Options to consider

who will be your birth partner(s)
how you feel about having a student present during labour/birth
different pain relief options for labour and birth
different positions for labour/birth
coping strategies and pain relief
how you feel about vaginal examinations
whether you would like continuous or intermittent monitoring of the baby’s heart during labour
any preferences you have if an assisted birth is recommended.
who will cut the cord/optimal cord clamping
skin-to-skin contact
your thoughts about infant feeding
how you would birth your placenta (afterbirth)
vitamin K for your baby.

It is useful to think about how you would like your baby’s birth to be in the event of having an induction of labour or a caesarean birth – planned or unplanned, and to ask your midwife or doctor what things you might need to consider for your own personal circumstances. Your midwife will discuss your preferences with you again when you are in labour and any reasons to consider changing the plan. You can share your birth plan with your midwife when you meet at the maternity unit (or at home if you are planning a homebirth). Complete your Personalised birth preferences plan in this app which can be printed out to share with your maternity team.

Your birth preferences and plan

How to make a birth plan Which? Your birth plan

13th August 201813th January 2021

Would you like to talk with somebody about your options for place of birth?

Some women may find it helpful to talk to someone about their birth options. This is especially true if they have had a pregnancy, labour or birth that was difficult previously, or if something unexpected happened. It is not unusual to be unsure about your options or what effect any choices may have on this pregnancy and birth. You can speak to your midwife, and if needs be she will refer you to a birth options clinic, which is normally run by the consultant midwife at your chosen maternity unit. If you are considering requesting a planned caesarean birth, this decision would be made with you and the specialist midwifery and obstetric teams. Ask your midwife to refer you to the appropriate clinic, where you will be able to discuss your options.

Contact my maternity unit

13th August 201813th January 2021

Which option is safest for me and my baby?

Safety is always the priority, so if you have certain needs or complications with your health and/or pregnancy it may mean that giving birth on a labour ward is the safest option. Your midwife or doctor will discuss this with you if it is their recommendation. If this is your first baby, and your pregnancy is considered low-risk, it is just as safe to have your baby in a midwife-led birthing centre as it is to have your baby in a labour ward. Research shows the risk to the baby is slightly increased when planning to give birth at home. If this is your second or subsequent baby, it is just as safe to have your baby at home as it is to have your baby in a midwife-led unit or in a labour ward. Women who give birth at home, or in a midwife-led birthing centre are much less likely to require medical assistance including caesarean section, instrumental delivery, blood transfusion and episiotomy.

Which? birth choice Birthplace study Is home birth safe?

13th August 201813th January 2021

Choosing place of birth

This is a decision you will make following discussion with your midwife or doctor at around 34-36 weeks of pregnancy, but it is helpful to start thinking about your preferences before this time.

Portal: Choosing place of birth

You can change your mind about where to have your baby at any point. If you choose to have your baby at home or in a midwifery led unit (birth centre), some events or complications before or during labour may mean transfer to the labour ward is advised.

Home

At home – in the comfort of your own home with the support of two midwives and whoever you choose to have with you. You can hire a birthing pool and your midwife can provide gas and air (entonox) if you want to use it.

Midwife-led unit (MLU)/ birth centre

This is a ward within the maternity unit. It is a homely and calm environment that supports normal birth with minimal assistance. Midwives and chosen birth partners are on hand to support you. You will have the choice of a birthing pool, gas and air (entonox), aromatherapy and opiate based pain relief, depending on your maternity unit of choice.

Obstetric-led unit (OLU)/ Labour ward/Delivery suite

This is a ward in a maternity unit where your care will be provided by a team of doctors and midwives. Normal birth with minimal intervention is always the goal, if it is safe to do so. Access to more specialised medical facilities and equipment is available for those women who need it.

Options for place of birth

Which option is safest for me and my baby? Would you like to talk with somebody about your options for place of birth?

Choosing place of birth Which? Birth choice Homebirth Planning a home water birth

13th August 20183rd June 2021

Your baby’s movements

Pregnant woman reclining and holding her pregnancy bump

From 16-24 weeks on you should feel the baby move more and more up until 32 weeks, then stay roughly the same until you give birth. Take time to become familiar with your baby’s normal pattern of movements. You should continue to feel your baby move regularly right up until you give birth to him or her. The movements your baby makes offer reassurance that he or she is well, and therefore if you notice these movements change or reduce from what you are used to, it is important to call your midwife or attend the maternity unit urgently.

The importance of monitoring fetal movements

This video is available in many other languages in North West London antenatal videos: The importance of monitoring fetal movements in 20 languages including sign language

Portal: Your baby’s movements

Contact my maternity unit

How often should my baby move? Baby movements in pregnancy Your baby’s movements Why movements matter? Information for healthcare professionals

13th August 201820th April 2021

Getting to know your baby during pregnancy

Taking time as part of your daily routine to think about and bond with your unborn baby is known to release oxytocin, a hormone which can help your baby’s brain to develop. Babies need adults to nurture and support their development during pregnancy and their speech, language and communication beyond birth. There is lots of helpful information to support you with chatting to your bump during pregnancy and talking, singing, playing and reading with your baby after birth. You can try:

talking, singing, playing and looking at books with your baby, and encouraging your partner/family/other children to do the same
gently massaging your bump
having a bath
trying pregnancy yoga
practising hypnobirthing
playing music to your baby
writing a letter to your baby
using an app to help you understand how your baby is growing and developing, such as the Baby Buddy App.

