Labour and birth

Birth choices

Having your baby with us

Birth centre

If you’ve chosen to have your baby with us at the Northumbria hospital, watch our video to familiarise yourself with our department and what will happen upon your arrival.

Midwife Led Units (MLUs)

Our three MLUs are open seven days a week, from 8.30am to 6pm on week days and from 9am to 2.30pm on weekends and bank holidays, with antenatal clinics, consultant-led clinics, postnatal drop-in clinics and community midwifery services.

The units have an overnight on-call system for women deemed to be low-risk who are due to give birth at the MLU’s and at home. Find out more here.

Berwick Infirmary:

Hexham General Hospital:

Alnwick Infirmary:

Home birth

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

For more information on where to give birth please visit: Where to give birth: the options - NHS (www.nhs.uk)

Whilst most birthing people choose to aim for a spontaneous vaginal delivery, there are alternative options for your delivery.

What is a caesarean section?

This is when your baby is delivered through a cut (incision) made in the lower part of your abdomen. Usually the incision is just below the pubic hair line (bikini line).

Caesarean sections are only performed at the Northumbria Specialist Emergency Care Hospital.

Elective Caesarean Section

A caesarean section is performed when it is thought that a vaginal delivery may cause concern for either the mother or baby. This can be for a number of reasons:

If there are concerns about your baby’s wellbeing in the womb
The pelvis is not big enough to allow the baby to pass through
When the placenta is covering the neck of the womb (cervix)
Sometimes if the baby is in the breech position (bottom first)
If the neck of the womb (cervix) does not open up enough during induction or in labour

There are many other reasons why it might be necessary to perform a caesarean section. If you are not sure why you might need to have one then please ask your midwife or doctor to explain.

If you request a caesarean section the consultant obstetrician will discuss this with you.

Find out more about elective caesarean section Considering a caesarean birth patient information leaflet | RCOG

Emergency Caesarean section

The most common reason for this is immediate concern for the wellbeing of the baby. If the baby is showing signs of distress or is not coping and birth is not imminent, then an emergency caesarean section may be recommended.

Another reason for an emergency section may be if your labour has slowed or stopped and interventions to encourage progress have been unsuccessful. A very prolonged labour may be unsafe for you or your baby as it can lead to your baby becoming distressed and an increased chance you may bleed more heavily after birth.

Your midwife will stay with you and continue to care for you in theatre and after your baby is born.

Caring for your wound after a caesarean birth

Please see this leaflet for more information about caring for your wound after a caesarean birth.

Instrumental Birth

An instrumental delivery is where either suction cup or forceps are used to gently pull the baby down the birth canal, whilst the mother pushes to achieve a vaginal birth.

If it is recommended that you need an instrumental delivery, the reason for it will be clearly explained to you by the obstetrician. You will have the chance to ask questions and discuss your options so you can give your informed consent to the procedure. Your midwife will stay with you and continue to support you throughout the birth.

For more information about planning your pregnancy care, place of birth and what options are available for you in the region, the ‘Pregnancy and Birth Choices in the North East and North Cumbria Web App’ is a great resource.

Women who have a history of one previous delivery by lower segment caesarean section (LSCS) may wish to consider a vaginal delivery in their subsequent pregnancy. The chance of successful vaginal delivery is between 72-75% (RCOG, 2015).

If you have given birth by LSCS previously, you will receive be offered additional consultant appointments, where midwives and obstetric staff will provide you will provide you with support and evidence-based information to enable you to make an informed choice regarding VBAC.

See leaflet here for more information

We run a monthly ‘Next Birth After Caesarean Section’ antenatal session via Zoom. The session is hosted by experienced clinicians who can answer all of your questions and provide you with the most up to date evidence to support your decision.

Book your place via Eventbrite here

Labour

Monitoring your baby’s heartbeat during labour:

We want you to have a healthy baby and the best possible experience of birth. In order to achieve this, there are some checks we will do to make sure that you are both coping well. For mum, this will include checking your temperature, pulse and blood pressure regularly.

For baby, we can monitor your baby’s heartbeat. This is called fetal heart monitoring and is the same as checking your bay’s pulse. Performing fetal heart monitoring allows us to assess your baby’s wellbeing.

Please see this leaflet for more information on types of fetal monitoring and the reasons for this.

