# data[].attributes.attachment_link.readable_text
Birth brings your wonderful new baby into the world but it can also bring some significant physical symptoms. The symptoms can include exhaustion, urinary incontinence, headaches, hair loss, back pain, sore breasts, caesarean-section or episiotomy site pain and vaginal bleeding (Martin et al, 2014).

You're not alone if you didn't feel prepared for managing these symptoms. After all, you don't know when you might develop the symptoms, how long they might last, and how they'll affect you (Martin et al, 2014). And some symptoms are a cause for concern.

What are the serious physical complications after giving birth?

The more serious physical complications of birth to watch out for and to get emergency medical help for can include:

Haemorrhage - you might have sudden and heavy blood loss, with other signs like faintness, dizziness, palpitations or your heart beating really fast. Read more about vaginal bleeding after birth here.

Infection - you might have a fever, be shivering, and have pain in your tummy or unpleasant vaginal discharge.

Pre-eclampsia or eclampsia - you might get headaches with changes in vision and/or nausea or vomiting in the first 72 hours after you give birth.

Blood clot in your leg (DVT) - you might have pain, swelling or redness in the calf muscle of one of your legs.

Blood clot in your lung - you might have difficulty breathing, shortness of breath or chest pain.

Common symptoms after giving birth

It's important to talk with a healthcare professional if you're worried about complications or any symptoms you're getting. During your appointments with them after you give birth, healthcare professionals should ask you about your health and offer you information to help you stay healthy. It's also important to get out and meet other mums and babies and to plan social activities.

Here's what can help with some of the common health concerns among women who have recently given birth...

Urine retention straight after birth

Having a warm shower or bath can help if you can't wee (urine retention) after giving birth. If that doesn't work, it's best to ask a healthcare professional as a catheter may be helpful (NICE, 2015).

Painful vagina and/or surrounding area (perineum)

Ask a healthcare professional to check your perineum for signs of infection and problems with healing if you have pain in this area. Crushed ice or cold gel pads and paracetamol can help. Here are some more tips for helping your perineum to heal after a tear.

If your perineum doesn't get better, you might be offered medication to help reduce any inflammation (NICE, 2015).

Constipation

Try to think about your diet and make sure you drink plenty of fluids if you're constipated. You might be offered a gentle laxative if changes in diet don't help you (NICE, 2015).

Urinary and faecal incontinence

It's not too early to restart your pelvic floor exercises to strengthen your pelvic floor so you don't wee accidentally. It's good to get advice from a healthcare professional about incontinence if you're at all worried or unsure (NICE, 2015).

Fatigue and tearfulness

This can be an emotional rollercoaster of a time and some people are recovering from a traumatic birth. You can read more in our article about the emotions you might experience after giving birth and what you can do if things are difficult.

If you're tired and teary, you could try to take some gentle exercise, take time to rest, and get plenty of help with caring for your baby if you can. If anaemia is causing problems such as tiredness, you might be offered iron supplements (NICE, 2015).

Rectal pain, bleeding, haemorrhoids

Increasing the amount of fluid and fibre in your diet can help with rectal pain, bleeding and haemorrhoids. Ask a healthcare professional to check your rectal area and refer you for more help if you're still having problems despite changing your diet (NICE, 2015).

Backache and musculoskeletal problems

If you've got back pain or other musculoskeletal pain after giving birth and don't know what's causing the problem, do ask a healthcare professional (NICE, 2015).

Cracked or painful nipples

If you have cracked or painful nipples, try to get support with attaching and positioning your baby from your health visitor or a breastfeeding counsellor. You can call 0300 330 0700 for feeding support from NCT (open every day from 8am to midnight) and read more about finding breastfeeding support in your area here. You could also try antifungal creams if you have thrush around your nipples (NICE, 2015).

Full, painful, tender breasts

If your breasts are full, painful and tender, unlimited breastfeeding, breast massage and hand expressing, and paracetamol can all help to relieve the pain, as can a well-fitting bra (NICE, 2015).

Flu-like symptoms, red, painful and tender breasts

If you have mastitis symptoms that last more than a few hours, you might be offered antibiotics to treat it (NICE, 2015).

Recovering after a caesarean birth

It can take about six weeks to recover from a caesarean birth. You'll be given pain relief medication and blood thinning drugs to use for the first few weeks. You'll also get advice about caring for your wound (NICE, 2015).

Do speak to your GP straight away if you have a high temperature, the wound becomes red, swollen or painful or if you feel generally unwell as those may be signs of infection (Tommy's, 2018). Also speak to your GP if you're still having pain or you don't feel you've recovered after six weeks (NICE, 2015).

For more on getting better after a caesarean birth, see our top tips on recovery and the practicalities of looking after yourself and your baby afterwards.

# data[].attributes.attachment_link.title
How to recover after giving birth | Labour & birth articles & support | NCT

# data[].attributes.attachment_link.description
Your body goes through an incredible experience during birth and recovery may take time. Here's what can happen to your body after birth and how to recover

# data[].attributes.body
Antenatal Teacher and Breastfeeding Counsellor, Hypnobirthing Coach, Baby Massage Teacher

Tel: 07815 698459

Please allow 12-24 hours for reply

E: info@jasmineblossombirthing.com

IG: @jasmine_blossom_birthing

# data[].attributes.attachment_link.readable_text
How does early labour start?

For up to a week before labour starts, you might notice that you're feeling a bit different. This is because changes are taking place in your body as it prepares for birth. While they're not reliable signs and they do vary between women (McCormick, 2003), here's what you might notice:

Mucus plug discharge: the plug of clear mucus ('show') released from your cervix, perhaps with a streak of blood, although this doesn't always happen until later in labour (McCormick, 2003; Becher, 2010; NHS, 2017a).

Feeling unusually energetic or 'nesting instinct' behaviours (cleaning and organising things, and being selective about who you want to be around) (McCormick, 2003; Anderson and Rutherford, 2013).

The NHS say that women could also experience:

loose bowels or the urge to go to the toilet more often

backache or mild cramps.

It's good to remember though that these symptoms could be related to the growing weight of your baby or a stomach upset.

You'll probably be at home during this stage (NHS, 2017a; NICE, 2017). It can help to take this opportunity to rest and nourish yourself with food that'll sustain your energy. It's also good to distract yourself with activities that you find fun and relaxing, such as having a bath or meeting a friend for a gentle stroll (NHS, 2017a).

Your birth partner can help you too by offering support and encouragement (NHS, 2017b).

Watch our video to find out what to expect and what you might feel as labour starts.

What starts early labour?

It's not known exactly what starts off labour but natural hormones (mainly oxytocin) in your body control your contractions. And your emotions and the external environment can influence your hormonal activity. So that means experiencing fear or stress makes you more likely have a labour that slows down or stops (Buckley, 2011). This is why some women try using relaxation and breathing exercises.

Your baby's actions, position and stage of maturity might also influence your progress towards labour.

How long should I stay at home in the latent/early stage of labour?

Many women feel anxious about remaining at home (Nolan, 2011; Gutteridge, 2013). But there are benefits of doing so.

Women who spend less time on the labour ward, are less likely to receive syntocinon, they feel more in control and have less need for pain management drugs. A couple of studies say that women who stayed at home during their latent stage described a 'sense of power' that stayed with them throughout labour (Lauzon et al, 2001; Carlsson, 2011).

There is no universal agreement about when the latent stage of labour ends and established labour begins (Hundley et al, 2017). The NHS suggests phoning your midwife for guidance if you experience the following signs:

regular contractions

lasting at least a minute

occurring every 5 minutes or less in active labour.

Most women describe these contractions as very painful while others say they are intense or overwhelming (Baker et al, 2001).

What does active labour vs early labour feel like?

For most women the early cramps and niggles will develop into stronger sensations. Some women say they're like strong menstrual cramps that gradually become stronger, longer and closer together (NHS, 2017a). There is no 'normal' path and you may have a very different experience to friends and family who have given birth.

While some women experience lots of sensations in the run up to active labour, others will have a quick onset. For this reason, early or latent labour is almost impossible to define (Enkin et al, 2000). The definition of active labour is:

regular, painful contractions and

progressive cervical dilatation from 4 cm.

Your midwife will talk to you about how many contractions you are having. But there is no single definition of the point at which active labour begins (Hundley et al, 2017). Your midwife will need to use their professional judgement as well as the local policy of the hospital or birth centre you are attending.

If you are choosing to go to hospital or a birth centre, your midwife may want to check you're in active labour before you come in by talking to you on the phone (NICE, 2017). It's possible your midwife might ask you to come to the hospital if they think active labour has started. In some areas, the midwife might visit at home first (NICE, 2017).

What should I do if I go into active/established labour?

Whatever your experience of contractions, you'll need to focus on them as you go from latent to active labour. You or your birth partner might notice that you start to switch off from the world around you while you use your coping techniques (Buckley, 2011).

At this stage many women find they want to be quiet and appreciate a more peaceful relaxed environment around them (Buckley, 2011). Holding a conversation becomes more difficult, especially during a contraction (Gutteridge, 2013).

Because everyone is so different, it is important to listen to your body and your own unique experience of labour (Dixon et al, 2013). Do ask your midwife if you're unsure about anything or want more information.

When should I call my midwife?

If you're less than 37 weeks pregnant, call your midwife if you're having contractions and have:

a watery discharge or bloody vaginal discharge and/or

regular contractions

lower back pain or cramping.

These are signs that you may be going into premature labour.

After 37 weeks, call your doctor or midwife if:

you think your baby's movements have slowed down

you think your waters have broken and/or (NHS, 2017a)

you have any bleeding.

(RCOG, 2011; NHS, 2017a)

From 36 weeks, it's a good idea to get ready for labour and the next section discusses some things to keep in mind.

"As your due date approaches, your body is getting ready for the baby and so can you by packing your maternity bag from 36 weeks."

What are Braxton Hicks contractions?

Braxton Hicks contractions are caused by the tightening of your uterine (womb) muscles in preparation for labour. That's why they're called practice contractions and are usually painless (NHS, 2016; Tommy's, 2017).

Some women experience Braxton Hicks contractions as early as their second trimester. So they're not an indicator of labour, more your uterus keeping itself fit and active (Tommy's, 2017).

Braxton Hicks contractions often become more noticeable at the end of pregnancy as the size of the uterus increases. You may be worried about confusing Braxton Hicks with labour itself (McCormick, 2003; Tommy's, 2017).

What do Braxton Hicks vs early labour contractions feel like?

When you're entering early labour, your contractions will become more frequent, rhythmic, intense and longer, as the cervix starts to soften and open up (dilate) (McCormick, 2003; NHS, 2017a). You can read more about the first stage of labour here. Braxton Hicks contractions usually stop after a period of time and don't increase in intensity (McCormick, 2003; Tommy's, 2017).

When should I get ready for my due date?

As your due date approaches, you will have lots on your mind so it's a good idea to run through the following and make sure everything is ready:

Have your bag ready for hospital or your home maternity pack at hand. Include some treats for yourself, such as your own pillows and cushions, snacks or music. (NHS, 2018)

Consider having more than one birth partner to support you in labour.

Go through your birth plan with your birthing partner, making sure you have all the information you need to make decisions about your care (Better Births, 2016)

Practise your pelvic floor exercises and take some gentle exercise (Woodley et al, 2017).

Consider protecting your bed with a plastic sheet or wearing a pad in case your waters break.

If you have any doubts about whether your labour is starting, give your midwife a call.

The build up to your due date can be exciting, stressful and tiring. So try to relax as much as you can in the last few weeks of pregnancy. Once your baby arrives things will certainly get busier.

What can your birth partner do?

Your birth partner can help you in the last few weeks to get ready for the arrival of your baby, they could:

keep a list of necessary telephone numbers including the community midwife and the labour ward

check the route to hospital, keep change for car park, or keep the number of a taxi company to hand

check whether mobile phones are allowed in the hospital or birth centre (if not, bring money for a phonecard or change)

make sure camera and phone batteries are charged.

Most importantly, birth partners should try to be patient, calm and supportive. Listen to your partner - she's the one who knows best what she needs and your support will be invaluable to her (Carlsson et al, 2011).
This page was last reviewed in January 2020.
Further information

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

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

Anderson M, Rutherford M. (2013) Evidence of nesting psychology during human pregnancy. Evolution and human behaviour. 34(6):390-397. Available at: https://www.sciencedirect.com/science/article/pii/S1090513813000706 (accessed 22nd November 2019)

Baker A, Fergurson S, Roach GD, Dawson D. (2001) Perceptions of labour pain by mothers and their attending midwives. J Adv Nurs. 35(2):171-9. Available at: https://www.ncbi.nlm.nih.gov/pubmed/11442696 (accessed 22nd November 2019)

Becher N, Waldorf, K, Hein M, Uldbjerg N. (2010) The cervical mucus plug: structured review of the literature. ACOG. 88(5): 502-513. Available at: https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1080/00016340902852898 (accessed 22nd November 2019)

Better Births. (2016) National Maternity Review Report. Available at: https://www.england.nhs.uk/wp-content/uploads/2016/02/national-maternity-review-report.pdf (accessed 22nd November 2019)

Buckley S. (2011) Undisturbed birth. AIMS Journal. 23(4). Available at: https://www.aims.org.uk/journal/item/undisturbed-birth (accessed 22nd November 2019)

Carlsson I-M, Ziegert K, Sahlberg-Blom E, Nissen E. (2011). Maintaining power: women's experiences from labour onset before admittance to maternity ward. Midwifery 28(1):86-92. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21237538 (accessed 22nd November 2019)

Dixon L, Skinner J, Foureur M. (2013) Women's perspectives of the stage and phases of labour. Midwifery. 29(1):10-7. Available at: https://www.midwiferyjournal.com/article/S0266-6138(12)00124-6/fulltext (accessed 22nd November 2019)

Enkin M, Keirse M, Neilson J, et al. (2000) A guide to effective care in pregnancy and childbirth 3rd ed. Oxford: Oxford University Press.

Gutteridge K. (2013) Assessing progress through labour using midwifery wisdom. Essentially MIDIRS 4(3):17-22.