Building a relationship with your baby

UNICEF UK Baby Friendly Initiate, Building a happy baby leaflet Baby buddy app Getting to know your baby Talking to your baby (Hungry Little Minds Five top reasons to understand more about talking to your baby I CAN’s Talking Point for parents

13th August 201813th January 2021

Work, maternity/paternity leave and money

After your 20 week ultrasound scan, you can ask your midwife or GP for a MATB1 form. This form entitles you to statutory maternity pay from your employer or maternity allowance from Jobcentre Plus. During pregnancy/after birth you are entitled to:

paid time off for your antenatal appointments
maternity pay or maternity allowance
maternity leave
protection against unfair treatment, discrimination or dismissal.

Working partners are entitled to one or two weeks paternity leave and together you may be able to take shared parental leave. If you are not working, or you/your household is on a low income you may be entitled to maternity benefits and allowances. If you are employed, you must inform your employer that you are pregnant at least 15 weeks before your baby’s due date. When you tell your employer they must perform a risk assessment, which ensures any necessary adjustments can be made to your working environment or pattern. It is worthwhile speaking to your company’s human resource department and accessing the policy on pregnancy and maternity leave. More information on maternity/paternity leave, work, child or other benefits and money can be found in these related links:

Government advice Advice on your maternity rights The Money Advice Service Pregnancy, breastfeeding and health and safety

13th August 201813th January 2021

Antenatal classes

Antenatal education (also known as birth preparation or parent craft classes) can help you to prepare for your baby’s birth, giving you confidence and information. You can attend these classes with your birthing partner so you can prepare together for the arrival of your baby. Antenatal education is also a good way to make friends with other parents who are expecting babies around the same time as you. These friendships can help parents through the first few months with their new baby. There are two types of class available to choose from:

free NHS antenatal classes available at your local maternity unit or children’s centre. Ask your midwife about these classes
private/independent antenatal classes.

Most antenatal classes can be started when you are around 28-32 weeks pregnant, but they can often get booked up in advance so it’s good to arrange your place early on. There are specialised antenatal classes for women expecting twins/triplets and your midwife or doctor will give you the information you need about these. Topics covered by antenatal classes include:

health in pregnancy, including a healthy diet
exercises to keep you fit and active during pregnancy
what happens during labour and birth
coping techniques for labour and information about pain relief
relaxation technique
information about the different modes of birth (vaginal, assisted with ventouse or forceps, caesarean)
caring for and feeding your baby
your health after giving birth
emotions and feelings during pregnancy, birth and after.

Classes can be attended by anyone – it doesn’t matter if it is your first baby or your fifth! A series of short videos have been created for those unable to attend classes in person:

Antenatal classes: Videos

Portal: Antenatal classes

Antenatal classes Find an NCT antenatal course Find an independent antenatal class near you

13th August 201813th January 2021

Stillbirth

When a baby passes away after 24 weeks of pregnancy, either before or during birth, this is known as a stillbirth. Stillbirth is one of the most devastating things a family can experience, and a range of support is given through a specialist team (including midwives, obstetricians, counsellors and charities) to parents who are affected by it. Many stillbirths are linked to a problem with the placenta, which is essential to a baby’s growth and development. If the placenta doesn’t work properly it can cause babies not to receive the oxygen and nutrients they need. Other causes include infection, heavy bleeding (known as haemorrhage), pre-eclampsia and pre-existing diabetes. Not all stillbirths can be prevented, but there are some simple things that can be done to minimise the risk:

stopping smoking and avoiding alcohol and drugs during pregnancy
sleeping on your side from around 28 weeks gestation, or turning on to your left side if you wake up on your back overnight
attending all of your appointments and scans so that your maternity team can monitor your baby’s health
calling your midwife/going to your maternity unit straight away if your baby’s movements are reduced from what you’re used to feeling.

Portal: Stillbirth

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13th August 201818th May 2021

Miscarriage and the loss of your baby

A miscarriage is the loss of a pregnancy during the first 24 weeks. An early miscarriage occurs up until 13 weeks of pregnancy. Symptoms of a miscarriage can include bleeding, abnormal vaginal discharge, lower abdominal pain and loss of pregnancy symptoms. The first trimester can be an anxious time for many reasons, one of which might be worrying about whether the pregnancy will continue. Sadly, as many as one in five early pregnancies will end in miscarriage. The loss of a baby at any stage of a pregnancy can be devastating for both parents. It doesn’t matter how far into the pregnancy it happened, or whether or not the pregnancy was planned, the sense of loss can be very strong. It is important to remember that everyone deals with loss differently and it’s ok to grieve for your baby. There are a number of organisations that can provide expert support and information for parents who have suffered a loss. Whilst there are a number of reasons why a pregnancy might not be successful, the majority of first trimester miscarriages occur because of a problem with the chromosomes which mean that the baby could never have developed, not because of anything the mum has done, or not done. The vast majority of women who suffer the loss of a baby do go on to have successful pregnancies in the future. A miscarriage can be diagnosed by an ultrasound scan. You may be required to stay in the maternity unit overnight but most women can go home on the same day. You will receive follow up from a doctor, nurse or midwife who specialises in early pregnancy. It is recommended that you inform your maternity care provider (antenatal clinic) about your miscarriage in case they are not aware. You may wish to delete the Mum & Baby app from your device.

Portal: Miscarriage and the loss of your baby

Coronavirus and Miscarriage: Your care

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