particularly if the cervix (the neck of the uterus) needs to be softened with pessaries or gels.

You will usually stay in the hospital maternity unit while you wait for it to work.

If you've had no contractions after 6 hours, you may be offered another tablet or gel.

If you have a controlled-release pessary inserted into your vagina, it can take 24 hours to work. If you are not having contractions after 24 hours, you may be offered another dose.

Sometimes a hormone drip is needed to speed up the labour. Once labour starts, it should proceed normally, but it can sometimes take 24 to 48 hours to get you into labour.

What induced labour feels like

Induced labour is usually more painful than labour that starts on its own, and you may want to ask for an epidural.

Your pain relief options during labour are not restricted by being induced. You should have access to all the pain relief options usually available in the maternity unit.

If you are induced you'll be more likely to have an assisted delivery, where forceps or ventouse suction are used to help the baby out.

If induction of labour does not work

Induction is not always successful, and labour may not start.

Your obstetrician and midwife will assess your condition and your baby's wellbeing, and you may be offered another induction or a caesarean section.

Your midwife and doctor will discuss all your options with you.

Natural ways to start labour

There are no proven ways of starting your labour yourself at home.

You may have heard that certain things can trigger labour, such as herbal supplements and having sex, but there's no evidence that these work.

Other methods that are not supported by scientific evidence include acupuncture, homeopathy, hot baths, castor oil and enemas.

Having sex will not cause harm, but you should avoid having sex if your waters have broken as there's an increased risk of infection.

For more information on induction, you can read the NICE information for the public on induction of labour.

Community content from HealthUnlocked

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An induced labour is one that's started artificially. Every year, 1 in 5 labours are induced in the UK. Sometimes labour can be induced if your baby is overdue or there's any risk to you or your baby's health.

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Induction of Labour: Sara Wickham presents some of the challenges surrounding this and sets forward the evidence and debate to enable informed decision making 

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Induction of Labour: Sara Wickham presents some of the challenges surrounding this and sets forward the evidence and debate to enable informed decision making 

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Parents information sheet on assisted birth

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The idea is that each of you completes the questions separately and then come together to discuss your findings...This is really useful to do to consider the practical and financial aspects of life with ta baby

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Just an idea on how to maybe space your thoughts out...

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What are 'normal' feelings for new parents and what might be more of a cause for concern for parents .

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

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The research report on the impact that chosen place of birth has on outcomes

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A (huge) list of potential things to pack if you are off to a birth centre or hospital - it's only a guide!

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Expert on attachment and baby, child and adult brain development (what every parent needs to know- is also on mainstream book sites/ Amazon etc

https://www.childmentalhealthcentre.org/ccmh/shop/

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As used in class...

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handouts, podcasts, research and much more- what's not to love- eh!

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Raising Children Network is supported by the Australian Government. Member organisations are the Parenting Research Centre and the Murdoch Childrens Research Institute with The Royal Children's Hospital Centre for Community Child Health.

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Loads of up to date research and news on parenting, relationships, managing work and other commitments

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Building a society that supports men as hands-on fathers and father-figures

The Fatherhood Institute is a UK charity working to build a society that values, prepares, and supports men as involved fathers and caregivers.

Evidence shows that involved fatherhood has unique and significant impacts on children, mothers, and fathers themselves; improves children's wellbeing and outcomes; and helps progress towards gender equality at home and in the workplace.

Our work focuses on research, policy, and practice. We publish research reviews, take part in new studies and test promising family interventions; advocate for policy change; produce practice resources; and train practitioners in perinatal, early years, education, and social care services.

In July 2023 we started a Parliamentary petition calling on the Government to improve its statutory paternity offer, by:

​

Paying employed fathers two weeks' paternity leave at 90% of salary

​

Introducing a 'daddy month' of four weeks' parental leave, paid at the same rate

​

Introducing a Paternity Allowance for fathers who are not employees

If 10,000 people sign the petition by 11 January 2024, the Government will have to respond to this proposal.

Our policy work streams

Discover our work to create more father-inclusive policies and services

Our research

Read our high-quality research reviews, co-investigations with eminent universities, and empirical research

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The Fatherhood Institute is a UK charity working to build a society that values, prepares, and supports men as involved fathers and caregivers. Our work focuses on research, policy, and practice.

