# data[].attributes.headline
For Dads and other non-gestational parents/any parent who did not physically give birth to the child

# data[].attributes.subject
For Dads and other non-gestational parents/any parent who did not physically give birth to the child

# data[].attributes.body
A tool to help you describe what you are going through and the support you would like to receive

# data[].attributes.body
Birthing balls (or birth balls) can help you stay active, ease labour pain and reduce the pain of contractions.

They can also help you get into a more upright position, helping bring your baby’s head further down into the pelvis.

# data[].attributes.attachment_link.title
How to use a birthing ball - Best Start in Life - NHS

# data[].attributes.attachment_link.description
How to use a birth ball during labour and which positions you can adopt, including sitting, hugging and leaning.

# data[].attributes.body
WEPP was created by pelvic health physiotherapists to provide easy access to safe and effective exercise videos and useful resources during and after pregnancy. It is a free exercise programme with something for everybody, including complete beginners. All our resources can be translated into over 100 languages.

# data[].attributes.attachment_link.readable_text
Welcome to Sussex WEPP

A Wellbeing and Exercise in Pregnancy Programme

Supporting Maternal Health Through WEPP

WEPP was created by pelvic health physiotherapists to provide easy access to safe and effective exercise videos and useful resources during and after pregnancy. It is a free exercise programme with something for everybody, including complete beginners. All our resources can be translated into over 100 languages.

Try Our Accessibility Toolbar

Testimonials

"WEPP was an invaluable service for me during my pregnancy and the postnatal period. Having access to safe and effective exercise videos and resources throughout such a vulnerable time has given me so much confidence in recovering both my body and mind. I recommend the service to all people I know may benefit from it."

Rachel R

"I've had a great experience using the WEPP website. The exercise videos are easy to follow and helpful for building confidence with movement. The content is both professional and made with care. Overall, WEPP is a really positive, supportive resource that's well designed and simple to use."

Lily J

"WEPP is such an important resource during pregnancy and the post natal period. I'd have been lost without it. The information was so helpful and reassuring and the videos were accessible and empowering. It was great to know how I could look after myself and my body during pregnancy and once baby was here. Forever grateful for WEPP!"

Sarah W

Why Should I Exercise?

Exercise in pregnancy has a number of benefits for you and your baby including reduced risk of high blood pressure, reduced risk of gestational diabetes (diabetes caused by pregnancy) and reduced risk of low mood.

Accessibility Tools

Your choices will be saved as a non-identifying cookie. This means that each time you load a webpage from this website, your chosen accessibility options will be applied. These cookies will last for 28 days before resetting.

Translate

Please translate the page prior to using Text to Speech if you'd like the page read in a different language.

Select a language from the Google provided selector below.

Text To Speech

When text to speech is active, you can click the play button to hear the whole sites content read aloud. You can also highlight a section of text and press play, to hear only the highlighted text.

Screen Mask

A screen mask is a reading tool which follows your cursor. It allows you to remove distractions from around the page and gives a clear area of focus.

Text Size

Use these icons to increase, decrease or reset the size of the text throughout the site.

Contrast

Change the colour of text and the background of the site with the selectors below. This removes images and makes the content across the site easier to read.

# data[].attributes.attachment_link.title
Sussex WEPP | A Wellbeing and Exercise in Pregnancy Programme

# data[].attributes.attachment_link.description
A Wellbeing and Exercise in Pregnancy Programme WEPP was created by pelvic health physiotherapists to provide easy access to safe and effective exercise videos and useful resources during and after pregnancy. It is a free exercise programme with something for everybody, including complete beginners. All our resources can be translated into over 100 languages.

# data[].attributes.body
Welcome to Perinatal Pathways, a quick and simple questionnaire to help you, your family and health professionals find services and helpful information for your mental health.

# data[].attributes.attachment_link.readable_text
Welcome to Perinatal Pathways, a quick and simple questionnaire to help you, your family and health professionals find services and helpful information for your mental health.

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

Ready to start? Press the start button below

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

# data[].attributes.body
Welcome to Perinatal Pathways, a quick and simple questionnaire to help you, your family and health professionals find services and helpful information for your mental health.

# data[].attributes.attachment_link.readable_text
Welcome to Perinatal Pathways, a quick and simple questionnaire to help you, your family and health professionals find services and helpful information for your mental health.

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

Ready to start? Press the start button below

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

# data[].attributes.attachment_caption
Updated in 2024, this simple, concise guide provides parents who are bottle feeding with an overview on how to bottle feed responsively and, for parents who are formula feeding, how to choose an infant formula.

# data[].attributes.headline
Infant formula and responsive bottle feeding

# data[].attributes.subject
Infant formula and responsive bottle feeding

# data[].attributes.body
A guide for parents

# data[].attributes.attachment_link.readable_text
This simple, concise guide provides parents who are bottle feeding with an overview on how to bottle feed responsively and, for parents who are formula feeding, how to choose an infant formula.

Bottle feeding as responsively as possible can help support the development of a close and loving parent-infant relationship. More tips on building a close and loving relationship with babies can be found in our Building a Happy Baby leaflet for parents.

UNICEF UK's Baby Friendly Initiative is firmly committed to the promotion, protection and support of breastfeeding. However, in the UK bottle feeding remains very common and so we also work to ensure the best outcomes possible for babies when they are not breastfed. When considering use of our materials outside of the UK, we suggest taking into account the country context and individual needs before deciding whether or not our materials are suitable for use.

Further reading

# data[].attributes.attachment_link.title
Infant formula and responsive bottle feeding - Baby Friendly Initiative

# data[].attributes.attachment_link.description
This guide provides an overview on how to bottle feed responsively and, for parents who are formula feeding, how to choose an infant formula.

# data[].attributes.body
This animation explains how women can reduce their risk of sustaining perineal trauma in childbirth.

# data[].attributes.attachment_link.title
Reducing your risk of perineal tears | RCOG

# data[].attributes.attachment_link.description
The following animation explains what an OASI is, the four components of the OASI Care Bundle and how women can reduce their risk of sustaining an OASI in childbirth.

# data[].attributes.headline
Romany Gypsy, Roma, or Traveller communities

# data[].attributes.subject
Romany Gypsy, Roma, or Traveller communities

# data[].attributes.body
Video resources for Romany, Roma and Traveller parents who may be seeking answers to common questions about infant feeding

# data[].attributes.attachment_link.title
Resources for healthcare professionals - Friends, Families and Travellers

# data[].attributes.attachment_link.description
This section is host to a collection of our essential healthcare resources, aimed at healthcare professionals who engage with Romany Gypsy, Roma, or Traveller communities. These resources have been co-developed and co-produced with community members, and […]

# data[].attributes.headline
RCOG information - tears and episiotomies

# data[].attributes.subject
RCOG information - tears and episiotomies

# data[].attributes.attachment_link.readable_text
This hub aims to inform about the types of tears that can occur during childbirth, how to minimise your risk of deeper tearing, and what can be done to help your recovery if you do tear.

We also aim to support you to take prompt action if you have any concerns about your recovery, helping you feel better informed when discussing any topics with a healthcare professional.

This information has been developed by the OASI Care Bundle Project Team, the OASI Care Bundle Clinical Champions and perineal specialists.

It is based on the RCOG Green-top Guideline No.29 The Management of Third and Fourth Degree Tears (June 2015) and expert opinion from the above named developers and key stakeholders in line with RCOG due process.

Please give us your feedback

We would like to understand how people are using this resource to help ensure it is relevant and useful. To give us your feedback, please complete our short survey.If you have any questions, please email womensvoices@rcog.org.uk

# data[].attributes.attachment_link.title
Perineal tears and episiotomies in childbirth

# data[].attributes.attachment_link.description
Welcome to our hub for perineal tears and episiotomies in childbirth.

# data[].attributes.headline
Assisted Vaginal Birth - Forceps or Ventouse (Kiwi/Suction cup) Delivery RCOG

# data[].attributes.subject
Assisted Vaginal Birth - Forceps or Ventouse (Kiwi/Suction cup) Delivery RCOG

# data[].attributes.body
Penny Simkin discusses the benefits of waiting for the cord to stop pulsating before cutting and clamping.

# data[].attributes.body
Spare 2 minutes of your time to learn more about how to do your pelvic floor exercises

# data[].attributes.body
Information to help you reduce the risk of sever perineal trauma during childbirth

# data[].attributes.body
To provide a safe space for dads to talk, listen and share their experiences of fatherhood across the country.

# data[].attributes.attachment_link.title
DadSpace | Supporting Mens Mental Health

# data[].attributes.attachment_link.description
DadSpace facilitates Brotherly Support Between Fathers by providing opportunities to talk, listen and share personal experiences of fatherhood.

# data[].attributes.body
A research team at Cardiff University have been studying birth in water and put this information together to let you know about labour and birth in water, and what evidence this new study has added.

# data[].attributes.body
A resource for parents to support their needs if their baby is on the neonatal unit

# data[].attributes.attachment_link.provider_name
Kent and Medway - Bump, Birth and Beyond

# data[].attributes.attachment_link.readable_text
Going home after neonatal care.

"When your child has had such a rough start and then they do start to hit milestones (whatever that might be) it feels incredible.

It's such an amazing achievement for you as a family and a great reason to celebrate."
Louise Flanagan (Mum to Ryan, Kent, Surrey and Sussex Parent Advisory Group member) Find out more

# data[].attributes.attachment_link.title
Neonatal :: Kent and Medway - Bump, Birth and Beyond

# data[].attributes.attachment_link.description
"When your child has had such a rough start and then they do start to hit milestones (whatever that might be) it feels incredible. It's such an amazing achievement for you as a family and a great reason to celebrate."

# data[].attributes.body
Click/press to open links and discover more information to support you through your neonatal journey.

# data[].attributes.body
Information about your pelvic floor and how to do pelvic exercises.

# data[].attributes.attachment_link.readable_text
Your pelvic floor will not be very strong initially after childbirth.

You may also feel that you have difficulties working with your pelvic floor and that you have little sensation.

This usually improves with time, but the more you are able to work your pelvic floor, the quicker the recovery will be.

You may find that you have trouble controlling your bladder and if you have this problem, you may need to see a physiotherapist to help you strengthen your pelvic floor.

# data[].attributes.attachment_link.description
Your pelvic floor will not be very strong initially after childbirth. You may also feel that you have difficulties working with your pelvic floor and that you have little sensation. This usually improves with time, but the more you are able to work your pelvic floor, the quicker the recovery will be.

# data[].attributes.body
Click here to follow our Birth Centre on Instagram

Darent Valley Birth Centre (@darentvalleybirthcentre)

# data[].attributes.body
What are Vaginal Examinations? Information to help you make an informed choice if you are offered a vaginal examination (VE)

# data[].attributes.attachment_link.readable_text
During labour, it is normal NHS policy to offer vaginal examinations, sometimes called a VE. It is important to know that they are entirely optional. This Birth Information Page explains some of the reasons why VEs are offered, and their benefits and risks, to help you to decide whether or not you would like to have them.

A VE involves a midwife or doctor inserting their fingers (after taking measures to reduce infection, including wearing gloves) into your vagina to feel the cervix and any changes that might be happening. This may be for a number of reasons; some of the most common reasons for offering VEs are:

To try to decide whether labour is 'established' or 'active'

To try to track the progress of labour by seeing how the cervix is dilating, thinning and changing over time

To help the midwife or doctor to judge the position of your baby and/or how they are moving through your birth canal

For any reason that VEs may be offered, the midwife or doctor is obliged to ensure that you completely understand these reasons before they perform a VE. If you decide to not have one, they have to support and respect that decision. Remember that you can also decline some and accept others. It's up to you.

It is important to know that although VEs are offered to almost every labouring woman or person, and they are often seen as an essential part of labour, they are not actually essential to the way labour is progressing and may not directly influence or dictate the outcomes for you or your baby. However, there is information that they can give, which may or may not be valuable to you and the caregivers looking after you. This article is intended to help you to decide what's right for you.

What do vaginal examinations feel like?

VEs are experienced very differently by everyone. Some people don't mind them. Others find them to be uncomfortable or painful. For others, having fingers inserted into their vagina can be a distressing experience; this is especially common for people who have experienced sexual abuse, although anyone can feel this way. While the midwife or doctor may have seen hundreds or thousands of vaginas, they may have never seen your vagina. How you feel each time an examination is carried out will also change, and so you cannot be expected to react to them the same way each time.

VEs are often done with the labouring woman or person lying on their back, because this is usually how midwives and doctors are taught to do them. This can be challenging for those who don't want to move out of a position they're in, and lying on our backs can make labour more painful than other positions. It is therefore useful to know that it is possible to do a VE in any position. Just ask!

Do you have to have vaginal examinations?

It is very important to know that no one can ever put their fingers into your vagina without your consent - ever.

Legally, VEs can only happen if you freely consent to them. Whether or not you choose to do so is up to you.

There are several reasons that vaginal examinations may be offered, some of which are listed above. It is important to note, however, that someone does not have to have a VE before they are provided with care of any kind (for example access to hospital, use of the pool, access to pain relief). Demanding this does not provide people with the genuine, free ability to say "no" and therefore is not informed consent.

Using vaginal examinations to decide whether labour is 'active'

The term 'active labour', or, sometimes, 'established labour', is intended to refer to the time when labour is progressing, rather than stop-starting, and the cervix has opened past a certain point. The way that labour happens can be very different for different people. A person can be 1cm dilated and be experiencing extremely painful contractions for which they need pain relief, and already be in 'active' labour. Another person may be 6cm dilated but still be having very slow, on-off labour which isn't yet ready to progress. Every labouring woman or person is different and relying only on vaginal examinations can lead to people being told that they're not in established labour and not being given access to hospital, even though they're ready for some additional support.

Labouring women and people might then additionally be denied adequate or appropriate pain relief because they are not considered to be at the right stage of labour. Some of these concerns have been increased during the Covid pandemic where women are, or were, sometimes denied the support of their partner until classed as being in the right stage of labour (i.e. 'active labour'). Such practices of relying on vaginal examinations to determine pain relief may invalidate a person's own need for the support of their partner and midwives. To stress this point, the fact that people are not as dilated as the hospital's guidelines state they should be when in 'active labour' does not change their needs.

While we acknowledge the sometimes confusing discussions about what is or isn't active labour, there is evidence to show that going into hospital too early in labour can lead to a higher number of interventions, which is something that you might want to consider. On the other hand, being turned away when you are seeking help can be very distressing. When deciding what is best for you, remember only you know how you feel and what you can cope with. We don't know for sure why women who are admitted to hospital earlier are more likely to have interventions. It might be that just being in hospital puts them on the track of the ' cascade of intervention '. However, it is also possible that some of those women who go to hospital earlier in labour do so because their instinct tells them that they need the additional help, and that they attend earlier because they need an intervention. The real answer is probably that both of these are what is happening.

The important thing to know is that you don't have to have a VE to access any service and services cannot be withheld from you if you decline a VE. Yet, VEs are often used to decide if someone is in active labour or not.

Using Vaginal examinations to estimate the progression of labour

It is very normal, when talking about birth, to hear the midwife or doctor mention the number of centimetres dilated. Your cervix needs to dilate from closed or nearly closed to around 10cm in order for your baby to be born. But it is important to know that this is not an exact measurement, and even two people can sometimes give you different results. However, all the cervix needs to be is fully open to allow the baby to pass through.

Not everyone dilates to exactly 10cm. What is really happening is that the cervix opens sufficiently to allow the baby to pass through. Again, this is not an exact measurement.

Because the cervix dilates from a small opening before labour to around 10cm as the baby is ready to be born, it might seem logical to assume that at 5cm labour is halfway through. This, however, is not true. The opening of the cervix is not linear. For example, it may take 10 hours of labour to reach 3cm, then jump to 10cm in an hour. Or it may go from closed to completely open in 2 hours. It may even be at 2cm for three weeks, before taking 8 hours to be ready for birth. Therefore, it is clear that what the cervix has done previously cannot tell us what it will do in the future. It may sometimes give us an idea of what to expect when someone is in labour, which is discussed below, but it does not tell us when the baby or babies will be born.

The idea that the opening of the cervix should follow a line on a graph was introduced by a man called Dr. Emanuel Friedman, in 1955. He tracked the length of labour of 500 women, all of White European backgrounds, and created a graph (The Friedman Curve) showing the 'average' length of labour, and how quickly the cervix supposedly opened. This data doesn't tell us whether there are differences in 'average labour' between people from different communities or ethnicities, as they were not included in the study. The graph plotted a line showing how much the cervix was expected to open each hour in order to be considered 'normal'.

An analogy might be to take all of the white children in a school. In each class, every child's height is measured, and then the average height of the children in class 1 is calculated, and the same for class 2, and class 3, and so on. It is then decided that the average height of the children in each class is the correct height, and all children who are smaller or taller than this average are wrong. Clearly, this makes no sense. Each child in the class is unique, and the right height for them.

Following the introduction of The Friedman Curve into obstetrics, it became expected that all women and birthing people's labours would follow this graph. If their cervix did not open sufficiently quickly, this was considered to be 'failure to progress' - a term that AIMS would like to see banned. Of course, not one of us is average, and our cervixes don't actually open according to Dr Friedman's graph. This means that using a vaginal examination to track the opening of the cervix in order to track labour progression, and to estimate how much longer labour may last, has little value. We simply cannot expect everyone to follow the "average".

There are exceptions to this. Sometimes, labour can stall for reasons such as the baby being in a position which makes it hard for them to press on the cervix (which helps it to open), or perhaps because the environment in the birth room means that the birthing woman or person doesn't feel safe, or cared for, which can trigger hormones which slow or stop labour. The cervix not dilating, or dilation slowing, might be an indication that changes in the room may need to happen, such as the people around, making the labouring woman or person feel more comfortable, or changes of position to help the baby to move. Other reasons may include dehydration, low blood sugar or exhaustion. See The AIMS Guide to Giving Birth to Your Baby for a more detailed look at labour and birth. Sometimes, even when all the environmental conditions are met, it may be appropriate to consider interventions such as a caesarean if the baby appears to be in a position that would make vaginal birth unlikely or may not be coping well with labour. In these cases, though, there are likely to be other indications of a problem, which your midwife or doctor must explain to you.

Other reasons why a vaginal examination may be offered

Sometimes, a VE is done to try to help to determine the position of the baby, by feeling the 'presenting part' of the baby, which means the part which is pressing on the cervix. Normally this will be the head, and by feeling the lines on the skull of the baby, the midwife or doctor may be able to work out whether or not the baby is coming down in a way that makes for an easier birth.

Sometimes, an examination of the vagina is offered as part of a check to see whether the waters have broken when it is not clear if this has happened. In this situation, this is likely to be done by using a speculum, which is a device to open the vagina and allow a midwife or doctor to more easily see inside and, if necessary and with your consent, to obtain a swab (a sample of fluid or discharge from within the vagina which is sent away to a lab to check against infection).

A VE is likely to also be offered before an induction, to see whether the cervix has already changed at all, and what would be the best option to try to encourage it to start to open.

Very rarely, a VE is offered during antenatal care although this is not normal practice in the UK.

What are the risks of vaginal examinations?

The most common risks of a vaginal examination are infection, pain and discomfort, so before you make a decision on whether or not to accept a VE, you may want to think about whether you want to know the information it may offer to you.

For some labouring women and people, the act of someone putting their fingers into their vagina can be hugely distressing. Any form of pain or distress can adversely affect labour, as this can release the hormone adrenaline, which inhibits a key labour hormone, oxytocin. This can slow labour down for some people, and sometimes stop it for a period of time. In addition, being told that you are 'not progressing', or not progressing as fast as expected, can lead to feeling disheartened and upset. As mentioned earlier, given that the dilation of the cervix at that moment gives no information as to the length that labour will ultimately be, this could be a pointless discouragement. The dilation measurement itself is not even necessarily accurate, and the estimate can differ from caregiver to caregiver.

Equally, for some labouring women and people, news that the cervix has dilated more can be reassuring and helpful, and give them the incentive to keep going!

Vaginal examinations can be a source of infection, and the more times they are done, the more chances there are of causing an infection. Unfortunately, anything that is put into the vagina - including a sterile speculum or gloved finger - will increase the risk of an infection whether or not the waters have broken, as doing so pushes germs up the vagina towards the uterus.

Additionally, a VE can cause the waters to be broken by mistake, which can then increase the risk of infection as well as sometimes causing contractions to become more difficult to cope with. In some cases, as we have heard many times on the AIMS helpline, midwives and doctors have accidentally or deliberately used a VE to break the waters despite the woman or person not having consented to having them broken.

It is very common towards the end of pregnancy for midwives or doctors to offer a 'stretch and sweep'. This is sometimes also offered in early labour. A stretch and sweep, commonly called a sweep, is a form of induction of labour that involves the midwife or doctor inserting their fingers into the vagina, and through the cervix. The procedure is explained in The AIMS Guide to Induction of Labour. Sometimes, a stretch and sweep might be performed after consent has been given for a VE, but explicit consent for the stretch and sweep has not been given. This is an assault because consent must be given for any intervention to be done. Just because a midwife or doctor has their fingers in someone's vagina does not mean that they can do another procedure at the same time.

What are the alternatives

While it may be arguable that knowing the dilation of the cervix by any method has limited value, due to the fact that it does not open at a linear rate, sometimes it may be useful to have an indication of progress. For labouring women and people who decide to decline the offer of a VE, some midwives and birth workers describe using other ways to estimate how labour is progressing, based on their own experience.

1) Watch and listen. While every woman and birthing person labours differently, it is generally possible to judge by a woman's behaviour how her labour is progressing. While this can be more difficult where a midwife might be caring for a number of labouring women and people, huge amounts of information can be gathered by just watching and listening.

2) The dilation line (sometimes called ' the purple line ') - In some women and birthing people (not all), a purple, silver, brown or red line can be seen, starting from the anus and developing up between the buttocks. This line tends to approximately reflect cervix dilation, with about 1cm of line equalling about 1cm of dilation of the cervix. This is not always the case - sometimes the line can be there but it does not relate to dilation - but it might be a useful indication in some cases.

3) Hot legs - as women and birthing people progress through labour, the extra blood needed by the uterus to do its hard work pulls blood away from their extremities. This can lead to the legs getting progressively colder, from the foot to the knee. When the colder part is at the mid calf, that equates roughly to 5cm dilated. This works less well for those who have had an epidural or some other pain relief. If they have been in a pool or warm bath, it will take around 20 minutes or so for the effect to be felt.

Summary

VEs might sometimes be useful for different reasons, but they do not provide benefits to all women and birthing people or their caregivers. It is always your choice whether or not you consent to having VEs, for any reason. If a healthcare provider coerces you into a VE, for instance by saying that you 'have to have one' before being given access to care, they leave themselves open to an accusation of criminal assault and battery, and other legal action (please see the AIMS information page on Obstetric Violence).

References:

[1] Miller et al, 2020, Variations in outcomes for women admitted to hospital in early versus active labour: an observational study: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-03149-7

[2] Friedman, 1955, Primigravid labor; a graphicostatistical analysis: https://pubmed.ncbi.nlm.nih.gov/13272981

[3] Gluck et al, 2020, The correlation between the number of vaginal examinations during active labor and febrile morbidity, a retrospective cohort study: www.ncbi.nlm.nih.gov/pmc/articles/PMC7183634
Further reading about Vaginal Exams VEs - Essential Diagnostic Tool? Respectful Vaginal Examinations Project - Co-Production in Action The Assessment of Progress Vaginal examinations: a symptom of a cervical-centric birth culture Assessing Progress in Labour The purple line as a measure of labour progress: a longitudinal study
Written by: Emma Ashworth
Reviewed by: Megan Disley and Fanny Kernohan
Reviewed on: 21/04/2023
Next review needed: 21/04/2025

AIMS does not give medical advice. Our website provides evidence-based information to support informed decision-making. The AIMS Helpline volunteers will be happy to provide further information and support. Please email helpline@aims.org.uk or ring 0300 365 0663.

If you found this information page helpful please consider making a donation to support the work of AIMS. We are a small charity that accepts no commercial sponsorship, in order to preserve our reputation for providing impartial, evidence-based information. You can make donations at Peoples Fundraising. To become an AIMS member or join our mailing list see Join AIMS
AIMS supports all maternity service users to navigate the system as it exists, and campaigns for a system which truly meets the needs of all.
Published on 26th April 2023

# data[].attributes.attachment_link.description
information for parents about vaginal examinations

# data[].attributes.body
Remember KICO - Knees In, Calves Out!

# data[].attributes.attachment_link.title
⭐Remember KICO⭐ Knees In, Calves Out when giving birth 💗 Birth position#viral #cutebaby #shortvideo

# data[].attributes.headline
How you can support your partner- an overview

# data[].attributes.subject
How you can support your partner- an overview

# data[].attributes.attachment_caption
Session 2 WHEN PLANS CHANGE AND ANALGESIA

# data[].attributes.attachment_caption
Session 3 INFANT FEEDING AND BONDING WITH YOUR BABY

# data[].attributes.headline
Optimal Positioning for Pregnancy, Labour and Birth

# data[].attributes.subject
Optimal Positioning for Pregnancy, Labour and Birth

# data[].attributes.attachment_caption
Session 4 EARLY PN PERIOD AND CARE OF YOUR NEW BABY

# data[].attributes.attachment_link.readable_text
Becoming a dad is one of life's most profound and transformative experiences. It's a journey filled with joy, anticipation, and a healthy dose of uncertainty.

However, thanks to MANtenatal's comprehensive online courses, dads-to-be can embark on this journey feeling empowered and prepared every step of the way.

# data[].attributes.attachment_link.description
Becoming a dad is one of life's most profound and transformative experiences. It's a journey filled with joy, anticipation, and a healthy dose of uncertainty. However, thanks to MANtenatal's comprehensive online courses, dads-to-be can embark on this journey feeling empowered and prepared every step of the way.

# data[].attributes.headline
Pain relief options for labour and birth

# data[].attributes.subject
Pain relief options for labour and birth

# data[].attributes.body
Information for expectant parents on pain relief choices during labour with and without medication

# data[].attributes.attachment_link.title
Labour Pains - Information on pain relief choices during labour

# data[].attributes.attachment_link.description
Information for expectant parents and healthcare professionals on pain relief choices during labour

# data[].attributes.body
A virtual tour of our Special Care Baby Unit (SCBU)

# data[].attributes.body
How to tell if Breastfeeding is going well? Unicef BFI

# data[].attributes.body
This link takes you to a Padlet that has videos and resources to help you through feeding challenges Tools for breastfeeding challenges (padlet.com)

# data[].attributes.attachment_link.authors[].name
St George's University Hospitals NHS Foundation Trust

# data[].attributes.attachment_link.title
Pain relief in labour: epidurals - English

# data[].attributes.attachment_link.description
Uploaded by St George's University Hospitals NHS Foundation Trust on 2016-04-25.

# data[].attributes.body
Read here to learn more about expressing your breastmilk as well as safe storage and preparation of breastmilk

# data[].attributes.attachment_link.readable_text
Expressing milk means squeezing milk out of your breast so you can store it and feed it to your baby later.

You might want to express milk if:

How to express breast milk

You can express milk by hand or with a breast pump. How often you express your milk, and how much you express, will depend on why you're doing it.

Sometimes it takes a little while for your milk to start flowing. Try to choose a time when you feel relaxed. Having your baby (or a photo of them) nearby may help your milk to flow.

You may find it easier to express if you cover your breasts with a warm towel first, or after you have a shower or bath.

Expressing breast milk by hand

Some find it easier to express milk by hand, especially in the first few days or weeks. It also means you can express without needing a pump, or an electricity supply.

Hand expressing allows you to encourage milk to flow from a particular part of the breast. This may be useful, for example, if one of the milk ducts in your breast becomes blocked.

Hold a sterilised feeding bottle or container below your breast to catch the milk as it flows.

These tips may help:

Before you start, wash your hands with soap and warm water.

Have something clean ready to collect the milk in.

Some find gently massaging their breasts before expressing helps their milk to let down.

Cup your breast with one hand then, with your other hand, form a "C" shape with your forefinger and thumb.

Squeeze gently, keeping your finger and thumb a few centimetres away from your nipple, just outside the darker area around it (areola). Do not squeeze the nipple itself as you could make it sore. This should not hurt.

Release the pressure, then repeat, building up a rhythm. Try not to slide your fingers over the skin.

Drops should start to appear, and then your milk usually starts to flow.

If no drops appear, try moving your finger and thumb slightly, but still avoid squeezing the darker area near your nipple.

When the flow slows down, move your fingers round to a different section of your breast, and repeat.

When the flow from one breast has slowed, swap to the other breast. Keep changing breasts until your milk drips very slowly or stops altogether.

Watch a video about expressing milk by hand on the UNICEF website

Expressing milk with a breast pump

There are 2 different types of breast pump: manual (hand-operated) and electric.

Manual pumps are cheaper but may not be as quick as an electric pump.

You may be able to hire an electric pump. Your midwife, health visitor or a local breastfeeding supporter can give you details of pump hire services near you.

The suction strength can be altered on some electric pumps. Build up slowly. Setting the strength to high straight away may be painful or damage your nipple.

You may also be able to get different funnel (the part that goes over your nipple) sizes to fit your nipples. The pump should never cause bruising or catch your nipple as it's sucked into the funnel.

Always make sure that the pump and container are clean and sterilised before you use them.

Find out how to sterilise baby bottles

Storing breast milk

You can store breast milk in a sterilised container or in special breast milk storage bags:

in the fridge for up to 8 days at 4C or lower (you can buy fridge thermometers online) - if you're not sure of the temperature of your fridge, or it is higher than 4C, use it within 3 days

for 2 weeks in the ice compartment of a fridge

for up to 6 months in a freezer, if it's -18C or lower

Breast milk that's been cooled in the fridge can be carried in a cool bag with ice packs for up to 24 hours.

Storing breast milk in small quantities will help avoid waste. If you're freezing it, make sure you label and date it first.

Defrosting frozen breast milk

It's best to defrost frozen breast milk slowly in the fridge before giving it to your baby. If you need to use it straight away, you can defrost it by putting it in a jug of warm water or holding it under running warm water.

Once it's defrosted, give it a gentle shake if it has separated. Use it straight away. Do not re-freeze milk that's been defrosted.

Once your baby has drunk from a bottle of breast milk it should be used within 1 hour and anything left over should be thrown away.

Warming breast milk

You can feed expressed milk straight from the fridge if your baby is happy to drink it cold. Or you can warm the milk to body temperature by putting the bottle in a jug of warm water or holding it under running warm water.

Do not use a microwave to heat up or defrost breast milk. This can cause hot spots, which can burn your baby's mouth.

Storing breast milk if your baby is in hospital

If you're expressing breast milk because your baby is premature or sick, ask the hospital staff caring for your baby for advice on how to store it.

Read more about breastfeeding a premature or sick baby

If you're having difficulty expressing breast milk

If you're finding it difficult or uncomfortable to express your breast milk:

Ask your midwife, health visitor or breastfeeding supporter for help. They can also tell you about other breastfeeding support available near you.

Search online for breastfeeding support in your area.

Call the National Breastfeeding Helpline on 0300 100 0212 (9.30am to 9.30pm daily).

The Bliss website also has advice about expressing milk for a premature or sick baby

Community content from HealthUnlocked

# data[].attributes.attachment_link.description
Everything you need to know about expressing and storing your breast milk, including tips on hand expressing and electric breast pumps, and how to freeze, defrost and warm breast milk.

# data[].attributes.headline
Baby's Movements in Pregnancy- Translated Languages

# data[].attributes.subject
Baby's Movements in Pregnancy- Translated Languages

# data[].attributes.body
Watch a video about Personalised Care here: Personalised Care and Support Planning in Maternity Services - YouTube

# data[].attributes.body
Learn all about having an induction at DVH
Induction of labour : Dartford and Gravesham NHS Trust (dgt.nhs.uk)

# data[].attributes.headline
Feeding Twins - Information from The Twins Trust (Formerly TAMBA)

# data[].attributes.subject
Feeding Twins - Information from The Twins Trust (Formerly TAMBA)

# data[].attributes.attachment_link.readable_text
Many mothers of twins or more breastfeed their babies successfully and we're here to support you.

Multiples are more likely to be born early and we know that very small or premature babies can find it difficult to breastfeed at the beginning. If you are unable to feed your babies straight away it doesn't mean that you won't be able to breastfeed.

Spending time with your babies, giving them skin-to-skin time with you or your partner and expressing breastmilk regularly, can all help babies to get going with breastfeeding. Talk to the hospital staff and your midwife about how they can support you to feed your babies in the way you want to.

To help you prepare for breastfeeding Twins Trust suggest that you:

Personal stories

Our work with peer-to-peer breastfeeding supporters has been made possible thanks to the National Lottery Community Fund.

# data[].attributes.attachment_link.description
Many mothers breastfeed their twins, triplets or more. Twins Trust is here to support you with whichever feeding choice is best for your family.

# data[].attributes.attachment_link.title
What is a Rectus Abdominis Diastasis [Dec 2022]

# data[].attributes.headline
DVH- New Baby- Advice for New Parents Booklet

# data[].attributes.subject
DVH- New Baby- Advice for New Parents Booklet

# data[].attributes.attachment_link.title
New baby- Advice for new parents booklet

# data[].attributes.body
This video by Dr. Amy Brown, explains why babies feed frequently and why this is normal and healthy

# data[].attributes.attachment_link.authors[].name
School of Health & Social Care, Swansea University

# data[].attributes.headline
Choices of where to have your baby (had a baby before)

# data[].attributes.subject
Choices of where to have your baby (had a baby before)

# data[].attributes.headline
Choices of where to have your baby (1st baby)

# data[].attributes.subject
Choices of where to have your baby (1st baby)

# data[].attributes.attachment_caption
The 9 stages your baby will go through once born, as they work out how to feed

# data[].attributes.body
Guidance on raspberry leaf tea. Produced by Denise Tiran, Specialist Complementary Therapies Midwife.

# data[].attributes.attachment_link.title
Home Birth under the care of Darent Valley Hospital

# data[].attributes.attachment_link.readable_text
It's important to understand your birth options if you're expecting more than 1 baby.
Twins and triplets are more likely to be born early and need special care after birth than single babies.

Your birth choices with twins

It's a good idea to discuss your birth options with your midwife or consultant early on in your pregnancy.

You'll normally be advised to give birth in a hospital, as there's a higher chance of complications with twins.

There are usually more health professionals at a multiple birth - for example, there may be 2 midwives, an obstetrician and 2 paediatricians (1 for each baby).

For more information on who's who, read about the antenatal team.

The process of labour is more or less the same as for 1 baby, but your maternity team will usually advise you to have your babies electronically monitored because of the higher risk of complications.

This means attaching belts with sensors (1 for each twin) to your bump. You'll still be able to move around into different positions.

Once your waters have broken, your midwife may ask your permission to attach a clip attached to a wire to the first baby's head to get a more accurate measure of their heartbeat.

You'll be offered a drip in case it's needed later - for example, to restart contractions after your first baby is born.

Triplets or more babies are almost always delivered by a planned caesarean section.

Can you have a natural birth with twins?

Lots of women think they have to have a caesarean section with twins, but in fact, many twin births are vaginal

If you're planning a vaginal delivery, it's usually recommended that you have an epidural for pain relief, but you can discuss this with your midwife.

If there are any problems, it's easier for your antenatal team to deliver your babies quickly if you have already got an epidural in place.
Find out more about the signs and stages of labour
You're more likely to have a vaginal birth if the first twin is in a head-down position.

But there may be medical reasons why a vaginal birth is not recommended.

If you have had a caesarean section before, for example, it's not usually recommended that you have a vaginal birth with twins.

As with any vaginal birth, you may need an assisted birth. This is where forceps or vacuum delivery are used to help deliver your babies.

Once the first baby is born, your midwife or doctor can check the position of the second baby by feeling your tummy and doing a vaginal examination. They may also use an ultrasound scan.

If the second baby is in a good position, it should be born soon after the first, as your cervix is already fully dilated.

If your contractions stop after the first baby is born, the doctor or midwife may discuss giving you hormones via a drip to restart them.

Caesarean section and twins

In the UK, more than half of twins and almost all triplets are delivered by caesarean section is a common method used during twin and triplet births.

You may choose to have a planned caesarean, or your doctor may recommend a caesarean, if:

the first baby is lying feet, knees or buttocks first (breech)

1 twin is lying sideways (transverse)

you have a low-lying placenta

your twins share a placenta

you have had a difficult delivery with a single baby before

As with any pregnancy, if you plan a vaginal birth, you may still end up needing an emergency caesarean.

In a small number of cases, some women deliver 1 twin vaginally and then need a caesarean section to deliver the second twin.

# data[].attributes.attachment_link.description
What to expect when your twins or triplets are born, including your birth choices and what happens if your babies are premature.

# data[].attributes.attachment_link.title
Twins Trust - We support twins, triplets and more...

# data[].attributes.attachment_link.description
Supporting you through every milestone of your journey with twins, triplets or more. From being pregnant with twins, triplets or quads through to parenting twins, triplets or quads, we are here for you.

# data[].attributes.body
*This video is a little outdated- we are currently working on a new one*
Information that has changed:
-A & E is no longer used as an entrance to maternity after 9pm, please use the Empress entrance instead.
- You can no longer pay for a private room.
- The visiting policy may differ, please see our website/ facebook page for up-to-date information.
- Aspen is now a postnatal ward for straight forward and complicated births.
- The Birth Centre is within Aspen ward and we now have plumbed in pools (see our Birth centre video).

# data[].attributes.attachment_link.title
Virtual Tour of Maternity Services at Darent Valley Hospital

# data[].attributes.headline
DVH Enhanced Recovery Programme (for planned Caesarean births)

# data[].attributes.subject
DVH Enhanced Recovery Programme (for planned Caesarean births)

# data[].attributes.attachment_link.title
Penny Simkin - Pain Versus Suffering in Labor

# data[].attributes.headline
Preparing for your Elective Caesarean Birth

# data[].attributes.subject
Preparing for your Elective Caesarean Birth

# data[].attributes.body
Please note that some of the information in the booklet is no longer applicable. We no longer offer the preparation classes or pre-surgery medications, speak to your obstetrician or midwife for updated content.

# data[].attributes.body
Designed for parents 28 weeks + in pregnancy. 4 week course, covering Labour and Birth, When Birth Takes a Different Path, Infant Feeding and Caring for Your New Baby. Presented over Microsoft Teams.

# data[].attributes.attachment_link.readable_text
We are sorry that we have had to suspend our Hypnobirthing classes. To support you during this time we have attached some resources that will help you to gain a knowledge and understanding of the role Hypnobirthing can play in your birth.

Hypnobirthing course material

In addition you may find the following links useful:

A preparation for birth course in which you will learn about the wonderful process of labour and how you can positively influence it by acquiring positive perceptions and learning to relax and to create a positive environment for birth.

Description:

We recommend you choose a start date around week 30 to 32 of pregnancy.

Runs for 4 consecutive Tuesdays, Wednesdays or Thursdays 7.00pm and 9.30pm

We also offer some weekend courses Sat and Sun 10.00am to 4.00pm (both days inclusive)

Cost £50 per person/couple

You must be booked to have your baby at Darent Valley Hospital in order to attend.
Dates: TBA

To avoid disappointment please book early.

Hypnobirthing is a complete antenatal programme focusing on a combination of childbirth education, self-hypnosis and deep relaxation techniques to help achieve a more comfortable birth. Hypnobirthing provides parents the tools they need to minimise the fear-tension-pain cycle, aiming for a more comfortable birth experience. Many women, midwives and doctors have seen that the use of Hypnobirthing techniques in the birthing process has a positive effect.

It is a method of self-help techniques that can continue to be employed when extra help is needed, enabling women to remain calm and in control and able to make informed choices in any type of birth. Women say that it helps them to cope better with labour and in particular to feel more in control of what is happening to them, which is known to be important (DOH 1993).

The deep relaxation and visualisation techniques taught in Hypnobirthing increase the production of endorphins and oxytocin, both of which are known to have beneficial effects in labour and birth. The aim of Hypnobirthing is for parents to achieve a calm, gentle birth. At Darent Valley Hospital we have developed a comprehensive Hypnobirthing course based on the Hypnobirth Midwives UK method.
Our course is unique in offering information on:

Understanding the process of labour and working with the body.

How to break the fear/tension/pain cycle.

Top tips for birth partners; the named birth partner will be trained to support the techniques.

How to achieve an active birth.

Practice positions and massage for labour.

Breathing and visualisation techniques for labour.

How the environment influences labour.

Hormones and their effect on birth.

Planned learning outcomes

Techniques of deep relaxation to help you eliminate the Fear-Tension-Pain cycle.

To explode the myth that pain is a necessary accompaniment to labour.

How your body is naturally designed to conceive, nurture and birth your baby with ease and comfort.

To use your natural birthing instincts to birth your baby in a way that most mirrors the way that nature intended.

How you and your birthing companion can create a birthing environment that is calm and joyful.

The course is facilitated by midwives and support staff, who are also trained Hypnobirthing practitioners. Therefore we feel you will receive a high standard service delivered by professionals skilled in both areas.

During your course you will be asked to practice and train in the techniques at home to gain the maximum benefit during labour. You can attend with your birth partner.

The Hypnobirthing course is £50, to cover the materials and resources. This includes:

10 hours of hypnobirthing teaching time

The Hypnobirthing workbook

Light Refreshments

Please can you spare a few minutes to share your feedback on our hypnobirthing courses. You can do this by clicking on this link: https://www.surveymonkey.co.uk/r/SKHR52D.

# data[].attributes.attachment_link.description
We are sorry that we have had to suspend our Hypnobirthing classes. To support you during this time we have attached some resources that will help you to gain a knowledge and understanding of the role Hypnobirthing can play in your birth.

# data[].attributes.headline
North Kent Maternity and Neonatal Voices Partnership (MNVP)

# data[].attributes.subject
North Kent Maternity and Neonatal Voices Partnership (MNVP)

# data[].attributes.body
The MNVP works together to contribute to the development and improvement of local maternity and neonatal care. Share your views here to ensure your voice is at the heart of our services. All feedback is anonymous to the trust.

North Kent Maternity & Neonatal Voices Partnership - MNVP | Facebook

# data[].attributes.attachment_link.readable_text
We aim to help dads have successful relationships with their families, and to support dads with anxiety, stress and mental health issues.

We hope to get dads engaged with services that have traditionally been targeted at mums, and to train & support volunteer dads to work with us.

We work directly with services that support Dads, families and especially babies to increase engagement and knowledge across the sector.

We want to make sure dads know how important they are, how to access support when they need it and why it's essential for baby's development.

# data[].attributes.attachment_link.description
VOLUNTEER WITH US EVENTS REGISTRATION FIND SUPPORT IN YOUR AREA DONATE HERE We aim to help dads have successful relationships with their families, and to support dads with anxiety, stress and mental health issues. We hope to get dads engaged with services that have traditionally been targeted at mums,

# data[].attributes.headline
Beside You- Breastfeeding Support in Kent and Medway

# data[].attributes.subject
Beside You- Breastfeeding Support in Kent and Medway

# data[].attributes.attachment_link.readable_text
Breastfeeding shouldn't leave you feeling sore. In the early days, you might feel a bit of discomfort while you and your baby are learning to breastfeed but this should go away.

A latch that isn't quite right can cause a lot of pain. With the right support with positioning and attaching from a local drop-in or health professional, you should find feeding much more comfortable. Find out more at about why breastfeeding might be hurting on our why I'm finding it painful page.

You're welcome to go along to a local breastfeeding drop-in for a chat if you do have any questions.

# data[].attributes.attachment_link.description
The #BesideYou campaign supports breastfeeding families in Kent and Medway.

# data[].attributes.body
One of our Consultants discusses Caesarean Birth and Assisted Birth

# data[].attributes.attachment_link.readable_text
We use cookies to give you the best possible online experience. If you continue, we will assume you are happy for your web browser to receive all cookies from our website. Accept

Baby Check App

Baby Check features 19 simple checks that parents can do if their baby is showing signs of illness. Each check tests for a different symptom and when completed, a score is calculated that tells parents or carers how ill their baby is. The app then lets parents know whether their baby needs to see a doctor or health professional.

Download for FREE from Google Play or the App Store.

Buy posters, business cards and other materials to help promote Baby Check to your clients and patients

Shop

# data[].attributes.attachment_link.description
The Baby Check App helps parents decide if their baby needs to see a doctor or health professional

# data[].attributes.attachment_link.description
Whether you’re currently pregnant or have recently given birth, look after your body with this prenatal and postnatal exercise home workout video from the NHS Fitness Studio.

# data[].attributes.headline
How to Tell if Your Baby is Feeding Well Video

# data[].attributes.subject
How to Tell if Your Baby is Feeding Well Video

# data[].attributes.headline
Holding Your Baby for Breastfeeding Video

# data[].attributes.subject
Holding Your Baby for Breastfeeding Video

# data[].attributes.attachment_link.title
HOLDING YOUR BABY FOR BREASTFEEDING 10 11 20 V4

# data[].attributes.attachment_link.title
Maternity - what to pack in your hospital bag

# data[].attributes.body
Here at Darent Valley hospital, we can offer a debriefing service whereby skilled midwives can discuss your birth experience and any planned future pregnancies and birth

# data[].attributes.attachment_link.readable_text
Some birthing experiences may leave women feeling traumatized, distressed or anxious. The actual birth experience may have been very different from the experience that was expected, which can be very difficult to deal with. These feelings and experiences can predispose to postnatal depression and which may lead onto post-traumatic stress disorder (PTSD).

Here at Darent Valley hospital, we can offer a debriefing service whereby skilled midwives can discuss your birth experience and any planned future pregnancies and birth.

Discuss their birthing experience, and their feelings around this.

To understand what happened to them and why in order to receive validation and resolve self-blame

Have the opportunity to express any negative feelings such as anger, frustration, or pain.

Discuss any positive aspects of their experience and also discuss implications for future pregnancy and birth.

Please also read the Patient Information Leaflet available HERE.

# data[].attributes.attachment_link.title
Online Self-Referral Form for Birth Experience Debrief

# data[].attributes.attachment_link.description
Some birthing experiences may leave women feeling traumatized, distressed or anxious. The actual birth experience may have been very different from the experience that was expected, which can be very difficult to deal with. These feelings and experiences can predispose to postnatal depression and which may lead onto post-traumatic stress disorder (PTSD).

# data[].attributes.body
This website was created with women and expectant families from Kent and Medway.

# data[].attributes.attachment_link.provider_name
Kent and Medway - Bump, Birth and Beyond

# data[].attributes.attachment_link.readable_text
This website was created with women and expectant families from Kent & Medway. Your maternity care is safest when you understand your choices and can make the right decisions for you and your baby. Bump, birth and beyond gives local, trusted information. Your local midwives and maternity team look forward to meeting you and answering any questions.

This website does not provide specific medical advice.

# data[].attributes.attachment_link.title
Home :: Kent and Medway - Bump, Birth and Beyond

# data[].attributes.attachment_link.description
This website was created with women and expectant families from Kent & Medway. Your maternity care is safest when you understand your choices and can make the right decisions for you and your baby. Bump, birth and beyond gives local, trusted information. Your local midwives and maternity team look forward to meeting you and answering any questions.

# data[].attributes.body
Follow us to keep up to date with the latest changes to covid restrictions/ visiting policies and much more

# data[].attributes.attachment_link.description
Caring for women and families in North Kent during pregnancy and birth. For pregnancy concerns ring... Darenth Wood Road, DA2 8DA Dartford

# data[].attributes.attachment_link.readable_text
DadPad is packed with information to give new fathers guidance on how to develop the confidence and practical skills needed to help look after their babies' physical and emotional needs.

Crucially, the app provides dads with guidance on how to support and seek help (when needed) for their partners and themselves as they adjust to their new roles. This will help individuals to better cope with the physical and emotional strains that fatherhood can place on individuals and relationships.

There are also details of local support groups for new dads and sources of help available in Kent and Medway.

To access DadPad for free, simply download the app using and enter your postcode (if you live out of our area but are booked with us please use the hospital's postcode - DA2 8DA).

# data[].attributes.attachment_link.description
DadPad is packed with information to give new fathers guidance on how to develop the confidence and practical skills needed to help look after their babies' physical and emotional needs. Crucially, the app provides dads with guidance on how to support and seek help (when needed) for their partners and themselves as they adjust to their new roles.

# data[].attributes.headline
Building a Relationship with Your Baby in Pregnancy

# data[].attributes.subject
Building a Relationship with Your Baby in Pregnancy