Hundley V, Way S, Cheyne H, Janssen P, Gross M, Spiby H. (2017) Defining the latent phase of labour: is it important? Evidence Based Midwifery. 15(3):89-94. Available at: https://dspace.stir.ac.uk/bitstream/1893/26109/1/EBM_138_Hundley.pdf (accessed 22nd November 2019)

Lauzon L, Hodnett E. (2001) Labour assessment programs to delay admission to labour wards Cochrane Database of Systematic Reviews. (3):CD000936. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000936/epdf/full (accessed 22nd November 2019)

McCormick C. (2003) The First Stage of Labour: Physiology and Early Care. In: Myles Text Book For Midwives. 14th edition. Edited by Fraser and Cooper. Churchill Livingstone.

NHS. (2017a) Signs that labour has begun. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/labour-signs-what-happens/ (accessed 22nd November 2019)

NHS. (2017b) What your birth partner can do. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/what-your-birth-partner-can-do/ (accessed 22nd November 2019)

NHS. (2017c) Premature labour and birth. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/premature-early-labour/ (accessed 22nd November 2019)

NHS. (2018) Pack your bag for birth. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/pack-your-bag-for-birth/ (accessed 22nd November 2019)

NICE. (2017) Intrapartum care for healthy women and babies. Available at: https://www.nice.org.uk/guidance/cg190/chapter/recommendations#latent-first-stage-of-labour (accessed 22nd November 2019)

Nolan M. (2011) What is women's experience of being at home in early labour? New Digest. Available at: https://www.nct.org.uk/sites/default/files/related_documents/3nolan-what-is-womens-early-experience-home-early-labour-18-9-.pdf (accessed 22nd November 2019)

RCOG. (2011) Royal college of gynaecologists green top guidelines. Reduced fetal movements Available at: https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_57.pdf (accessed 22nd November 2019)

Tommy's. (2017) Braxton Hicks. Available at: https://www.Tommy's.org/pregnancy-information/labour-birth/braxton-hicks (accessed 22nd November 2019)

Woodley SJ, Boyle R, Cody JD, Mørkved S, Hay-Smith EC. (2017) Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews. (12): CD007471. Available at: https://www.cochrane.org/CD007471/INCONT_how-effective-are-pelvic-floor-muscle-exercises-undertaken-during-pregnancy-or-after-birth (accessed 22nd November 2019)

# data[].attributes.attachment_link.title
The early signs of labour | Labour & birth articles & support | NCT

# data[].attributes.attachment_link.description
You might already know about active labour but what happens before that? Here we explain the early signs of labour and when to call your midwife...

# data[].attributes.attachment_link.readable_text
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].

# data[].attributes.attachment_link.title
First stage of labour: signs, coping and when to go to hospital | Labour & birth articles & support | NCT

# data[].attributes.attachment_link.description
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.

# data[].attributes.attachment_link.title
Perineal massage in pregnancy | Pregnancy, Worries and discomforts articles & support | NCT

# data[].attributes.attachment_link.description
Find out what perineal massage is and how it might work to help you avoid a tear or episiotomy when you give birth.

# data[].attributes.body
A brief overview of the pain relief options

# data[].attributes.attachment_link.readable_text
When it comes to giving birth, most women want to know: how much is it going to hurt and will I be able to cope with the pain? Unfortunately, you can't answer either of these questions with certainty. But what you can do is improve your ability to cope with pain during labour, as well as understand your options for pain relief and their impact on you, your labour and baby.

Your birth partner(s) will make a huge difference to how you feel during labour. Emotional support, such as encouragement and reassurance from somebody you trust, can really boost your confidence and ability to cope with pain when you need it most.

Here we look at the different pain relief options that are available during labour.

Overcoming fear during labour

Labour is complex but, unfortunately, fear can affect this amazing process.

Fear makes you release adrenaline, which slows down the production of oxytocin and prepares your body to fight or run away (not helpful when you're trying to give birth). This makes your contractions less efficient and you focus on the pain and feel worse. So staying calm is the key to coping with pain.

To help you feel relaxed, it's good to read up on what happens during labour and choose a place to give birth where you feel safe.

It'll help to choose the right person to be your birth partner to help you cope with the pain and discomfort of labour more easily. It should be a person you trust, and who can give you encouragement, reassurance, listen to you and just be there. Research has shown that emotional support is important for women in labour.

Attending antenatal classes is also a really useful way of preparing for labour and gaining an understanding of what will happen on the day.

If it feels really tough, ask your midwife how you are getting on. Positive encouragement - knowing you are coping really well and making good progress - can make all the difference.

Position and movement in labour

Labour can last a long time so, at the beginning, try movement, upright positions, massage and water to help you cope. If you head straight for maximum pain relief, you'll never know how other things can help - plus your labour may end up being even longer.

Lying on your back can make your contractions slower and more painful. Different positions and movement, such as rocking, swaying and leaning forwards, maximises your body's ability to give birth as it helps ease your baby along the birth canal.

Pros

Maximises your body's ability to give birth.

No lasting side-effects for you or your baby

Cons

Try not to overdo it; saving energy is also important. Lying on your side for a while or sitting up supported by lots of pillows can help your body to work really well while you conserve energy.

Water and birthing pools in labour

Water soothes pain and, in a large birthing pool, supports you, enabling you to glide into any position. For more about water births and using water during labour, see here.

TENS (Transcutaneous Electrical Nerve Stimulation) machine in labour

A TENS machine transmits mild electrical impulses to pads on your back. These block pain signals and help your body to produce endorphins. For more about the pros and cons of TENS, see here.

Complementary therapies

Various complementary therapies are available, such as acupuncture, aromatherapy, reflexology, yoga, self-hypnosis and massage.

Pros

Some studies show acupuncture is helpful.

Massage or pressure on the lower part of your back can help reduce levels of stress and ease discomfort, too.

You can learn self-hypnosis techniques for labour by attending a course or using CDs; you don't have to have a hypnotherapist with you in labour.

Cons

There is little research proving the effectiveness of these treatments though lots of women say that they found these techniques useful.

Apart from massage and self-hypnosis, you will need a registered practitioner to perform the therapies.

Sterile water injections

Sterile water injections involve injecting a tiny bit of water into the skin of your lower back to help with back pain during labour. For more about sterile water injections, see here.

Gas and air (Entonox) in labour

Entonox is a colourless, odourless gas made up of half nitrous oxide and half oxygen. You'll probably be given gas and air through a mouthpiece and told how to breathe it in. Read more about Entonox here.

Painkilling drugs in labour (opioids such as pethidine, diamorphine, meptid and remifentanil)

Pethidine, diamorphine and meptid are pain relieving drugs given by injection into the thigh. Some hospitals offer remifentanil, which is a very strong, short-acting painkiller given via a drip that you can control yourself using a machine. For more details, see our articles about intramuscular opioids and remifentanil.

Epidural

Epidural analgesia is a local anaesthetic injected into the space between two vertebra in your back. It usually removes all pain and most feeling from the waist down.

The combined spinal epidural (CSE) injection contains a low dose of pain-relieving drugs and works more quickly than an epidural alone. Read more about their pros and cons in our articles about epidurals and CSEs.

Top tips for labour

The following tips have been found to be useful by women in labour:

1. Before labour, spend some time imagining having your new baby in your arms after the birth and that all is well. Imagining that you did it, and that you did it as you wanted, creates a positive picture to focus on.

2. Moving about helps labour to progress and women have said they were better able to work with the pain while rocking and leaning forwards (the pressure of the baby's head on the cervix will promote the release of oxytocin as well as endorphins - the body's natural pain relievers). Focus on letting go and relaxing any muscles that aren't needed to hold you in a position.

3. Focus on the out breath during a contraction. Keep the breathing calm and rhythmic.

4. Make a noise if you want to - be somewhere with people that are happy for you to moan, grunt, sigh or even swear if that helps.

5. Belly-dancing, hip-wriggling and stepping movements all help your baby settle into a good position to be born.

6. Massage or pressure on the lower part of your back just above the top of your bottom can help.

7. Water helps women relax and move more easily; being in a pool can give women a feeling of safety and security.

8. Positive, affirmative thoughts and supportive comments from birth partners help to promote confidence in the process. 'You are doing well - your body is made for this - feel the power of your body - your body knows how to do this - each pain is progress' are all positive and encouraging statements.

9. During labour, think about welcoming each contraction. As your contractions become stronger, longer and closer together your body is getting ready to give birth.

10. Rest, relax and conserve energy between contractions as labour progresses.

11. Have confidence in your own self-help resources.

12. Acknowledge that labour is unpredictable and that uncertainty is difficult to go along with. Try to go with the flow.

Recognising the point at which labour feels worst - when you have had enough - is often the point just before you are ready to start pushing your baby out. Having people with you who help you feel strong and capable can make all the difference.

Do what feels best for you

Every labour is different and each woman should choose whatever she needs to help her work with the pain of labour. Most importantly, have confidence that you can do it.
This page was last reviewed in August 2019.
Further information

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

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

NHS Choices guide to pain relief.

Research from the Royal College of Obstetricians and Gynaecologists (RCOG) about the use of water as pain relief in labour.

Information from NHS Choices about complementary therapies during pregnancy and before birth.

# data[].attributes.attachment_link.title
Pain relief in labour | Labour & birth articles & support | NCT

# data[].attributes.attachment_link.description
Find out about the different options available for pain relief in labour and childbirth, including epidural, pethidine, TENS and other ways to reduce pain.

# data[].attributes.body
What is it?

# data[].attributes.attachment_link.readable_text
You know having a baby will be life-changing, so you might be preparing yourself by attending classes and Googling just about everything to do with childbirth. You might also be thinking about alternative pain relief methods and labour techniques, like hypnobirthing.

Hypnobirthing is gaining popularity as some say it's a way of birthing gently and calmly. Some people describe it as allowing them to give birth without medication (The Guardian, 2015). So if you're wondering what hypnobirthing is all about, here we introduce you to this mysterious-sounding technique...

What is hypnobirthing?

"Hypnobirthing teaches relaxation, visualisation and self-hypnosis skills (Varner, 2015)."

This preparation tries to give pregnant women a positive view of birth and the belief that childbirth does not have to be painful. The aim is a shorter, more comfortable, easier labour, with less need for intervention or pain relief (Madden et al, 2016).

How does hypnobirthing work?

Hypnosis focuses on preparing a woman for birth by reframing the representation of labour from a painful and difficult experience to a positive one (Catsaros, 2020).

Women's experience of labour pain can vary in intensity; but fear, tension and anxiety can worsen it (Catsaros, 2020; RCM 2014) and the mental and physical activities practised through hypnobirthing can lessen this.

So can it really work - what's the evidence?

A systematic review of hypnosis-based interventions during pregnancy found that it improved childbirth experience by reducing fear and pain and enhancing a sense of control (Catsaros, 2020).

It improved women's emotional experience and outlook towards birth with less anxiety, increased satisfaction, fewer birth interventions, more postnatal wellbeing and a better childbirth experience overall (Catsaros, 2020). Other research has found that self-hypnosis promoted 'feelings of calmness, confidence and empowerment (Finlayson et al, 2015).'

How can I practice hypnobirthing?

Practitioners say hypnobirthing can create an altered state of conscious awareness (Madden et al, 2016). Hypnobirthing involves learning techniques that you can use in preparation for and during labour like:

visualisation

pregnancy and birth affirmations

relaxation

deep breathing

self-hypnosis

mindfulness.

(Semple et al, 2011; Madden et al, 2016)

How do I learn hypnobirthing techniques?

You can learn about hypnobirthing by reading about it, or through listening to hypnosis tracks or podcasts. Some of the online resources that you'll find are free (Madden et al, 2016).

If you'd prefer to attend a class, some NCT courses include elements of teaching about hypnobirthing as well as breathing techniques and ways to stay relaxed during labour. But you can find specialist hypnobirthing courses that add more specific techniques (Madden et al, 2016). Hypnobirthing classes teach the techniques mentioned above, such as self-hypnosis, deep relaxation and deep breathing, in addition to birth positions and the basic physiology of birth.

Once you've learnt the techniques, you'd use them to help you focus and concentrate completely on your body and your baby. Hypnobirthing can be used in all birth settings, during vaginal or caesarean birth, with or without all types of pain relief and can be added to your birth plan.

If I try hypnobirthing will I be aware of what is happening?

A common misconception about hypnobirthing is that women lose control of their thoughts and actions in a hypnotic state. In fact, women who learn hypnobirthing use it to be less aware of external stimuli. They also learn to have a more focused attention and responsiveness to verbal or non-verbal suggestions. The idea is that these suggestions might make her feel safer, more relaxed and comfortable, and give her some relief from her pain (Madden et al, 2016).

So women who use self-hypnosis during labour are fully in control and aware of what is happening to them and to those around them. What hypnobirthing actually aims to do is help a woman focus and enhance her birthing experience.

What are the advantages of hypnobirthing?

It can help women feel more confident with themselves and their capacity to go through labour feeling in control, leading to a more positive birth experience (Catsaros, 2020).

Hypnobirthing reduces anxiety and reduces fears related to pregnancy and childbirth (Which?, 2018; Downe, 2015). This can lead to lower perceptions of pain during labour and a shorter labour (Catsaros, 2020).

It can promote positive mental health and self-confidence after birth (Catsaros, 2020).

NICE states that women who choose to use hypnosis during childbirth should be supported in doing so (NICE, 2014).

A review of the evidence suggested hypnosis might help to reduce the pain of labour and does not seem to have any adverse effects on outcomes (Smith et al, 2006).

What are the disadvantages?

There can be a difference between what you expect to or hope will happen during labour and the reality of your birth experience.

Styles and language may vary between different hypnobirthing schools or practitioners, so you may wish to look into what suits you best (Varner, 2015).

It takes time to learn about hypnobirthing, practice it and master the breathing, visualisation and self-hypnosis techniques. It is more effective when it has been practised regularly during pregnancy so will take time and commitment (Varner, 2015; Catsaros, 2020).

Hypnobirthing courses are an additional cost. Although in some parts of the UK, NHS hospitals have introduced free hypnobirthing classes (Which?, 2018).

Women who use self-hypnosis techniques may seem so relaxed that health care professionals could underestimate their progression of labour (Catsaros, 2020).

There is very little research on the feelings and experiences of birth partners when hypnobirthing is used (Catsaros, 2020).

How do I find out more about hypnobirthing?

Ask your midwife whether there are any local antenatal courses that might include hypnobirthing.

Ask friends and family members about their birth experiences and talk to those who have tried hypnobirthing.

Read hypnobirthing birth stories online and listen to podcasts on the topic.

This page was last reviewed in March 2021.
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.

Learn how to use breathing exercises in this labour video from Tommy's.

Catsaros S, Wendland J. (2020) Hypnosis-based interventions during pregnancy and childbirth and their impact on women's childbirth experience: A systematic review. Midwifery. Available at: https://doi.org/10.1016/j.midw.2020.102666 [Accessed 23rd March 2021].

Downe S, Finlayson K, Melvin C, Spiby H, Ali S, Diggle P, et al. (2015) Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness. BJOG. 122(9):1226-1234. Available at: https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1111/1471-0528.13433 [Accessed 23rd March 2021].

Finlayson, K., Downe, S., Hinder, S. et al. Unexpected consequences: women's experiences of a self-hypnosis intervention to help with pain relief during labour. BMC Pregnancy Childbirth 15, 229 (2015). https://doi.org/10.1186/s12884-015-0659-0&nbsp;

Madden K, Middleton P, Cyna AM, Matthewson M, Jones L. (2016) Hypnosis for pain management during labour and childbirth. Cochrane Database Syst Rev. (5):CD009356. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD009356.pub3/full [Accessed 23rd March 2021].

NICE. (2014) Intrapartum care for healthy women and babies. Available at: https://www.nice.org.uk/guidance/cg190 [Accessed 23rd March 2021].

RCM. (2014) How to support hypnobirthing. Midwives. 5:34-35. Available at: https://www.rcm.org.uk/sites/default/files/34-35_0.pdf [Accessed 19th April 2021].

Semple A, Newburn M; NCT. (2011) Research overview: self-hypnosis for labour and birth. Perspective. December: 16-20. https://www.nct.org.uk/sites/default/files/related_documents/Research%20overview-%20Self%20hypnosis%20for%20labour%20and%20birth%20%282011%29_2.pdf

Tommy's (2018) What is hypnobirthing? Available at: https://www.tommys.org/pregnancy-information/labour-birth/pain-relief-labour/hypnobirthing [Accessed 21st March 2021].

Varner CA. (2015) Comparison of the Bradley method and HypnoBirthing childbirth education classes. J Perinata Educ. 24(2): 128-136. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4744344/ [Accessed 23rd March 2021].

Which? (2018) What is hypnobirthing? Available at: https://www.which.co.uk/birth-choice/coping-with-pain-in-labour/what-is-hypnobirthing [Accessed 23rd March 2021].

# data[].attributes.attachment_link.title
Hypnobirthing: where to start | Labour & birth articles & support | NCT

# data[].attributes.attachment_link.description
We discuss what you need to know about hypnobirthing and the potential advantages and disadvantages of using this technique in labour and birth.

# data[].attributes.attachment_link.readable_text
Kathryn Kelly, NCT antenatal teacher, explains: 'The Fourth Trimester is a way of describing the period after birth when both parents and baby are adjusting to their new lives.

'We think of other trimesters as being three months long, and we can think in terms of roughly another three months after the birth to make the adjustments to being a new family.'

What's the fourth trimester like for babies?

Having been in your warm womb for nine months, your baby has now got to get used to a sensory overload of sights, sounds and smells, as well as a frequently colder environment where they're not constantly supported by your protective amniotic fluid.

Kathryn says: 'Babies have been used to being fed continuously, sleeping when they want to, and being rocked in the cosy embrace of their mum's tummy. When babies are born we introduce gaps between feeds, and put them in a different place to sleep. It's no wonder that they can find this scary, and it's natural that they cry to express their fears.'

Understandably, babies are likely to cry more in this three-month period than any other time in their life. But however logical it might be, it doesn't make this period any easier for new parents. Knowing that other parents are going through the same experience, and thinking of this period as the fourth trimester, might help.

'Parents describe it as a very useful concept, which reminds them that it is OK to find the early days with a baby hard. It is a period of transition, where women become mums, men become dads, and babies adjust to life outside the womb,' Kathryn says.

What can you do to help your baby in the fourth trimester?

Fundamentally, the closer your baby feels to you, the happier they will be. According to Kathryn: 'Anything that mum, dad or other carers can do to replicate the womb-like world will help their baby feel safe. And when we feel safe, we thrive. For your baby, this means holding them close, perhaps in a sling, so they feel the warmth of your body, hear your heartbeat, and are gently rocked as you go about your day (or night).

'Feeding for babies, just like for adults, is about more than just nutrition, it's also social - a way of sharing and being with those we care for. Feeding your baby whenever they they want to will support their emotional development, as well as their physical and intellectual development.

'Your baby will sleep when they're tired, and you will both feel safer if they're close to you. Many parents tell me that in the early days their baby won't sleep in their Moses basket or crib, but only when they're held by a parent. This is perfectly normal and understandable when you think about the baby's point of view. It's important that parents find out about the safer sleep guidelines, and work out a way of sleeping that suits them as a family.'

Can you 'spoil' your baby in the fourth trimester?

No. Despite some people saying that babies need to 'learn' that you won't rush to pick them up every time they cry, in this crucial Fourth Trimester period you can't care for them too much. In fact, the more you look after them when they're upset, the more reassured and confident they'll be.

How might you be feeling?

Even if you're not an international tennis champion, parents who have gone from living busy, independent lives, can find the sudden change to around-the-clock care for a completely dependable infant hard.

Add to that the need to recover from a traumatic or difficult birth, and you can understandably feel like you're the one in need of a little TLC. Kathryn says: 'With the emotional changes in a woman's body, plus the realisation of the enormous responsibility of having a baby, new mums can feel overwhelmed and tearful at times.

'Partners can be dealing with their own response to the birth, their changing identity, and strong feelings about protecting and providing for the family. All of these feelings can also be affected by the way both mum and her partner were parented themselves.'

As with all stages of early parenthood, it's worth remembering that this stage will pass. In what seems no time at all, you might be looking back at the period with fondness at how tiny and attached to you your baby was when they were first born.

However, that is not to downplay how challenging the Fourth Trimester can be for parents. When you're in it, it's all-consuming. You can feel like you don't know what you're doing and you're constantly one step behind.

So, what should I do?

If you think in terms of the first three months of your baby's life being a Fourth Trimester, it can be easier to take the pressure off getting back to 'normal'. You wouldn't have been trying to rush around tidying the house and welcoming endless visitors when you were heavily pregnant, so don't put pressure on yourself to do it now.

'When women are discharged from healthcare some people might think that means they should be able to return to normal life, but there is a long period of adjustment and care needed at home,' says Kathryn. 'Friends and family can support new parents with food, help around the house, and reassurance that they are doing a great job of looking after their baby.'

This is especially important for mums who are raising their baby alone, in which case asking for help from friends and family in advance can help ensure you get the support you need.

Kathryn adds: 'Having very modest aims in the early days - getting outside most days (perhaps a short walk around the block), eating well, resting as much as possible - will change over time to meeting up with friends regularly, getting some exercise every day, and doing the most necessary housework.'

When will the crying settle down?

'As babies grow and change, things that seemed easy one day might feel very difficult another,' Kathryn says. 'A baby's crying tends to peak at around week six, which can mean that parents feel they must be doing something wrong, or that there is a problem with their baby. However, this is normal, and has usually reduced by three months.

'Parents report the excitement and happiness that comes when they see their baby is starting to interact with them, including smiling for the first time.'

Where can I get more help?

'Part of the challenge of this early period is the feeling that there is so much to learn, and to worry about,' explains Kathryn. 'Using safe sources when looking for information about caring for yourself or your baby will reduce anxiety.

'Reputable sources such as NCT practitioners and the website, or NHS health professionals and are a good place to start. Avoid sources of information (including people or media) who make you feel bad about your parenting, and stick with people who you trust and who support you.

'Although things can feel like they're getting harder in the early weeks, most people are feeling much better by around three months after the birth, and some will feel fine before that. If parents are still finding life a real struggle at that point they might consider talking to a health professional, or seeking more support from friends and family, to help them until they are feeling more in control.'

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.

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. To find out when an NCT nearly new sale is happening near you, search here.

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

# data[].attributes.attachment_link.title
What is the fourth trimester? | Baby & toddler articles & support | NCT

# data[].attributes.attachment_link.description
Everyone knows that pregnancies last three trimesters - so what exactly is the Fourth Trimester? We explain what this crucial stage is, and what it means for you and baby

# data[].attributes.attachment_link.readable_text
Should I choose to have my labour induced?

You might want to consider some of the risks and benefits of induction before you make a decision about it. Inductions are offered for various reasons, which include:

longer pregnancy

pre-labour rupture of membranes (PROM) after 37 weeks

a baby that's expected to be larger

health complications for the mother or baby

when the baby has died

when the baby is unable or unlikely to survive outside the womb.

(NHS, 2020; Fisher, 2021; NICE, 2021a)

Many hospitals offer inductions from 41 weeks of pregnancy, or earlier if there are other medical conditions or complications for either mother or baby (NICE, 2021a). No test can predict whether an individual baby would be better to wait for labour to start or if labour should be induced (Middleton, 2020).

Your healthcare providers will provide you with information, so read below to find out what questions to ask.

Why the concern about a longer pregnancy?

Most pregnancies come to a natural end with birth between 37 and 42 weeks. Some end earlier and some are a little longer. Over 80 in 100 babies arrive before 41 weeks of pregnancy and 99 in 100 by 42 weeks of pregnancy (NICE, 2021a). The length of pregnancy can be a family trait. So you may want to consider how long your previous pregnancies and those of your female relatives were (Oberg et al, 2013).

Induction is offered in longer pregnancies because, after 41 weeks, there is a higher chance of a baby being admitted to a neonatal intensive care unit, and the rate of stillbirth increases from less than one in 1,000 at 40 weeks to three in 1,000 (Middleton, 2020; NICE, 2021a). After pregnancies lasting over 41 weeks, more women have a caesarean birth (NICE, 2021a).

While these risks are still comparatively low at 41 weeks, some research has found that the increased risk of stillbirth is higher for people from a minority ethnic background or those who live in deprived areas. So you may wish to discuss this with your healthcare provider (NICE, 2021a).

In mothers over 40 years old, induction is likely to be offered earlier, although this does not form part of national guidance. This is because as we age, we can accumulate other health conditions that may affect pregnancy. Such offers should be individualised, because for example, a fit and healthy 42-year-old may have a healthier pregnancy than a woman of 35 with additional health issues. If someone declines an induction, they will be offered additional monitoring of the baby, which can also be declined (NICE, 2021a).

Why is induction offered if my waters go?

Depending on when the waters break during pregnancy, an induction may be offered. When the amniotic sac of waters around the baby ruptures before contractions have started, it slightly increases the chance of infection for the baby, and giving birth reduces this risk (NICE, 2021a).

It is unlikely that an induction would be offered before 34 weeks of pregnancy unless there is an additional complication for the baby. Your carers may recommend waiting until 37 weeks for an induction if there are no other complications and the baby is doing well (NICE, 2021a).

If someone is over 37 weeks pregnant and their waters break with no signs of labour, they may be offered the choice of an induction or 24 hours to wait and see if labour starts (NICE, 2021a). It always remains the woman's decision to accept or decline an induction. If you decline, then your carers will explain how to reduce the chance of infection.

Why is induction offered for a larger baby?

Induction may be offered if a baby seems to be growing larger than expected, although there is little evidence around the benefits and risks of induction in this situation (NICE, 2021a). A larger baby in this situation is considered to be one with an estimated weight in the largest five in 100 babies (NICE, 2021a). However, the baby's size is difficult to determine accurately (RCOG, 2012).

When a baby may be larger, it slightly increases the chance of the mother finding it harder to birth them without injury to herself. For this reason, caesarean birth may also be considered as an option (NICE, 2021a).

Shoulder dystocia is where the baby's shoulders are not born by the mother's efforts in the next contraction after the head is born (Menticoglou, 2018). For women who do not have diabetes, there is a slightly increased chance of this happening with expectant management of a longer pregnancy (NICE, 2021a). (See our articles on diabetes in pregnancy if that applies to you.) It's useful to know that almost half of the cases of shoulder dystocia occur in smaller babies (RCOG, 2012), which is why there is no national guidance to always induce or move to a caesarean birth when the baby is suspected to be larger.

When might an induction be offered due to health complications?

There are many reasons why an induction could be considered. For example, if a pregnant woman has high blood pressure or if a baby is not growing as expected (NHS, 2020). There may be many factors to consider, and you could ask why an induction is being recommended.

Induction for a baby that has died or is unable or unlikely to survive outside the womb

Sometimes a baby has died before being born, or tests show that they will be unable or unlikely to survive outside the womb. In this situation, an induction may be offered as an option for birth, alongside waiting for labour to start or giving birth by caesarean (NICE, 2021a).

In these difficult circumstances, maternity units offer specialist support to the family (NICE, 2021a). There is plenty of time for the different options to be explored, and suggestions for how to say goodbye to the baby are offered.

What are the pros and cons of membrane sweeps?

A 'membrane sweep' or 'stretch and sweep' might make it more likely that labour starts without a formal induction (NICE, 2021a). It involves a midwife inserting one or two fingers into the vagina and using a circling motion sweeping the cervix to free the membranes (Finucane et al, 2020). The risks of this are pain, discomfort and possible vaginal bleeding, along with irregular or regular contractions that may not lead to established labour (Madeley, 2021; NICE, 2021a). You can ask the midwife for a vaginal examination before proceeding with the sweep, as that may tell you that labour is already starting.

In three studies that asked the question, the majority of women found a sweep to be an acceptable way to prevent a formal induction of labour (Finucane et al, 2020). However, a systematic review showed that seven women would need sweeps to prevent a single induction (Boulvain et al, 2005).

Women may experience repeated sweeps as physically and emotionally exhausting (Madeley, 2021). The procedure could also cause an accidental rupture of the membranes protecting the baby, which would lead to an offer of induction within 24 hours as there would then be a risk of infection (Avdiyovski et al, 2019; NICE, 2021a).

What happens when labour is induced?

To begin with, you will be offered a vaginal examination and monitoring of your baby's heart rate (NICE, 2021a). This may be a good time to ask any further questions that you have. Different forms of inductions may be offered depending on your NHS trust and how dilated your cervix is.

A chemical induction involves the use of artificial hormones inserted as a gel, tablet or 'tampon' into the vagina. A mechanical induction instead uses a catheter or small rods placed in the cervix which slowly expand, stretching it open (NICE, 2021a). These methods are both known as cervical ripening and can take several days. Women often describe this as a negative experience, particularly if they were staying on their own in hospital or were unsure what to expect (Brown and Furber, 2015).

If labour is progressing, the midwife may suggest breaking the waters, and then setting up a drip of synthetic oxytocin to stimulate stronger contractions (NICE, 2021a). You can postpone or decline these suggestions (NICE, 2021a).

What are the disadvantages of induced labour?

A chemical induction can cause the uterus to contract strongly in a way that the mother or baby find difficult, so both you and your baby will be continuously monitored using a machine connected to straps around the abdomen (NICE, 2021a). This may affect your ability to move and might be uncomfortable.

Induction of labour will affect your birth options (NICE, 2021a). Birth will be arranged for a hospital setting and it may not be possible to use a birth pool. This could be because your NHS trust doesn't have the facilities to monitor you in the pool, or because your labour is more complicated, so the pool is not recommended.

Some people report an induced labour to be more painful, and the hospital stay during and after birth may be longer. It is also associated with a more negative birth experience (Adler et al, 2020; NICE, 2021a).

There may be a higher chance of complications during an induced labour if it is your first baby (Dahlen et al, 2021). One sixteen-year study has found that babies whose birth was induced were more likely to experience hospitalisation for infections up until 16 years of age, particularly if born before 41 weeks gestation (Dahlen et al, 2021).

Do I have a say in the decision to have an induction?

Yes, it's good to remember that your views, beliefs and values are central to decisions about your care. This includes whether you want to accept the offer of induction (Dekker, 2020; NICE, 2021a,b). You can also talk to your healthcare provider if you wish to request an induction for any reason (Dekker, 2020; NICE, 2021a).

For example, a healthy first-time mum who wants an unmedicated birth might feel strongly that they want a spontaneous labour. At the same time, it may be very important to someone who has experienced miscarriages in the past to lower the risk of stillbirth by any means necessary.

You may have preferences over what methods are used during induction, and you can talk to your healthcare professional about this (NICE, 2021a). Some hospitals offer outpatient induction where the start of the process can happen at home. Current research has found this to be as safe and effective as being in hospital and may cause less discomfort, but it may not be offered everywhere (Dong et al, 2020).

Your midwife or obstetrician should explain why you are being offered an induction and the methods, risks, benefits and alternatives. They should also encourage you to look at information about it and give you time to discuss your decision with your partner or family. Midwives or obstetricians should support you in whatever decision you make (NICE, 2021a).

Take a look at Dr Sara Wickham's Five Questions to ask if you're offered induction of labour (Wickham, 2022).

What are the side effects of being induced?

Severe side effects of the drugs used for cervical ripening are very rare. But general side effects can include nausea, vomiting, diarrhoea and headaches (uncommon) (NICE, 2022a).

Similarly, syntocinon, which is given by drip to augment or strengthen labour, can cause headaches, nausea, vomiting and very occasionally a rash. It can also have a negative effect on breastfeeding (Cadwell and Brimdyr, 2017).

Induction is an increasingly common process carried out in the UK. NHS data show that 34% of labours were induced in 2020 to 2021 (NHS Digital, 2021). Almost two-thirds (60 in 100) of these induced women gave birth without forceps/ventouse or caesarean. About 17 in 100 had births assisted with forceps or ventouse and 22 in 100 had an unplanned caesarean birth (NHS Digital, 2021).

These figures apply to all inductions for all reasons, not just those performed for longer pregnancies. The national rates for all births in 2020 to 2021 were: 54 in 100 births did not involve forceps/ventouse or caesarean sections; 13 in 100 were assisted births; and 33 in 100 were caesarean births (which includes planned and unplanned caesareans) (NHS Digital, 2021).

Weighing up the pros and cons...

Feeling like they have plenty of information can help some people to weigh up the benefits of induction against any potential risks. Other people can find it a bit overwhelming.

With most decisions about giving birth, you only have to decide one small thing at a time. One of the things you can ask your healthcare providers is: 'Can I stop at this point if I change my mind?' and 'Which avenues am I closing by making this decision?'

You can consider what kind of information will help you feel you've made the decision that's best for you and your baby.
This page was last reviewed in September 2022.
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.

# data[].attributes.attachment_link.title
Induced labour: reasons, pros and cons | Pregnancy, Your pregnancy week by week articles & support | NCT

# data[].attributes.attachment_link.description
You might want to consider some of the risks and benefits of induction before you make a decision about it. Inductions are offered for various reasons, which include: longer pregnancy pre-labour rupture of membranes (PROM) after 37 weeks a baby that's expected to be larger health complications for the mother or baby when the baby has died when the baby is unable or unlikely to survive outside the womb.

# data[].attributes.attachment_link.title
What is a stretch and sweep? - Dr Sara Wickham

# data[].attributes.attachment_link.description
Many women are offered a ‘stretch and sweep’ in late pregnancy. But what is this, why and how is it done, does it work and can you say no?

# data[].attributes.attachment_link.title
KG Hypnobirthing "Down" Breathing Exercise

# data[].attributes.attachment_link.readable_text
In this article

What is postnatal depression?

Postnatal depression (PND) is sometimes confused with the baby blues. The baby blues are when you feel moody, weepy, tired or anxious during the first 10 days after giving birth. These feelings will usually pass within a few days (Mind 2016a, SIGN 2012).

However, unlike the baby blues, PND is an illness that is unlikely to get better quickly, without help (NHS 2018a). It's important to get the support you need as soon as possible if you think you may have PND. Your symptoms could last for months and can have a big impact on you, your baby and your family (NHS 2018a, NICE 2018).

How common is PND?

Postnatal depression is surprisingly common, affecting more than one in 10 mums within a year of giving birth (NHS 2018a). And as some women don't seek help, or don't acknowledge that they have PND, the true rate is likely to be even higher than this (NICE 2018).

PND can also affect dads and partners (NHS 2018a). Read our article for more information on postnatal depression in dads.

How will I know if I have PND?

The signs and symptoms of PND will be different for every mum (NHS 2016b, RCP 2018). Your friends or family may spot the signs before you do, but the main symptoms include:

A persistent feeling of sadness and low mood, which may feel worse in the mornings.

Loss of interest in the world around you and no longer enjoying things that used to give you pleasure.

Lack of energy and feeling tired all the time.

Trouble sleeping at night and feeling sleepy during the day.

Feeling that you're unable to look after your baby.

Feeling easily overwhelmed.

Problems concentrating and making decisions.

Loss of appetite or an increased appetite (comfort eating).

Feeling agitated, irritable or very apathetic (you "can't be bothered").

Feelings of guilt, hopelessness and self-blame.

Feeling you don't have a positive bond with your baby, perhaps feeling indifferent about him and no sense of enjoyment in his company.

Frightening thoughts, for example, about hurting your baby. These can be scary, but they're very rarely acted upon.

Thinking about suicide and self-harm. (NHS 2018b, PANDAS nd, Patient.info 2017)

Most mums have at least one of these feelings, some of the time. It's normal to have good days and bad days. But if you're feeling these symptoms often, and they don't get better, you could have PND (NICE 2014, 2018).
Take our quiz to see if you may have postnatal depression.

Signs of postnatal depression

When does PND usually happen?

PND often develops within the first few months after giving birth, particularly in the first five weeks (RCP 2018, SIGN 2012). But it could start at any time in the first year (NICE 2018, SIGN 2012). A third of women with postnatal depression have symptoms which started in pregnancy and continue after birth (NICE 2018, RCP 2018).

You may have been really enjoying looking after your baby before depression crept up on you. If you were anxious or depressed while you were pregnant, your baby's arrival may not have helped to lift your depression.

What causes PND?

Experts don't fully understand why some women become depressed and others don't. It's likely to be for a few reasons, rather than just one cause. Sometimes, the things you have to face every day just get on top of you and make it harder for you to look after yourself, rest and eat well.

Certain circumstances may make it harder for you to cope, such as:

You've experienced physical, emotional or sexual abuse as a child or later in life.

You have been depressed before, or have had problems with your mental health, or were depressed during a previous pregnancy.

You are going through a stressful or difficult life event, such as an illness or death in the family, or losing a job, and you don't have good social support.

You're an asylum seeker or refugee.

You've given birth to twins or more.

You have a chronic illness or other medical problem.

You don't have a supportive partner or you are experiencing problems in your relationship.

Your baby was born prematurely or has a low birth weight (Howard et al 2014).

How is PND treated?

With help, you will get better. Your GP or health visitor will support you, so that you can look after yourself and your baby well. Be reassured that having PND does not mean that you are a bad mother, or that you will have your baby taken away from you (Mind 2016a).

You GP may want to check your physical health, as lacking some vitamins and minerals such as iron could worsen feelings of depression (NICE 2018).

Depending on the severity of your PND, your GP may recommend one or a combination of the following treatments:

Self-help

If you have mild PND, your GP may recommend a guided self-help route, working through a book or an online course. These self-help courses usually last nine to 12 weeks (NHS 2018c, NICE 2018).

Your GP may also recommend the following self-help strategies:

Sleep or rest whenever possible. If someone is able look after your baby for a couple of hours, put on some soothing music, have a warm drink and relax. Try to nap when your baby is sleeping, and forget your to-do list for a while (Woolhouse et al 2015). Read our tips for improving the quality of your sleep.

Eat a healthy, well-balanced diet. With all the new demands on your body, eating well is important. Try not to go for long periods without eating, to avoid a dip in your blood sugar levels (NHS 2018c). Food fuels your energy and immune system, so a balanced diet will prevent you from becoming tired and feeling run down (RCP 2018).

Exercise. It may be the last thing you feel like doing, but exercise will help you to feel better in mind and body (NHS 2018e, Pritchett et al 2017). You could join an exercise class (NICE 2018), or your GP may refer you to a personal trainer or an exercise scheme (SIGN 2012). If it's a struggle to get started, try to keep your goals manageable. Just going for a walk with your baby can help to lift your mood (Pritchett et al 2017). If you did yoga or Pilates classes while you were pregnant, you could go along again now (Buttner et al 2015, Ko et al 2013).

Meet other mums. Having a baby can be isolating, but if you have PND, you may feel particularly alone. Ask your health visitor about groups for new parents in your area and see if you can go along, perhaps with a friend (RCP 2018). Adult company and developing friendships can be a real lifeline.

Be kind to yourself. Taking care of yourself and your baby are the most important things. Try not to load yourself up with tasks that aren't essential. Be realistic about what you can achieve and don't beat yourself up if things don't go as planned. Try to treat yourself as you would a friend (Mind 2016a). Do activities that you find relaxing and enjoyable, such as listening to music, reading a book or having a warm bath (NHS 2018c).

Talking therapies
Though talking to your partner or a friend can help, they may find it difficult to understand what you are going through.

If you have moderate to severe PND, your GP may refer you to a support group, counsellor or psychotherapist. She may also arrange cognitive behavioural therapy (CBT) or interpersonal therapy (IPT) (NICE 2018, SIGN 2012). CBT can help you to break the cycle of unhelpful or unrealistic thinking which could be contributing to your depression. IPT explores whether problems in your relationships with others may be contributing to your depression (Melville 2016).

Unfortunately, waiting lists for these therapies tend to be long in many areas of the UK (RCP 2018). Some charities can also put you in touch with a trained volunteer who is used to talking to mums with PND (NHS 2018c).

Antidepressants

Antidepressants can help to lift your mood by increasing the levels of the chemical, serotonin, in your brain (BNF 2019, NHS 2018d). They can help you to sleep, feel less irritable and more able to cope with the demands of caring for your new baby (BNF 2019).

Between 50 and 70 per cent of women who take antidepressants, find that their PND symptoms ease within a few weeks of starting treatment (NHS 2018d). If you are prescribed a course of antidepressants it can seem like the first few tablets make no difference, but after two to four weeks of taking them, you should begin to feel better (BNF 2019, NHS 2018c, 2018d).

Antidepressants don't always work for everyone, and may cause side effects (BNF 2019). Though they are not addictive (Mind 2016b, RCP 2018), you can experience withdrawal symptoms when you stop taking them, especially if you've been taking them for a long time. For this reason it's advisable to reduce the dose slowly instead of just stopping taking them (Mind 2016b).

Commonly prescribed antidepressants for PND include selective serotonin reuptake inhibitors (SSRIs), such as:

fluoxetine (Prozac)

sertraline (Lustral)

citalopram (Cipramil) (NHS 2018d)

Some antidepressants are considered to be safe to take if you are breastfeeding, providing your baby is healthy and born at full term (NICE 2018, RCP 2018).
Sertraline is often recommended over fluoxetine for breastfeeding mums, as smaller amounts of these drugs pass into your breastmilk and they clear from your system more quickly (NICE 2018). If your baby seems sleepy, not interested in feeding or irritable after you have taken antidepressants, talk to your GP (NICE 2018).

Many mums who take antidepressants continue to breastfeed, because it improves their confidence and strengthens their bond with their baby (Figueiredo et al 2013). Feeling close to your baby can help you to tackle PND (Figueiredo et al 2013).

Talk to your doctor or specialist to get a clear understanding of the risks and benefits involved in taking specific antidepressants. This is especially important if you're breastfeeding (Mind 2016a, NICE 2014, 2018).

What if these PND treatments don't work?

If your PND is severe and it doesn't respond to the treatments above, you may be referred to a perinatal mental health team. This is likely to include specialist nurses, as well as a psychologist or a psychiatrist (NICE 2018, SIGN 2012).

Your team will recommend you try additional treatments, such as:

More intensive CBT.

Other psychological treatments, such as psychotherapy.

Therapies such as baby massage to help you develop the bond with your baby, if this has become a problem.

Different medications (NHS 2018c).

How can my partner, friends and family help?

It can be hard for those closest to you to understand how awful you're feeling. But they have an important part to play in helping you to get better. Tell them what you are going through and give them any information you have about PND. Your partner may also be depressed (Mind 2016a, RCP 2018), and understanding how to support you could help him to feel better, too.

Ask loved ones for help, because practical support, such as helping around the house or preparing food, can go a long way towards lifting your mood. Just an hour or so of them babysitting, so you can rest or have time alone or with your partner, will help to refresh you (Mind 2016a, Woolhouse et al 2016).

Can I prevent PND?

We don't know. Some doctors may prescribe antidepressants immediately after the birth if you are at high risk of PND (NHS 2016a, NICE 2018).

Take care of yourself while you're pregnant, try to reduce your stress levels, and accept any help that's offered. The more support you have during your pregnancy, the stronger you are likely to feel when you have your baby.

If you've had PND before, or felt depressed during a previous pregnancy, tell your GP, so you can be treated sooner (NICE 2018, SIGN 2012).

Where can I get more support?

It's a good idea to ask your health visitor about support services in your area. She may be able to put you in touch with an early help support worker, counsellor or local support group. It can be reassuring to meet other mums who are going through something similar (NHS 2018c).

There are also a number of national support groups that you can contact for advice:

The Association for Post Natal Illness can put you in touch with trained, experienced volunteers.

The British Association for Counselling and Psychotherapy details qualified counsellors and psychotherapists by area.

Family Action offers specialist support services for parents with mental health problems, including perinatal services.

Family Lives is a helpline (0808 800 2222) that provides support and information for parents who are under stress.

Home-Start will visit you at home and offer friendship, support and practical help, as well as put you in touch with other parents in your area.

You can search for local support groups and find details of national telephone or email support lines on the Maternal Mental Health Alliance website.

Mind, the mental health charity, provides information and support for parents with postnatal depression and other perinatal mental health issues. You can get details of help and support in your area by ringing 0300 123 3393 (9am to 6pm, Monday to Friday) or emailing info@mind.org.uk.

Your local National Childbirth Trust (NCT) may be able to put you in touch with others who have, or have had, PND. You can also meet other new parents in your area by attending an NCT Early Days course.

See a selection of apps you can use to help improve your mental health in the NHS Apps library.

The PANDAS Foundation offers support and advice for any parent who is experiencing a perinatal mental illness. The helpline (0843 289 8401) is open every day from 9am to 8pm.

Visit the BabyCentre community to talk to other mums who understand how you are feeling.

Last reviewed: March 2019

References

BNF. 2019. Antidepressant drugs. British National Formulary. bnf.nice.org.uk [Accessed February 2019]

Buttner MM, Brock RL, O'Hara MW, et al. 2015. Efficacy of yoga for depressed postpartum women: a randomized controlled trial. Complement Ther Clin Pract. 21(2):94-100

Figueiredo B, Dias CC, Brandao S, et al. 2013. Breastfeeding and postpartum depression: state of the art review. J de Pediat 89(4):332-8. www.sciencedirect.com [Accessed February 2019]

Howard LM, Molyneaux E, Dennis C-L, et al. 2014. Non-psychotic mental disorders in the perinatal period. Lancet 384(9956):1775-88. www.thelancet.com [Accessed February 2019]

Ko YL, Yang CL, Fang CL, et al. 2013. Community-based postpartum exercise program. J Clin Nurs 22(15-16):2122-31

Letourneau NL, Dennis CL, Cosic N, et al. 2017. The effect of perinatal depression treatment for mothers on parenting and child development: a systematic review. Depress Anxiety 34(10):928-66

Melville NA. 2016. IPT effective for depression, anxiety, eating disorders. MedScape. www.medscape.com [Accessed February 2019]

Mind. 2016a. Understanding postnatal depression and perinatal mental health. National Association for Mental Health. www.mind.org.uk [Accessed February 2019]

Mind. 2016b. What withdrawal problems can antidepressants cause? National Association for Mental Health. www.mind.org.uk [Accessed February 2019]

NHS. 2018a. Postnatal depression. NHS, Health A-Z. www.nhs.uk [Accessed February 2019]

NHS. 2018b. Symptoms: postnatal depression. NHS, Health A-Z, Postnatal depression. www.nhs.uk [Accessed February 2019]

NHS. 2018c. Treatment: postnatal depression. NHS, Health A-Z, Postnatal depression. www.nhs.uk [Accessed February 2019]

NHS. 2018d. Antidepressants. NHS, Health A-Z. www.nhs.uk [Accessed February 2019]

NHS. 2018e. Exercise for depression NHS Choices, Health A-Z, Moodzone. www.nhs.uk [Accessed February 2019]

NICE. 2014. Antenatal and postnatal mental health: clinical management and service guidance. National Institute for Health and Care Excellence, Clinical guideline, 1925. www.nice.org.uk [Accessed February 2019]

NICE. 2018. Depression: antenatal and postnatal. National Institute of Health and Care Excellence, Clinical Knowledge Summaries. Cks.nice.org.uk [Accessed February 2019]

PANDAS. nd. Postnatal depression PANDAS Foundation UK. www.pandasfoundation.org.uk [Accessed April 2019]

Patient.info. 2017. Postnatal depression. Patient.info. https://patient.info/ [Accessed April 2019]

Pritchett RV, Daley AJ, Jolly K. 2017. Does aerobic exercise reduce postpartum depressive symptoms? A systematic review and meta-analysis. Br J Gen Pract 67(663): e684-91. www.ncbi.nlm.nih.gov [Accessed February 2019]

RCP. 2018. Postnatal depression The Royal College of Psychiatrists. www.rcpsych.ac.uk [Accessed March 2013]

SIGN. 2012. Management of perinatal mood disorders: a national clinical guideline. Scottish Intercollegiate Guidelines Network. www.sign.ac.uk [Accessed March 2013]

Woolhouse H, Small R, Miller K, et al. 2015. Frequency of "Time for Self" is a significant predictor of postnatal depressive symptoms: results from a prospective pregnancy cohort study Birth 43(1):58-67 https://onlinelibrary.wiley.com [Accessed February 2019]

# data[].attributes.attachment_link.description
In this article Postnatal depression (PND) is sometimes confused with the baby blues. The baby blues are when you feel moody, weepy, tired or anxious during the first 10 days after giving birth. These feelings will usually pass within a few days (Mind 2016a, SIGN 2012).

# data[].attributes.attachment_link.title
Vitamin K and newborns: what you need to know | Labour & birth articles & support | NCT

# data[].attributes.attachment_link.description
If you’ve heard people talk about Vitamin K but are feeling a bit clueless, here’s the information you’ll need.

# data[].attributes.headline
NCT links to baby care, including bathing and baby massage

# data[].attributes.subject
NCT links to baby care, including bathing and baby massage

# data[].attributes.attachment_link.readable_text
Sign up now for NCT's exclusive Pregnancy & Baby Guide

First name

Last name

Email

Due date/Date of birth

Postcode

Address

Town/City

You need to know…

We would like to keep in touch with you about our services, support, events, campaigns, and fundraising. We'll only contact you in the ways you want, and we'll keep your data safe. (See our privacy policy for further details.)

I agree to NCT contacting me in the following ways:

Email*

Post

Telephone

SMS text

By submitting this form you are agreeing to our website's general Terms and Conditions of use.

To update your permissions, contact us on 0300 330 0700 or email enquiries@nct.org.uk

Expand

Support line

0300 330 0700

Practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers.

See all costs

Calling us costs the same as any local call, however, if you have free 'inclusive' minutes on a landline or mobile, it will be included in those.

About

Vision, mission & goal

Trustees

Careers

Contact us

News & views

News

Forums

Support us

Membership

Volunteering

Partnerships

Donate

Fundraising

Professionals

Train to be an NCT Practitioner

Breastfeeding peer support training

Birth and Beyond Community Support Programme (BBCS)

Work with us

Bottom links nct2

Safeguarding

Media

Privacy and cookies

Contact us

Editor login

NCT, Brunel House, 11 The Promenade, Clifton Down, Bristol BS8 3NG
Reg Charity No (England and Wales): 801395, (Scotland): SC041592. Reg Company No: 2370573.

# data[].attributes.attachment_link.description
In the first weeks and months, you'll be getting to grips with looking after your new baby. Find out everything you need to know about babycare basics.

# data[].attributes.attachment_link.title
What is a caesarean birth? | Labour & birth, Different types of birth articles & support | NCT

# data[].attributes.attachment_link.description
Caesarean birth is when a baby is born by abdominal surgery. Some are planned, while others are unplanned or emergency caesareans.

# data[].attributes.headline
How to find local NCT meet ups and activities...

# data[].attributes.subject
How to find local NCT meet ups and activities...

# data[].attributes.attachment_link.description
From coffee groups to meet-ups for new dads, our local groups and activities can help you build up a supportive social network.

# data[].attributes.headline
Find a NCT early days course in your area 

# data[].attributes.subject
Find a NCT early days course in your area 

# data[].attributes.attachment_link.description
Having a baby is life-changing. Help yourself adjust and grow in confidence with an Early Days course. You’ll be guided by one of our highly experienced course leaders, meet other mums in the same boat, build a network of support and gain valuable knowledge, skills and insight.

# data[].attributes.attachment_link.title
Informed is Best: How to spot fake news about your pregnancy, birth and baby

# data[].attributes.attachment_link.description
Pinter & Martin is an independent publishing company specialising in pregnancy, birth, parenting, breastfeeding, yoga and psychology books

# data[].attributes.attachment_link.title
The Little Book of Positive Birth Stories by Claire Fulton | Waterstones

# data[].attributes.attachment_link.description
Buy The Little Book of Positive Birth Stories by Claire Fulton from Waterstones today! Click and Collect from your local Waterstones or get FREE UK delivery on orders over £25.

# data[].attributes.attachment_link.readable_text
Pregnant women and maternity services are facing an induction epidemic. As medical guidelines include more "at risk" categories, women and our already overwhelmed and under resourced maternity systems are increasingly pressured to induce birth before labour begins spontaneously. Women are deemed to be too large and too old, while babies are estimated to be too big and too overdue. But is 'better-out-than-in' really a safer option than waiting to birth in your own time?

Staggeringly, over a third of all pregnant women have their labour medically induced, and this is accompanied by a tsunami of avoidable medical interventions. Worldwide, this trend is growing at an alarming rate. This is despite both a lack of evidence demonstrating its benefits and a wealth of evidence indicating the significant short- and long-term negative impacts of induction on the health and wellbeing of mothers and their babies.

In this timely book, Dr Sara Wickham demystifies the evidence and highlights the significant discrepancies between guidelines and what we really know about the benefits of supporting women to birth spontaneously. With her renowned ability to make complex issues understandable, her holistic approach and more than twenty-five years' experience as a midwife and researcher, Dr Wickham draws on a wide range of evidence, including the voices of women and practitioners, to answer vital questions such as: How accurate are due dates? Is it really that risky to wait? Does induction make a difference? And, perhaps most importantly, how can we address the induction epidemic?

In Your Own Time is both a masterclass in what the evidence really says about induction of labour and a fascinating insight into how birth has come to be controlled by Western medicine.

"This is such a vitally important book. With her brilliant brain and extensive experience, Dr Sara Wickham has pulled together and clearly interpreted the complex evidence about induction of labour. This book provides clarity about why increasing numbers of women are having their labours induced, and the problems with current guideline recommendations. It also offers suggestions about what we can all do to reclaim the parameters of normal and support women to birth in their own time. Anyone who cares about women and their experiences of birth needs this book." Dr Rachel Reed, midwife and researcher.

# data[].attributes.attachment_link.title
In Your Own Time: How western medicine controls the start of labour and why this needs to stop

# data[].attributes.attachment_link.description
Pregnant women and maternity services are facing an induction epidemic. As medical guidelines include more "at risk" categories, women and our already overwhelmed and under resourced maternity systems are increasingly pressured to induce birth before labour begins spontaneously. Women are deemed ...

# data[].attributes.attachment_link.title
Sprogcast - Episode 4 - Risk (June 2015) by Pinter & Martin

# data[].attributes.attachment_link.description
Hosted by Karen Hall and Mark Harris, with Rebecca Schiller.

# data[].attributes.attachment_link.provider_name
East Suffolk and North Essex NHS Foundation Trust

# data[].attributes.attachment_link.readable_text
Pregnant mums and their partners can now take an interactive tour around the maternity department at Ipswich Hospital.

Midwife Emily is our video guide, giving families all the information they need prior to their visit.

View our video below.
Back to top

# data[].attributes.attachment_link.authors[].name
East Suffolk and North Essex NHS Foundation Trust

# data[].attributes.attachment_link.title
Take a tour around Ipswich Hospital's maternity unit | East Suffolk & North Essex NHS Foundation Trust

# data[].attributes.attachment_link.description
Pregnant mums and their partners can now take an interactive tour around the maternity department at Ipswich Hospital. Midwife Emily is our video guide, giving families all the information they need prior to their visit. View our video below. Back to top

# data[].attributes.body
A brilliant, unbiased and very informative podcast

# data[].attributes.attachment_link.readable_text
The birth-ed podcast opens up conversations about all aspects of pregnancy, birth and parenthood, with the UKs leading women's health experts- from Midwives to Obstetricians, Doulas to Activists. The birth-ed podcasts sets out to leave you feeling fully informed, confident and positive about what this journey might entail. Through our inspiring, informative and sometimes challenging conversations, we leave no stone unturned when it comes to preparing you for your pregnancy, birth and the postnatal period.

The birth-ed podcast opens up conversations about all aspects of pregnancy, birth and parenthood, with the UKs leading women's health experts- from Midwives to Obstetricians, Doulas to Activists. The birth-ed podcasts sets out to leave you feeling fully informed, confident and positive about what this journey might entail. Through our inspiring, informative and sometimes challenging conversations, we leave no stone unturned when it comes to preparing you for your pregnancy, birth and the postnatal period.

Prepared me for my second broth (at home)

If you are pregnant I would highly recommend listening to this podcast - as many episodes as you can! This, along with the online course and pregnancy yoga, and working with a doula, led me and my husband to deciding on a home birth for our second baby a month ago. It was empowering and amazing and I felt well-prepared. Thank you for everything that you do - so much helpful information and encouragement!

A must listen for anyone who is pregnant!

I've been following Meghan on Instagram for a while and always love how she shares information in a nuanced, thoughtful way. The podcast is an extension of that and is BRILLIANT. If you are pregnant, especially in the U.K., and want to feel informed and empowered about what your options are and how to navigate maternity services then I highly recommend this podcast.

Informative and helpful

Range of guests and topics- really helpful for anyone about to give birth- however you're doing it!!

# data[].attributes.attachment_link.description
The birth-ed podcast opens up conversations about all aspects of pregnancy, birth and parenthood, with the UKs leading women's health experts- from Midwives to Obstetricians, Doulas to Activists. The birth-ed podcasts sets out to leave you feeling fully informed, confident and positive about what th...

# data[].attributes.body
NHS guid to car seat safety

# data[].attributes.attachment_link.readable_text
It's recommended to buy a baby car seat before your baby is born if possible. It's important to buy a seat that fits your car and is suitable for a newborn.
If you have your baby in hospital or a birth centre, you will need the car seat to drive your newborn home safely. It's a good idea to practise fitting the seat before your baby is born.

Tips for buying a baby car seat

When buying a car seat, it's best to try a few in your car before making a decision. Try to find a retailer who is willing to help you with this. Ask whether staff have been trained in fitting car seats.

Check whether your car has Isofix connectors built into it. These are designed to make fitting baby and child car seats simpler. Most modern family cars have them. They may be hidden in the cracks between the padding of your car seats.

Some car seat manufacturers have online guides showing which cars their seats will fit in. If your baby is likely to travel in another car regularly - for example, with other family members - check the car seat fits their car, too.

Always choose a baby or child car seat that's right for your child's current height and weight - see What size car seat? for more.

Do not buy a secondhand car seat. It could have been damaged in an accident, and may not have all its parts, including the instructions. It may also not be the safest and most user-friendly model, plus it may not fit your car properly.

Only accept a car seat from friends or family if you know its history, it's not too old and it comes with instructions.

Think about how you will be using the car seat. If you'll be lifting your baby in and out of the car a lot, for example, you may be better off getting a lightweight seat with a base that stays in the car.

All car seats in this country should be EU approved. Look for the "E" mark label on the seat.

What are i-Size car seats?

i-Size is an European safety standard for baby and child car seats. It's part of regulation ECE R129, which will eventually replace the old safety regulation R44/04. The idea is that all car seats will eventually meet the tighter i-Size safety standards.

Your car must have Isofix connectors for you to be able to use an i-Size car seat. At the moment there are only a few i-Size seats on the market in the UK and not all cars have Isofix connectors.

Visit the Royal Society for the Prevention of Accidents (RoSPA) child car seats website for more on i-Size car seats.

What size car seat?

Car seats are divided into 3 main groups, depending on your baby or child's age and weight:

group 0+ - rear-facing car seats suitable for babies aged up to about 15 months or who weigh up to 13 kg (29lb); some can be clipped on to a pushchair frame and are known as travel systems

group 1 - forward-facing seats suitable for children who weigh 9-18kg (20-40lb) or who are aged from about 9 months to 4 years

group 2/3 - high-backed booster seats suitable for children who weigh 15-36kg (33lb-5st 9lb) or are aged from about 4 to 11 years

You can also buy combination seats that cross over these groups, such as group 0+/1 seats, which are suitable from birth until your child weighs about 18kg (40lb) or is aged about 4. These can be more economical, but may not offer the same level of protection.

Baby or child car seat fitting

It is dangerous and illegal to carry a baby in a rear-facing baby seat in a front passenger seat that has an active airbag. Forward-facing seats in the same position, while not illegal, are not ideal. It's always safer for children to travel in the back of the car.

Make sure the seat is fitted properly in the car, following the manufacturer's instructions.

Look out for safety days where experts demonstrate how to fit baby and child car seats safely. These often take place in supermarket or shopping mall car parks.

Using a baby or child car seat

Make sure you always put your baby into their car seat from the pavement side of the car.

Make sure your baby is securely strapped in according to the manufacturer's instructions. When you buy your car seat, ask the retail staff to demonstrate how to strap your baby into it.

Use a rear-facing car seat for as long as your baby fits into it, as these offer better protection in the event of a car accident.

Credit:

Janine Wiedel Photolibrary / Alamy Stock Photo

https://www.alamy.com/father-putting-baby-into-baby-seat-in-car-before-journey-image1807781.html?pv=1&stamp=2&imageid=EA803192-38ED-4BEC-9733-A9952516E6DF&p=4227&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d2%26resultview%3dsortbyPopular%26npgs%3d0%26qt%3dAY95A6%26qt_raw%3dAY95A6%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d788068%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d1%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3d%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d

More help and advice on car seats

# data[].attributes.attachment_link.description
It's recommended to buy a baby car seat before your baby is born if possible. It's important to buy a seat that fits your car and is suitable for a newborn. If you have your baby in hospital or a birth centre, you will need the car seat to drive your newborn home safely.

# data[].attributes.attachment_link.readable_text
The safest cot is a clear cot

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

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

When preparing your baby's sleep space, remember:

No pillows or duvets

No cot bumpers

No soft toys or comforters

No weighted or bulky bedding

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

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

# data[].attributes.attachment_link.title
Safer sleep overview - The Lullaby Trust

# data[].attributes.attachment_link.description
An easy guide to practicing safer sleep for your baby and reducing the risk of sudden infant death syndrome (SIDS, or cot death).

# data[].attributes.attachment_link.readable_text
It's not known why some babies die suddenly and for no apparent reason from sudden infant death syndrome (SIDS), or cot death.

Experts do know placing a baby to sleep on their back reduces the risk, and exposing a baby to cigarette smoke or allowing them to overheat increases the risk.

It's also known there's an association between sleeping with your baby on a sofa or chair and SIDS.

Follow the advice on this page to reduce the risks as much as possible.

How to reduce the risk of SIDS

To reduce the risk of SIDS:

place your baby on their back to sleep, in the same room as you, for the first 6 months

keep your baby's head uncovered - their blanket should be tucked in no higher than their shoulders

if wearing your baby in a sling or carrier, do not cover their head with the sling material or with a muslin

place your baby in the "feet to foot" position, with their feet at the end of the cot or Moses basket

do not let your baby get too hot or cold

never sleep with your baby on a sofa or armchair

do not smoke when you're pregnant or around your baby after they're born, and do not let anyone smoke in the same room as your baby

Place your baby on their back to sleep

Place your baby on their back to sleep from the very beginning for both day and night sleeps. This will reduce the risk of cot death.

Do not put your baby to sleep on their side or tummy.

Once your baby is old enough to roll over, there's no need to worry if they turn onto their tummy or side while sleeping.

Do not let your baby's head become covered

Babies whose heads are covered with bedding are at an increased risk of SIDS.

To prevent your baby wriggling down under the covers, place them in the "feet to foot" position. This means their feet are at the end of the crib, cot or Moses basket.

To put your baby in the feet to foot position:

tuck the covers in securely under your baby's arms so they cannot slip over their head - use 1 or more layers of lightweight blankets

use a baby mattress that's firm, flat, well-fitting, clean and waterproof on the outside - cover the mattress with a single sheet

do not use duvets, quilts, baby nests, wedges, bedding rolls or pillows

If you use a sling or carrier, make sure you use it safely.
The Lullaby Trust has more information and advice about swaddling your baby and using slings

Do not let your baby get too hot or too cold

Overheating can increase the risk of SIDS. Babies can overheat because of too much bedding or clothing, or because the room is too hot.

When you check your baby, make sure they're not too hot. If your baby is sweating or their tummy feels hot to the touch, take off some of the bedding. Do not worry if their hands or feet feel cool - this is normal.

It's easier to adjust for the temperature by using layers of lightweight blankets. Remember, a folded blanket counts as 2 blankets. Lightweight, well-fitting baby sleeping bags are a good choice, too.

Babies do not need hot rooms. All-night heating is rarely necessary. Keep the room at a temperature that's comfortable - about 16 to 20C is ideal.

If it's very warm, your baby may not need any bedclothes other than a sheet.

Even in winter, most babies who are unwell or feverish do not need extra clothes.

Babies should never sleep with a hot water bottle or electric blanket, next to a radiator, heater or fire, or in direct sunshine.

Babies lose excess heat through their heads, so make sure their heads cannot be covered by bedclothes, slings or carriers while they're asleep.

Remove hats and extra clothing as soon as you come indoors or enter a warm car, bus or train, even if it means waking your baby.

Be safe if you share a bed with your baby

If you share a bed with your baby (co-sleeping), you should:

make sure they sleep on a firm, flat mattress lying on their back

not have any pillows or duvets near them

not have other children or pets in the bed at the same time

It's important not to share a bed with your baby if they had a low birthweight (less than 2.5kg or 5.5lb) or if you or your partner:

smoke (no matter where or when you smoke and even if you never smoke in bed)

have had 2 or more units of alcohol

have taken recreational drugs

have taken medicine that causes drowsiness

Never sleep with a baby on a sofa or armchair

It's lovely to have your baby with you for a cuddle or a feed, but sleeping with your baby on a sofa or armchair is linked to a higher risk of SIDS.

It's safest to put your baby back in their cot before you go to sleep.

Do not let anyone smoke near your baby

Babies exposed to cigarette smoke before and after birth are at an increased risk of SIDS. Do not let anyone smoke in the house, including visitors.

Ask anyone who needs to smoke to go outside. Do not take your baby into smoky places.

If you smoke, sharing a bed with your baby increases the risk of cot death.

Get help and support if you want to quit smoking

Feeding, dummies and SIDS

Breastfeeding your baby reduces the risk of SIDS.

It's possible using a dummy at the start of a sleep also reduces the risk of SIDS. But the evidence is not strong and not all experts agree that dummies should be promoted.

If you do use a dummy, do not start until breastfeeding is well established. This is usually when your baby is around 1 month old.

Stop giving them the dummy when they're between 6 and 12 months old.

Get medical help quickly if your baby is unwell

Babies often have minor illnesses that you do not need to worry about.

Give your baby plenty of fluids to drink and do not let them get too hot. If your baby sleeps a lot, wake them up regularly for a drink.

It can be difficult to judge whether an illness is more serious and needs urgent medical attention.

See spotting the signs of serious illness for guidance on when to get help.

# data[].attributes.attachment_link.title
Reduce the risk of sudden infant death syndrome (SIDS)

# data[].attributes.attachment_link.description
Sudden infant death syndrome (SIDS), or cot death, is rare. Find out how you can reduce the risk even further.

# data[].attributes.headline
Milli Hill-Books and Birth Plan downloads

# data[].attributes.subject
Milli Hill-Books and Birth Plan downloads

# data[].attributes.attachment_link.description
Telegraph, Guardian, ipaper, Independent, Mother&Baby and many others.

# data[].attributes.headline
A guide to buying safe sleep essentials 

# data[].attributes.subject
A guide to buying safe sleep essentials 

# data[].attributes.attachment_link.title
Baby product information - The Lullaby Trust

# data[].attributes.attachment_link.description
It can be hard to know which products are safest for your baby to sleep in. We’re here to help you find the safest baby products…

# data[].attributes.body
https://www.nhs.uk/conditions/caesarean-section/recovery/

# data[].attributes.attachment_link.readable_text
You'll probably be in hospital for 1 or 2 days after a caesarean section, and may need to take things easy for several weeks.

Recovering in hospital

Most women can leave hospital 1 or 2 days after having a caesarean section.

While in hospital:

you'll be given painkillers to reduce any discomfort

you'll have regular close contact with your baby and can start breastfeeding

you'll be encouraged to get out of bed and move around as soon as possible

you can eat and drink as soon as you feel hungry or thirsty

a thin, flexible tube called a catheter will remain in your bladder for at least 12 hours

your wound will be covered with a dressing for at least 24 hours

When you're well enough to go home, you'll need to arrange for someone to give you a lift as you will not be able to drive for a few weeks.

Looking after your wound

Your midwife should also advise you on how to look after your wound.

You'll usually be advised to:

gently clean and dry the wound every day

wear loose, comfortable clothes and cotton underwear

take a painkiller if the wound is sore - for most women, it's better to take paracetamol or ibuprofen (but not aspirin) while you're breastfeeding

watch out for signs of infection

Non-dissolvable stitches or staples will usually be taken out by your midwife after 5 to 7 days.

Your scar

The wound in your tummy will eventually form a scar.

This will usually be a horizontal scar about 10 to 20cm long, just below your bikini line.

In rare cases, you may have a vertical scar just below your bellybutton.

The scar will probably be red and obvious at first, but should fade with time and will often be hidden by your pubic hair.

On darker skin, the scar tissue may fade to leave a brown or white mark.

Controlling pain and bleeding

Most women experience some discomfort for the first few days after a caesarean, and for some women the pain can last several weeks.

You should make sure you have regular painkillers to take at home for as long as you need them, such as paracetamol or ibuprofen.

Aspirin and the stronger painkiller codeine present in co-codamol is not usually recommended if you're breastfeeding.

Your doctor will be able to advise you on the most suitable painkiller for you to take.

You may also have some vaginal bleeding.

Use sanitary pads rather than tampons to reduce the risk of spreading infection into the vagina, and get medical advice if the bleeding is heavy.

Returning to your normal activities

Try to stay mobile and do gentle activities, such as going for a daily walk, while you're recovering to reduce the risk of blood clots. Be careful not to overexert yourself.

You should be able to hold and carry your baby once you get home.

But you may not be able to do some activities straight away, such as:

driving

exercising

carrying anything heavier than your baby

having sex

Only start to do these things again when you feel able to do so and do not find them uncomfortable. This may not be for 6 weeks or so.

Ask your midwife for advice if you're unsure when it's safe to start returning to your normal activities.

You can also ask a GP at your 6-week postnatal check.

When to get medical advice

Contact your midwife or a GP straight away if you have any of the following symptoms after a caesarean:

severe pain

leaking urine

pain when peeing

heavy vaginal bleeding

your wound becomes more red, painful and swollen

a discharge of pus or foul-smelling fluid from your wound

a cough or shortness of breath

swelling or pain in your lower leg

These symptoms may be the sign of an infection or blood clot, which should be treated as soon as possible.

# data[].attributes.attachment_link.description
Find out about after a caesarean section, including what you can expect and how long you need to avoid activities such as driving.

# data[].attributes.attachment_link.readable_text
When it comes to childbirth, we all want to have an easy, short, and healthy labor and delivery. While there are a number of things you can do to help achieve that, there's evidence that something as simple as eating dates during pregnancy can also help. Yes, dates.

Research suggests the date fruit:

Has an oxytocin-like effect on the body, leading to increased sensitivity of the uterus.

Stimulates uterine contractions.

Reduces postpartum hemorrhage the way oxytocin does.

"Date fruit contains saturated and unsaturated fatty acids such as oleic, linoleic, and linolenic acids, which are involved in saving and supplying energy and construction of prostaglandins. In addition, serotonin, tannin, and calcium in date fruit contribute to the contraction of smooth muscles of the uterus. Date fruit also has a laxative effect, which stimulates uterine contractions."

Dates also have many nutritional benefits, including:

Natural sugars (fructose) that easily break down in the body and won't spike blood sugar levels, but offer high energy.

Fiber that helps you stay full, relieves constipation, and lowers your risk for gestational diabetes and preeclampsia.

Potassium-one of the best electrolytes. It helps maintain water/salt balance which helps regulate blood pressure.

Magnesium, which supports muscular health and helps alleviate muscle spasms and cramps in pregnancy.

Folate, which ensures your baby's spinal cord matures properly, avoiding neural tube defects.

Vitamin K, which maintains proper blood clotting and healthy bones.

More Evidence Supporting Dates During Pregnancy

Three separate studies suggest that eating dates during pregnancy can help you have an easier labor and birth-and all three studies have fairly consistent results.
1. According to this study, women who ate six dates a day for the four weeks leading up to their due date were:

74% more dilated than non-date eaters at admission to birthplace

38% more likely to have intact membranes

21% more likely to spontaneously go into labor

28% less likely to use prostin/oxytocin to induce labor

Additionally, the date eaters had:
2. Published in the Journal of Midwifery & Reproductive Health, this study looked at date consumption in late pregnancy as it related to cervical ripening, and found that women who ate 70-75 grams of dates per day after 37 weeks pregnant had:
Plus, the date eaters were

55% less likely to use oxytocin to induce labor

68% more likely to have a successful vaginal delivery after labor induction

3. Published in the Journal of Obstetrics and Gynaecology, this study supported all the initial findings. The authors concluded that:

"Dates fruit consumption during late pregnancy has been shown to positively affect the outcome of labour and delivery without adverse effect on the mother and child."

Learn to have an amazing birth - Birth Course Promo [In-article]

(without leaving your couch)

In the studies referenced above, pregnant women began eating 70-75g of dried dates per day three or four weeks before their estimated due date.

Of course, you can begin eating dates earlier in your pregnancy if you like. But keep in mind that dates are high in sugar. If you have blood sugar issues, go easy on them early in pregnancy. But, by all means, start eating six dates a day from 36 weeks on!
Six dates per day is the magic number-provided that you're eating smaller deglet noor dates.

Deglet noor dates are about 1 inch long.

Medjool dates can be up to 2 inches long.

If you're eating medjool dates, you only need about 3 dates to reach the 75 grams recommended in the studies.

Not sure which type of date you have in your refrigerator? It's probably a deglet noor. They account for over 90 percent of the dates grown in the USA.

The 2007 study mentioned above specifies deglet noor dates, but I'm guessing that the deget noor variety was used in all the studies.

In the 2014 study, participants were given 70-75 grams (2.5-2.6 oz) of dates per day in three divided doses, which is equal to approximately six deglet noor dates.

By comparison, six medjool dates weigh around 135 grams, or twice as much as deglet noor dates.

Nutritionally, medjool dates and normal deglet noor dates are nearly identical.

So which should you consume? Either one is fine, but if you're eating the larger medjool dates, you only to need to eat around three per day.

You can't go wrong with any of the organic options at the top of this page.

Dates are a healthy and delicious snack, so how can you add them to your diet?

Add dates during pregnancy in this awesome oatmeal recipe.

Add dates to replace sugar in your favorite recipe or to sweeten your homemade almond milk.

Use dates and nuts to make an easy pie crust in the food processor.

Add soaked dates to homemade nut butter for a sweet treat.

Add dates to sweeten homemade salad dressing.

Add dates during pregnancy easily with these yummy (paleo friendly) bars made from dates.

What Other Moms Say About Dates During Pregnancy:

I asked the moms on my Facebook page if they ate dates during pregnancy, and if they think the dates helped. Here are some of their responses.

I faithfully ate the recommended amount of dates each day from 35 weeks on and my nurse and Doctor both commented on how soft my cervix was! I had a great labor and delivery and dates definitely played a role in that. - Ginnette L.

Dates are awesome to eat while pregnant! All three times I ate dates in the last month or so of pregnancy. My labors were all very quick (each four hours from the first contraction to delivery). - Barbara A.

I always joke that the only reason my labors were quick and easy was because of my date obsession. My longest labor was nine hours, but I was induced. My shortest was three hours and I only has to push four times. With my nine hour labor I didn't have to push once-he just came out on his own. - Rochelle H.

Ate six a day from week 35 on. Labor was 1.5 hours and no tearing. Water broke right before baby's head came out. - Nicole M.

I ate at least six a day, sometimes more the last five weeks of pregnancy. It definitely helped with dilating and thinning. After five hours of labor I was dilated 6-7 and 100 percent effaced. In another half hour I was complete! I give the dates a lot of credit for that. My doctor commented on how soft my cervix was whenever he checked me those last few weeks. - Michelle T.

I ate them almost every day, and my doctor said I effaced a lot faster than other first time moms. When I went into labor I was already 80 percent! - Trisha P.

Need More Easy Ideas for Labor?

Try these...

1. Choose the right childbirth class and pain management technique: The right childbirth class should inform and empower you to make the best decisions for you and your baby and helps you to gain confidence in your body's ability to give birth. IT should also help you learn some natural pain coping techniques (way better than chemical ones!).

2. Consider working with a birth doula: A birth doula is your best friend and advocate during childbirth.

3. Choose the right birthing location: Home birth, birth center, or hospital-the choice is up to you. Look into all of the available options before making a final decision about what's right for you and the birth you want.

4. Know your options: Learning about routine interventions, like epidurals and Pitocin, can help you stay in control of your natural birth.

5. Practice perineal massage: This can help prevent tearing during childbirth.

6. Exercise: Regular exercise before and during pregnancy can help shorten labor, ease discomfort and avoid exhaustion during labor. Try these 7 easy exercises to prepare for birth.

7. Excellent nutrition: Being properly nourished with real food can go a long way to keeping your strength up and increase stamina during labor. This includes taking the right prenatal vitamin.

8. Get baby into an optimal position: Often baby's position is the reason women go past their due date, have difficult labors or require induction. Though there's no such thing as easy childbirth, getting baby in the best position before labor begins give you the best chance for a shorter and easier labor.

How About You?

Did you eat dates during pregnancy? Do you think it made your labor easier?

References

https://www.ncbi.nlm.nih.gov/pubmed/21280989

https://www.ncbi.nlm.nih.gov/pubmed/28286995

http://jmrh.mums.ac.ir/article_2772_0.html

https://www.medscape.org/viewarticle/577747

http://www.jordantimes.com/news/local/medjool-dates-farming-expand-fourfold-amid-rising-demand

http://articles.latimes.com/1995-10-05/food/fo-53386_1_deglet-noor - ("The vast majority of California's date harvest-90% to 95%-is the Deglet Noor")

Comparing the Efficacy of Dates and Oxytocin in the Management of Postpartum Hemorrhage (PDF). Shiraz E-Medical Journal April 2007. Khadem N, Sharaphy A, Latifnejad R, Hammod N, Ibrahimzadeh S.

# data[].attributes.attachment_link.title
Dates During Pregnancy: Do They Really Ease Labor?

# data[].attributes.attachment_link.description
When it comes to childbirth, we all want to have an easy, short, and healthy labor and delivery. While there are a number of things you can do to help achieve that, there's evidence that something as simple as eating dates during pregnancy can also help. Yes, dates.

# data[].attributes.attachment_link.readable_text
What is a sling, wrap or carrier?

A sling, wrap or carrier is what you use to carry your child on your body, it's commonly called babywearing. It's not a new phenomenon and has been practised for centuries in different cultures. We'll use the terms sling, wrap and carrier interchangeably in the rest of this article.

There are lots of types of slings so it's worth finding out about the different styles, and even trying a few before you buy one. Read our article Which baby carrier, wrap or sling is best for me? to find out more.

Are there are any benefits to using a sling?

Many parents say it's practical, whatever your lifestyle. Try tidying up or getting lunch ready for your toddler with your newborn in a baby carrier or baby sling. You'll probably see what they mean.

Slings help with transportation but they can also help parents and babies to bond and stay active while navigating the changes of new parenthood (Whittle, 2019; Williams and Turner, 2020). Younger parents' relationships with their baby have benefited from babywearing (Williams and Turner, 2020). Parents of multiple babies may find it easier to manage if one baby is held in a sling, and some use a sling for each baby. Parents who are wheelchair users or have limited arm capacity may find it an accessible way to transport or bond with their baby. It can also be an opportunity for fathers and co-parents to share closeness and nurture their babies (Whittle, 2021).

Research has found that parents who carry their babies tend to be more responsive to their babies as they are in close contact. This promotes bonding and interactions that improve their baby's speech, social and emotional development (Anisfeld et al, 1990; Williams and Turner, 2019; Norholt, 2020). Some studies suggest that for mothers, it can have positive mental health benefits, lowering stress and promoting breastfeeding (Norholt, 2020).

What are the risks of using slings?

Unfortunately, some babies have been injured and even died in unsafe baby slings and carriers, although this is very rare. Non-fatal injuries were mainly caused by dropping or the adult falling, while deaths were caused by positional asphyxiation (Batra et al, 2015; Rowe et al, 2022). (Positional asphyxiation is where the baby's body position blocks their breathing and they suffocate if this goes unnoticed.) These risks have led to tighter safety standards for slings and carriers to keep babies safe.

If your baby was born with a low birth weight or has a medical condition, please discuss the safe use of a carrier or sling with a health professional. Remember to be aware of your child and check them regularly, especially if your baby is under four months old.

How can I keep my baby safe in their sling, wrap or carrier?

When it comes to using slings, it's very important to make sure you're following a few simple guidelines. You'll need to check the manufacturer's instructions, following their advice for whether the size, weight and age of your baby is right for the sling.

Before you use the sling or carrier, check for signs of wear and tear. Don't use it if you have any concerns. The safest type of sling or carrier keeps the baby solidly against the parent's body in an upright position and distributes the child's weight evenly across the wearers shoulders hips and back (ROSPA, 2022).

When your baby is in the wrap, check them often, making sure nothing is blocking their nose and mouth. Also make sure you read and follow the UK Sling Consortium's TICKS checklist:

(UK Sling Consortium, 2015)

Baby positions for slings and carriers

A recommended position is known as the spread squat, jockey position or M-position. The spread squat is where the baby is facing their adult and has their thighs spread around the wearer's torso. The baby also has their hips bent so their knees are slightly higher than their buttocks, or at buttock level with the thighs supported.

This practice is beneficial for at least the first 6 months for correct hip development, and also encourages social development as they are facing their caregiver. It is particularly important if a baby is being held in a sling for long periods of time (International Hip Dysplasia Institute, 2022). Read more about hip dysplasia (hips growing abnormally) in our article about it.

Can I breastfeed in a sling?

Using a sling while breastfeeding is associated with a longer duration of breastfeeding, due to convenience and the increased responsiveness that comes with keeping a baby close throughout the day (Pisacane et al, 2012; Little, 2019). It's important to know how to do it safely though. Do make sure you check the manufacturer's instructions as some suggest you don't breastfeed in their slings. Here are our tips:

1. Most people will stop and settle so they breastfeed while stationary. However, if you are feeding on the go then keep an eye out for trip hazards.

2. Check your baby can breathe easily. A healthy baby will never compromise their own ability to breath, but a poorly one may struggle.

3. Support your baby at all times.

4. You can breastfeed vertically or in a more laidback position. While you will still have to use your hands, the sling can give you more freedom to move. It also frees up one hand to help you get your latch sorted.

5. After feeding, ensure your baby is facing up and their head is clear of the sling and your body.
This page was last reviewed in June 2022.
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.

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

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

For more information on the slings available, find your nearest NCT sling library. Our sling libraries have a wide variety of slings and carriers to try and hire so you can find which one works best for you.

# data[].attributes.attachment_link.title
Everything you need to know about slings and carriers | Baby & toddler articles & support | NCT

# data[].attributes.attachment_link.description
A sling, wrap or carrier is what you use to carry your child on your body, it's commonly called babywearing. It's not a new phenomenon and has been practised for centuries in different cultures. We'll use the terms sling, wrap and carrier interchangeably in the rest of this article.

# data[].attributes.attachment_link.description
Is it your first booking with Woodbridge Yoga? There is no need to Login In first. Please select the class from the list below and follow the prompts. If you have any questions, please email us at woodbridgeyoga@gmail.com.

# data[].attributes.attachment_link.readable_text
1. Taking care of yourself

With a newborn baby in your life it can be easy to prioritise their needs above your own, but you also need to focus on yourself and get enough rest and support so your body can heal.

Take it easy and ask for help if you need it. Making time to look after yourself is important - having a bath, taking a nap, or going for a short walk can all support emotional wellbeing and physical recovery.

Physical wellbeing - get plenty of rest, don't lift anything heavier than your baby, eat healthily and keep hydrated (NHS, 2019a).

Emotional wellbeing - the postnatal period can trigger lots of different thoughts and emotions, as you reflect on and process your birth experience. If you need emotional support, you could contact a peer support service, or many hospitals offer a birth reflections service. Some independent midwives will also review maternity notes with you to help you understand what happened and why.

2. Organise help (and accept it)

Sometimes it feels difficult to ask for and accept help, but now is the time to draw on the support of your friends and family to help out however you need it.

We are not all fortunate enough to have family or friends living close by, but think about who you could ask for help, so you can focus on resting and recovering from surgery, and bonding with your baby.

If you don't have anyone nearby, you might want to consider hiring a postnatal doula. They're trained to support you after birth and can often provide support with breastfeeding or bottle feeding, if you want it. They can help you with your recovery and answer any questions you might have about your baby. They often have lots of local information and are happy to provide whatever support you need in the home too. A few hours of doula support could be a great gift to a new family!

If planning a caesarean birth, you could consider the tasks your support network could do ahead of time, like freezing meals, and decide who could help with which tasks.

If you don't have a local support network, ask your health visitor or contact your local children's centre to find out if any support is available locally. For example, a charity like Homestart  might be able to offer practical help.

It's also a good idea to contact  your local NCT branch  to see what NCT support and social groups are nearby.

3. Get moving

It's important to be mobile after having a caesarean to help prevent the risk of blood clots or deep vein thrombosis, and aid healthy recovery (NHS 2019a, NHS 2019b; Sheedy et al 2022). You'll be encouraged to get out of bed in hospital as soon as you regain feeling in your legs and feel able to walk (NHS 2019a).

At first it might be painful or uncomfortable getting out of bed. You may find it easier to get out of bed by rolling on your side. You can then put your feet over the edge of the bed and push yourself up to a sitting position. It may be helpful to have a midwife or birth partner close by the first few times you stand up, in case you feel lightheaded and/or wobbly.

When you get home, it's a good idea to get up and start going for gentle walks when you feel up to it. Over time, you'll start to feel better.

Gentle exercise, such as walking, can start as soon as possible, moving on to gentle swimming or yoga from six weeks, depending on how recovery is going (NHS 2019b). Stronger exercise may need to wait longer for internal healing and you can discuss this with your midwife or GP.

4. Attend postnatal check ups

Your midwife or health visitor should give you information about recovering from a caesarean. This may include practical information about how to clean your wound, when to return to your usual activities and when to seek medical advice.

Each hospital trust is different, but most offer contact with a midwife every day for the first few days after a baby has been born. These are good opportunities to discuss recovery, and check the wound is healing well.

You will be offered an appointment after around five days to a week to remove any stitches or staples, if they are not the dissolving kind.

You will be offered midwifery support for at least the first 10 days, before being discharged. Every recovery is different, and the length of time support is offered should be personal to your birth and recovery.

You will also be offered a postnatal check with your GP at six to eight weeks after birth, which is another opportunity to seek guidance and support with recovery.

5. Don't rush back behind the wheel

Wait to get back to driving until you feel up to it. You might have to wait six weeks or longer to get back behind the wheel (NHS 2019a).

It's worth checking with your insurance company if they have a policy on driving after a caesarean.

The DVLA suggests that a doctor should be able to say when a driver is likely to be able to drive again, but in practice, a midwife or GP would say that you can begin driving again when you feel you have recovered from the surgery.  It would be a good idea to wait until you feel physically able and comfortable to perform an emergency stop.

6. Know when to seek medical advice

Although rare, it's important to know the signs of possible infection or deep vein thrombosis following a caesarean birth.

Contact your local maternity assessment centre or your GP immediately if you experience any of the following:

severe pain

pain when weeing

a cough or shortness of breath

pain or swelling in your lower leg

discharge, pus or bad-smelling fluid from the caesarean wound

heavy vaginal bleeding, or large clots

the wound becomes red, swollen and painful

fever, high temperature, or you feel very unwell (NHS 2019a)

If you can't get through to your doctor, call 111 for advice or an emergency appointment.
This page was last reviewed in April 2022
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.

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

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

Find out more about HomeStart - a family support charity that offers practical support to parents.

NICE provides evidence-based recommendations about caesarean.

# data[].attributes.attachment_link.title
Top tips for recovery after a caesarean birth | Labour & birth, Different types of birth articles & support | NCT

# data[].attributes.attachment_link.description
Having a caesarean is a major operation so you'll need to take it easy afterwards. Here we share some caesarean birth recovery tips to help you heal.

# data[].attributes.attachment_link.readable_text
Good information about vitamin K is key for every parent.

In most countries, one of the first decisions that parents need to make for their baby is whether or not they want their baby to have vitamin K. If they do, it's usually given within the first hour of birth.

It's your decision whether or not your baby has vitamin K. It's also up to you to decide which kind of vitamin K (oral or injection) you want your baby to have. So you'll want to weigh up the pros and cons, as with every decision you'll make for your child.

I have been researching vitamin K for more than twenty years, and I have written several books and information leaflets on this subject. Here's the most recent.

I have written this summary of information about vitamin K that you might want to consider when making your decision. It's based on the information in my book, and you might also want to visit my vitamin K information hub, which offers a few more articles on vitamin K.

1. Vitamin K is offered in order to prevent a rare but serious blood clotting problem.

Vitamin K is needed in the human body for several key processes.

One of the most important is that it helps blood to clot.

This is why it is offered to newborn babies. Without it, a small number of babies will develop a rare but serious blood clotting problem.

We used to call this problem haemorrhagic disease of the newborn (HDN). It is now more commonly known as vitamin K deficiency bleeding (VKDB).

2. The likelihood of the problem is low, but it can be serious.

Exact figures vary, but the chance of a baby experiencing VKDB if they don't have vitamin K is about 1 in 11,000.

Most babies who have VKDB will recover, especially if they receive treatment quickly. This is why it is important to be vigilant if you decide to decline vitamin K.

A small number of the babies who experience VKDB will experience long-term damage and, sometimes, a baby will die. The actual chance of death from VKDB is very low, but if we give vitamin K to all babies, it's even less likely.

3. Vitamin K can be given by mouth or by injection.

Vitamin K can be given by injection, or your baby can have oral drops.

The drops may be given in several doses over the first few weeks of your baby's life.

Oral drops are not as effective as the injection, but some parents prefer to give vitamin K that way.

The timing and amount of vitamin K that is given orally can vary between areas of the world.

Vitamin K is also added to formula milk.

4. Vitamin K is very effective, especially when given by injection.

We do not have a randomised controlled trial into vitamin K.

However, other studies, audits and long experience suggest that vitamin K is very effective at preventing VKDB when given by injection.

Oral vitamin K is less effective than vitamin K given by injection. But oral vitamin K is more effective than no vitamin K. We don't have good data on exactly how effective oral vitamin K is.

5. Vitamin K is very safe, but there are a few downsides.

Compared to some drugs, vitamin K is considered very safe.

The injection of vitamin K will occasionally result in infection (at the injection site), bruising or bleeding (as with any injection). It can cause pain to the baby when it is being given.

There have been cases of the wrong drug being injected, but these are rare.

Some people are concerned about other possible downsides to vitamin K, because it hasn't been well researched.

We have given vitamin K to millions of babies for many years because we know that it prevents almost all cases of VKDB.

But we don't know why babies have a relatively low level of vitamin K (compared to adults). It may be that this is beneficial to them in some way.

No research has been done into this, and not enough research has been carried out into possible side effects.

The fact that so much is unknown makes the decision difficult for some parents.

6. There are alternatives; it's not always 'all or nothing'.

As with many birth and parenting decisions, it's not always an 'all or nothing' decision.

For instance:
You may decide to have oral vitamin K rather than the injection.
In this situation, be aware that Vitamin K is fat soluble. So in order to be properly absorbed by the baby's body, it should be given with or just after a feed. Also be aware that it tastes bitter. Many babies will try to spit it out again and you might want to have your finger ready to scoot it back in!
You may decide to wait and see and make a decision according to your situation.
There are a few key vitamin K information issues to consider. If your baby is breastfed and is slow to feed or has feeding problems, the chance of VKDB is higher and you may want to reconsider. If you or your baby have antibiotics, this can increase the chance of VKDB. Again, you may want to take that into account. Likewise if your baby has a procedure such as a tongue tie division or circumcision.

It is good to look into all aspects of this decision to make sure that you are fully informed.

7. It's up to you

As I said at the beginning of this blog post, this is your decision.

You have the right to have good information and make the decision that is right for you and your baby.

I hear from midwives and others in some areas of the world (notably the USA) that parents are sometimes told that it is illegal to decline vitamin K.

This may not be true, so please check what your rights are.

It is also the case that, unfortunately, some parents are put under pressure to accept vitamin K. In some situations, senior professionals are brought in to try to persuade parents to accept it.

If you are thinking of declining vitamin K, I really would recommend that you look further into this area. Here's a link to my book if you'd like to get more depth.

We have an entire information hub on this topic, with links to several more articles and blog posts.

And if you are thinking of declining vitamin K, please take a look at this information in particular.

Books to help you become informed and make the decisions that are right for you...

# data[].attributes.attachment_link.title
Seven things every parent needs to know about vitamin K - Dr Sara Wickham

# data[].attributes.attachment_link.description
Dr Sara Wickham, author of Vitamin K and the Newborn, shares information about vitamin K. Seven things every parent needs to know before making a decision.

# data[].attributes.headline
Evidence based info for informed decision making for pregnancy and birth

# data[].attributes.subject
Evidence based info for informed decision making for pregnancy and birth

# data[].attributes.attachment_link.readable_text
Supporting you, Campaigning for all

* Campaigning for better births for all

* Protecting human rights in childbirth

* Independent information about pregnancy and birth

* Raising awareness of research

When's your due date?

What does your "due date" mean? How long is a normal pregnancy? How might being given a due date affect you and your baby? Enter the first day of your last period to discover when you're most likely to give birth.... and to find out more about due dates, induction and "post date" babies.

Date of the first day of your last period

The date of your last period allows an estimation of when you ovulated and conceived your baby.

A surprising number of women will have a bleed after they are pregnant, and although seeking advice from a doctor or midwife is recommended, usually this bleeding is not a problem.

Adjusted cycle length

Your menstrual cycle is counted from the first day of one period to the first day of the next. The average menstrual cycle is 28 days long, but many women will have longer or shorter cycles than this.

Ovulation usually takes place about 14 days before the next period. This means in a short cycle ovulation will be less than 14 days after your last period and with a long cycle more than 14 days after your last period. Giving the length of the cycle allows this to be taken into account in calculating your due date.

Many women have irregular cycles which make using the last day of their period less reliable for estimating due date.

# data[].attributes.attachment_link.title
The Positive Birth Book Visual Birth Plan

# data[].attributes.attachment_link.description
We now have a fantastic free website where you can choose from all the visual birth plan icons from The Positive Birth Book by Milli Hill, or create your own bespoke icons, to create a personalised visual birth plan (VBP) that you can then download and share with your care providers as you make decisions about your bir

# data[].attributes.attachment_link.description
It can be hard to tell if a newborn baby is seriously ill because they can’t tell you what’s wrong. Here’s how to know when to call the GP…

# data[].attributes.attachment_link.readable_text
We are the LGBT Mummies organisation.

Our sole purpose is to support LGBT+ women & people globally on the path to motherhood or parenthood.
We provide guidance on the different family creation pathways through our website, social channels & support groups, whilst providing access to our global community to meet other like-minded families.

From providing guidance on fertility clinics & sperm banks, resources, connecting you to supporting organisations, brands, sharing studies, our private support groups, to celebrating & sharing your lived experiences & our annual events where families come together.

Whether you are thinking of starting a family or have children already
by home insemination, fertility treatment, surrogacy, adoption, fostering. Whether you're a single parent, couple,
co-parent, poly family or a stepparent, all families are welcome.

Our mission is to acquire true equity & equality for LGBT+ families to that of our heterosexual counterparts.

We passionately campaign for LGBT+ family equality & positive policy change. We do this through our ongoing recommendations, training & conversations with the Government, NHS, corporate & charitable organisations, to improve support for LGBT+ families across healthcare, law & society.

Through our educational arm, PROUD FOUNDATIONS, we provide education & training, consultancy services, speakers & project work to educate & enable organisations to better support our community by improving policies, guidelines & resources.

We work tirelessly to inspire people worldwide on their journey, whilst working to 'usualize' & celebrate our families in society, in turn creating a more inclusive future for our children.

# data[].attributes.attachment_link.description
We are the LGBT Mummies organisation. Our sole purpose is to support LGBT+ women & people globally on the path to motherhood or parenthood.We provide guidance on the different family creation pathways through our website, social channels & support groups, whilst providing access to our global community to meet other like-minded families.

# data[].attributes.attachment_link.description
Finding out you are pregnant with twins, triplets or more can be an exciting but sometimes overwhelming time. We have all the support you need.

# data[].attributes.attachment_link.readable_text
While a vast amount of research has been done concerning the sleep of single babies, much less has focussed on multiples. Here we summarise the research which has been done.

Whilst Sudden Infant Death Syndrome (SIDS) is extremely rare, the rate is two- to four-times higher in twins, compared to singleton babies. This is likely to be because many more twins are born premature and/or at a low birth weight; factors which are associated with increased SIDS risk in all babies.

It is important that parents are aware of how the sleep environment of twins can affect SIDS risk, as well as its effect on babies' sleep, and ease of night-time care.

Twins Trust, a charity focused on twins and multiple births, provide information for sleeping twins and multiples.

# data[].attributes.attachment_link.description
Learning you are pregnant with twins, triplets or more changes your expectations and plans. But you can still plan to breastfeed. Breastmilk is a complete and perfect food for your baby. It is especially important for multiples, who are often small at birth. Breastfeeding also helps you create a spe…

# data[].attributes.attachment_link.description
We discuss what you need to know about hypnobirthing and the potential advantages and disadvantages of using this technique in labour and birth.

# data[].attributes.attachment_link.description
To help us keep this website secure, please wait while we verify you’re not a robot! It will only take a few seconds…

# data[].attributes.attachment_link.title
Breastfeeding after a Caesarean Birth - The Breastfeeding Network

# data[].attributes.attachment_link.description
As part of caesarean awareness month in April, we’re sharing some information on breastfeeding after a caesarean section. Your caesarean may be planned or unplanned, but either way it needn’t derail your breastfeeding journey – the key is to be informed so you can be as prepared as possible. First,…