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Male midwife, dad and author Mark Harris shares advice on birth and being a birth partner

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- the complete resource for fathers to be -

Birthing4Blokes supports you to be the very best that you can be
on the day that she gives birth to your baby.

The confidence to understand her needs and calls for help!

My main worries were: "Could I be the person my partner needed when she needs it?" and "How will I cope with her changing moods?". I didn't understand the changes she was feeling both physically and mentally. How was I going to cope with the run up to labour and the birthing process?

The Online Course actually gave me an insight into how women think and how my actions can help stimulate oxytocin and the positive effects of doing that.

Working through the program gave me the confidence to understand her needs more fully and the ability to hear what were calls for help when she felt alone. I became more able to help her know that I was going to be the person she needed when it came to the labour and birth of our baby.

I realised that I could be an incredibly positive influence in supporting her, as she went into the natural state she felt she need to be in for giving birth. She seemed to grow in faith and trust that she was in a safe place and that her needs were being met.

My belief and self confidence have gone through the roof.

Marks program and book is helping our ongoing relationship as well, I now have a better understanding regarding the 'natural dance' of relationships. It is helping me to be a better partner and father. Learning these things is still impacting our relationship, she seems more secure and often says she feels loved and valued by me, the growing bond with our baby is being deeply benefited.

I have really valued the program and will promote it amongst my friends both female and male.

Thanks Mark, you're a hero!

This On line training was priced at £97

NOW available fo FREE .

You DO NOT need a code.

Copyright 2017 by Birthing4Blokes.

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Birthing4Blokes - Everything a 'Father to be' needs to know

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the complete resource for fathers to be - Birthing4Blokes supports you to be the very best that you can be on the day that she gives birth to your baby. The confidence to understand her needs and calls for help! My main worries were: "Could I be the person my partner needed when she needs it?"

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Jane Evans explains out 'three brains' and how we can help children to develop their frontal lobes- be aware her work focusses around children who have experienced trauma, however the learning is just as relevant for all parents I feel!

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Taming And Tending Your Meerkat Brain | Jane Evans | TEDxBristol

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For parents of babies born early or sick

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For babies born premature or sick | Bliss

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Our vision is that every baby born premature or sick in the UK has the best chance of survival and quality of life.

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Interesting information and birth stories of home birth

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Angela Horn's
Home Birth Reference Page

Your browser does not appear to support frames. No problem - please go to the non-frames version of the Home Birth Reference Page.

The non-framed pages contain the same information as the framed pages; all you will miss is the navigation bar.

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Angela Horn's Home Birth Reference Page Your browser does not appear to support frames. No problem - please go to the non-frames version of the Home Birth Reference Page. The non-framed pages contain the same information as the framed pages; all you will miss is the navigation bar.

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Nottingham Latent Phase of Labour leaflet

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Nottingham Latent Phase of Labour leaflet

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Really helpful leaflet about managing earlier labour at home

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Nottingham Leaflet on Induction of Labour

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Nottingham Leaflet on Induction of Labour

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Helpful leaflet outlining the clinical pathway and support for parents who choose to accept an induction of labour

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Cry-sis - An Organisation to help cope with babies and crying 

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Cry-sis - An Organisation to help cope with babies and crying 

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Lots of useful evidenced advice and a helpline too

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Who we are

In 1981 a small group of parents, who were experiencing problems with their crying and sleepless babies, set up a support group. They discovered how important support is and how reassuring it can be to talk to someone. Today that support group has become Cry-sis, the only UK charity offering help and support to parents with babies who cry excessively or have sleeping problems. From modest beginnings Cry-sis has become a well-respected national charity which:

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Support For Crying And Sleepless Babies | Cry-sis

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Cry-sis, the only UK charity offering help and support to parents with babies who cry excessively or have sleeping problems. Call the helpline now...

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Group B Strep- what is it and what are the options

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Group B Strep- what is it and what are the options

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Evidence around Group B Strep from the NCT

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What is Group B Streptococcus (GBS)?

Group B Streptococcus is also known as GBS, Strep B or Group B Strep. It is a common bacterium that normally causes no harm (NHS Choices, 2018). The issue comes if you have Group B Streptococcus when you're pregnant or have just had a baby (RCOG, 2017).