There are many types of analgesia which you might like to try:

Self-help in labour

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

learn about labour – this can make you feel more in control and less frightened about what’s going to happen; talk to your midwife, ask them questions, and book on to our antenatal classes
learn how to relax, stay calm and breathe deeply
keep moving – your position can make a difference, so try kneeling, walking around, or rocking backwards and forwards
bring a partner, friend or relative to support you during labour, but do not worry if you do not have a partner – your midwife will give you all the support you need
ask your partner to massage you – although you may find you do not want to be touched
have a bath

Water / birthing pool

Water is useful for managing pain in labour. It encourages you to relax and is thought to make the contractions seem less painful. The use of water for pain relief is available as long as there are no contraindications (factors that mean a birthing pool should not be used). The water will be kept at a temperature that is comfortable for you but not above 37°C. Your temperature will also be monitored closely. If any problems are detected with either you or your baby, you will be asked to leave the pool.

Hypnobirthing

We fully support birthing parents who wish to use hypnobirthing through their labour. You are welcome to discuss this with your midwife and add this to your birth plan so that all staff are aware of your choices.

Hypnobirthing can help you manage stress hormones, such as adrenalin, and reduce anxiety, which should lead to a calmer birth. During labour, your body produces a chemical called oxytocin, which helps progress your labour. Stress hormones affect the production of oxytocin, and make your labour longer.
Managing stress may also help to reduce some of the fear and pain experienced during labour.
In some cases, hypnobirthing has been shown to make labour shorter.
Practising hypnobirthing – whether it’s at a class, with a book or CD – may help you to feel more prepared and in control when labour starts.
It may help you cope with anxieties if you had a previous traumatic birth experience.
Hypnobirthing may reduce the need for drugs and medical intervention. However, you can have additional pain relief as well if you want to.
It can be added to any birth plan and the techniques can be used wherever you give birth – in a hospital or birth centre, or at home.
Hypnobirthing may benefit you after birth too, with some evidence showing that it can lower the chance of postnatal depression.
Hypnobirthing can help your birth partner play a more active role during labour.

Tens machine

This stands for transcutaneous electrical nerve stimulation. We have a number of TENS machine available for you to use in all of our hospitals. TENS is believed to work by stimulating the body to produce more of its own natural painkillers, called endorphins. It also reduces the number of pain signals sent to the brain by the spinal cord.

TENS has not been shown to be effective during the active phase of labour, when contractions get longer, stronger and more frequent. It’s most effective during the early stages, when many women experience lower back pain.

Gas and air/Entonox

This is a mixture of oxygen and nitrous oxide gas. Gas and air will not remove all the pain, but it can help reduce it and make it more bearable. Many women like it because it’s easy to use and they control it themselves.

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

This is an injection of an opiate medicine into your thigh or buttock to relieve pain. It can also help you to relax. It takes about 20 minutes to work after the injection. The effects last between 2 and 4 hours.

Diamorphine/Pethidine injections (opioids)

There are some side effects to be aware of:

it can make some women feel woozy, sick and forgetful
if pethidine or diamorphine are given too close to the time of delivery, they may affect the baby’s breathing – if this happens, another medicine to reverse the effect will be given these medicines can interfere with the baby’s first feed

Epidural

An epidural is a type of local anaesthetic and is given by an anaesthetist. It numbs the nerves that carry the pain impulses from the birth canal to the brain. For most women, an epidural gives complete pain relief. It can be helpful for women who are having a long or particularly painful labour.

There is a pain relief comparison card here.

What is induction of labour?

Most pregnancies will end between 37 and 42 weeks when labour starts naturally and results in the birth of the baby. Induction of labour is a process that starts your labour artificially. On average one in five women may have their labour induced and your individual circumstances can be discussed with your midwife or consultant.

Hear from our advanced clinical practitioner, Julie Wyton about the induction of labour process.

When might induction be recommended?

Induction of labour is usually offered at 41 weeks of pregnancy if labour has not started naturally. The choice to proceed with Induction of Labour is yours once you have received all of the relevant information. You may find the NHS Choices leaflet helpful when making your decision

Induction of labour will be recommended if there are concerns that you or your baby’s health would be at risk if your pregnancy continued.

Some examples of medical reasons for induction include: