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You are entitled to free NHS prescriptions and NHS dental care (check-ups and treatment) during pregnancy and for 12 months after giving birth. Your child can also have free prescriptions and NHS dental care until they are at least 16 years old. Speak to your midwife, doctor or health visitor. They'll complete the application for you. They can do this as soon as they confirm that you're pregnant.

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Maternity exemption certificates | NHSBSA

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For pregnant women and those who have had a baby within the last 12 months

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For the list of the current peer support weekly drop in groups please check the Harrow Early Support/Children's Centres timetable.

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Children’s centres timetables – London Borough of Harrow

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We provide services for the residents of Harrow. Report an issue, submit an application, pay for something or see what’s going on in the London borough of Harrow.

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Young children often get sick – it is part of growing up.

It can be stressful for parents and carers when a child is not well. Often, the illness is not serious and the child can be treated

safely at home or with support from a GP, pharmacist or health visitor.

This booklet has been designed by a team of experts to help you care for your sick child. It will help you identify when an illness is minor and when it is serious. We recommend treating minor illnesses at home, where your child will be most comfortable.

For more advice and advice in other languages visit the healthier

together page: https://what0-18.nhs.uk/

If you need medical help, use the NHS 111 online service: https:// 111.nhs.uk . Call 111 if you need urgent help for a child

under five or cannot get help using the online service.

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Each year thousands of under-5s are admitted to hospital following accidents, and lots of these accidents are preventable. This NHS website page advises parents on how to protect their baby or toddler from some of the most common accidents that affect young children. These include: choking; suffocation; strangulation; falls in babies; when your baby starts crawling; poisoning; burns and scalds; drowning, house fires; glass-related injuries etc.

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Safety for babies, including preventing falls, burns and scalds, choking and suffocation, strangulation, drowning and poisoning.

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Brent and Harrow Perinatal Mental Health Team 

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Brent and Harrow Perinatal Mental Health Team

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Brent and Harrow Perinatal Mental Health Team

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The Brent and Harrow Perinatal Mental Health team supports women and birthing people with their mental and emotional wellbeing during pregnancy and up to two years after having a baby. This specialist care is available wherever suits you best, such as close to the maternity unit of your choice, your home or in Family Hubs.

You can access this service even if you choose to deliver your baby at a different hospital from Northwick Park, as long as you are a resident or you are registered with a GP in Brent or Harrow. If you aren’t based in these areas we also offer support across other London boroughs.

The team works in partnership with other services such as maternity, midwifery, health visitors and GPs, Talking Therapies, children and adult social care services and voluntary organisations. We want to help you to be as well as possible during pregnancy and after birth so that you can enjoy family life.

Instagram: instagram.com/brentandharrowperinatal

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Brent and Harrow Perinatal Mental Health Team :: Central and North West London NHS Foundation Trust

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Fun, information-packed antenatal classes for Harrow parents-to-be! Led by our trained Antenatal Educator, join us for supportive sessions filled with expert advice, antenatal education, practical tips, and plenty of time for your questions.

Suitable from 30 weeks pregnant through to your baby’s birth.

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Birth and Parenting Confidence | Blossom Antenatal: Antenatal Classes

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Antenatal Classes - Sociable, Virtual / Online & In-person. Thousands of parents-to-be join us. Find your Blossom Village.

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Comprehensive support from pregnancy and then throughout a child's feeding journey. Including weekly drop in groups in Harrow, families feeding experiences, useful links. For the list of the current peer support weekly drop in groups please check the Harrow Early Support/Children's Centres timetable.

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Harrow is a fully reaccredited UNICEF Baby Friendly Community!

So what is a Baby Friendly Community? Well... The UK Baby Friendly Initiative is based on a global accreditation programme of UNICEF and the World Health Organization. It is designed to support breastfeeding and parent infant relationships by working with public services to improve standards of care.

We offer support to all mothers, whether breastfeeding, mixed feeding or formula feeding.

Our Volunteers can support you and provide information on:

Sharing breastfeeding experiences

How to get breastfeeding off to a good start

Why Skin to Skin contact is so good for your baby and you!

Why love is good for your baby's brain

Understanding the benefits of breastfeeding

The importance of feeding your baby responsively

Feeding Cues and what they mean

Preparing formula safely if you choose to give your baby formula milk

Challenges with breastfeeding

Hand expressing

Storage of breastmilk

Going back to work

Breastfeeding in public

Breastfeeding through pregnancy

Come to a group and find out more.

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Harrow is a fully reaccredited UNICEF Baby Friendly Community ! So what is a Baby Friendly Community? Well... The UK Baby Friendly Initiative is based on a global accreditation programme of UNICEF and the World Health Organization. It is designed to support breastfeeding and parent infant relationships by working with public services to improve standards of care.

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Duration: 1 hour 30 minutes
Cost: FREE

Breastfeeding is a beautiful way to bond with your baby while giving them essential nutrients and a strong immune boost—breastmilk is truly amazing!

In our workshop, we’ll demystify how your body makes milk, the role of hormones, and why you might want to “harvest” colostrum before birth. We also encourage partners to join - it’s a great way to understand the science and learn how to offer support.

You'll learn different feeding positions, how to get a good latch, and what to expect in the early days. Breastfeeding can come with challenges, but with the right know-how, you’ll be prepared. We'll cover common struggles (like latching issues and sore nipples) and share practical tips to help you navigate them with confidence.

Join our online class to get the insights and support you need for a smooth and rewarding breastfeeding journey!

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If you're planning to bottle feed with expressed breast milk or infant formula, these tips will help you feed your baby and keep them safe and healthy. If you decide to use infant formula, first infant formula (first milk) should always be the first formula you give your baby. You can use it throughout the first year.

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Handy tips for bottle feeding your baby, including hygiene, being prepared, how to wind your baby and how to keep them safe.

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Dealing with children's minor accidents

Many GP surgeries, minor injury units, walk-in centres and pharmacies are equipped to deal with minor problems, such as cuts or items trapped in the nose or ear.

In this situation, ask a GP or NHS 111 for advice on where to go before you go to A&E.

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Read about how to look after a sick child, including dealing with minor accidents and when you should get help.

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Antenatal Classes / Preparing for Parenthood Sessions at Northwick Park Hospital (Free)

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Antenatal Classes / Preparing for Parenthood Sessions at Northwick Park Hospital (Free)

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These classes can help you to prepare for your baby’s birth and give you confidence and information. They usually cover staying healthy during pregnancy; antenatal support services and how can help you plan your birth; what to expect during labour, including pain relief and your birth and infant feeding, wellbeing, and postnatal support services. These sessions are led by midwives, and they're for parents at 32 weeks.

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Our preparing for parenthood session offers you advice about your pregnancy, birth, and the period after your baby is born.

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Harrow Children's Centres - Early Support run Weaning parties from 6 and a half months and Weaning workshops ideally from 4.5 - 5 months. See their current programme timetable for more information.

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Children’s centres timetables – London Borough of Harrow

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We provide services for the residents of Harrow. Report an issue, submit an application, pay for something or see what’s going on in the London borough of Harrow.

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Blossom Antenatal in Harrow operates a Baby Bank that provides essential baby items for 0-18 months, including clothes, prams, and cots, to families facing financial challenges. They work through a referral system with midwives, health visitors, and social workers to ensure that help reaches those who need it most. To make a referal visit https://www.blossomantenatal.com/referrals.

The Baby Bank also offers Family Shop sessions, allowing families to self refer and choose items at their own pace.  https://www.blossomantenatal.com/family-shop

Located at the The Blossom Hub, 74 High Street Wealdstone, HA3 7AF. Visits by appointment only.

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From staying healthy in pregnancy and what to expect, to various information about parenthood, from breastfeeding to when your baby will have their first vaccinations.

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From finding out your due date, early pregnancy signs and symptoms, to getting ready for labour and birth - this is your complete pregnancy guide.

Get tips on coping with morning sickness, choosing where to give birth, what to buy for your newborn and plenty more.

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See our complete guide to being pregnant and staying healthy today, including our week-by-week guide and information around vitamins, alcohol and much more.

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Anyone in England can register with a GP surgery to access NHS services. It's free to register. You do not need proof of address or immigration status, ID or an NHS number.

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Anyone in England can register with a GP surgery to access NHS services. It's free to register.

You do not need proof of address or immigration status, ID or an NHS number.

GP surgeries are usually the first contact if you have a health problem. They can treat many conditions and give health advice. They can also refer you to other NHS services.

How it works

Most people need to register with a surgery close to where they live.

You can use the Find a GP service to look for a surgery.

In the search results you can see:

if a GP surgery is currently accepting patients

reception opening times

reviews of the surgery

Once you've chosen a surgery, you'll need to fill in a registration form. These are usually available on:

the NHS App

the GP surgery's website

the GP surgery's profile page on the NHS website (Find a GP)

You can also get a paper form from the surgery.

It's also possible to register with a GP surgery outside your local area.

Do I need ID or proof of address?

No, you do not need ID, an NHS number or proof of address to register.

Some GP surgeries ask for supporting documentation as it can:

help the surgery find your medical records or transfer them from your current GP

confirm that you live in the surgery's area (or "practice boundary") if they do not accept patients from outside this area

If you do not have a permanent address you can still register using a temporary address or the address of the GP surgery.

Can a GP surgery refuse to register me?

A GP surgery can refuse to register you if:

they're not accepting new patients

you live outside their area and they only accept patients inside this area

you have been removed from that surgery before

If a GP surgery refuses to register you, they must write to you within 14 days explaining why.

If you have problems registering with a GP surgery, contact:

Registering children

Children under 16 need to be registered by their parent or guardian. This usually means filling in a separate form. You may also be asked to provide a form of ID to prove that you're their parent or guardian.

If you have a personal child health record (red book) from the birth of your child, it will help to provide this.

Changing GP surgeries

You can change your GP surgery if you need to.

This might be because:

you've moved

you've had problems with your current GP surgery

you were removed from the patient list

When you register with a new GP surgery, you'll usually get a message to tell you your registration has been successful.

Your medical records will be transferred from your old GP. This can take up to 28 days.

Changing your address

You should tell your GP surgery if you change your address.

If you do not tell your GP that you've moved there's a risk that:

NHS letters giving appointment dates or test results go to the wrong address

your GP surgery may not be able to provide home visits or other services if you move outside their area

If you register with a new GP, they will let your old GP know you've moved.

Registering as a temporary resident

You can register as a temporary resident with a GP surgery for up to 3 months. This can be helpful if you're living away from home but do not want to change your home GP surgery.

To register you'll need to fill out a temporary services form (GMS3), available from GP surgeries.

After 3 months, you'll have to reapply to register as a temporary resident or become a permanent patient.

You may also be able to register as a temporary resident if you are visiting from abroad.

If your application is refused, you can still receive any treatment you need immediately for up to 14 days.

Registering someone you care for under the Mental Capacity Act

If someone over 16 is unable to register with a GP because they cannot make decisions about their care, registration can be done by:

a relative

the main carer

a lasting power of attorney

a person appointed by a court under the Mental Capacity Act

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Find out how to register with a GP surgery in England.

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Trying for a baby, Having a baby if you are LBBT+, finding out if you are pregnant, your pregnancy care, keeping well in pregnancy, pregnancy week by week, pregnancy-related conditions, labour and birth, and general support.

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All you need to know about pregnancy, labour and birth including trying to get pregnant, foods to avoid, antenatal care and how to keep well in pregnancy.

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You can give birth at home, in a unit run by midwives (a midwifery unit or birth centre) or in hospital. Your options about where to have your baby will depend on your needs, risks and, to some extent, on where you live.

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Choosing your birth location

You can give birth at home, in a unit run by midwives (a midwifery unit or birth centre) or in hospital.

Your options about where to have your baby will depend on your needs, risks and, to some extent, on where you live.

If you're healthy and have no complications (low risk) you could consider any of these birth locations. If you have a medical condition, it's safest to give birth in hospital, where specialists are available. This is in case you need treatment during labour.

If you give birth at home or in a unit run by midwives, you're less likely to need assistance such as forceps or ventouse (sometimes called instrumental delivery).

Wherever you choose, the place should feel right for you. You can change your mind at any point in your pregnancy.

Find out what's in your area

Your midwife will discuss the options available in your area but, if you're willing to travel, you're free to choose any maternity services.

As well as from your midwife, you can get information from:

children's centres

your GP surgery

local maternity units - find maternity services near you

Maternity Voices Partnerships (MVPs) - ask at your local hospital's maternity unit

You may also want to get advice from your friends and family.

Talk to your midwife about going to have a look around the local maternity services, and ask questions if you do not understand something or think you need to know more.

Home birth

If you have a straightforward pregnancy, and both you and the baby are well, you might choose to give birth at home.

Giving birth is generally safe wherever you choose to have your baby.

But if you're having your first baby, home birth slightly increases the risk of serious problems for the baby - including death or issues that might affect the baby's quality of life - from 5 in 1,000 for a hospital birth to 9 in 1,000 for a home birth.

If you're having your second baby, a planned home birth is as safe as having your baby in hospital or a midwife-led unit.

It's rare but, if something goes seriously wrong during your labour at home, it could be worse for you or your baby than if you were in hospital with access to specialised care.

If you give birth at home, you'll be supported by a midwife who will be with you while you're in labour. If you need any help or your labour is not progressing as well as it should, your midwife will make arrangements for you to go to hospital.

Advantages of home birth

The advantages of giving birth at home include:

being in familiar surroundings, where you may feel more relaxed and better able to cope

not having to interrupt your labour to go into hospital

not needing to leave your other children, if you have any

not having to be separated from your partner after the birth

increased likelihood of being looked after by a midwife you have got to know during your pregnancy

lower likelihood of having an intervention, such as forceps or ventouse, than giving birth in hospital

Considerations

There are some things you should think about if you're considering a home birth.

You may need to transfer to a hospital if there are complications.

Epidurals are not available at home, but you can use gas and air, a warm bath, a birth pool, TENS and any relaxation techniques you've learned. Find out about pain relief in labour.

Your doctor or midwife may recommend you give birth in hospital - for example, if you're expecting twins or if your baby is lying feet first (breech). Your midwife or doctor will explain why they think a hospital birth is safer for you and your baby.

If you choose to give birth at home or in a unit run by midwives, you should be given information by your midwife or GP about what would happen if you had to be transferred to hospital during labour and how long this would take.

Planning a home birth

Ask your midwife whether a home birth is suitable for you and your baby.

If it is, your midwife will arrange for members of the midwifery team to help and support you. Here are some questions you might want to ask:

how long would it take if I needed to be transferred to hospital?

which hospital would I be transferred to?

would a midwife be with me all the time?

how do I obtain a birthing pool?

Midwifery units or birth centres

Midwifery units or birth centres are more comfortable and homely than a maternity unit in a hospital. They can be:

part of a hospital maternity unit, where pregnancy (obstetric), newborn (neonatal) and anaesthetic care is available

separate from a hospital, and without immediate obstetric, neonatal or anaesthetic care

Advantages of a midwifery unit or birth centre

The advantages of giving birth at a midwifery unit include:

being in surroundings where you may feel more relaxed and better able to cope with labour

being more likely to be looked after by a midwife you have got to know during your pregnancy

the unit potentially being much nearer your home

lower likelihood of having an intervention such as forceps or ventouse than giving birth in hospital

Considerations

There are some things to think about if you're considering giving birth in a midwifery unit or birth centre.

You may need to be transferred to a hospital if there are any complications.

In a unit that's completely separate from a hospital, you won't be able to have certain kinds of pain relief, such as an epidural. Ask your midwife whether the unit or centre is part of a hospital or completely separate.

Your doctor or midwife may feel it's safer for you to give birth in hospital

Planning a birth in a midwifery unit or birth centre

Ask your midwife if there are any midwifery units or birth centres in your area. There may be others you can use if you're prepared to travel.

Hospital birth

Most births happen in an NHS hospital maternity unit. If you choose to give birth in hospital, you'll be looked after by midwives, but doctors will be available if you need their help.

You'll still have choices about the kind of care you want. Your midwives and doctors will provide information about what your hospital can offer.

Advantages of hospital birth

The advantages of giving birth in hospital include:

direct access to obstetricians if your labour becomes complicated

direct access to anaesthetists, who give epidurals and general anaesthetics

there will be specialists in newborn care (neonatologists) and a special care baby unit if there are any problems with your baby

Considerations

There are some things you should think about if you're considering a hospital birth:

you may go home directly from the labour ward or you may be moved to a postnatal ward

in hospital, you may be looked after by a different midwife from the one who looked after you during your pregnancy

you're more likely to have an epidural, episiotomy, or a forceps or ventouse delivery in hospital

Planning a hospital birth

Your midwife can help you decide which hospital feels right for you. If there's more than one hospital in your area, you can choose which one to go to. Find out more about the care provided in each so you can decide which will suit you best.

Birth questions to ask

Here are some questions you might want to ask if you're considering having your baby in a midwifery unit or birth centre, or in hospital:

Are tours of the maternity facilities available before the birth?

When can I discuss my birth plan?

Are TENS machines available for pain relief or do I need to hire one?

What equipment is available - for example mats, a birthing chair or bean bags?

Are there birthing pools?

Are fathers, close relatives or friends welcome in the delivery room?

Are they ever asked to leave the room - if so, why?

Can I move around in labour and find my own position for the birth?

What is the policy on induction, pain relief and routine monitoring?

Are epidurals available?

How soon can I go home after the birth?

What services are provided for premature or sick babies?

Who will help me if I choose to formula feed?

Will my baby be with me all the time or is there a separate nursery?

Are there any special rules about visiting?

How long would it take if I needed to be transferred to hospital from a birth centre?

Which hospital would I be transferred to?

Would a midwife be with me all the time?

Wherever you decide to give birth, you can change your mind at any stage of pregnancy. Talk to your midwife if there's anything you're not sure or want to know more about.

For more information visit birthrights.

If you are thinking about unassisted birth

You can choose to have a home birth without a midwife with you (unassisted birth). This is sometimes called freebirth.

Talk to a midwife if you are worried about your care.

They can:

discuss with you the role of the midwife and help you make an informed choice

personalise your care and support so it's right for you.

If you decide to have an unassisted birth, you can change your mind at any time during your pregnancy or labour. NHS midwives will always be available to support you.

A midwife can offer you support and advice during labour, and check on the health of you and your baby. They'll know if you or your baby need help, and can arrange for medical attention if needed.

If you have an unassisted birth, you'll need to tell a GP or local maternity services about your baby's birth as soon as they've been born. This is because by law every birth in the UK needs to be recorded (notified) within 36 hours. A GP or midwife will need to see you before they can notify the birth.

When the birth has been notified, your baby will get an NHS number for their NHS care.

Further information:

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Find out about your options for where to give birth: at home, in hospital or at a midwife-led (midwifery) unit. Learn more about which pain relief methods will be available.