In the UK, 20% to 40% of women carry GBS in their vagina and rectum. You're unlikely to know you carry it (RCOG, 2017).

Group B Streptococcus and pregnancy

If you have Group B Streptococcus, your baby will be exposed to it around labour and birth. While most babies won't be affected, there is a small chance of your baby becoming seriously ill or even dying. In extremely rare cases GBS infection can cause miscarriage, early labour or stillbirth (NHS Choices, 2015).

The risk of your baby getting GBS infection is higher if:

your baby was born before 37 weeks (the risk is higher the more premature they were)

you previously had a baby who developed GBS infection

you had a high temperature during labour

you had any positive urine or swab tests for GBS in this pregnancy

your waters broke more than 24 hours before your baby was born.

Early-onset Group B Streptococcus

Early-onset GBS in newborns begins in the first week after birth. Most of these infected babies develop symptoms within 12 hours of birth.

Symptoms and signs of GBS are:

being floppy and unresponsive

not feeding well

grunting, noisy breathing, moaning, problems in breathing properly

high or low temperature

fast or slow heart rates

fast or slow breathing rates

irritability

crying inconsolably

changes in their skin colour, including blotchiness

low blood pressure

low blood sugar (NHS Choices, 2015; RCOG, 2017).

You should contact your GP as soon as possible if you notice any of these signs or are worried about your baby. Early treatment can be lifesaving (RCOG, 2017).

Late-onset Group B Streptococcus

Late-onset GBS usually develops seven or more days after a baby is born. This condition is not associated with pregnancy so your baby has probably been infected after birth from someone else.

Group B Streptococcus infection complications

Most babies with GBS infection can be treated successfully and will make a full recovery. However, sometimes the infection can lead to life-threatening complications like:

blood poisoning (septicaemia)

pneumonia

meningitis (NHS Choices, 2015).

One in 10 babies born with GBS will die from the infection and another one in five babies who survive the infection will be affected permanently. The complications of early-onset GBS include cerebral palsy, deafness, blindness and serious learning difficulties (NHS Choices, 2015).

Rarely, GBS can cause infection in the mother's womb or urinary tract, or can cause an infection of the blood called sepsis (NHS Choices, 2015; NHS Choices, 2018).

Group B Streptococcus testing in the UK

At the moment, the NHS does not routinely test for GBS in pregnant women (RCOG, 2017; NHS Choices, 2018). This is because: it's uncommon for GBS to give your baby an infection; tests are not accurate enough; and many babies affected by it are born earlier than when they'd be screened (RCOG, 2017).

Some women may choose to get tested and pay to do that privately (NHS Choices, 2018).

Reducing the risk in newborn babies

You will be offered antibiotics through a drip during labour if:

you have tested positive for GBS

GBS has caused a urine infection

you previously had a baby diagnosed with GBS infection

your waters break after 37 weeks and you know you carry GBS (in such cases, you'll be induced)

you develop any infection during labour, even if it is not confirmed that you carry GBS

your labour starts before 37 weeks.

Giving birth

If you are infected with GBS, you need to discuss with your midwife where you'll give birth. This is to make sure that antibiotics are available during labour. It might be tricky to provide antibiotics at home or in some midwifery-led units.

If you go into labour or your waters break, make sure you contact your midwife so they can make sure you get antibiotics as soon as possible. Always tell your midwife or doctor if you previously had a baby with a GBS infection or if you tested positive for GBS during this pregnancy.

Tests and treatment for babies

To check whether your baby is affected by GBS, a sample of their blood or the fluid from around their spinal cord will be taken. If your doctor suspects your baby has GBS, they'll be treated with antibiotics immediately.

Breastfeeding

Breastfeeding your newborn baby is safe even if there are signs of GBS infection. Breastfeeding has not been shown to increase the risk of GBS infection (RCOG, 2017).
This page was last reviewed in May 2018
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, labour and life with a new baby.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

For more information, visit the Group B Strep Support website here.

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Group B Streptococcus: what you need to know in pregnancy

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Group B Streptococcus is also known as GBS, Strep B or Group B Strep. It is a common bacterium that normally causes no harm (NHS Choices, 2018). The issue comes if you have Group B Streptococcus when you're pregnant or have just had a baby (RCOG, 2017).

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Cats and Babies- advice from the Cats Protection League

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Cats and Babies- advice from the Cats Protection League

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Cats protection advice on cats and babies

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Dogs and Children- advice from the RSPCA

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Dogs and Children- advice from the RSPCA

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Dogs and children can be great friends and having a dog can help children develop kindness, understanding and respect for living things. Dog companionship can improve a child's social skills with people and caring for a pet can encourage responsibility.

Because of this many families have dogs. Children quickly understand and learn to treat the dog as part of the family but it is important that parents teach children how to stay safe around dogs, to protect both child and dog.

Our top tips to keeping kids safe and dogs happy

Watch our video of top tips from our very own Samantha Gaines, mother to a toddler, dog owner and dog welfare expert.

Dogs and children communicate differently

From a dog's point of view, children communicate differently to adults; they cry, yell, shriek, crawl and run about flailing their arms. Dogs find it hard to understand children and even harder to tell them when they want to be left alone!

Children often treat dogs as their peers; they hug, cuddle, hold and scold them. Children express affection for their family through close facial contact e.g. kissing. While this may seem sweet, a dog may find this threatening and it can be quite dangerous.

For these reasons young children are more likely to be bitten than any other group and research shows that children are far more likely to be bitten by their family dog than any others. However, there are lots of things you can do to make sure your child is safe and your dog is happy.

Helping children and dogs to enjoy living together

We've teamed up with veterinarian and animal behaviourist, Dr Sophia Yin, to design a set of materials to help parents understand and recognise dog behaviour making it easier for children to stay safe and dogs happy.

Take a look at our '6 Golden Rules' for a quick guide on staying safe.

Understand how your dog is feeling - learn to recognise important body language signals.

Download our leaflets and posters and teach:

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Children and dogs - How they can live together | RSPCA

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Dogs and children can be great friends and having a dog can help children develop kindness, understanding and respect for living things. Dog companionship can improve a child's social skills with people and caring for a pet can encourage responsibility. Because of this many families have dogs.

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This site has been growing and developing since May 2002. We are very grateful for the support we have recieved. We hope to continue to extend the information available, enabling more and more parents take control of their birth experiences.

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Information on different types of pain management for labour

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Information on different types of pain management for labour

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Welcome to LabourPains.com, the public information website of the OAA. Created specifically for expectant parents as well as midwives and healthcare professionals. On this site you can learn all about the pain relief choices available during labour and how to cope with labour pains. We provide ad-free resources with no conflicts of interest. The information on LabourPains.com has been written by a multi-disciplinary group of doctors, midwives and mothers, ensuring that you have access to information which is trustworthy, unbiased and scientifically proven. Take a look, tell us what you think and don't forget to spread the word!

We are now expanding our portfolio of translations of our main publications beyond the 20 most common languages used in the UK following feedback at meetings and our enquiries page. We are really grateful to the charity Translators without Borders who are helping us to reach out to mothers and their families of all nationalities. Newer additional translations have been generously provided by OAA members to help us to support more languages. We trust these translations to be as accurate as possible and hope that they are useful to you.

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Welcome to LabourPains.com, the public information website of the OAA. Created specifically for expectant parents as well as midwives and healthcare professionals. On this site you can learn all about the pain relief choices available during labour and how to cope with labour pains. We provide ad-free resources with no conflicts of interest.

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Whether it's your partner, daughter or friend due to give birth, it's an honour to be asked to be a birth partner. Yet this exciting role can also be daunting. Here we discuss some top tips to help you get ready.

You'll find a whole number of ways you can help support the mum-to-be during labour (NHS Choices, 2017a). One place to start is by talking to them in advance about their expectations of you - ask them how they'd like you to support them. This will help you both feel more prepared ahead of the birth and confident in your role as birth partner (NHS Choices, 2017b).

Watch this video for tips on how to support your partner during labour.

1. Be prepared

Birth partners should be prepared and ready. The weeks around their due date are not a good time to book an impromptu holiday or be in a meeting with your mobile phone switched off.

Talk through their birth plan (if they have one) with the mum-to-be well in advance. Attending birth classes like an NCT course together can help you learn about what to expect in labour (Which? Birth Choice, 2018). Classes will also help you write a birth plan if you want one (Which? Birth Choice, 2018).