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London North West University Healthcare -  pregnancy and maternity care

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London North West University Healthcare -  Pregnancy and Maternity Care

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London North West University Healthcare -  Pregnancy and Maternity Care

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Covers self referral, Urgent Care when pregnant, antenatal appointments, where to give birth, birth partners and support, signs of labour, getting comfortable after labour, after your baby is born, NWP Maternity Voices, Caesarean Birth, App, books and info, Maternity Improvement Plan, and Guidelines and Procedures.

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Congratulations on your pregnancy! We provide maternity, antenatal, and
postnatal services for mums in Brent, Ealing, and Harrow.

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Enter a town, city or postcode to find your local hospital.

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Find a hospital near you on the NHS website. Check your local hospital's opening times, services and facilities, performance measures, reviews and ratings.

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Check the inspection report for Maternity Services at a hospital

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Check the inspection report for Maternity Services at a hospital

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Check the inspection report for Maternity Services at a hospital

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CQC is the independent regulator of health and adult social care in England. They inspect and rate NHS and independent (private) hospitals. You can use their inspection reports and ratings to help you understand the quality of care at the hospitals you are considering for birth.

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Use our information to check hospitals in England and the quality of their care.

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Northwick Park Maternity Voices Partnership (MVP)

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Northwick Park Maternity Voices Partnership (MVP)

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Northwick Park Maternity Voices Partnership (MVP) works with you and our maternity team to help improve our services for mums in Brent, Ealing, and Harrow. The MVP is chaired by local mums and they want to hear your views and experiences of our maternity services.. Also check out the 'Ask the Midwife' weekly session.

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Northwick Park Maternity and Neonatal Voices Partnership (MNVP)

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Northwick Park Maternity and Neonatal Voices Partnership (MNVP) works with you and our maternity team to help improve our services for mums in Brent, Ealing, and Harrow. The MNVP is chaired by local mums and they want to hear your views and experiences of our maternity and neonatal care.

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Health Service v's Private Maternity Care: what are your options?

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Health Service v's Private Maternity Care: what are your options?

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HS vs Private Maternity Care: what are your options? WHICH article comparing NHS and private maternity care to help you decide what's right for you.

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From paying for scans and doulas to private hospitals and amenity beds, this guide explains what's available if you go private before, during or after giving birth.
We also list the pros and cons for both NHS and private maternity services and explain what you might expect to pay if you decide to go private.
For ways to keep your family living costs down, and kids of all ages happy,
NHS vs private maternity care: pros and cons

NHS maternity care: pros

It's free. This includes scans, antenatal care, the birth itself and postnatal care. Although there may be some exceptions for non-UK residents, you'll never be turned away from NHS maternity care.

You have access to a wide range of experts. You'll be under the care of some of the world's best obstetrics experts without having to pay.

You have some choices about your birth. There's some scope to tailor your experience, such as deciding where you give birth, switching hospitals and requesting an elective c-section.

NHS maternity care: cons

You might not get the birth you want. The NHS will try to support your wishes but if, for example, all the birthing pools at your chosen facility are in use when you need one, the water birth you hoped for might not happen.

You might not feel as supported as with private care. Staff shortages and shift changes can mean various midwives may be looking after you during your pregnancy, which can be unsettling.

Private maternity care: pros

A team of familiar experts. Whether it's an obstetrician or midwife-led delivery, you'll get to know your team throughout your maternity care and birth.

Regular contact. You can contact the facility as much as you like. You might even have your obstetrician's mobile number for out-of-hours use.

Hotel-like facilities. Luxury and privacy are standard and facilities often include 24-hour room service, en suite facilities and more flexible visiting hours.

Private maternity care: cons

It's expensive. Even with a package it can cost many thousands of pounds and that's before the added extras that would be standard with the NHS.

You may end up with NHS treatment anyway. Most private delivery services are situated within or next to NHS hospitals and in an emergency they'll use their facilities, such as an obstetric emergency theatre on a standard labour ward. has its own intensive care facilities for newborns and mums.

There might not be private facility near you. Most are in the London, which might be problematic if you need to factor in antenatal care and also if your birth happens quickly and unexpectedly.

Can I give birth in a private hospital?

Yes, you can choose to give birth in a private maternity hospital or unit, or pick and choose aspects of private maternity care that suit your needs.

For example, although the NHS offers expectant mums at least two ultrasound scans during pregnancy , some parents-to-be would like 3D or 4D scans to see the baby's features more closely and these are only available privately.

Giving birth in a private hospital or in an NHS private wing means your chosen consultant will look after you for your antenatal care, delivery and postnatal care, unless you choose midwife-led care.
Taking your new arrival home in a child car seat ? Choose one that's passed our tough crash tests
How much does a private birth cost?

When we looked in September 2023, the lowest cost we found for a vaginal delivery with a consultant was £5,995 (the at Guy's and St Thomas's Hospital in London) and the highest was £7,110 (at the ), but you may end up paying additional charges.

We totted up some of these to demonstrate how these hidden extras can soon add up and reached a grand total of £8,998* in addition to the basic consultant-led care package starting from £6,625, making a grand total of £15,623.

Here are some examples of extras you might pay for and what they could cost you (based on prices from ):

Diagnostic and tissue testing: £24 for individual blood tests, £120 for histopathology (examining cells under a microscope) and £400 for an NIPT screen test (Harmony Test).

Pregnancy scans: Some may be included in your package, otherwise expect to pay at least £200 for each scan eg £210 for six-to-10 week dating scan and £310 for 20-week fetal anomaly scan.

Anaesthetics and pain relief: £850 for an epidural (£500 for a top-up plus £275 private unit charge), £750 for c-section anaesthesia (£500 for top-up), £400 for instrumental delivery anaesthesia.

Stitches and sutures: £900 for cervical or abdominal sutures (plus £300 for the anaesthetic) and around £200 for their removal.

Dressings and medication: Pharmacy charges for prescriptions and medication from £9, plus dressings from £50.

Induction and instrumental delivery: £525 for an induction, £525 for an instrumental delivery by a consultant obstetrician (not including additional obstetrician or anaesthetist fees), £1,540 to have your placenta surgically delivered and £30 plus handling fee for each unit of blood products if required.

Hospital visits before or after the birth: £1,325 antenatal admission per night, £250 prenatal ward attendance of less than three hours/£530 as a day case and £950 for a maternity day admission with a surgical procedure and £525 for an external cephalic version (ECV) procedure to turn your baby around.

Extra nights stay (after first night): £1,325 in postnatal room.

Some of the private facilities we looked at list additional extras online while others ask you to get in touch for more information. Either way, check so you know what's included and what's not.

Other extras to factor in may include additional costs for multiple births, and travel and accommodation to your chosen facility (most are in the London area), plus be prepared to pay a deposit that's either a percentage or a flat fee (eg £11,700 for a c-section at the Lindo Wing).

What maternity care can I get on the NHS?

NHS antenatal care

With the NHS, you get seven to 10 antenatal appointments with a midwife, as well as blood tests and at least two free .

If you have more complicated needs, you'll also see a consultant (doctor) in addition to your midwife appointments.

NHS when giving birth

Most women have their baby in an NHS maternity unit, but if you choose to have your baby at home, two NHS midwives will come to support you during the birth.

You'll always have your own room in a hospital or birth centre for the birth itself and be looked after by midwives. But if you're induced and also if you're staying overnight following the birth, you may need to spend time on a shared antenatal ward.

NHS postnatal care

You'll go home a few hours after a straightforward birth or after a couple of days if you've had a c-section or experienced complications.

You'll have an average of three to four postnatal appointments with NHS midwives once discharged, either at your home, or at a local clinic or children's centre.
Take a look at the most popular and types of breast pump to choose from
How can I enhance my NHS maternity care?

You can still choose aspects of private maternity care to suit your needs, even if you're not going completely private.

In fact, our 2022 survey** showed that out of just over 1,400 parents, nearly all had paid for private services during pregnancy or birth.

Private pregnancy scans and blood tests

Our 2022 research showed that a large number parents (83%) had a private scan during the pregnancy and 19% had a private blood test.

The NHS provides you with all the diagnostic scans you need but some people pay for extras such as 3D and 4D scans at a private facility to see their baby's features more clearly and to get video footage of it.

For more information see our guide to NHS and private ultrasound scans during pregnancy .

Private amenity room after the birth

Women having an NHS birth sometimes choose to pay to hire a private 'amenity' room within the NHS maternity unit to give them more privacy.

The rooms are often just off the postnatal ward, and can cost anything from around £80 up to five times that, depending on where you are in the UK.

Our research showed that while just 6% of parents opted for a private amenity room in the NHS, 97% found it useful.

Hiring a doula

A doula is trained in supporting expectant and new parents, but they're not there to replace midwives or other health staff.

They can work with you during your pregnancy, be with you as an advocate or birth partner, or provide support in the early days postnatally - their service is tailored to your needs.

In our survey, 5% of respondents paid to have a doula and 90% of these said they found it useful.

Is NHS maternity care always free?

The rules say no-one should ever be denied NHS maternity care, but in some cases it isn't free.

The UK has a residence-based healthcare system so if you are 'ordinarily resident' here you're entitled to free NHS maternity care, whatever your citizenship or immigration status.

The charity Maternity Action has a guide to who is considered ordinarily resident in the UK to help you see where you stand.

Each NHS Trust has an Overseas Visitor Team with responsibility for reaching a decision about whether you'll be charged for your maternity care if you aren't ordinarily resident.

Can I choose to go private mid-way through my pregnancy?

Yes, and this may help you to keep the costs down.

For example, delivery by an obstetrician at the private facility of is £7,500 from 12 weeks of pregnancy, £6,500 from 28 weeks, £6,000 from 32 weeks and £5,500 from 36 weeks.

However, in other situations you could find that the amount it costs is the same as if you started private treatment earlier on in your pregnancy.

For example, , which represents independent midwifery, says that because an independent midwife has fixed costs to bear and will often have to work harder within a short space of time to give you the care you need, you still pay the full amount.

You should be aware that, as per Department of Health guidelines, if you transfer from private to NHS care you're not permitted to change back to private care.

Can I pay for a private room in an NHS hospital after the birth?

The availability of private or 'amenity' rooms following delivery varies from one hospital to the next, as does the price.

Some offer single amenity rooms with shared facilities, others have private rooms with en suite facilities and there may also be additional provisions such as tea and coffee, a TV and scope for someone to stay with you overnight.

However, they tend to be allocated on a first-come, first-served basis and can't be held or booked in advance. So there's no guarantee you'll get one, plus you may have to relocate to a postnatal ward to accommodate someone with a clinical need greater than yours.

Costs vary but can start at around £80 for a single room with shared bathroom facilities, rising to, in some cases, upwards of £400 a night.

Whatever you end up paying, you are still an NHS patient and won't be given preferential treatment.

Can I hire a private midwife?

If you want more flexibility in your maternity care than the NHS can provide, you can look into hiring a private or independent midwife.

says a complete package of care throughout pregnancy, birth and the postnatal period costs anywhere between £2,000 and £5,000, although it can cost as much as almost £9,000.

Most independent midwives are happy to accept payment in instalments or flexible payment plans, and in some special circumstances they may consider caring for women for a reduced fee.

In this video, an independent midwife explains what she believes are the benefits of using a paid-for, non-NHS midwife for maternity care.

Having a home birth with a private midwife

Many women who choose to have an independent or private midwife are planning to have a home birth.

Private midwives can be a good option if you're finding it difficult to get support for a home birth from your local NHS services.

If you're having a home birth with a private midwife, there's still the possibility you may need to be transferred to hospital because you or your baby needs extra help.

In this case, the NHS midwives and doctors in the hospital will take over your care. However, your private midwife will still be there to act as a supportive birth partner.

Postnatal care with a private midwife

Women who have given birth with private midwives can pay to carry on seeing the same midwife they had throughout their pregnancy, after the baby is born.

Others may choose to supplement their NHS postnatal care by having additional private appointments as well.
See all our * Individual blood tests £24, histopathology £120, Harmony/NIPT test £400, £530 as day case at prenatal ward, external cephalic version (ECV, or turning the baby) £525, epidural £850 plus top-up £500 and private unit epidural charge £275, induction from £525, instrumental delivery £525 and anaesthesia £400, surgical delivery of placenta £1540, cervical or abdominal sutures £900 plus anaesthetic £300 and suture removal £200, dressings from £50, pharmacy charges for prescriptions and medication from £9, additional night in postnatal room £1,325. Based on prices from The Kensington Wing at Chelsea and Westminster Hospital in London, correct as of 28 September 2023. ** Baby & Child survey carried out in February 2022. for information on child car seats, pushchairs, baby monitors, nursery furniture and much more
In addition to providing continuity of care, a private midwife can assist if you're having problems with breastfeeding and will also be a familiar face if you've had a challenging or difficult birth.

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NHS vs private maternity care: what are your options? - Which?

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We compare the pros and cons of NHS and private maternity care. Learn about the antenatal care and birth options available for free through the NHS, and what private midwives and hospitals can offer, how much it costs and what you can access

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You'll be offered some screening tests during pregnancy to try to find any health conditions that could affect you or your baby. The tests can help you make choices about further tests and care or treatment during your pregnancy or after your baby's born. All screening tests offered by the NHS are free.

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Find out about screening tests in pregnancy. These include ultrasound scans and blood tests to try to find any health conditions that could affect you or your baby.

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Most pregnant women who carry group B streptococcus (GBS) bacteria have healthy babies. But there's a small risk that GBS can pass to the baby during childbirth. If you have GBS, or you've had a baby who's been affected by it before, you should be offered antibiotics during labour to reduce the risk of your baby getting ill.

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Most pregnant women who carry group B streptococcus (GBS) bacteria have healthy babies.

But there's a small risk that GBS can pass to the baby during childbirth.

Sometimes GBS infection in newborn babies can cause serious complications that can be life-threatening, but this is not common.

Extremely rarely, GBS infection during pregnancy can also cause miscarriage, early (premature) labour or stillbirth.

What is GBS?

GBS is one of many bacteria that can be present in our bodies. It does not usually cause any harm.

When this happens, it's called carrying GBS, or being colonised with GBS.

It's estimated between 2 and 4 women in every 10 in the UK carries GBS in their digestive system or vagina.

Around the time of labour and birth, many babies come into contact with GBS. Most are unaffected, but a small number can become infected and very unwell.

Early-onset GBS infection

If a baby develops GBS infection in the first week after birth, it's known as early-onset GBS infection.

Symptoms include:

being floppy and unresponsive

grunting when breathing, or working hard to breathe when you look at their chest or tummy

a high or low temperature

very fast or slow heart rate

very fast or slow breathing

changes in their skin colour, including blotchy skin

not feeding well or vomiting milk

crying and unable to settle

What complications can GBS infection cause?

Most babies who become infected can be treated successfully and will make a full recovery.

But even with the best medical care, the infection can sometimes cause life-threatening complications, such as sepsis or meningitis.

Rarely, GBS can cause infection in the mother. For example, in the womb or urinary tract or, more seriously, sepsis.

Preventing early-onset GBS infection
The Royal College of Obstetricians and Gynaecologists (RCOG) has more information on GBS infection in newborn babies
If you have GBS, or you've had a baby who's been affected by it before, you should be offered antibiotics during labour to reduce the risk of your baby getting ill.

If there's a chance your new baby could have GBS, you might be advised to stay in hospital for at least 12 hours after the birth so they can be checked regularly for signs of infection.

For more information, see Is my baby at risk of early-onset GBS infection?

Late-onset GBS infection

Late-onset GBS infection develops 7 or more days after a baby is born. This is not usually associated with pregnancy.

The baby probably became infected after the birth. For example, they may have caught the infection from someone else.

The symptoms of late-onset GBS are the same as early-onset GBS. Call 999 or take your baby to A&E if they have symptoms of GBS.

GBS infections after 3 months of age are extremely rare.

Breastfeeding does not increase the risk of GBS infection and will protect your baby against other infections.

Further information

Page last reviewed: 3 August 2022
Next review due: 3 August 2025

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What are the risks of group B streptococcus (GBS) infection during pregnancy?

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Most pregnant women who carry group B streptococcus (GBS) bacteria have healthy babies. But there's a small risk that GBS can pass to the baby during childbirth. Sometimes GBS infection in newborn babies can cause serious complications that can be life-threatening, but this is not common.

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Gestational diabetes is high blood sugar (glucose) that develops during pregnancy and usually disappears after giving birth. It can happen at any stage of pregnancy, but is more common in the second or third trimester.

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Gestational diabetes is high blood sugar (glucose) that develops during pregnancy and usually disappears after giving birth.
It can happen at any stage of pregnancy, but is more common in the second or third trimester.

It happens when your body cannot produce enough insulin - a hormone that helps control blood sugar levels - to meet your extra needs in pregnancy.

Gestational diabetes can cause problems for you and your baby during pregnancy and after birth. But the risks can be reduced if the condition is detected early and well managed.

Who's at risk of gestational diabetes

Any woman can develop gestational diabetes during pregnancy, but you're at an increased risk if:

you are over 40

your body mass index (BMI) is above 30 - use the BMI healthy weight calculator to work out your BMI

you previously had a baby who weighed 4.5kg (10lb) or more at birth

you had gestational diabetes in a previous pregnancy

1 of your parents or siblings has diabetes

you are of south Asian, Black, African-Caribbean or Middle Eastern origin (even if you were born in the UK)

you have had a gastric bypass or other weight-loss surgery

If any of these apply to you, you should be offered screening for gestational diabetes during your pregnancy.

Symptoms of gestational diabetes

Gestational diabetes does not usually cause any symptoms.

Most cases are only discovered when your blood sugar levels are tested during screening for gestational diabetes.

Some women may develop symptoms if their blood sugar levels gets too high (hyperglycaemia), such as:

increased thirst

needing to pee more often than usual

a dry mouth

tiredness

blurred eyesight

genital itching or thrush

But some of these symptoms are common during pregnancy and are not necessarily a sign of gestational diabetes. Speak to your midwife or doctor if you're worried about any symptoms you're experiencing.

How gestational diabetes can affect your pregnancy

Most women with gestational diabetes have otherwise normal pregnancies with healthy babies.

However, gestational diabetes can cause problems such as:

your baby growing larger than usual - this may lead to difficulties during the delivery and increases the likelihood of needing induced labour or a caesarean section

polyhydramnios - too much amniotic fluid (the fluid that surrounds the baby) in the womb, which can cause premature labour or problems at delivery

premature birth - giving birth before the 37th week of pregnancy

pre-eclampsia - a condition that causes high blood pressure during pregnancy and can lead to pregnancy complications if not treated

your baby developing low blood sugar or yellowing of the skin and eyes (jaundice) after he or she is born, which may require treatment in hospital

the loss of your baby (stillbirth) - though this is rare

Having gestational diabetes also means you're at an increased risk of developing type 2 diabetes in the future.

Screening for gestational diabetes

During your first antenatal appointment (also called a booking appointment) at around week 8 to 12 of your pregnancy, your midwife or doctor will ask you some questions to determine whether you're at an increased risk of gestational diabetes.

If you have 1 or more risk factors for gestational diabetes you should be offered a screening test.

The screening test is called an oral glucose tolerance test (OGTT), which takes about 2 hours.

It involves having a blood test in the morning, when you have not had any food or drink for 8 to 10 hours (though you can usually drink water, but check with the hospital if you're unsure). You're then given a glucose drink.

After resting for 2 hours, another blood sample is taken to see how your body is dealing with the glucose.

The OGTT is done when you're between 24 and 28 weeks pregnant. If you've had gestational diabetes before, you'll be offered an OGTT earlier in your pregnancy, soon after your booking appointment, then another OGTT at 24 to 28 weeks if the first test is normal.
Find out more at Lab Tests Online: Glucose Tests.

Treatments for gestational diabetes

If you have gestational diabetes, the chances of having problems with your pregnancy can be reduced by controlling your blood sugar levels.

You'll be given a blood sugar testing kit so you can monitor the effects of treatment.

Blood sugar levels may be reduced by changing your diet and being more active if you can. Gentle activities such as walking, swimming and prenatal yoga can help reduce blood sugar. But tell your midwife or doctor before starting an activity you haven't done before.

However, if these changes don't lower your blood sugar levels enough, you will need to take medicine as well. This may be tablets or insulin injections.

You'll also be more closely monitored during your pregnancy and birth to check for any potential problems.

If you have gestational diabetes, it's best to give birth before 41 weeks. Induction of labour or a caesarean section may be recommended if labour does not start naturally by this time.

Earlier delivery may be recommended if there are concerns about your or your baby's health or if your blood sugar levels have not been well controlled.

Find out more about how gestational diabetes is treated.

Long-term effects of gestational diabetes

Gestational diabetes normally goes away after birth. But women who've had it are more likely to develop:

gestational diabetes again in future pregnancies

type 2 diabetes - a lifelong type of diabetes

You should have a blood test to check for diabetes 6 to 13 weeks after giving birth, and once every year after that if the result is normal.

See your GP if you develop symptoms of high blood sugar, such as increased thirst, needing to pee more often than usual, and a dry mouth - do not wait until your next test.

You should have the tests even if you feel well, as many people with diabetes do not have any symptoms.

You'll also be advised about things you can do to reduce your risk of getting diabetes, such as maintaining a healthy weight, eating a balanced diet and exercising regularly.

Some research has suggested that babies of mothers who had gestational diabetes may be more likely to develop diabetes or become obese later in life.

Planning future pregnancies

If you've had gestational diabetes before and you're planning to get pregnant, make sure you get checked for diabetes. Your GP can arrange this.

If you do have diabetes, you should be referred to a diabetes pre-conception clinic for support to ensure your condition is well controlled before you get pregnant.

Read more about diabetes in pregnancy.

If you have an unplanned pregnancy, talk to your GP and tell them you had gestational diabetes in your previous pregnancy.

If tests show you do not have diabetes, you'll be offered screening earlier in pregnancy (soon after your first midwife appointment) and another test at 24 to 28 weeks if the first test is normal.

Alternatively, your midwife or doctor may suggest you test your blood sugar levels yourself using a finger-pricking device in the same way as you did during your previous gestational diabetes.
Community content from HealthUnlocked

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Find out what gestational diabetes is, what problems it can cause, how it's diagnosed, and what the treatments are.

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The Pregnancy and Post-birth Wellbeing Plan

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The Pregnancy and Post-birth Wellbeing Plan

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The Wellbeing Plan is a 2-page plan, endorsed by NICE (National Institute for Health and Care Excellence), that helps you start thinking about how you feel emotionally and what support you might need in your pregnancy and after the birth.

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The Pregnancy and Post-birth Wellbeing Plan

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The Wellbeing Plan helps you start thinking about how you feel emotionally and what support you might need in your pregnancy and after the birth.

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Pregnancy yoga at home with The Yoga Midwife

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Pregnancy yoga at home with The Yoga Midwife

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Yoga is a great way to stay active during and after pregnancy. The Yoga Midwife on the Tommy's Pregnancy Charity website takes you through some simple poses to get you started.

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Pregnancy yoga at home with The Yoga Midwife

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Yoga is a great way to stay active during and after pregnancy. The Yoga Midwife takes us through some simple poses to get you started.

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Blossom Relaxation classes and hypnobirthing

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Blossom Relaxation Classes and Hypnobirthing

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Blossom Relaxation Classes and Hypnobirthing

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Free online classes offered by trained professionals.

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 ACAS - Know your rights at work during pregnancy

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 ACAS - Know your rights at work during pregnancy

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ACAS is an independent public body that receives funding from the government to free and impartial advice to employers, employees and their representatives. Information on telling your employer you are pregnant, taking Maternity Leave, holiday, pay, time off for appointments, having IVF treatment, and returning to work. There are also a number of things your employer must do to help remove any health and safety risks to you and your unborn baby at work. Includes information on individual risk assessments,changing your work duties, agency worker and rights etc.

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Health at work during pregnancy - Maternity leave and pay

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Your health and safety rights at work during pregnancy, including if you're sick.

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Overview of rights while pregnant at work and maternity pay etc.

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Check your legal rights on how your employer has to treat you when you’re pregnant at work.

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It's important to remember that giving birth doesn't always go perfectly to plan, and things may have to change at the last minute, but it's good to have looked at, and discussed your preferred options in advance. See website for birth plan checklist and template.

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Birth plan checklist

It's important to remember that giving birth doesn't always go perfectly to plan, and things may have to change at the last minute.

Your midwife will be there to help you make the best and safest decision for you and your baby.

Here is a checklist of things to think about:

Where do you want to give birth? This could be at home, in a midwifery unit or in hospital.

Do you want someone with you during the birth, such as your partner or a family member?

If you need a forceps or vacuum delivery, would you want someone with you?

If a caesarean is necessary, do you want someone with you?

What birthing equipment do you want to use? This could include mats or beanbags.

Do you want to use any special facilities, such as a birthing pool?

Do you want to keep active during labour?

What position would you prefer to be in while you're in labour?

Do you want immediate skin-to-skin contact with your baby, before the cord is cut?

Are you happy for midwives, nurses and doctors in training to be present during your labour?

What are your pain relief preferences?

How do you want to feed your baby?

Can your baby be given vitamin K if they need it?

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What to include in your birth plan - Start for Life

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Learn about what to consider when making a birth plan, including a checklist to think through your preferences and a birth plan template.

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This class is a chance to get all your questions answered and take time to think about and plan your journey through the maternity system. The course will cover; how the maternity system works; what happens at scans and appointments; how is your health and baby’s health monitored through pregnancy; pregnancy and work - your rights; relaxation; your changing body and much much more.

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Blossom Antenatal Breastfeeding Class (Free)

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Blossom Antenatal Breastfeeding Class (Free)

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A free online workshop that covers how your body makes milk - the effects your hormones have on milk, exactly what colostrum is and why/how you may want to “harvest” it antenatally, partner involvement, different positions for feeding, what a 'good' latch looks like, the most common challenges that new mums face when breastfeeding and practical solutions to help you overcome them or where to find further support.

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Collecting your colostrum while you are pregnant 

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Collecting your colostrum while you are pregnant 

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Mothers start to produce colostrum (early milk) while pregnant. Being able to express colostrum is a useful skill to have, and you can save it. Being familiar with your breasts and how they work will give you confidence after the birth. You’ll be able to express a small amount of colostrum onto your nipple if your baby needs encouragement to feed. You’ll be able to express colostrum for your baby if he has difficulty feeding or is cared for in the neonatal intensive care or special care baby unit. And being able to hand express will help you avoid problems with engorgement and mastitis.

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Mothers start to produce colostrum (early milk) while pregnant. Being able to express colostrum is a useful skill to have. Saving your expressed colostrum may also be beneficial if your baby is likely to need special care after birth.

Why express while pregnant?

Being familiar with your breasts and how they work will give you confidence for after the birth.

You'll be able to express a small amount of colostrum onto your nipple if your baby needs encouragement to feed.

You'll be able to express colostrum for your baby if he has difficulty feeding or is cared for in the neonatal intensive care or special care baby unit.

Being able to hand express will help you avoid problems with engorgement and mastitis.

If your baby doesn't breastfeed well in the first few days, being able to hand express will help you:

Express your milk if needed.

Provide your own milk for your baby to prevent or treat conditions such as low blood sugar or jaundice.

Avoid the need to give infant formula.

Special circumstances

Learning to hand express while pregnant, and collecting and saving the colostrum can be helpful in some special situations, including:

Planned caesarean or induced birth
Consider expressing the day before birth so your milk is available if you and your baby are separated. This will be especially useful if your baby will be born early.

Babies with a cleft lip or palate
This may be diagnosed during pregnancy. Babies with any form of cleft can find it harder to breastfeed. Breastfeeding is particularly important for the first six months as it helps protect these babies against ear and respiratory infections. When the cleft is repaired, your milk helps promote healing and protects your baby against hospital germs.

Mothers with diabetes
In the first 24 hours after birth, babies of diabetic mothers risk developing low blood sugar levels (hypoglycaemia). A baby needs colostrum to maintain his blood glucose levels. Exclusive breastfeeding has been shown to reduce the risk of a baby developing diabetes later in life.

Mothers with breast abnormalities or who have had breast surgery
Stored colostrum can be helpful if you encounter problems establishing milk production.

Other medical conditions
Some medical conditions may make it harder for you and your baby to establish breastfeeding. Or, if you need to start medications that are incompatible with breastfeeding, your saved colostrum can still be given to your baby.

Talk to your midwife

Some NHS hospital trusts already have policies in place for sharing information on antenatal expression. Your midwife and other members of your antenatal care team may have information to share on breast massage and how to hand express. They should also be able to give you small sterile syringes with identity labels in which to save your colostrum.

Do ask if the hospital has an Infant Feeding Specialist who will be well informed about breastfeeding and a source of support in those early days.

A handy technique

Hand expression is a useful technique to learn even though most mothers find they rarely need to express and store their milk. It is effective, convenient and free. You may also find you can express more milk by combining hand expression with pumping than using just a pump.

When to start expressing

Is it safe?

Don't worry - following the suggestions to express for a few minutes each day is unlikely to trigger labour. Check with your midwife if you are at risk for early labour. If you experience any uterus cramps when expressing, stop immediately and contact your midwife.

Expressing during pregnancy

1. It helps to be warm and relaxed.

2. You could practise in the bath or shower at first. When you start collecting colostrum, express after a bath or shower.

3. Wash your hands.

4. Massage your breasts to help milk flow.

5. Hand express from one breast. Take care NOT to cause pain or discomfort.

6. You are likely to see small droplets or drips of colostrum appear as you express. Express directly into the container so you save every precious drop. If you've been given syringes and find it difficult to collect your colostrum, express into a small clean container (e.g. cup) and draw the colostrum up into the syringe.

You can express up to three times in the same day. If you plan to express again that day, store the syringe in the coldest part of the fridge. This is usually at the back.

Once you've expressed for the last time that day, seal the syringe in a bag. Label and date it before placing it in the freezer. The colostrum could be kept in the fridge if you're going to be induced or have a planned caesarean section within a day or two. Fresh colostrum inhibits the growth of bacteria and can be safely refrigerated for 48 hours.

Why hand express?

Hand expression is the best way to express colostrum. It is simple to learn and gets easier with practice. You'll only be expressing small amounts so using a pump will be impractical and may not be as effective. You may receive information and a demonstration on hand expression from your midwife.

Our article Hand Expression of Breastmilk also describes an effective method. Antenatally, you'll only need to express for three to five minutes - just until you have a few drops of colostrum. It may not seem very much, but a baby's first feed is no more than a teaspoon of colostrum. By expressing up to three times in a day, you can express enough for a feed. With practice and regular stimulation, you'll be able to express more colostrum.

When you go into labour

Take your stored colostrum with you to the hospital in a cool bag. The hospital can arrange to keep your colostrum frozen, possibly in the special care baby unit. Make sure you or your birth partner makes a note of where it is stored and that details are in your notes.

If you and your baby are likely to have difficulties or be separated, one of the containers can be defrosted once you're close to birth. This is then ready for the first feed, if needed.

When baby arrives

Your baby will need to breastfeed at least 8-12 times in 24 hours. If, for any reason, you are separated or unable to breastfeed your colostrum can be defrosted if needed, one container at a time to avoid waste. Your colostrum can also be used if your baby needs supplements.

The first few days

Frequent breastfeeding and keeping your baby close by will help establish your milk supply and get breastfeeding off to a good start. If you and your baby are separated, express milk eight times in each 24 hours including at least once at night, until your baby is able to breastfeed. Expressing as well as breastfeeding is important if your baby isn't feeding well, or needs supplements for any reason. This will help establish milk production and provide milk for your baby's next feed if needed. For any problems, seek skilled help from an LLL Leader - check our website for details.

Written by Karen Butler, Sue Upstone & mothers of La Leche League GB.
Updated February 2022
Further Reading
Beginning Breastfeeding
Caesarean Birth and Breastfeeding
Comfortable Breastfeeding
Diabetes and Breastfeeding
Hand Expression of Breastmilk
Is My Baby Getting Enough Milk?
Jaundice in the Healthy Newborn
My Baby Won't Breastfeed
Sleepy Baby - Why and what to do

LLLI Stories
Cleft Lip & Palate Breastfeeding
Books
The Womanly Art of Breastfeeding LLLI. London: Pinter & Martin, 2010
Breastfeeding Answers Made Simple. Mohrbacher, N. Amarillo, Tx: Hale Publishing, 2010.
References
Cox, S. An ethical dilemma: should recommending antenatal expressing and storing of colostrum continue? Breastfeeding Review 2006; 14(3):11-6.
Cox, S. Expressing and storing colostrum antenatally for use in the newborn period. Breastfeeding Review 2006; 14(3):11-6.
Oscroft, R. Antenatal expression of colostrum. Pract Midwife 2001;4 (4): 32-5.
Forster, D. et al. Diabetes and Antenatal Milk Expressing (DAME). Lancet, 2017; 389 (10085): 2204-2213.

This information is available to buy in printed form from the LLLGB Shop

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Antenatal Expression of Colostrum - La Leche League GB

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Mothers start to produce colostrum (early milk) while pregnant. Being able to express colostrum is a useful skill to have. Saving your expressed colostrum may also be beneficial if your baby is likely to need special care after birth. Why express while pregnant? Being familiar with your breasts and how they work will give you [...]

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The perineum is the area of skin and muscle between the vagina and anus. Find out what perineal massage is and how it might work to help you avoid a tear or episiotomy when you give birth.

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Perineal massage in pregnancy | Pregnancy, Worries and discomforts articles & support | NCT

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Find out what perineal massage is and how it might work to help you avoid a tear or episiotomy when you give birth.

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The NCT is a national charity that supports people as they become parents from pregnancy, through birth, and then early parenthood. A wealth of information is available on their website and there is also a local branch in Harrow.

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We're here to support you to have best possible experience of pregnancy, birth, and early parenthood.

Supporting you to make informed decisions

Helping create networks of vital support & life-long friendships

Campaigning on issues that matter to parents

From better postnatal support to improving NHS maternity services for everyone.

Feel connected and supported through our social antenatal and postnatal courses and local community groups.

Make decisions that feel right for your family with our evidenced-based information for parents.

Information for parents

If you're pregnant or a new parent, we know that you will have a number of questions and concerns about coronavirus. In our sections below, we've created a range of articles about how coronavirus might affect your pregnancy, birth and early days as a parent.

Courses and workshops

Interactive, engaging and social, our antenatal course is a fun and exciting way to grow your knowledge of birth and early parenthood, and make life-long friends.
View all courses & workshops

Local activities and meet-ups

Our local activities and meet-ups can help you build up a supportive social network around you.

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Supporting you to make informed decisions Helping create networks of vital support & life-long friendships Campaigning on issues that matter to parents From better postnatal support to improving NHS maternity services for everyone. Feel connected and supported through our social antenatal and postnatal courses and local community groups.

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Find out about Bumps and Babies sessions and walk and talks. Email: harrow@nct.org.uk

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Harrow | Local activities & meet-ups | NCT

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Welcome to NCT Harrow!We are a friendly, diverse branch covering the Harrow area (including Pinner, Stanmore, Kenton and Wembley).Our local groups, activities and events are run by volunteers. We support local families and raise money for all of NCT’s work, locally and nationally.

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Whoever your birth partner is – the baby's parent, a close friend, partner, or a relative – there are many practical things they can do to help you. The most important thing your birth partner can do is just be with you. Talk to your birth partner about the type of birth you'd like and the things you prefer not to do so they can help support your decisions. It can help to go through your birth plan together.

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Whoever your birth partner is - the baby's parent, a close friend, partner, or a relative - there are many practical things they can do to help you.

The most important thing your birth partner can do is just be with you.

Talk to your birth partner about the type of birth you'd like and the things you prefer not to do so they can help support your decisions. It can help to go through your birth plan together.

There's no way of knowing what your labour is going to be like or how each of you will cope, but there are many ways a partner can help.

Whatever kind of birth you're planning for, your birth partner can:

keep you company and help pass the time during the early stages

hold your hand, wipe your face and give you sips of water

massage your back and shoulders, and help you move about or change position

comfort you as your labour progresses and your contractions get stronger

remind you how to use relaxation and breathing techniques, perhaps breathing with you if it helps

support your decisions, such as the pain relief you choose, even if they're different from what's in your birth plan

help you explain to the midwife or doctor what you need - and help them communicate with you - which can help you feel more in control of the situation

tell you what's happening as your baby is being born if you cannot see what's going on

Your birth partner may be able to cut the umbilical cord - you can talk to your midwife about this.

You can also read about feelings and relationships in pregnancy, including worries about the birth and sex in pregnancy.

Make sure you and your birth partner both know what to pack for the birth, and what to expect at the hospital or maternity unit if you're planning to have your baby there.

Find maternity services near you.
Community content from HealthUnlocked

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Find out how your birth partner can help during labour, such as reminding you of relaxation techniques, massaging you and holding your hand.

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Doulas provide continuous support for the whole family through pregnancy, birth and in the early days of parenthood. Paid to fulfil a role with new parents and families they are there to listen, give confidence and not judge. Offering flexible, practical and emotional support in homes as well as in hospitals throughout the UK. Searchable directory of registered qualified doulas.

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Doula UK - The non-profit association of doulas in the UK

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Doulas support the whole family to have a positive experience of pregnancy, birth and the early weeks with a new baby. Find a doula near you.

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An induced labour is one that's started artificially. It's common for labour to 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.

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An induced labour is one that's started artificially.

It's common for labour to 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 41 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.

A membrane sweep would usually be offered to you after 39 weeks.

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.

Some women find the procedure uncomfortable or painful. You may get some cramping and vaginal bleeding afterwards.

If labour does not start after a membrane sweep you may be offered an additional sweep or 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.

There are 2 main ways labour can be induced:

Hormones can be put inside your vagina using a vaginal tablet (pessary) or a gel, or given as tablets that you swallow.

Devices such as balloon catheter (a small balloon, full of water) or an osmotic dilator (a type of sponge) can be used to widen your cervix.

You'll usually be offered hormones first to see if they work, unless there's a medical reason you cannot take hormones.

It usually takes many hours for these treatments to start working. You will usually stay in the hospital maternity unit, though you may be able to go home in some cases.

Sometimes a hormone drip is needed to speed up the labour. You may also need to have your waters broken artificially.

What induced labour feels like

If you need to be induced it may affect where you can give birth. You may need to stay in hospital for longer and have more examinations.

Induced labour is usually more painful than labour that starts on its own.

Your pain relief options during labour are not restricted by being induced.

You should have access to all the pain relief options usually available, such as an epidural or water birth.

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. You may be offered another method of induction or a caesarean section, or you may be able to wait a few hours and then be assessed again.

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 hot baths, certain food or drinks, having sex or herbal supplements. But there's no evidence that these work. Also there's no information about the safety of herbal supplements and they could be harmful to you or your baby.

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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Find out about induction of labour, where the midwife or doctor starts labour artificially using a membrane sweep, pessary or hormone drip.

# data[].attributes.body
Before inducing labour, you'll be offered a membrane sweep, also known as a cervical sweep, to bring on labour. A membrane sweep would usually be offered to you after 39 weeks. To carry out a membrane sweep, your midwife or doctor sweeps their finger around your cervix during an internal examination.

# data[].attributes.attachment_link.readable_text
An induced labour is one that's started artificially.

It's common for labour to 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 41 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.

A membrane sweep would usually be offered to you after 39 weeks.

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.

Some women find the procedure uncomfortable or painful. You may get some cramping and vaginal bleeding afterwards.

If labour does not start after a membrane sweep you may be offered an additional sweep or 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.

There are 2 main ways labour can be induced:

Hormones can be put inside your vagina using a vaginal tablet (pessary) or a gel, or given as tablets that you swallow.

Devices such as balloon catheter (a small balloon, full of water) or an osmotic dilator (a type of sponge) can be used to widen your cervix.

You'll usually be offered hormones first to see if they work, unless there's a medical reason you cannot take hormones.

It usually takes many hours for these treatments to start working. You will usually stay in the hospital maternity unit, though you may be able to go home in some cases.

Sometimes a hormone drip is needed to speed up the labour. You may also need to have your waters broken artificially.

What induced labour feels like

If you need to be induced it may affect where you can give birth. You may need to stay in hospital for longer and have more examinations.

Induced labour is usually more painful than labour that starts on its own.

Your pain relief options during labour are not restricted by being induced.

You should have access to all the pain relief options usually available, such as an epidural or water birth.

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. You may be offered another method of induction or a caesarean section, or you may be able to wait a few hours and then be assessed again.

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 hot baths, certain food or drinks, having sex or herbal supplements. But there's no evidence that these work. Also there's no information about the safety of herbal supplements and they could be harmful to you or your baby.

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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Find out about induction of labour, where the midwife or doctor starts labour artificially using a membrane sweep, pessary or hormone drip.

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How to tell if you're in labour and what happens during labour and birth. 

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How to tell if you're in labour and what happens during labour and birth. 

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Latent stage of labour

The latent stage of labour is where your cervix starts to soften and open (dilate) so your baby can be born.

You may begin to feel irregular contractions, but it can take many hours, or even days, before you're in established labour. It's usually the longest stage of labour.

At this stage, your contractions may range from being slightly uncomfortable to more painful. There's no set pattern to how many contractions you get or how long they last.

During the latent stage, it's a good idea to have something to eat and drink because you'll need energy for when labour is established.

If your labour starts at night, try to stay comfortable and relaxed. Sleep if you can.

If your labour starts during the day, stay upright and gently active. This helps your baby move down into your pelvis and helps your cervix to dilate.

Breathing exercises, massage and having a warm bath or shower may help ease pain during this early stage of labour.

Established labour (1st stage of labour)

Established labour is where your cervix has dilated to about 4cm and your contractions are stronger and more regular.

When to contact a midwife

Call your midwife or maternity unit if:

your contractions are regular (every 5 minutes or more often)

your waters break

your contractions are very strong and you feel you need pain relief

you're worried about anything

If you go into hospital before your labour has become established, they may suggest you go home again for a while.

Once labour is established, your midwife will check on you from time to time to see how you're progressing and offer you support, including pain relief if you need it.

You can either walk around or get into a position that feels comfortable to labour in.

Your midwife will offer you regular vaginal examinations to see how your labour is progressing. If you do not want to have these, you do not have to - your midwife can discuss with you why she's offering them.

Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated.

In a 1st pregnancy, the time from the start of established labour to being fully dilated is usually 8 to 18 hours. It's often quicker (around 5 to 12 hours), in a 2nd or 3rd pregnancy.

When you reach the end of the 1st stage of labour, you may feel an urge to push.

Monitoring your baby in labour

Your midwife will monitor you and your baby during labour to make sure you're both coping well.

This will include using a small handheld device to listen to your baby's heart every 15 minutes. You'll be free to move around as much as you want.

Your midwife may suggest electronic monitoring if there are any concerns about you or your baby, or if you choose to have an epidural.

Electronic monitoring involves strapping 2 pads to your bump. One pad is used to monitor your contractions and the other is used to monitor your baby's heartbeat. These pads are attached to a monitor that shows your baby's heartbeat and your contractions

Sometimes a heart monitor called a foetal scalp electrode can be attached to the baby's head instead. This can give a more accurate measurement of your baby's heartbeat.

You can ask to be monitored electronically even if there are no concerns. Having electronic monitoring can sometimes restrict how much you can move around. Your midwife can discuss this with you.

If you have electronic monitoring with pads on your bump because there are concerns about your baby's heartbeat, you can take the monitor off if your baby's heartbeat is shown to be normal.

A foetal scalp electrode will usually only be removed just as your baby is born, not before.

Speeding up labour

Labour can sometimes be slower than expected. This can happen if your contractions are not coming often enough, are not strong enough, or if your baby is in an awkward position.

If this is the case, your doctor or midwife may talk to you about 2 ways to speed up your labour: breaking your waters or an oxytocin drip.

Breaking your waters

Breaking the membrane that contains the fluid around your baby (your waters) is often enough to make contractions stronger and more regular. This is also known as artificial rupture of the membranes (ARM).

Your midwife or doctor can do this by making a small break in the membrane during a vaginal examination. This may make your contractions feel stronger and more painful, so your midwife will talk to you about pain relief.

Oxytocin drip

If breaking your waters does not work, your doctor or midwife may suggest using a medicine called oxytocin (also known as syntocinon) to make your contractions stronger. This is given through a drip that goes into a vein, usually in your wrist or arm.

Oxytocin can make your contractions stronger and more regular and can start to work quite quickly, so your midwife will talk to you about your options for pain relief.

You will also need electronic monitoring to check your baby is coping with the contractions, as well as regular vaginal examinations to check the drip is working.

2nd stage of labour

The 2nd stage of labour lasts from when your cervix is fully dilated until the birth of your baby.

Finding a position to give birth in

Your midwife will help you find a comfortable position to give birth in. You may want to sit, lie on your side, stand, kneel, or squat, although squatting may be difficult if you're not used to it.

If you've had lots of backache while in labour, kneeling on all fours may help. It's a good idea to try some of these positions before you go into labour. Talk to your birth partner so they know how they can help you.

Find out what your birth partner can do.

Pushing your baby out

When your cervix is fully dilated, your baby will move further down the birth canal towards the entrance to your vagina. You may get an urge to push that feels a bit like you need to poo.

You can push during contractions whenever you feel the urge. You may not feel the urge to push immediately. If you have had an epidural, you may not feel an urge to push at all.

If you're having your 1st baby, this pushing stage should last no longer than 3 hours. If you've had a baby before, it should take no more than 2 hours.

This stage of labour is hard work, but your midwife will help and encourage you. Your birth partner can also support you.

What happens when your baby is born

When your baby's head is almost ready to come out, your midwife will ask you to stop pushing and take some short breaths, blowing them out through your mouth.

This is so your baby's head can be born slowly and gently, giving the skin and muscles in the area between your vagina and anus (the perineum) time to stretch.

Sometimes your midwife or doctor will suggest an episiotomy to avoid a tear or to speed up delivery. This is a small cut made in your perineum.

You'll be given a local anaesthetic injection to numb the area before the cut is made. Once your baby is born, an episiotomy, or any large tears, will be stitched closed.

Find out about your body after the birth, including how to deal with stitches.

Once your baby's head is born, most of the hard work is over. The rest of their body is usually born during the next 1 or 2 contractions.

You'll usually be able to hold your baby immediately and enjoy some skin-to-skin time together.

You can breastfeed your baby as soon as you like. Ideally, your baby will have their 1st feed within 1 hour of birth.

Read more about skin-to-skin contact and breastfeeding in the first few days.

3rd stage of labour

The 3rd stage of labour happens after your baby is born, when your womb contracts and the placenta comes out through your vagina.

There are 2 ways to manage this stage of labour:

active - when you have treatment to make it happen faster

physiological - when you have no treatment and this stage happens naturally

Your midwife will explain both ways to you while you're still pregnant or during early labour, so you can decide which you would prefer.

There are some situations where physiological management is not advisable. Your midwife or doctor can explain if this is the case for you.

What is active management?

Your midwife will give you an injection of oxytocin into your thigh as you give birth, or soon after. This makes your womb contract.

Evidence suggests it's better not to cut the umbilical cord immediately, so your midwife will wait to do this between 1 and 5 minutes after birth. This may be done sooner if there are concerns about you or your baby - for example, if the cord is wound tightly around your baby's neck.

Once the placenta has come away from your womb, your midwife pulls the cord - which is attached to the placenta - and pulls the placenta out through your vagina. This usually happens within 30 minutes of your baby being born.

Active management speeds up the delivery of the placenta and lowers your risk of having heavy bleeding after the birth (postpartum haemorrhage), but it increases the chance of you feeling and being sick. It can also make afterpains (contraction-like pains after birth) worse.

Read more about preventing heavy bleeding after birth.

What is physiological management?

No oxytocin injection is given, and the 3rd stage of labour happens naturally.

The cord is not cut until it has stopped pulsing. This means blood is still passing from the placenta to your baby. This usually takes around 2 to 4 minutes.

Once the placenta has come away from your womb, you should feel some pressure in your bottom and you'll need to push the placenta out. It can take up to an hour for the placenta to come away, but it usually only takes a few minutes to push it out.

If the placenta does not come away naturally or you begin to bleed heavily, you'll be advised by your midwife or doctor to switch to active management. You can do this at any time during the 3rd stage of labour.

Read more about what happens straight after you give birth.

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Find out what happens during labour and birth, including the 3 stages of labour, contractions, dilation, birth positions and monitoring your baby.

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Thinking about how, what happens and where to give birth? We're here to help you feel more confident. We've got information and tips on everything you need to know.

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Labour can be painful. It can help to learn about all the ways you can relieve the pain. It's also helpful for whoever is going to be with you during your labour to know about the different options, as well as how they can support you.

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Your pain relief options

Labour can be painful - it can help to learn about all the ways you can relieve the pain.

It's also helpful for whoever is going to be with you during your labour to know about the different options, as well as how they can support you.

Ask your midwife or doctor to explain what's available so you can decide what's best for you.

Write down your wishes in your birth plan, but remember you need to keep an open mind. You may find you want more pain relief than you'd planned, or your doctor or midwife may suggest more effective pain relief to help the delivery.

Self-help in labour

You're likely to feel more relaxed in labour and better placed to cope with the pain if you:

learn about labour - this can make you feel more in control and less frightened about what's going to happen; talk to your midwife or doctor, ask them questions, and go to antenatal classes

learn how to relax, stay calm and breathe deeply

keep moving - your position can make a difference, so try kneeling, walking around, or rocking backwards and forwards

bring a partner, friend or relative to support you during labour, but do not worry if you do not have a partner - your midwife will give you all the support you need

ask your partner to massage you - although you may find you do not want to be touched

have a bath

take paracetamol, which can help relieve some of the pain in the early stages of labour

Gas and air (Entonox) for labour

This is a mixture of oxygen and nitrous oxide gas. Gas and air will not remove all the pain, but it can help reduce it and make it more bearable. It's easy to use and you control it yourself.

You breathe in the gas and air through a mask or mouthpiece, which you hold yourself. The gas takes about 15 to 20 seconds to work, so you breathe it in just as a contraction begins. It works best if you take slow, deep breaths.

Side effects

there are no harmful side effects for you or the baby

it can make you feel lightheaded, sick, sleepy or unable to concentrate, but if this happens you can stop using it

If gas and air does not give you enough pain relief, you can ask for a painkilling injection as well.

Pethidine injections in labour

This is an injection of a medicine called pethidine into your thigh or buttock to relieve pain. It can also help you to relax. Sometimes, less commonly, a medicine called diamorphine is used.

It takes about 20 minutes to work after the injection. The effects last between 2 and 4 hours, so would not be recommended if you're getting close to the pushing (second) stage of labour.

Side effects

There are some side effects of pethidine and diamorphine to be aware of:

it can make you feel woozy, sick and forgetful

if pethidine or diamorphine are given too close to the time of delivery, they may affect the baby's breathing - if this happens, another medicine to reverse the effect will be given

these medicines can interfere with the baby's first feed

Epidural

An epidural is a type of local anaesthetic. It numbs the nerves that carry the pain impulses from the birth canal to the brain. It should not make you sick or drowsy.

In most cases, an epidural gives complete pain relief. It can be helpful if you are having a long or particularly painful labour.

An anaesthetist is the only person who can give an epidural, so it will not be available at home. If you think you might want one, check whether anaesthetists are always available at your hospital.

How much you can move your legs after an epidural depends on the local anaesthetic used. Some hospitals offer "mobile" epidurals, which means you can walk around.

However, this also requires the baby's heart rate to be monitored remotely (by telemetry) and many hospitals do not have the equipment to do this. Ask your midwife if mobile epidural is available in your local hospital.

An epidural can provide very good pain relief, but it's not always completely effective in labour.

How does an epidural work?

To have an epidural:

a drip will run fluid through a needle into a vein in your arm

while you lie on your side or sit up in a curled position, an anaesthetist will clean your back with antiseptic, numb a small area with some local anaesthetic, and then introduce a needle into your back

a very thin tube will be passed through the needle into your back near the nerves that carry pain impulses from the womb (uterus). Medicines (usually a mixture of local anaesthetic and opioid) are administered through this tube. It takes about 10 minutes to set up the epidural, and another 10 to15 minutes for it to work. It does not always work perfectly at first and may need adjusting

the epidural can be topped up by your midwife, or you may be able to top it up yourself through a machine

your contractions and the baby's heart rate will need to be continuously monitored. This means having a belt around your abdomen and possibly a clip attached to the baby's head

Side effects of epidurals in labour

There are some side effects of epidurals to be aware of.

An epidural may make your legs feel heavy, depending on the local anaesthetic used.

Your blood pressure can drop (hypotension), but this is rare because the fluid given through the drip in your arm helps to maintain good blood pressure.

Epidurals can prolong the second stage of labour. If you can no longer feel your contractions, the midwife will have to tell you when to push. This means that forceps or a ventouse may be needed to help deliver the baby (instrumental delivery).

When you have an epidural, your midwife or doctor will wait longer for the baby's head to come down (before you start pushing), as long as the baby is showing no signs of distress. This reduces the chance you'll need an instrumental delivery. Sometimes less anaesthetic is given towards the end, so the effect wears off and you can feel to push the baby out naturally.

You may find it difficult to pee as a result of the epidural. If so, a small tube called a catheter may be put into your bladder to help you.

You may get a headache after an epidural. This happens in about 1 in 100 cases and can be treated.

Your back might be a bit sore for a day or two, but epidurals do not cause long-term backache.

You may feel tingles or pins and needles down one leg after having a baby. This happens in about 1 in 2,000 cases. This is more likely to be the result of childbirth itself rather than the epidural. You'll be advised by the doctor or midwife when you can get out of bed.

Remifentanil

Remifentanil goes into a vein in your arm. You control it yourself by pushing a button.

It works quickly and wears off after a few minutes. You can use it up until your baby is born.

You'll need a small clip on your finger to measure your oxygen levels, as remifentanil can make you feel breathless or need oxygen.

Side effects

Remifentanil can make you feel sleepy, sick, dizzy or itchy. These stop once you stop taking the medicine.

Like pethidine, remifentanil can affect the baby's breathing but this usually wears off quickly.

Using water in labour (water birth)

Being in water can help you relax and make the contractions seem less painful. Ask if you can have a bath or use a birth pool. The water will be kept at a comfortable temperature, but not above 37.5C, and your temperature will be monitored.
Find out more about using water during labour and birth on the National Childbirth Trust website

TENS machines

TENS stands for transcutaneous electrical nerve stimulation. Some hospitals have TENS machines. If not, you can hire your own machine.

TENS has not been shown to be effective during the active phase of labour, when contractions get longer, stronger and more frequent. It's probably most effective during the early stages, when you may have lower back pain.

TENS may also be useful while you're at home in the early stages of labour or if you plan to give birth at home. If you're interested in TENS, learn how to use it in the later months of your pregnancy. Ask your midwife to show you how it works.

How TENS machines work

Electrodes are taped on to your back and connected by wires to a small battery-powered stimulator. Holding this, you give yourself small, safe amounts of current through the electrodes. You can move around while you use TENS.

TENS is believed to work by stimulating the body to produce more of its own natural painkillers, called endorphins. It also reduces the number of pain signals sent to the brain by the spinal cord.

Side effects of TENS machines

There are no known side effects of TENS for either you or the baby.
Read more about TENS

Alternative methods of labour pain relief

You may choose alternative treatments such as acupuncture, aromatherapy, homeopathy, hypnosis, massage and reflexology. Most of these techniques are not proven to provide effective pain relief.

If you'd like to use any of these methods, it's important to discuss them with your midwife or doctor and let the hospital know beforehand. Most hospitals do not offer them for pain relief during labour.

If you want to try any of these techniques, make sure the practitioner is properly trained and experienced.
Learn more about complementary and alternative medicines and how they're regulated Find maternity services near you

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Find out about the different methods of pain relief in labour, including self-help, gas and air, birth pools, pethidine and epidurals.

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

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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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Useful guides to everything from contractions, when to call the midwife and the different stages of labour.

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Latent stage of labour

The latent stage of labour is where your cervix starts to soften and open (dilate) so your baby can be born.

You may begin to feel irregular contractions, but it can take many hours, or even days, before you're in established labour. It's usually the longest stage of labour.

At this stage, your contractions may range from being slightly uncomfortable to more painful. There's no set pattern to how many contractions you get or how long they last.

During the latent stage, it's a good idea to have something to eat and drink because you'll need energy for when labour is established.

If your labour starts at night, try to stay comfortable and relaxed. Sleep if you can.

If your labour starts during the day, stay upright and gently active. This helps your baby move down into your pelvis and helps your cervix to dilate.

Breathing exercises, massage and having a warm bath or shower may help ease pain during this early stage of labour.

Established labour (1st stage of labour)

Established labour is where your cervix has dilated to about 4cm and your contractions are stronger and more regular.

When to contact a midwife

Call your midwife or maternity unit if:

your contractions are regular (every 5 minutes or more often)

your waters break

your contractions are very strong and you feel you need pain relief

you're worried about anything

If you go into hospital before your labour has become established, they may suggest you go home again for a while.

Once labour is established, your midwife will check on you from time to time to see how you're progressing and offer you support, including pain relief if you need it.

You can either walk around or get into a position that feels comfortable to labour in.

Your midwife will offer you regular vaginal examinations to see how your labour is progressing. If you do not want to have these, you do not have to - your midwife can discuss with you why she's offering them.

Your cervix needs to open about 10cm for your baby to pass through it. This is what's called being fully dilated.

In a 1st pregnancy, the time from the start of established labour to being fully dilated is usually 8 to 18 hours. It's often quicker (around 5 to 12 hours), in a 2nd or 3rd pregnancy.

When you reach the end of the 1st stage of labour, you may feel an urge to push.

Monitoring your baby in labour

Your midwife will monitor you and your baby during labour to make sure you're both coping well.

This will include using a small handheld device to listen to your baby's heart every 15 minutes. You'll be free to move around as much as you want.

Your midwife may suggest electronic monitoring if there are any concerns about you or your baby, or if you choose to have an epidural.

Electronic monitoring involves strapping 2 pads to your bump. One pad is used to monitor your contractions and the other is used to monitor your baby's heartbeat. These pads are attached to a monitor that shows your baby's heartbeat and your contractions

Sometimes a heart monitor called a foetal scalp electrode can be attached to the baby's head instead. This can give a more accurate measurement of your baby's heartbeat.

You can ask to be monitored electronically even if there are no concerns. Having electronic monitoring can sometimes restrict how much you can move around. Your midwife can discuss this with you.

If you have electronic monitoring with pads on your bump because there are concerns about your baby's heartbeat, you can take the monitor off if your baby's heartbeat is shown to be normal.

A foetal scalp electrode will usually only be removed just as your baby is born, not before.

Speeding up labour

Labour can sometimes be slower than expected. This can happen if your contractions are not coming often enough, are not strong enough, or if your baby is in an awkward position.

If this is the case, your doctor or midwife may talk to you about 2 ways to speed up your labour: breaking your waters or an oxytocin drip.

Breaking your waters

Breaking the membrane that contains the fluid around your baby (your waters) is often enough to make contractions stronger and more regular. This is also known as artificial rupture of the membranes (ARM).

Your midwife or doctor can do this by making a small break in the membrane during a vaginal examination. This may make your contractions feel stronger and more painful, so your midwife will talk to you about pain relief.

Oxytocin drip

If breaking your waters does not work, your doctor or midwife may suggest using a medicine called oxytocin (also known as syntocinon) to make your contractions stronger. This is given through a drip that goes into a vein, usually in your wrist or arm.

Oxytocin can make your contractions stronger and more regular and can start to work quite quickly, so your midwife will talk to you about your options for pain relief.

You will also need electronic monitoring to check your baby is coping with the contractions, as well as regular vaginal examinations to check the drip is working.

2nd stage of labour

The 2nd stage of labour lasts from when your cervix is fully dilated until the birth of your baby.

Finding a position to give birth in

Your midwife will help you find a comfortable position to give birth in. You may want to sit, lie on your side, stand, kneel, or squat, although squatting may be difficult if you're not used to it.

If you've had lots of backache while in labour, kneeling on all fours may help. It's a good idea to try some of these positions before you go into labour. Talk to your birth partner so they know how they can help you.

Find out what your birth partner can do.

Pushing your baby out

When your cervix is fully dilated, your baby will move further down the birth canal towards the entrance to your vagina. You may get an urge to push that feels a bit like you need to poo.

You can push during contractions whenever you feel the urge. You may not feel the urge to push immediately. If you have had an epidural, you may not feel an urge to push at all.

If you're having your 1st baby, this pushing stage should last no longer than 3 hours. If you've had a baby before, it should take no more than 2 hours.

This stage of labour is hard work, but your midwife will help and encourage you. Your birth partner can also support you.

What happens when your baby is born

When your baby's head is almost ready to come out, your midwife will ask you to stop pushing and take some short breaths, blowing them out through your mouth.

This is so your baby's head can be born slowly and gently, giving the skin and muscles in the area between your vagina and anus (the perineum) time to stretch.

Sometimes your midwife or doctor will suggest an episiotomy to avoid a tear or to speed up delivery. This is a small cut made in your perineum.

You'll be given a local anaesthetic injection to numb the area before the cut is made. Once your baby is born, an episiotomy, or any large tears, will be stitched closed.

Find out about your body after the birth, including how to deal with stitches.

Once your baby's head is born, most of the hard work is over. The rest of their body is usually born during the next 1 or 2 contractions.

You'll usually be able to hold your baby immediately and enjoy some skin-to-skin time together.

You can breastfeed your baby as soon as you like. Ideally, your baby will have their 1st feed within 1 hour of birth.

Read more about skin-to-skin contact and breastfeeding in the first few days.

3rd stage of labour

The 3rd stage of labour happens after your baby is born, when your womb contracts and the placenta comes out through your vagina.

There are 2 ways to manage this stage of labour:

active - when you have treatment to make it happen faster

physiological - when you have no treatment and this stage happens naturally

Your midwife will explain both ways to you while you're still pregnant or during early labour, so you can decide which you would prefer.

There are some situations where physiological management is not advisable. Your midwife or doctor can explain if this is the case for you.

What is active management?

Your midwife will give you an injection of oxytocin into your thigh as you give birth, or soon after. This makes your womb contract.

Evidence suggests it's better not to cut the umbilical cord immediately, so your midwife will wait to do this between 1 and 5 minutes after birth. This may be done sooner if there are concerns about you or your baby - for example, if the cord is wound tightly around your baby's neck.

Once the placenta has come away from your womb, your midwife pulls the cord - which is attached to the placenta - and pulls the placenta out through your vagina. This usually happens within 30 minutes of your baby being born.

Active management speeds up the delivery of the placenta and lowers your risk of having heavy bleeding after the birth (postpartum haemorrhage), but it increases the chance of you feeling and being sick. It can also make afterpains (contraction-like pains after birth) worse.

Read more about preventing heavy bleeding after birth.

What is physiological management?

No oxytocin injection is given, and the 3rd stage of labour happens naturally.

The cord is not cut until it has stopped pulsing. This means blood is still passing from the placenta to your baby. This usually takes around 2 to 4 minutes.

Once the placenta has come away from your womb, you should feel some pressure in your bottom and you'll need to push the placenta out. It can take up to an hour for the placenta to come away, but it usually only takes a few minutes to push it out.

If the placenta does not come away naturally or you begin to bleed heavily, you'll be advised by your midwife or doctor to switch to active management. You can do this at any time during the 3rd stage of labour.

Read more about what happens straight after you give birth.

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Find out what happens during labour and birth, including the 3 stages of labour, contractions, dilation, birth positions and monitoring your baby.

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Assisted Delivery (forceps or a ventouse suction cup) 

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Assisted Delivery (forceps or a ventouse suction cup) 

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An assisted birth (also known as an instrumental delivery) is when forceps or a ventouse suction cup are used to help deliver the baby. Ventouse and forceps are safe and only used when necessary for you and your baby. Assisted delivery is less common in women who've had a spontaneous vaginal birth before.

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Find out about assisted birth or assisted delivery, which uses forceps or vacuum (ventouse) to help deliver the baby.

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Knowing what to expect and understanding why your doctor or midwife might recommend an assisted birth can help you feel more confident about the process. It's especially good to know about this just in case you have a long, challenging labour, or if concerns about the baby crop up. Read on to find out more.

What is an assisted birth?

An assisted or instrumental birth is when ventouse or forceps are used in the later stages of labour to help a baby to be born.

"About one in eight babies in the UK are born with the help of these instruments." (RCOG, 2012, 2016; NHS, 2017)

You're more likely to need an assisted birth if you're giving birth vaginally for the first time.

What are ventouse and forceps?

A ventouse is a cup-shaped suction device that can be attached to your baby's head to help them to be born. You might have heard it called a vacuum delivery (NHS, 2017).

Forceps are smooth, curved metal instruments that look like large tongs. They're placed around the baby's head to help pull the baby out.

Why might I need help with the birth of my baby?

Sometimes, when the second stage of labour is very long, an assisted birth is suggested because:

the baby needs a little help to move out of the birth canal, particularly if they are lying in the back-to-back position

there are concerns about you or your baby

you are exhausted

you are unable to push, perhaps after an epidural, or because you have a condition that prevents you from doing so.

(RCOG, 2012; NICE, 2014; NHS, 2017)

What are my other options?

If your doctor thinks an assisted birth is possible but could be difficult, you would be moved to an operating theatre in case you need a caesarean section (NICE, 2014). Usually, you'd be offered an assisted birth first because if it works this can help your baby out quicker than a caesarean. This is important if the baby is in trouble.

As with any medical intervention being offered, you can say 'no' to an assisted birth. Your doctor or midwife should first discuss why you need an assisted birth and their choice of instrument and gain your consent (RCOG, 2012). A caesarean birth involves major surgery, which carries risks and takes longer.

If the ventouse or forceps do not help your baby out, you will need a caesarean.

What happens during a forceps or ventouse assisted birth?

The midwife or obstetrician will examine you. If there are concerns about you or your baby's health, you might need an emergency caesarean and be moved to an operating theatre. This way, if the forceps or ventouse is unsuccessful, a caesarean birth can happen soon after. For example, if the baby's head needs to be turned, forceps or ventouse might not help so easily.

If you haven't already had an epidural, you will be offered one, or a single spinal injection or local anaesthetic to numb the area around the vagina (RCOG, 2012). You'll lay on your back and have your feet in stirrups. Your bladder will be emptied using a catheter.

You might have a cut (episiotomy) made at this point to make your vaginal opening bigger (RCOG, 2012; NICE, 2014). This isn't routine but might be necessary (NHS, 2017). You're less likely to experience vaginal tearing with ventouse than with forceps (RCOG, 2012).

In a ventouse delivery, the obstetrician or specially-trained midwife will attach a suction cup to your baby's head. They'll then gently pull when you have a contraction, to help your baby out. They might need to pull more than once (RCOG, 2012).

A ventouse is not suitable if you are less than 34 weeks pregnant. This is because the baby's head is softer thus increasing the risk of your baby getting bruised, or having a brain haemorrhage or jaundice (RCOG, 2012).

If you have a forceps delivery, the doctor or midwife would gently place them around your baby's head. Then on the next contraction you will be asked to push as your baby is carefully pulled. You'd normally need an episiotomy first (RCOG, 2012).

Ventouse or forceps delivery?

Ventouse and forceps are both safe and effective. If you do need assistance, your doctor would choose the most suitable instrument for you, your baby and your situation. Forceps are more successful in assisting the birth than ventouse. Yet ventouse is less likely to cause vaginal tearing (NHS, 2017).

Can I avoid an assisted birth?

An assisted birth can't always be avoided but you can reduce the risk. Here's how:

If your pregnancy has been straightforward, try planning to give birth in a birth centre or at home. That means you are less likely to need forceps, ventouse or any other interventions.

Continuous support from a birth partner other than your midwife can make a positive difference.

Remain upright or on your sides and mobile to give you and your baby the best chance of a spontaneous birth.

Avoid an epidural if possible, or if you do have an epidural, wait for a while after your cervix is fully dilated before beginning to push.

(Hodnett et al, 2010; Hollowell et al, 2011; RCOG, 2012; Hodnett et al, 2013; NCCWCH, 2014)

What can birth partners do?

It might be helpful to think about the support you can give your partner if she need forceps or ventouse assistance. This could mean offering reassurance if this is a change to your birth plan, or simply holding her hand during the birth (RCM, 2012).

Some partners have said they found it difficult watching forceps or ventouse being used. So consider where you might want to stand during the birth.

It's also a good idea to discuss birth scenarios in advance so you're clear on whether your partner would prefer you to stay with her or go with the baby if needed. For example, you could provide skin-to-skin care for the baby if your partner isn't able to.

What are the effects of a forceps or ventouse delivery on babies?

Some parents-to-be worry their baby may be harmed during an assisted birth. But any effects are likely to be short term, resolving within 24 to 48 hours (RCOG, 2012).

Forceps can cause bruising, marks or cuts on a baby's head, while a ventouse may temporarily affect the shape of a baby's head (RCOG, 2012). The suction cup used for ventouse delivery might also mark a baby's head or cause a bruise that disappears in time (NHS, 2017). Small cuts on a baby's face and head may occur but generally fade quickly (RCOG, 2012).

If you are worried about any after-effects, talk to your health visitor or GP.

How will I be affected?

It's normal to feel bruised and sore after birth, particularly if you had an assisted birth.

Help and support is available, so do seek medical advice if you experience any difficulties or complications. Your midwife or GP can talk through your options with you.

As you're more likely to have an episiotomy during an assisted birth, stitches and swelling or tearing may make going to the toilet painful (RCOG, 2015). You'll probably need to up your intake of fibre (RCOG, 2015). You could also take a stool softener to make it easier to open your bowels. See our article about episiotomy care and recovery for more details.

Four in 100 women who have a ventouse birth will have a third or fourth degree tear (into the tissue surrounding the anus). That compares with eight to 12 women in 100 who have a forceps birth will have a third or fourth degree tear (RCOG, 2012).

Third or fourth degree tears would need to be repaired in an operating theatre and it is normal to feel pain for two or three weeks afterwards (RCOG, 2015). You'll be offered pain-relief and a course of antibiotics after the operation, and will need to keep the area clean (RCOG, 2015). See our article about perineal tears for more details.

Most women will recover from an assisted birth within a few weeks. But some might experience complications, such as severe vaginal tearing, blood clots and urinary or anal incontinence (RCOG, 2012). If you have any medical concerns talk to your midwife, health visitor or GP.

How will I feel?

Sometimes, an assisted birth can leave new parents feeling as if the situation was taken out of their hands. Difficult birth experiences like an assisted birth can affect women's psychological health with around one third of women in the western world evaluating their childbirth experience as traumatic (Ayers et al, 2006).

If this is how you feel, it can help to chat to the doctor or midwife before you leave hospital. You could ask about what happened and why it was necessary (RCOG, 2012).

Some women and their partners might also want to talk about the emotional impact after they have gone home (RCOG, 2012). If you did an NCT antenatal course, you could get in touch with your antenatal teacher to talk this through.

Most hospitals have a 'birth reflections' service. This service gives you the chance to discuss the events with a midwife and resolve unanswered questions (Ayers et al, 2006).

Will I need an assisted birth if I have another baby?

It's unlikely you will need an assisted birth with subsequent babies. Most women (80%) who have an assisted vaginal birth give birth spontaneously next time around (RCOG, 2012).

This page was last reviewed in September 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.

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Assisted birth: ventouse or forceps delivery | Labour & birth, Different types of birth articles & support | NCT

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Some births need a little help. Here we explain what an assisted birth is, why ventouse or forceps might be needed, what happens and how you might feel.

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A caesarean section, or C-section, is an operation to deliver your baby through a cut made in your tummy and womb. The cut is usually made across your tummy, just below your bikini line. A caesarean is a major operation that carries a number of risks, so it's usually only done if it's the safest option for you and your baby. Around 1 in 4 pregnant women in the UK has a caesarean birth.

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What is a caesarean birth? | Labour & birth, Different types of birth articles & support | NCT

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Caesarean birth is when a baby is born by abdominal surgery. Some are planned, while others are unplanned or emergency caesareans.

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A caesarean section, or C-section, is an operation to deliver your baby through a cut made in your tummy and womb.
The cut is usually made across your tummy, just below your bikini line.

A caesarean is a major operation that carries a number of risks, so it's usually only done if it's the safest option for you and your baby.

Around 1 in 4 pregnant women in the UK has a caesarean birth.

Why caesareans are carried out

A caesarean may be recommended as a planned (elective) procedure or done in an emergency if it's thought a vaginal birth is too risky.

Planned caesareans are usually done from the 39th week of pregnancy.

A caesarean may be carried out because:

your baby is in the breech position (feet first) and your doctor or midwife has been unable to turn them by applying gentle pressure to your tummy, or you'd prefer they did not try this

you have a low-lying placenta (placenta praevia)

you have pregnancy-related high blood pressure (pre-eclampsia)

you have certain infections, such as a first genital herpes infection occurring late in pregnancy or untreated HIV

your baby is not getting enough oxygen and nutrients - sometimes this may mean the baby needs to be delivered immediately

your labour is not progressing or there's excessive vaginal bleeding

If there's time to plan the procedure, your midwife or doctor will discuss the benefits and risks of a caesarean compared with a vaginal birth.

Asking for a caesarean

Some women choose to have a caesarean for non-medical reasons.

If you ask your midwife or doctor for a caesarean when there are not medical reasons, they'll explain the overall benefits and risks of a caesarean to you and your baby compared with a vaginal birth.

If you're anxious about giving birth, you should be offered the chance to discuss your anxiety with a healthcare professional who can offer support during your pregnancy and labour.

If after discussing all the risks and hearing about all the support on offer you still feel that a vaginal birth is not an acceptable option, you should be offered a planned caesarean. If your doctor is unwilling to perform the operation, they should refer you to a doctor who will.

What happens during a caesarean

Most caesareans are carried out under spinal or epidural anaesthetic.

This mean you'll be awake, but the lower part of your body is numbed so you will not feel any pain.

During the procedure:

a screen is placed across your body so you cannot see what's being done - the doctors and nurses will let you know what's happening

a cut about 10 to 20cm long will usually be made across your lower tummy and womb so your baby can be delivered

you may feel some tugging and pulling during the procedure

you and your birth partner will be able to see and hold your baby as soon as they have been delivered if they're well - a baby born by emergency caesarean because of foetal distress may be taken straight to a paediatrician for resuscitation

The whole operation normally takes about 40 to 50 minutes.

Occasionally, a general anaesthetic (where you're asleep) may be used, particularly if the baby needs to be delivered more quickly.
Find out more about how a caesarean is carried out

Recovering from a caesarean

Recovering from a caesarean usually takes longer than recovering from a vaginal delivery.

Providing there are no complications, most women can go home 1 to 2 days after having a caesarean.

You may experience some discomfort in your tummy for the first few days. You'll be offered painkillers to help with this.

When you go home, you'll need to take things easy at first. You may need to avoid some activities, such as driving, until you have had your postnatal check-up with the doctor at 6 weeks.

The wound in your tummy will eventually form a scar. This may be obvious at first, but it should fade with time and will often be hidden in your pubic hair.
Find out more about recovering from a caesarean

Risks of a caesarean

A caesarean is generally a very safe procedure, but like any type of surgery it carries a certain amount of risk.

It's important to be aware of the possible complications, particularly if you're considering having a caesarean for non-medical reasons.

Possible complications include:

infection of the wound or womb lining

blood clots

excessive bleeding

damage to nearby areas, such as the bladder or the tubes that connect the kidneys and bladder

temporary breathing difficulties in your baby

accidentally cutting your baby when your womb is opened

Find out more about the risks of a caesarean

Future pregnancies after a caesarean

If you have a baby by caesarean, it does not necessarily mean that any babies you have in the future will also have to be delivered this way.

Most women who have had a caesarean section can safely have a vaginal delivery for their next baby, known as vaginal birth after caesarean (VBAC).

But you may need some extra monitoring during labour just to make sure everything is progressing well.

Some women may be advised to have another caesarean if they have another baby.

This depends on whether a caesarean is still the safest option for them and their baby.

For more information, read the Royal College of Obstetricians and Gynaecologists leaflet on birth options after previous caesarean section.

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Find out why caesarean sections are carried out, whether you can ask for one, what they involve, and what the risks are.

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Maternity Trauma and Loss Care Service (North West London)

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Maternity Trauma and Loss Care Service (North West London)

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The service aims to meet the needs of women, pregnant people and those who have experienced pregnancy or birth - affected by psychological distress as a result of severe fear of childbirth, birth trauma or baby loss.

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Maternity Trauma and Loss Care Service (North West London) :: Central and North West London NHS Foundation Trust

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Sadly, some babies are lost during pregnancy, birth, or shortly afterwards. Tommy's have information and support for anyone who has experienced the loss of a baby, whether through miscarriage, stillbirth, neonatal death, or termination for medical reasons.

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We’re here to provide information and support for anyone who has experienced a miscarriage, stillbirth, neonatal death or termination for medical reasons.

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The Association provides support and information to anyone affected by miscarriage, ectopic pregnancy or molar pregnancy.

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The Miscarriage Association is here to provide support and information to anyone affected by miscarriage, ectopic pregnancy or molar pregnancy.

If this is happening now, happened recently or happened long ago...

If you are worried about signs or symptoms - or the lack of them...

If you are 'in limbo', waiting for another scan or for test results...

If you are concerned for someone else ...

... in all these cases, we aim to be of help.

Miscarriage and pregnancy loss support services

This section provides details of our pregnancy loss helpline, live chat service and telephone support volunteers; our email support service; our online support options; our support groups and our leaflets.

We have a separate page that provides information about counselling after a miscarriage, as that's not something we offer ourselves.

Do let us know if there's anything else you need from us to help you through.

Once I was able to talk to people who really understood, I managed to come to terms with my feelings and work through my grief.

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Miscarriage and pregnancy loss support - The Miscarriage Association

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The Miscarriage Association is here to provide support and information to anyone affected by miscarriage, ectopic pregnancy or molar pregnancy. If this is happening now, happened recently or happened long ago... If you are worried about signs or symptoms - or the lack of them...

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Skin-to-skin contact really helps with bonding and attachment with your baby. It's a good idea to have your baby lifted onto you as soon as they're born and before the cord is cut so you can be close to each other straight away. Continue to do skin to skin with your baby when you get home.

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It's natural to focus on your baby's birth while you're pregnant. But it's a good idea to also know what to expect after labour.
Skin-to-skin contact really helps with bonding. It's a good idea to have your baby lifted onto you as soon as they're born and before the cord is cut so you can be close to each other straight away.

Either before, or just after the cord is clamped, your baby will be dried and then covered with a towel to stop them getting cold. You can continue to hold and cuddle your baby while this is done.

Your baby may have some of your blood on their skin and perhaps vernix, the greasy white substance that protects your baby's skin in the womb.

If you prefer, you can ask the midwife to dry your baby and wrap them in a blanket before your cuddle.

Mucus may need to be cleared out of your baby's nose and mouth.

Some babies need a bit of help to get their breathing established.

Your baby may be taken to another part of the room to have some oxygen. They'll be brought back to you as soon as possible.

Your baby will be examined by a midwife, neonatal nurse or paediatrician, then weighed and possibly measured, and given a wrist or ankle band with your name on.

Your midwife or maternity support worker will help you wash and freshen up before you go to the postnatal ward.

Vitamin K for newborn babies

You'll be offered an injection of vitamin K for your baby. This helps prevent a rare bleeding disorder called haemorrhagic disease of the newborn.

Your midwife should have discussed the injection with you while you were pregnant.

If you'd prefer for your baby not to have an injection, they can have vitamin K by mouth instead, but they'll need further doses.

Stitches for tears or cuts

Small tears and grazes are often left without stitches because they can usually heal without treatment.

If you need stitches or other treatments, you should be able to carry on cuddling your baby while this is being done.

If you have had a large tear or an episiotomy, you'll need stitches.

If you have already had an epidural, it can be topped up. If you haven't, you should be offered a local anaesthetic to numb the area.

Preventing bleeding after the birth

Postpartum haemorrhage (PPH) is a complication where you bleed heavily from the vagina after your baby's birth.

There are 2 types of PPH, depending on when the bleeding takes place:

primary or immediate - bleeding that happens within 24 hours of birth

secondary or delayed - bleeding that happens after the first 24 hours and up to 12 weeks after the birth

Sometimes PPH happens because your womb doesn't contract strongly enough after the birth.

It can also happen because part of the placenta has been left in your womb or you get an infection in the lining of the womb (endometritis).

To help prevent PPH, you'll be offered an injection of oxytocin as your baby is being born. This stimulates contractions and helps to push the placenta out.

Now read about you and your body after the birth.

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What to expect after your baby is born, including information on skin-to-skin contact, bonding, stitches and vitamin K injections.

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Most babies are healthy and will not have any of the conditions the newborn screening tests are looking for. But for babies that do have a health problem, early detection and treatment can improve their health and prevent severe disability or even death.

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Your newborn baby will be offered some screening tests in their first 6 to 8 weeks.

Why newborn screening is offered

Most babies are healthy and will not have any of the conditions the newborn screening tests are looking for.

But for those babies who do have a health problem, the benefits of screening can be enormous.

Early treatment can improve their health and prevent severe disability or even death.

The screening tests are quick and simple, and will not harm your baby in any way.

It's recommended that your baby has the tests, but you can decline them if you wish.

Newborn physical examination

Every baby is offered a thorough physical examination soon after birth to check their eyes, heart, hips and, in boys, testicles.

This is to identify babies who may have conditions that need further testing or treatment.

The examination is carried out within 72 hours of birth and then again at 6 to 8 weeks of age, as some conditions can take a while to develop.
Find out more about the newborn physical examination

Newborn hearing screening

The newborn hearing test is done soon after your baby is born.

If you give birth in hospital, you may be offered the test before you and your baby are discharged.

Otherwise, it will be done by your health visitor or another healthcare professional within the first few weeks.
Find out more about the newborn hearing test

Newborn blood spot (heel prick) test

The newborn blood spot test involves taking a small sample of your baby's blood to check it for 9 rare but serious health conditions.

When your baby is about 5 days old, a healthcare professional will prick your baby's heel and collect a few drops of blood on a special card. This is sent off for testing.

The heel prick may be uncomfortable and your baby may cry, but it's all over very quickly.
Find out more about the newborn blood spot test

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Your newborn baby will be offered some screening tests in their first 6 to 8 weeks. Most babies are healthy and will not have any of the conditions the newborn screening tests are looking for. But for those babies who do have a health problem, the benefits of screening can be enormous.

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The team can offer you and your family support before your baby arrives, in the early weeks after birth and as your child grows. Staff work alongside you and your family with any parenting issues and guide you to find your local services and groups that can also support you as a parent.

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Clients are seen at Milmans Children's Health Hub, Children Centres and health centres, as well as their own home, where appropriate.

You can self refer. Please contact us if you are worried about:

Your child's health and development

Your own ability to cope due to stress or ill health

Other family problems affecting your children

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Harrow Health Visiting Service :: Central and North West London NHS Foundation Trust

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Clients are seen at Milmans Children's Health Hub, Children Centres and health centres, as well as their own home, where appropriate. You can self refer.

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Harrow Health Visiting Service - what they offer+

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Harrow Health Visiting Service - what they offer+

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Drop-in sessions to get your baby weighed by a Health Visitor. For the most up-to-date information on when these are running check the Early Support Hub/Children's Centres timetable.

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Children’s centres timetables – London Borough of Harrow

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We provide services for the residents of Harrow. Report an issue, submit an application, pay for something or see what’s going on in the London borough of Harrow.

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Before babies are able to understand language, we often communicate and comfort them through touch. If a baby cries, for example, parents will hold, cuddle or stroke them. Baby massage is part of this natural impulse. Baby massage is a lovely way for parent's to enjoy time with their baby , promote relaxation and your baby's overall well-being, while also helping you to bond with them. Blossom are running a Baby Massage course as part of the Early Support Hub programme. See the current timetable or visit the Maternity Champions website. A number of private providers will also offer Baby Massage sessions.

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Before babies are able to understand language, we often communicate and comfort them through touch. If a baby cries, for example, parents will hold, cuddle or stroke them. Baby massage is part of this natural impulse.

Find out about the benefits of baby massage for you and your baby in this video.

What is baby massage?

Baby massage is the gentle, rhythmic stroking of your baby's body using your hands. As part of a massage routine, you might gently manipulate your baby's ankles, wrists and fingers.

"You might also talk softly, hum or sing to them while massaging to create a sense of calm and reassurance for your baby".

What are the benefits of baby massage?

Baby massage was introduced about 30 years ago in neonatal wards to support the development of premature babies in intensive care units. A study in 2004 found that babies in intensive care units who were massaged spent less time in hospital, had slightly better scores on developmental tests and slightly fewer postnatal complications.

Today, there is widespread belief that baby massage can increase a mum's awareness of her baby's needs and support their early bond, as well as improve her sense of well-being if she is suffering with postnatal depression or other mental health issues. The evidence is inconclusive on these points but parents do say they find baby massage a lovely way of bonding with their baby.

Many talk about the following benefits:

Becoming more confident in handling their child and better at recognising their needs.

Improved positive interaction with their baby.

A great way for partners, family members and carers to bond with baby.

Improved sleep for their baby.

When can I start baby massage?

There are no set guidelines regarding the minimum age for when to start baby massage. Although nurturing touch can be given from birth, some babies may find formal, structured massage too stimulating in the very early weeks.

When it comes to baby massage classes, some babies may find a formal class overwhelming in the early weeks. It can also be hard for parents to make it to a class on time or consistently with a newborn. As a result, many parents prefer to wait until their baby is about six weeks old when their routine is more settled and their behaviour is sometimes more predictable.

"It can also be helpful to start baby massage after your baby's six week check so any issues with development, such as hip dysplasia, might be identified".

Getting ready to massage your baby

Here are some tips to help you try baby massage at home:

Choose a time when your baby is content and alert, not tired or hungry, and interested in what's going on around them. This makes it more likely that they'll be ready to interact with you.

Try sitting on the floor, bed or sofa, with your baby safely on a towel in front of you.

Find a position that's comfortable, gives you good eye contact with no overhead lights and where your baby is warm.

It's up to you whether your child is nappy-free, but it can help to at least loosen their nappy when massaging the tummy.

It can be a nice idea to introduce a massage after bath and before bed as part of a bedtime wind-down.

How to give your baby a massage

Before beginning 'ask permission' by rubbing a little oil between your hands near your baby's ears, and ask 'can I give you a massage?' This may sound a little strange but your child will become familiar with this cue and know that massage is about to start. It also gives your baby a chance to let you know if they don't feel like a massage.

It's great to massage the whole of your child's body using a range of techniques. To get you started, we describe some strokes below for the legs and feet.

Once you have 'asked permission', gently hold one of your baby's legs between your palms.

Then, with one hand, hold your baby's ankle securely. Mould your other hand around the top of your child's thigh, then slide it down the leg towards the ankle.

Swap hands and repeat. Always keep your child's ankle supported and use slow, flowing strokes.

Next, cradle your child's foot in your hands and use your thumbs to stroke over the sole of the foot from heel to toes, one thumb after another. Hold your fingers in a tripod grip and gently tug each toe between thumb and finger.

Holding your child's foot in your hands, walk the thumbs across the middle third of the foot from one side to the other like a little caterpillar crawling on a leaf.

You could also do circles on the palms of their hands singing 'Round and round the garden like a teddy bear'. Continue with finger and thumb tugs.

Finish by repeating the stroking action in the opposite direction, i.e. from ankle to thigh.

You can repeat each stroke a few times, always responding to what your child seems to enjoy.

What oils/products should I use for baby massage?

While using oil can make massage easier for parents and more relaxing for their baby, there is limited evidence on what oil is best to use for baby massage.

Most research into the use of oils on a baby's skin has not focussed on their use for baby massage but for skincare issues, such as dry skin or eczema. This is important to note because there may be a difference in the effect of using oils in baby massage once a week compared to every day for skincare reasons or for more frequent massage.

The NHS also recommends parents do not use any oils or lotions until their baby is one month old. This is because at birth, the top layer of a baby's skin is very thin and easily damaged. Over the first month (or longer in premature babies), a baby's skin matures and develops its own natural protective barrier.

Here is a list of oils and what is know about them:

Cold-pressed oil - while there is a lack of evidence on its benefits, some parents prefer to use a cold pressed oil, which is manufactured differently to cooking oils and has fewer impurities.

Mineral oils or petroleum-based ointments are an option if your baby has dry or broken skin, as they have been found to be effective and safe for treating skin problems, such as dermatitis and eczema.

Mustard oil can have a toxic effect on the skin barrier, causing irritation and potential damage to delicate baby skin.

Olive oil is not recommended for baby massage because of its high oleic acid content. This can make some layers of a baby's skin dryer.

Other oils, such as grapeseed oil or coconut oil - these have not been effectively tested in research trials so there isn't much information about their effectiveness or risks.

Peanut oil contains proteins that may sensitise a baby to an allergic reaction to peanuts or cause a reaction on a baby's skin.

Sunflower oil is often recommended for baby massage but recent research has suggested it might have adverse effects on a baby's later skin barrier function. This was only a small trial though and more research is needed to establish the exact risk.

Vegetable oils high in polyunsaturated fats may be gentler on your baby's skin.

Safety tips for baby massage

Here are some tips to help you massage your baby safely:

* Make sure you use oil that is safe for your baby's skin and if it was to get into their mouth (see list above).
* When massaging your child's arms or legs, always support the ankle or wrist with one hand.
* When massaging your child's tummy with a circular motion, go clockwise rather than anti-clockwise.
* If your child becomes upset or falls asleep, stop massaging.

Enjoy baby massage

If your baby doesn't seem to enjoy massage right away, don't worry. It's a new experience for you both and it can take a bit of getting used to. Try a few minutes the first time and build up as your child gets more used to it.

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.

Why not try one of our NCT Mother and Baby Yoga courses or baby massage classes?

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Before babies are able to understand language, we often communicate and comfort them through touch. If a baby cries, for example, parents will hold, cuddle or stroke them. Baby massage is part of this natural impulse. Find out about the benefits of baby massage for you and your baby in this video.

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Blossom are running a Baby Massage course at Hillview Children's Centre (HA2) as part of the Early Support Hub programme. See the current Early Support timetable or visit the https://www.blossomantenatal.com/harrow-baby-massage.

Baby massage sessions are also offered at the Blossom Hub, 74 High Street, Wealdstone, HA3 7AF. Visit https://blossomantenatal.com/baby-massage-hub-jan to book a place on the course.

A number of private providers will also offer Baby Massage sessions.

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Maternity Champions are committed to providing essential support and education for expectant mothers and their families in Harrow. Our mission is to promote…

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Introducing your baby to solid foods - Weaning

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Introducing your baby to solid foods - Weaning

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Introducing your baby to solid foods, sometimes called complementary feeding or weaning, should start when your baby is around 6 months old. At the beginning, how much your baby eats is less important than getting them used to the idea of eating. They'll still be getting most of their energy and nutrients from breast milk or first infant formula. Giving your baby a variety of foods, alongside breast or formula milk, from around 6 months of age will help set your child up for a lifetime of healthier eating.

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How to move on to solid foods and drinks, meal ideas and food safety.

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Information and tips on getting your baby used to night and day, where should your baby sleep, establishing a baby bedtime routine, how much sleep does your baby need from newborn to toddler, sleep patterns and coping with disturbed nights sleep.

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Some babies sleep much more than others. Some sleep for long periods, others in short bursts. Some soon sleep through the night, while some don't for a long time.
Your baby will have their own pattern of waking and sleeping, and it's unlikely to be the same as other babies you know.

It's also unlikely to fit in with your need for sleep. Try to sleep when your baby sleeps.

If you're breastfeeding, in the early weeks your baby is likely to doze off for short periods during a feed. Carry on feeding until you think your baby has finished or until they're fully asleep. This is a good opportunity to try to get a bit of rest yourself.

If you're not sleeping at the same time as your baby, don't worry about keeping the house silent while they sleep. It's good to get your baby used to sleeping through a certain amount of noise.

How can I get my baby used to night and day?

It's a good idea to teach your baby that night-time is different from daytime from the start. During the day, open curtains, play games and don't worry too much about everyday noises when they sleep.

At night, you might find it helpful to:

keep the lights down low

not talk much and keep your voice quiet

put your baby down as soon as they've been fed and changed

not change your baby unless they need it

not play with your baby

Your baby will gradually learn that night-time is for sleeping.

Where should my baby sleep?

For the first 6 months your baby should be in the same room as you when they're asleep, both day and night. This can reduce the risk of SIDS (sudden infant death syndrome).

Particularly in the early weeks, you may find your baby only falls asleep in your or your partner's arms, or when you're standing by the cot.

You can start getting your baby used to going to sleep without you comforting them by putting them down before they fall asleep or when they've just finished a feed. It may be easier to do this once your baby starts to stay alert more frequently or for longer.

If you use a baby sling to carry your baby, make sure you use it safely. The Lullaby Trust has information about swaddling your baby and using slings safely.

Establishing a baby bedtime routine

You may feel ready to introduce a bedtime routine when your baby is around 3 months old. Getting them into a simple, soothing bedtime routine can be a great opportunity to have 1-to-1 time with your baby.

The routine could consist of:

having a bath

changing into night clothes and a fresh nappy

putting them to bed

reading a bedtime story (see more in Baby and toddler play ideas)

dimming the lights in the room to create a calm atmosphere

giving a goodnight kiss and cuddle

singing a lullaby or having a wind-up musical mobile you can turn on when you've put your baby to bed

brushing their teeth (if they have any)

As your child gets older, it can be helpful to keep to a similar bedtime routine. Too much excitement and stimulation just before bedtime can wake your child up again. Spend some time winding down and doing some calmer activities, like reading.

How much sleep does your baby need?

Just as with adults, babies' and children's sleep patterns vary. From birth, some babies need more or less sleep than others. The list below shows the average amount of sleep babies and children need during a 24-hour period, including daytime naps.

Newborn sleep needs

Most newborn babies are asleep more than they are awake. Their total daily sleep varies, but can be from 8 hours up to 16 or 18 hours. Babies will wake during the night because they need to be fed. Being too hot or too cold can also disturb their sleep.

Sleep requirements at 3 to 6 months old

As your baby grows, they'll need fewer night feeds and will be able to sleep for longer. Some babies will sleep for 8 hours or longer at night, but not all. By 4 months, they may be spending around twice as long sleeping at night as they do during the day.

Baby sleep at 6 to 12 months

For babies aged 6 months to a year, night feeds may no longer be necessary and some babies will sleep for up to 12 hours at night. Teething discomfort or hunger may wake some babies during the night.

Sleep requirements from 12 months

Babies will sleep for around 12 to 15 hours in total after their first birthday.

2-year-old sleep needs

Most 2 year olds will sleep for 11 to 12 hours at night, with 1 or 2 naps in the daytime.

Sleep requirements for 3 to 4 year olds

Most children aged 3 or 4 will need about 12 hours sleep, but this can range from 8 hours up to 14. Some young children will still need a nap during the day.

Coping with disturbed nights

Newborn babies invariably wake up repeatedly in the night for the first few months, and disturbed nights can be very hard to cope with.

If you have a partner, ask them to help. If you're formula feeding, encourage your partner to share the feeds. If you're breastfeeding, ask your partner to take over the early morning changing and dressing so you can go back to sleep.

Once you're into a good breastfeeding routine, your partner could occasionally give a bottle of expressed breast milk during the night. If you're on your own, you could ask a friend or relative to stay for a few days so you can get some sleep.

Dealing with baby sleep pattern changes

All babies change their sleep patterns. Just when you think you have it sorted and you've all had a good night's sleep, the next night you might be up every 2 hours.

Be prepared to change routines as your baby grows and enters different stages. And remember, growth spurts, teething and illnesses can all affect how your baby sleeps.

If your baby is having problems sleeping or you need more advice about getting into a routine, speak to your health visitor.

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Read tips on how to help your baby sleep, including what to expect, establishing a routine, and safe sleeping.

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Co-sleeping/ Bedsharing - The Lullaby Trust

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Co-sleeping/ Bedsharing - The Lullaby Trust

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Some parents choose to share a bed or other sleep surface (also known as co-sleeping) with their babies. Read our advice on how to co-sleep more safely and watch the video.

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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.

When not to co-sleep

Whether you choose to co-sleep or it is unplanned, there are some key risks you should avoid.
Co-sleeping with your baby is very dangerous if:
In these scenarios, it is always best to put baby in their own safe sleep space, such as a cot or Moses basket. Keeping the cot or Moses basket next to your bed might make this easier.
Never fall asleep on a sofa or armchair with your baby. The risk of SIDS is 50 times higher for babies when they sleep on a sofa or armchair with an adult. They are also at risk of accidental death as they can easily slip into a position where they are trapped and can't breathe.
Co-sleeping more safely

Keep pillows and adult bedding away from your baby or any other items that could cover their head or cause them to overheat. A high proportion of babies who die as a result of SIDS are found with their head covered by loose bedding.

Follow all The Lullaby Trust's other safer sleep advice to reduce the risk of SIDS such as sleeping baby on their back

To reduce the risk of accidents, do not bring other children or pets into bed with you.

Try to make sure or check that baby cannot be trapped, wedged or fall out of bed or get trapped between the mattress and the wall

Never leave your baby unattended in an adult bed

For more info on co-sleeping and safer sleep read our guide for parents
If you are bedsharing with your baby you should consider any risks before every sleep. It is easy for your situation to change if you are unwell or have drunk any alcohol, which means your baby will be safest in a separate sleep space such as a cot or Moses basket on that occasion.

Co-sleeping with your baby: FAQs

I am worried I might fall asleep while I breastfeed my baby at night, is this ok?

Click here to open this question

Breastfeeding reduces the chance of SIDS. If you feel you might fall asleep we would recommend you prepare the bed as described above so it is safer for baby if this happens.

Make sure you know the advice on when never to co-sleep so you know when to take particular care. It is really important that you do not accidentally fall asleep with your baby on a sofa or armchair. If you think you might fall asleep on a sofa or armchair, put the baby down in a safe place to sleep.

Should I co-sleep with my baby?

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The safest place for a baby is their own separate sleep space, such as a cot or Moses basket. We would just advise you to read all the information on co-sleeping and how to reduce the risks, so you can make an informed decision for you and your baby.

However, there are some circumstances where we would strongly recommend against co-sleeping such as on a sofa or armchair, if anyone in the bed smokes or has drunk alcohol or your baby was premature or a low birth weight.

Can I co-sleep with twins or multiples?

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If you choose to bedshare with twins or multiples we would advise not to bedshare with more than one baby at a time due to risk of accidents associated with bedsharing with more than one baby or child.

Is it safer to co-sleep using a nest or pod than with a baby just lying on the adult bed?

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No. We do not recommend that babies sleep on soft surfaces such as pods or nests. If you choose to co-sleep with your baby the safest place is a clear space on a firm flat mattress the same as we would advise with a cot.

Why do you advise against co-sleeping in certain scenarios?

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It is estimated that around half of SIDS deaths occur whilst co-sleeping, and that most of these are in high risk situations. We do not know the cause of SIDS and why these deaths happen but we do know what some of the risk factors are and that removing those risks greatly lowers the chance of SIDS occurring.

For that reason we strongly advise against co-sleeping when there are risk factors such as a baby being premature or a parent having drunk alcohol.

What bedding should I use for my baby when we co-sleep?
The Lullaby Trust has worked with Public Heath England, Unicef UK Baby Friendly and Basis on two publications to support families with safer sleep advice and advice on co-sleeping more safely. We have also collaborated on a guide for health professionals to have more open and productive discussions with families about safer sleep and co-sleeping. These can be downloaded below.

Click here to open this question

Adult bedding should be kept well away from your baby along with any belts or cords from clothing. Keep adult bedding at your waist height and add an extra layer of clothing if you are cold

A baby sleeping bag is a good way of giving your baby their own bedding when bedsharing.

Baby sleeping bags should be well fitted, so the baby can't wriggle down inside. Most sleeping bags are fitted according to a baby's weight, rather than age.

You might also be interested in reading the two Unicef Baby Friendly publications, which are both endorsed by The Lullaby Trust:

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Some parents choose to share a bed (known as co-sleeping) with their babies. Read our advice on how to co-sleep more safely.

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You can start brushing your baby's teeth as soon as they start to come through. Use a baby toothbrush with a tiny smear of fluoride toothpaste. Don't worry if you don't manage to brush much at first. The important thing is to get your baby used to brushing their teeth as part of their daily routine. You can help by setting a good example and letting them see you brushing your own teeth.

See Harrows oral health support by visiting https://www.whittington.nhs.uk/default.asp?c=42368.

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You can start brushing your baby's teeth as soon as they start to come through. Use a baby toothbrush with a tiny smear of fluoride toothpaste.
Don't worry if you don't manage to brush much at first. The important thing is to get your baby used to brushing their teeth as part of their daily routine. You can help by setting a good example and letting them see you brushing your own teeth.

Tooth brushing tips for babies

Use a tiny smear of toothpaste for babies and toddlers up to 3 years old, and a pea-sized amount for children aged 3 to 6 years.

Gradually start brushing your child's teeth more thoroughly, covering all the surfaces of the teeth. Do it at least twice a day: just before bed and at another time that fits in with your routine.

Not all children like having their teeth brushed, so you may have to keep trying. Make it into a game, or brush your own teeth at the same time and then help your child finish their own.

The easiest way to brush a baby's teeth is to sit them on your knee, with their head resting against your chest. With an older child, stand behind them and tilt their head backwards.

Brush the teeth in small circles, covering all the surfaces, and encourage your child to spit the toothpaste out afterwards. There's no need to rinse with water, as this will wash away the fluoride.

Check to make sure your child gets the right amount of toothpaste and they're not eating or licking toothpaste from the tube.

Carry on helping your child brush their teeth until you're sure they can do it well enough themselves. This will normally be until they're at least 7.

Taking your baby to the dentist

Take your child with you when you go for your own dental appointments so they get used to the idea.

NHS dental treatment for children is free, but not all dentists will take on new NHS patients.

To find a dentist, you can use our services search, ask at your local clinic, or contact NHS England on 0300 311 22 3 or email england.contactus@nhs.net.

Sugar and tooth decay

Sugar causes tooth decay. It's not just about the amount of sugar in sweet food and drinks, but how long and how often the teeth are in contact with sugar.

Lollipops and sweet drinks in a formula bottle are particularly damaging, because they bathe the teeth in sugar for long periods of time. The acid in drinks like fruit juice and squash can harm teeth as well.

The sugars found naturally in whole fruit and milk are less likely to cause tooth decay.

Sucrose, glucose, dextrose, maltose, fructose and hydrolysed starch are all sugars. Invert sugar or syrup, honey, raw sugar, brown sugar, cane sugar, muscovado sugar and concentrated fruit juices are also sugars.

How to cut down sugar in your child's diet

These tips will help you reduce the amount of sugar in your child's diet and prevent tooth decay:

Avoid sugar-sweetened drinks - the best drinks for young children are plain milk and water.

It's OK to use bottles for expressed breast milk, formula milk, or cooled boiled water. But using them for juices or sugary drinks can increase tooth decay.

From 6 months old, you can offer babies drinks in a non-valved free-flowing cup.

When your baby starts eating solid foods, encourage them to eat savoury food and drinks with no sugar. Check if there's sugar in pre-prepared baby foods (including the savoury ones), rusks and baby drinks. Read more about food labels.

If you choose to give your child sweet foods or fruit juice, only give them at mealtimes. Remember to dilute 1 part juice to 10 parts water. Your child should have no more than 1 drink of fruit juice (150ml) in any 1 day as part of their 5 A Day.

Don't give your child biscuits or sweets - ask family and friends to do the same. Offer things like stickers, hair slides, crayons, colouring books and bubbles instead. They may be more expensive than sweets, but they last longer.

At bedtime or during the night, only give your child breast milk, formula or cooled boiled water.

If your child needs medicine, ask a pharmacist or GP if there's a sugar-free option.

Check your whole family's sugar intake - see how to cut down on sugar in your diet.

Should I give my baby a dummy?

It's fine to give your baby a dummy but avoid using them after 12 months of age. Using dummies after this can encourage an open bite, which is when teeth move to make space for the dummy. They may also affect your child's speech development.

Discourage your child from talking or making sounds with a dummy or their thumb in their mouth, and don't dip dummies in anything sweet, such as sugar or jam.

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You can start brushing your baby's teeth as soon as they start to come through. Use a baby toothbrush with a tiny smear of fluoride toothpaste.

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Baby First Aid (also called Paediatric First Aid) 

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Baby First Aid (also called Paediatric First Aid) 

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A number of private companies will offer baby first aid courses in your area including an online session with Blossom www.blossomantenatal.com. You can also look at websites like the NHS, St.John Ambulance and Red Cross to read useful information on what to do.

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Learn how to stop a baby choking and what to do if they have an accident.

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Learn skills to help a baby or child in a first aid emergency

Our First Aid skills are simple, easy-to-learn, and suitable for anyone looking to learn first aid and help others in an emergency. Explore the different skills below to enhance your own learning so you may be able to assist during an emergency.

Staying safe while giving first aid

Please always consider your personal safety when giving first aid. Look out for any dangers and only act when you're confident it is safe to do so.

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Learn simple first aid skills for babies and children so you will feel confident to help in an emergency.

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Provide mother-to-mother, parent-to-parent breastfeeding support. Useful online resources and links to local support.

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Friendly breastfeeding support from pregnancy onward.

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Paediatric First Aid - CPR, Choking & More

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Paediatric First Aid - CPR, Choking & More

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First aid advice for children and babies including choking, croup, drowning, head injuries, hypothermia, how to do a primary survey, CPR and the recovery position.

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Paediatric First Aid - CPR, Choking & More

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Get first aid advice from St John Ambulance about paediatric first aid, including CPR on children and babies, seizures in babies and children, and more.

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As well as online information they operate a helpline 8am to midnight, 7 days a week

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Support with breastfeeding or bottle feeding: our infant feeding line | Baby & toddler, Feeding articles & support | NCT

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Find out more here about our infant feeding support line and the help available if you have any questions or concerns about feeding your baby.

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During pregnancy don't forget to book your flu vaccine during flu season, and from 16 weeks of your pregnancy, the whooping cough (pertussis) vaccine.

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Harrow Talking Therapies Service (IAPT) 

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Harrow Talking Therapies Service (IAPT) 

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Provided by Central and North West London NHS Foundation Trust the Talking Therapies Service provide a range of free and confidential talking therapies for people who feel anxious and worried or down and depressed in the borough of Harrow. This includes perinatal mental health problems which can happen during pregnancy or after the birth (postnatal depression). Referral is via GP, or any health professional or you can self-refer.

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Skip to main content Skip to accessibility tools

Harrow Talking Therapies Service is part of the national 'NHS Talking Therapies for Anxiety and Depression' service, provided by Central and North West London NHS Foundation Trust. We provide a range of talking therapies for people who feel anxious and worried or down and depressed in the borough of Harrow.

If you think you might be anxious or depressed, then you can refer yourself by giving us a call, sending us an email, or using our online self-referral form. Or if you prefer, you can ask your GP, or any health professional, about the service and they can refer you to us. If English is not your first language we will provide interpreters, including British Sign Language interpreters for all your appointments.

You are eligible for this service if you live, work, study and/or are registered with a GP in the borough of Harrow - to check where your GP is, use the service finder on NHS Choices, here

Read more about self-referring to our service below, or go straight to the Harrow self-referral form by clicking the "Self-refer to Harrow" button.

Self Referring

Before making a referral, check if this service is appropriate for you by completing the short questionnaire below. If you score more than 3 then you may benefit from talking therapies. The referral form can be accessed by clicking on the button below the questionnaire.

Our Talking Therapies Services are not able to provide immediate support in an emergency. If you require immediate help please contact your GP or call the Urgent Advice Line on 0800 0234 650 open 24 hours. For more information about what to do if you need help urgently, visit our emergency page here.

Over the past two weeks have you been bothered by the following?

Not at all

Several days

More days than not

Nearly every day
Total

Contact us

Address:

Harrow Talking Therapies, 12-14 Station Road, Harrow, HA1 2SL

Telephone:
020 8515 5015
Email:
harrow.iapt@nhs.net
If you prefer, you can also ask your GP or any other health professional to refer you. We provide our services jointly with our partner organisation, Mind in Harrow.

Opening Hours:

Monday:

8am - 8pm

Tuesday:

8am - 8pm

Wednesday:

8am - 8pm

Thursday:

8am - 5pm

Friday:

8am - 5pm

How to get to the Harrow Talking Therapies Service (IAPT):

Nearest Train/Underground Stations:

Harrow and Wealdstone (Bakerloo Line, London Overground and National Rail) - 4 minutes walking
Bus stops and Routes:

Harrow Civic Centre / Harrow Mosque: bus numbers 140, 182, 186, 258, 340, 618, 640
Parking:

There is parking for the service within Northwick Park Hospital.

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Harrow Talking Therapies are suitable for people with problems such as feelings of low mood, anxiety, stress, worry, and problems coping with daily life and relationships.

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Adjusting to life with a new baby can be tough, and it is very

common and normal for parents to feel anxious and overwhelmed at times. It is important to talk about how you feel and to get the support you need.

To help if you are having difficult feelings, we are running postnatal group support sessions at the Hillview children’s centre. We aim to provide you with some extra support for your physical and mental health and well-being.

You will be able to attend one group consultation with other parents and a team of healthcare practitioners.

Together, we will discuss topics and answer your questions around caring for your new baby and how to look after your wellbeing and mood.

You will also get a one-to-one check in with one of our team for more personalised support.

Please speak to your GP, health visitor or children's centre

about being referred to us. Alternatively, you can self-refer by completing our self referral

form. Visit www.blossomantenatal.com/referrals

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Harrow Cove is a safe, inviting, and inclusive space where residents of the borough can go if they are experiencing mental health crisis.

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Harrow Cove is a safe, inviting, and inclusive space where residents of the borough can go if they are experiencing mental health crisis.

Where: Carramea Centre, 27 Northolt Road, South Harrow, London, HA2 0LH

When: Open 2pm to 10pm, 7 days a week, 365 days a year.

Free to attend. No appointment necessary, simply turn up.
Find out more about the Harrow Cove here

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If you are a resident of Harrow, you can just turn up to the Harrow Cove if you need support with your mental health.

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Looking after your mental health after baby is born - for dads and partners

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Looking after your mental health after baby is born - for dads and partners

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Looking after your mental health after baby is born - for dads and partners

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Having a baby brings a lot of changes. Here’s some information for partners and new dads about how to look after your health after your partner gives birth.

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Perinatal mental health (PMH) concerns emotional and psychological wellbeing during pregnancy and after birth. It covers all mental health problems associated with pregnancy, birth and beyond. These include pre and postnatal depression, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and postpartum psychosis. Organisation offering support with any of these areas.

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Postnatal depression and perinatal mental health in Partners (MIND) 

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Postnatal depression and perinatal mental health in Partners (MIND) 

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If your partner is pregnant or recently gave birth, you might feel the focus should be on their health. But partners can also develop mental health problems around this time too. This can include feelings of depression and anxiety. Since it's connected to becoming a parent, some doctors might say you're experiencing postnatal depression - or paternal depression. Others might say the term 'postnatal' only applies if you're the one who gave birth. But no matter how you label your mental health problems as a partner, you're not alone and support is available.

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Registering your child's birth  - Northwick Park

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Registering your child's birth  - Northwick Park

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NWP comes under Brent so you would need to register at Brent Town Hall. Legally you must register your child's birth within 42 days of them being born.

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To register a birth you will need to:

register the birth within 42 days of the birth. This is a legal requirement

check if the birth took place in the borough of Harrow

book an appointment with the register office

Babies born in Northwick Park hospital

If your baby was born in Northwick Park Hospital register the birth with Brent's register office.

Babies born outside the borough of Harrow

If your baby was born outside the borough of Harrow you may indeed register the birth at Harrow. However, you will not receive your baby's certificate at your appointment. Instead, the details of the birth will be forwarded to the borough where the birth took place. That council will issue the birth certificate and post it to your home address. There's no fee for making the declaration at Harrow, however the borough issuing the certificate will charge a fee.

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Register a birth – London Borough of Harrow

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Register the birth of child in born in the borough of Harrow

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Find out about how to register the birth of your child, change or order certificates and book a baby-naming ceremony.

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Stillbirths occur when a pregnancy has continued beyond 24 weeks, but the baby dies before the birth. If you live in Harrow, but the stillbirth took place outside Harrow, you can also make the declaration at Harrow's register office.

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Stillbirths occur when a pregnancy has continued beyond 24 weeks, but the baby dies before the birth.

Stillbirths should be:

registered within 42 days

recorded by the borough in which the stillbirth took place

To register a stillbirth so that the borough can record it, please contact us to book an appointment.

Stillbirths which have taken place outside the borough of Harrow

If you live in Harrow, but the stillbirth took place outside Harrow, you can also make the declaration at Harrow's register office. This includes a stillbirth that took place at Northwick Park hospital.

The Harrow register office will note the details and forward them to the borough in which the stillbirth took place. You will then be sent the certificate. To make a declaration you will need to contact us to book an appointment.

Who can register the stillbirth?

The stillbirth can be registered by:

the mother

either of the parents if they are married at the time of the stillbirth

the mother and father together if they are not married to each other at the time of the still birth

In circumstances where neither of the parents can register the stillbirth, then the following people can make the registration:

someone who was present at the stillbirth

someone who is responsible for the stillborn child

the person who may have found the stillborn child (if the date and place of the stillbirth is unknown)

Before you start

Fees to register a stillbirth

Registering a stillbirth: The registration costs £11 and is payable by debit or credit card.

Making a declaration of a stillbirth: The charge to make a declaration is £11 and is payable by debit or credit card.

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How to register a stillbirth - London Borough of Harrow

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The stillbirth registration procedure, who can register a stillbirth and registration/declaration fees

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Whether you would like to find out more about what to expect when expecting twins, triplets or more; feeding, sleeping, starting school, friendships, getting to grips with the teenage years, or anything multiples related, Twinline is there to offer information and support.

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Twins Trust - We support twins, triplets and more...

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Supporting you through every milestone of your journey with twins, triplets or more. From being pregnant with twins, triplets or quads through to parenting twins, triplets or quads, we are here for you.

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Support network for parents with twins, triplets or more, whether you're expecting, have babies or toddlers or school age children.

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Provides packs of items for families with preschool children in need. A referral partner (professional or organisation working with families) completes the referral on behalf of the family. The referral partner passes on the items to families. Can also provide a Moses Basket and changing mat and some larger items on request.

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Products that can be picked up at the baby bank include food, prams, baby seats, and clothes. Parents looking to visit the Baby Bank can do so on Fridays between 10.00am and midday without needing a referral.

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Listing of all UK Baby Banks including those in neighbouring boroughs to Harrow.

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Little Village only operates in London, but there are more than 200 baby banks across the UK.

If you'd like to support a baby bank local to you, or if you need support, check out this interactive map to see who's where.

This map may not include all baby banks. If you would like your baby bank to be added to the map, please click here.

If you are struggling to look at the map on your phone, try rotating your phone to landscape.
Creating a national alliance of baby banks
Four partners ( Little Village, Baby Bank Network Bristol, Save the Children and Purposeful Ventures) are working together to explore the creation of a new national baby bank alliance whose aim is to increase the profile and impact of the vital work undertaken by over 200 baby banks run in local communities across the UK. Our hope is that an alliance will help baby banks to share knowledge and resources, attract funding, in kind donations, corporate partners that they couldn't secure alone and grow the overall baby bank movement.

For more information on the Baby Bank Alliance, please visit the website here: www.babybankalliance.org

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Little Village only operates in London, but there are more than 200 baby banks across the UK. If you'd like to support a baby bank local to you, or if you need support, check out this interactive map to see who's where. This map may not include all baby banks.

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Healthy Start (milk, fruit & vegetables and vitamins) 

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Healthy Start (milk, fruit & vegetables and vitamins) 

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Pregnant or a parent/carer of children under 4 years old? Check for eligibility for the Healthy Start scheme, which provides access to free fruit, vegetables, pulses, milk and vitamins.

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What is Healthy Start?

If you're more than 10 weeks pregnant or have a child under 4, you may be entitled to get help to buy healthy food and milk.

If you're eligible, you'll be sent a Healthy Start card with money on it that you can use in some UK shops. We'll add your benefit onto this card every 4 weeks.

You can use your card to buy:

plain liquid cow's milk

fresh, frozen, and tinned fruit and vegetables

fresh, dried, and tinned pulses

infant formula milk based on cow's milk

You can also use your card to collect:

Healthy Start vitamins - these support you during pregnancy and breastfeeding

vitamin drops for babies and young children - these are suitable from birth to 4 years old

If you live in Scotland

You can get help from Best Start Foods (opens in a new tab) instead.

Advice on healthy eating

For more advice on healthy eating, visit:

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If you're more than 10 weeks pregnant or have a child under 4, you may be entitled to get help to buy healthy food and milk. If you're eligible, you'll be sent a Healthy Start card with money on it that you can use in some UK shops.

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Collect Healthy Start Vitamins in Harrow

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Collect Healthy Start Vitamins in Harrow

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Beneficiaries are also entitled to free vitamins for both mother and child up to 4 years. These vitamins are tailored to mother and child’s nutritional requirements and are fundamental to healthy growth and development. Visit this page to see a list of places in Harrow where the vitamins can currently be collected from.

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Get help to buy food and milk (Healthy Start)

Are you pregnant or a parent/carer of children under 4 years old? You may be eligible for the Healthy Start scheme, which provides access to free fruit, vegetables, pulses, milk and vitamins. The value could be over £1,000 per child, if claimed from pregnancy to the child's 4th birthday.

In April 2022 Healthy Start vouchers were replaced with a pre-paid debit card. Instead of receiving paper vouchers in the post every month, beneficiaries will have a pre-paid card. It gets topped up once a month with their Healthy Start item allowance. It can be used in all supermarkets and food outlets that accept Mastercard®.

The scheme currently entitles beneficiaries to the following to spend on Healthy Start items:

£4.25 each week of your pregnancy from the 10th week

£8.50 each week for children from birth to 1 year old

£4.25 each week for children between 1 and 4 years old

What can you buy with the Healthy Start card?

plain liquid cow's milk

fresh, frozen, and tinned fruit and vegetables

fresh, dried, and tinned pulses

infant formula milk based on cow's milk

Healthy Start vitamins

Beneficiaries are also entitled to free vitamins for both mother and child up to 4 years. These vitamins are tailored to mother and child's nutritional requirements and are fundamental to healthy growth and development.

In Harrow, these can currently be collected from:

Milmans Resource Centre, Grove Avenue, Pinner, HA5 5PF. Call 020 3317 2555 to book your collection

Cedars Children's Centre, Whittlesea Road, HA3 6LS. Call 020 8736 6222 to book your collection

Kenmore Park Children's Centre, Warneford Road, HA3 9HZ. Call 020 8416 8400 to book your collection

Fridays 9.30-11.30am only: Wealdstone Baby Bank, Wealdstone Methodist Church, Locket Road, HA3 7ND. No need to call in advance, just turn up.

How do I check my eligibility and apply?

Visit www.healthystart.nhs.uk/how-to-apply

When you receive your new Healthy Start card you must activate it by calling Healthy Start on 0300 330 7010

For more questions on the new Healthy Start card please visit the frequently asked questions page.

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Healthy Start - London Borough of Harrow

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There are a number of Food Banks running in the borough. See website for full details and how to access these services.

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Help with the cost of living – London Borough of Harrow

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Details of support available from the government, the council and local organisations

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(See also Harrow Early Support Hubs Timetable, Health Visiting Teams & FIS for lists of services)

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(See also Harrow Early Support Hubs Timetable, Health Visiting Teams & FIS for lists of services)

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Children's Centre - Early Support Hubs in Harrow

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Children's Centre - Early Support Hubs in Harrow

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The Children's Centre offer services for SEND families including lots of sensory play sessions. Hillview also has sessions with the Portage service, and offers a number of specialist groups including 'Let's Play Together'. See the current timetable for more details or contact details for the Children's Centres. Hillview Children's Centre is on a shared site with a mainstream Nursery School. It has an additional resourced provision funded by the London Borough of Harrow. The fund is for nursery-aged children with moderate to severe complex learning needs and who may be identified as requiring an Education, Health and Care Plan (EHC Plan), when they are of school age.

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Children’s centres timetables – London Borough of Harrow

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We provide services for the residents of Harrow. Report an issue, submit an application, pay for something or see what’s going on in the London borough of Harrow.

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Portage is a home teaching programme. It's designed for pre-school children aged 0-5 years, who are experiencing delayed development and are not in a pre-school/school setting. The portage home visitors can: make regular planned home visits; help to set appropriate developmental goals; suggest practical ways to aid children’s development; lend appropriate toys and equipment designed to support the programme; provide information, particularly regarding early education issues; write progress reports for parents, which can also be shared with appropriate professionals and more.

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Portage is a home teaching programme. It's designed for pre-school children aged 0-5 years, who are experiencing delayed development and are not in a pre-school/school setting.

What does the service provide?

The service aims to enable parents and carers to gain skills and confidence to meet the educational and developmental needs of their child.

We believe in working close in partnership with parents and carers. They have expert knowledge about their child and situation, and that knowledge ensures the best action for the child is taken.

The portage home visitors:

make regular planned home visits

help to set appropriate developmental goals

suggest practical ways to aid children's development

lend appropriate toys and equipment designed to support the programme

provide information, particularly regarding early education issues

write progress reports for parents, which can also be shared with appropriate professionals

offer parent / child groups at local Children Centres

work in collaboration with Speech and Language Therapists to offer training to parents of pre-school aged children with a diagnosis of autism following the National Autistic Society. View the EarlyBird programme.

To access the service please contact us via the contact details at the bottom of this page, or make an enquiry via our online form.

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Harrow Portage Home Visiting Service – London Borough of Harrow

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Portage is a home teaching programme for pre-school children aged 0-5 years, who are experiencing delayed development and are not in a pre-school/school setting.

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Harrow Parent Carer Forum, is made up of a group of parents of disabled children. We represent the voices of families of SEN/disabled children from birth to 25 years living in the London Borough of Harrow. Have a downloadable SEND Glossary guide on their website.

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Harrow Early Years Special Educational Needs and Disabilities (SEND) Team (0-5 years) 

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Harrow Early Years Special Educational Needs and Disabilities (SEND) Team (0-5 years) 

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The Harrow Early Years SEND Team provide a service which supports Private, Voluntary, and Independent nurseries (PVI), childminders and school nurseries. The team offer a number of services, including supporting the inclusion of children with additional needs into a setting; developing early years practice within the PVI sector, childminders and up to the end of reception class; advising and supporting the completion of forms, including inclusion funding, transition, 2-year-old checks, EHC (Education, Health and Care) plan and referrals to other professionals, writing reports that incorporate advice and strategies for the staff (key person) to support the individual child and much more.

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The Harrow Early Years SEND Team provides a service which supports Private, Voluntary, and Independent nurseries (PVI), childminders and school nurseries. Their service is provided through advice and practical support around approaches to identification, assessment and intervention of SEN children within the SEN Code of Practice 2014.

As part of the Local Authority we comply with the following regulations:

Equalities Act (2010)

Children's & Families Act Section 3 (2014)

Statutory Framework for the Early Years Foundation Stage (EYFS 2021)

Special Educational Needs and Disability Code of Practice 0-25 (2014)

What does the service provide?

Within Harrow Early Years, the SEND team offer a number of services, including:

Supporting the inclusion of children with additional needs into a setting.

Developing early years practice within the PVI sector, childminders and up to the end of reception class.

Adopting the graduated approach with the 4 stages of action:

Advising and supporting with the completion of forms including inclusion funding, transition, 2 year old checks, EHC (Education, Health and Care) plan and referrals to other professionals e.g. Health services.

Writing reports that incorporate advice and strategies for the staff (keyperson) to support the individual child.

These are to be shared with parents and other professionals involved with the child

Provide support for setting based named SENCOs to ensure arrangements are in place to support children with SEND through training and Senco Surgeries

Support strengthening links between the settings, parents, schools, and social care and health services.

Support the development and delivery of training.

By working closely with PVI settings, childminders and school nurseries, who incorporate strategies through early intervention, this will endeavour to give the children the best start in their early years and to prepare for child readiness.
How we work

Using the multi-agency referral system within Harrow;

We are contacted regarding concerns around the child's:

communication and language

cognition and learning

social, emotional or mental health

sensory/physical needs

This service is accessed by settings that have concerns about the child's learning and developmental needs.

With parental permissions via the setting, meetings are arranged to discuss the child's strengths and needs. If required an observation of the child will be carried out along with the key person and strategies/next steps will be set.

Signposting to other appropriate professional services, if required.

Further discussions may be arranged to continue support in monitoring the individual child, ensuring that strategies are being implemented and reviewed.

Contact us

If you would like to know more about our work, would like to access the service, or have any further questions, you can contact us between 8.30 am - 4.30 pm, Monday to Friday:

Harrow Early Years SEND (0-5 years)

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Harrow's Local Offer provides information about services for young people with Special Educational Needs & Disabilities.

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Harrow's Local Offer provides information about services for children and young people 0-25 with Special Educational Needs & Disabilities. The Local Offer has been created by parents and professionals.

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Harrow's Local Offer provides information about services for young people with Special Educational Needs & Disabilities.

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The team work with children and young people from birth to 25 years, with hearing and / or vision impairment. They can work with them in their homes, play-groups, nurseries, schools and colleges. You can watch their video about the service in British Sign Language (BSL) on the website.

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We work with children and young people from birth to 25 years, with hearing and / or vision impairment. We can work with them in their homes, play-groups, nurseries, schools and colleges.

You can watch our video about the service in British Sign Language (BSL).

What does the service provide?

We are a team of qualified teachers with experience of working both in mainstream and special schools. We provide training for specialist qualifications in hearing impairment or vision impairment. The team also includes other specialist sensory staff with additional qualifications.

We can:

offer support and advice to families about their child's sensory impairment

provide assessments regarding the child or young person's sensory impairment

write advice and provide strategies to support children and young people in their learning and development

provide specialist equipment when needed

teach Braille and British Sign Language as appropriate

train teachers and other professionals about sensory impairment

liaise with parents and other professionals

provide awareness-raising sessions for peers

attend meetings and reviews

signpost families to other services

How do I access the service?

We have an open referral system. This means that pupils, parents / carers and professionals can all refer to us.

The child or young person being referred must:

have a vision impairment or vision difficulties and /or have hearing impairment or hearing difficulties

be between 0 and 25 years of age

live in Harrow

or

live in a different local authority but attend a Harrow educational setting without an Education Health Care Plan (EHCP)

Once referred, the child or young person with sensory impairment will be assessed by a specialist teacher in order to identify if support is required from the Children's Sensory Team.

If the young person is, a Harrow resident of 16- 25 years and attends a Further Education College without an EHCP, their college will provide advice and support or request to buy Children's Sensory Team (CST) services.

Independent educational settings must pay for the service received from the CST. A service can only be offered if the CST has capacity to provide this service. This flowchart illustrates the pathway to service.

Requesting a referral

Mobile devices

If you are completing these forms via a mobile device, please ensure you have the Abode Reader app installed. You can get it from Google Play for Android devices or the App Store for iPhone.

Harrow Children's Sensory Team (CST) Charges

Who pays for the service?

In most cases the CST services are free for Harrow's young people who meet the required criteria. However, the services are charge to the education setting for if the child fits either of the following descriptions:

the child is a Harrow resident, who attends an independent school and does not have an Education, Health Care Plans (EHCP); the educational setting will have to pay for the CST services

the child is a Harrow resident, who attends a further education college and does not have an Education Health Care Plan (EHCP); the college will have to pay for the services

If your child meets either of these descriptions please complete the CST charged services request form ​

Contact us

Harrow Children's Sensory Team
Harrow Council
Tel: 020 8051 8370
Email This email address is being protected from spambots. You need JavaScript enabled to view it.

For deaf or partially hearing callers, we welcome communication via email, fax, text or by using the Text Relay ServiceTel: 0800 731188
Textphone: 0800 500 888
Email:This email address is being protected from spambots. You need JavaScript enabled to view it.

Further information on Children's Sensory Team

Children's Sensory Team Events

Courses for professionals

Professionals can also see the courses available via Support Services for Education (SS4e) portal. Direct link on SS4E for the Children's Sensory Team: https://ss4eharrow.uk/Services/6484

In addition to the courses on SS4e, we offer bespoke training in education settings. The bespoke courses can be requested by contacting This email address is being protected from spambots. You need JavaScript enabled to view it. or by directly contacting the CST teacher connected to the setting.

Courses for young people and/ or their families

Currently, courses for parents are advertised via email. Please contact CST by emailing This email address is being protected from spambots. You need JavaScript enabled to view it. for information on what is currently available.

CHSWG meetings

(Children's Hearing Services Working Group)

Children's Hearing Services Working Groups (CHSWGs) ensure that the services for deaf children and their families in your area work together to provide the best support possible. They are based in health authority areas in England

Parents of deaf children, as well as any other service users, and professionals who provide services for deaf children, such as teachers of the deaf, audiologists, and speech and language therapists. NDCS also attends many CHSWG meetings.

All meetings are via MS Teams links and are scheduled to run between 10am to 12pm and meet three times a year.

If you are a parent or carer please register here to join the CHSWG meetings and the links will be sent to you. Alternatively use the QR code below:

If you would like to ask a question please submit it via the CHSWG online form or use the QR code below:
Additional resourced provision
Harrow schools with additional resourced provision for children and young people with hearing impairment

Cedars Manor School
Whittlesea Road
Harrow
HA3 6LS
Tel: 020 8428 5845
Website: www.cedarsmanorschool.co.uk

Hatch End High School
Headstone Lane
Harrow
HA3 6NR
Tel: 020 8428 4330
Website: www.hatchend.harrow.sch.uk

There are no Harrow additionally resourced schools for children and young people with vision impairment.

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Harrow's Local Offer provides information about services for young people with Special Educational Needs & Disabilities.

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You will be offered regular health and development reviews (health visitor checks) for your baby until they are around 2. These are to support you and your baby, and make sure their development is on track. The reviews are usually done by a health visitor or a member of their team. They may be done in your home or at a GP surgery, baby clinic or children's centre.

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Your baby’s health and development reviews

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Find out when your baby will have their health and development reviews (health visitor checks), and what happens at each one.

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Personal Child Health Record (PCHR) - Also known as the Red Book

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Personal Child Health Record (PCHR) - Also known as the Red Book

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Shortly before or after your baby is born, you'll be given a personal child health record (PCHR). This usually has a red cover and is known as the "red book". It's a good idea to take your baby's red book with you every time you visit the baby clinic or GP. They will use it to record your child's weight and height, vaccinations and other important information.

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Your baby’s health and development reviews

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Find out when your baby will have their health and development reviews (health visitor checks), and what happens at each one.