Ask your partner if there are any specific ways they would like you to support them during labour and the birth. Also ask about any no-go areas. And know your limits too - if there are bits of the birth you prefer not to get hands on with, make it clear beforehand. For example, let her know if you don't want to help cut the baby's umbilical cord.

If you're planning to use any new kit during labour like a TENS machine, make sure you test it out ahead of time and know how to use it.

2. Be there and know what she wants

The number one thing you can do for a woman in labour is be there as continuous support for them and help them with whatever they need at the time. Research has shown that having a familiar birth partner present throughout labour can help improve the birth experience (Bohren et al, 2017).

Whether that's simply being there to hold her hand, or offering moral support and bringing some positive energy to the room (NHS, 2017b). Try to talk about what emotional, physical and practical support she would like too. Help her write down a birth plan or talk through it if she would like to. That way, you know her preferred birth choices like the back of your hand.

3. Provide company

During the early stages of labour you can help keep her company, make sure she is comfortable and help pass the time together.

You might be able to go for a walk together in the early stages of labour, watch television, listen to music or read together.

You can assist with whatever helps the mum-to-be feel comfy. She might like you to help her to bath, you could fetch her some relaxing creature comforts, or give her a hand to keep moving.

You'll also need a break. Make sure you bring some snacks for you too and wear comfy clothes to keep yourself in top form (Northern Lincolnshire and Goole NHS, 2015).

4. Give her practical support

You can help in lots of practical ways. You could drive the mum-to-be to the hospital, carrying her hospital bag and helping her check into the birthing suite or hospital (NHS, 2017b).

When you get there, you could do things like helping her to move around the room and change positions. She might love you to give her a back rub or get her a cup of tea.

If she is planning a home birth you can help set up everything she needs at home, whether that's a birthing pool or somewhere comfy for the mum-to-be. On the day you could offer to get the mum-to-be a hot drink and make phone calls to keep family updated.

The key here is to discuss and plan in advance what practical support she would like you to provide.

5. Provide emotional support

As the mum-to-be's labour progresses and contractions get stronger you can be her rock, comforting and reassuring her. Simple gestures like holding or squeezing her hand and giving positive words of encouragement can really help.

6. Support her physically and take care of yourself

You can encourage the mum-to-be to keep active during labour and help her move about or change positions so she feels more comfortable (NHS, 2017b). You could also offer to massage her back and shoulders, wipe her face with a cold flannel, or simply give her a reassuring hug. You might also find you need to back off a bit if she needs space. Ask what she'd prefer.

To continue to support the mum-to-be well during labour, you also need to be on top form. You might be supporting and providing comfort to her for a long time. You may even find you haven't slept all night and are extremely tired.

So take time out if you need it - whether that's going for a quick toilet break, getting a hot drink or stepping out to make a phone call. Make sure you bring snacks and wear comfy clothes (Northern Lincolnshire and Goole NHS, 2015).

7. Listen to her

Try to really listen to what she needs on the day. It can be easier said than done but you will need to be intuitive and try and understand what she needs and when. Especially if she is in too much pain to express it well herself.

Be aware that her needs might change as her labour progresses. At times during labour, the mum-to-be might like emotional and physical support. Yet there might be other times when she would like to be left alone to help her focus.

8. Be confident, encourage and motivate

If you are upbeat and confident in a woman's ability to give birth, this will help encourage and support her.

Words are powerful. You can help your partner stay motivated during labour by offering words of encouragement. Tell her how much you love her, how well she is doing. Also respect her wishes if she asks you to be quiet.

Encourage her to use any relaxation and breathing techniques you have learnt, perhaps by doing them with her. She might not be able to see what is happening as the baby is being born. So help to motivate her by telling her what is happening and when you can see the baby's head.

9. Be an advocate

You might need to express the mum-to-be's needs to the midwife or doctor (NHS, 2017b). So help to explain to the health professional what she would like. You might also need to explain to her any new information from the health professionals.

Support the mum-to-be's decisions, even if they're different from what's in her birth plan. She might want to choose a different type of pain relief, for example.

10. Be flexible

Be prepared to be flexible. No two labours are the same and, although you can prepare, you will need to adapt to whatever is working or not working during labour. It's possible that everything will go to plan but you might also find that an urgent medical situation arises and alters the course of the labour.

If this happens, tell the mum-to-be what's happening if you can and continue to encourage and reassure her. This will help her feel more in control of the situation.

You might be waiting a long time for her labour to progress, or you may have to make quick decisions based on medical advice and her best interests. Be prepared to be flexible on the day and go with the flow.

Give yourself a pat on the back too

Being a birth partner can be an incredibly rewarding experience. Yet it can also be nerve wracking and emotionally draining.

As well as congratulating the mum-to-be on their new arrival, don't forget to take some time out for yourself afterwards and talk to a friend about it. Make sure you give yourself some recognition for the part you have played in the baby's birth too.

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, labour and life with a new baby.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

Find out more about NCT Doulas and how they can during labour. NCT Doulas provide women, and their partners, with skilled physical and emotional assistance during labour. They have up-to-date knowledge and information about labour and birth and help provide encouragement to woman. This helps enable them to have the type of labour and birth they would like. NCT Doulas are qualified professionals who have completed a professional Doula UK course, developed by NCT in partnership with the University of Worcester.

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Whether it's your partner, daughter or friend due to give birth, it's an honour to be asked to be a birth partner. Yet this exciting role can also be daunting. Here we discuss some top tips to help you get ready. You'll find a whole number of ways you can help support the mum-to-be during labour (NHS Choices, 2017a).

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Babies and Sleep- research and information

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Babies and Sleep- research and information

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Ignore their name- this is a fantastic site all about babies and sleep - shhhh don't wake the babies!

https://www.basisonline.org.uk/

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Research-based information on baby sleep for parents and practitioners, covering normal infant sleep, sleep safety, where and how babies sleep, SIDS and SUDI, parental sleep and free resources.

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Information on different choices in where to give birth 

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Information on different choices in where to give birth 

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Find your local maternity units by searching for your postcode on the NHS maternity service .

How does the tool work

The interactive Where to give birth tool is designed to encourage women to think about where would be most suitable for them to give birth - be that at home, in a birth centre or in a hospital labour ward.

The recommendations of the tool are based on guidelines on place of birth from the National Institute for Health and Care Excellence (NICE), the results of the Birthplace Study from the British Medical Journal (2011) as well as considerations for women's personal preferences.

Results are only an indication of a birth setting that is suitable based on the details you submit to the tool. It does not constitute medical advice nor guarantee availability of your option. It's your responsibility to discuss your choice with healthcare professionals to find the right place for you to give birth.

Coronavirus and birthing options

The RCOG says, 'Maternity units everywhere are working around the clock right now to manage additional pressures and facilitate women's choices.'

Although, like all areas of the NHS, maternity services are being affected by the pandemic, it says maternity units are working to ensure services are provided in a way that is safe, with the necessary staffing levels and the ability to provide emergency care where necessary.

In some areas of the UK, Trusts and Boards had to pause their home birth service or close their midwife-led unit but most of these cases have now been reinstated. You will be told if this is not the case.

Pregnant women with suspected or confirmed coronavirus are being advised to give birth in a hospital obstetric unit for the safety of both mum and baby, even if they had been planning delivery at home or in a midwife-led centre.

This is so that the baby can be monitored using continuous electronic foetal monitoring, and your oxygen levels, temperature and respiratory rate can be monitored, too.

This kind of monitoring can only take place in an obstetric unit where doctors and midwives are both present.

It is also reported that women with symptomatic COVID-19 have an increased risk of caesarean birth, making it even more important that they give birth in an obstetric unit where prompt access to emergency care is available.

The RCOG says that women's birth plans should be followed as closely as possible and advises checking with your local maternity team as to what birthing options are available.

If you have chosen private antenatal care and to give birth in a private facility, contact them directly to see how coronavirus will impact you.

Page last updated 09/03/21. Please check out Royal College of Obstetricians and Gynaecologists for any more recent updates.

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Find your local maternity units by searching for your postcode on the NHS maternity service . The interactive Where to give birth tool is designed to encourage women to think about where would be most suitable for them to give birth - be that at home, in a birth centre or in a hospital labour ward.

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Royal College of Midwives- Video on midwife and mum trying out different positions for labour and rationale on why it can help labour 

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Royal College of Midwives- Video on midwife and mum trying out different positions for labour and rationale on why it can help labour 

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A printable sheet of tips