Questions about pregnancy
 – labour and pain relief

Q I'm worrying about writing my birth plan. I don’t really know what I want!

A It’s not a test! If you write something and want to change your mind you can, even at the last moment. You don’t even have to write a birth plan unless you want to.

The aim of the birth plan is just to put down some notes to help the midwife when you are in labour. Think about anything that you really want to happen – or that you are really hoping to avoid.

If you find writing hard, ask a friend to make some notes for you. Your midwife will be able to answer any questions and will be able to write down your preferences on the notes.

Q What should I pack in my baby bag for labour?

A It’s a good idea to pack two bags, one for labour and one for after the birth.
Even if you are planning a home birth you should pack these bags, just in case things don’t go to plan and you have to be taken to hospital.

Your labour bag
• Your antenatal notes
• A couple of nightdress or big T-shirts – ones you don’t mind getting dirty in labour and can throw away
• Flannel and water spray bottle
• Ipod and speakers or stereo and CDs (you might need batteries as you may not be able to plug them in)
• Energy snacks: dried fruit, bananas
• Magazines
• Lip balm
• Disposable underwear or old pants
• eight sanitary towels
• First clothes for your baby: hat, sleep-suit, vest
• A few newborn nappies
• Wipes/cotton wool and lotion
• Camera!
• Small change for the taxi or car park

Your birth partner might also want to pack a few things to help pass the time in hospital (books, snacks, etc).

After the birth bag
• Two front-opening nightdresses (so you can breastfeed)
• Light dressing gown and slippers
• Disposable underwear or old pants you can throw away
• 24 sanitary towels (large, thick pads are better than the ultra-thin variety). You can’t use tampons
• 2 or 3 nursing bras
• Pack of breast pads (you’ll need these even if you don’t breastfeed as your breasts will leak milk)
• Toiletries for you: toothbrush and paste, comb, moisturiser, shampoo and soap
• Small change for the phone (you can’t always use your mobile in hospital) – don’t forget a list of phone numbers
• Clothes to come home in (remember, you’ll still have a bit of a bump!)
• Sleepsuits and vests for baby
• Hat, scratch mittens and socks
• Nappies (your baby might get through about 12 a day)
• Wipes/cotton wool and lotion
• Shawl or blanket
• Cardigan to come home in
The hospital usually provides basic items like towels and blankets for your baby. Ask your midwife if she has a list of things that your hospital requires you to bring in.

Q Is a home birth safe?

A Home births can be a lovely experience and many women enjoy the experience. It can often mean that you are more relaxed and therefore need less pain relief. If you think you’d like a homebirth talk to your midwife about it during your pregnancy. If you are in a low risk group your midwife will hopefully be able to arrange this for you. If your midwife or doctor thinks that you have complications that means you need closer monitoring in hospital during labour then they may advise against a home birth. Otherwise, there is no reason why it should be more risky than a hospital birth.

Babies don’t always do what you want – even before they are born. If your baby gets into difficulty during labour, or you need medical attention, you must be prepared to change your plans and follow the advice of your care team.
Wherever you have your baby, a community midwife will visit you at home every few days for around ten days after the birth.

Q What type of pain relief can I have for a home birth?

A You can use all the non-medical pain relief options such as water and massage and walking and also TENS and Entonox (gas and air). Talk to your midwife before the birth about what else you can use. You wouldn’t be able to have an epidural at home. Many women don’t know how they would feel in labour and what pain relief they would need so if during the labour you think you need more pain relief then you can transfer into hospital.

Q I’m worried that I won’t know when my labour has started. What are the signs of labour?

A This is a common worry for first-time mothers, although once labour really starts, you’ll definitely know.

Your waters might break, in which case labour is, or soon will be, under way, or you may start by feeling contractions. These contractions differ from the practice contractions known as Braxton Hicks that you may already have had. They feel stronger, deeper and more painful.

Look out too for waves of backache as some women find that this is where they feel the contractions.

Once labour has started, contractions become more regular and don’t go away! When you are having contractions every five minutes, contact your midwife and discuss whether you should go into hospital (or, if you have chosen a home birth, whether she comes to you). If this is not your first baby or you are likely to have a quick labour you may be advised to call them earlier.

If you don’t know whether you’re in labour, telephone the labour ward day or night or the midwife who is looking after you.

They are used to dealing with false alarms so don’t worry.

Q I can’t sleep because I keep on worrying about the birth and labour. I'm scared of labour especially.

A Giving birth often feels daunting, especially if other women have been telling you about their experiences.

It is worth remembering that you’re not going to be facing this alone. You’ll have a midwife who’ll be there to support and help you. Her experience and knowledge will mean that you’ll be guided through the birth. She can also offer you pain relief in small or larger doses – depending on how you feel.

Talk to your midwife now about how you are feeling so you can talk through your choices. Think too about things that you might like to have around you during labour that will help you to relax. This might mean music or a favourite perfume.

Most women want someone they know well with them to act as a birth partner. This can be a friend, relative or partner. Pick someone who you trust and who is good company.

Q Is there any way that I can get my baby to come on time?

A Few babies arrive on time – most come when they feel like it. This is why it is best not to focus too much on the due date. If your baby is overdue, your midwife will monitor you carefully, and if your baby still hasn’t arrived seven days after the due date she will suggest ways to speed things up and given a date to be induced.

Q My friend said that she got depressed after giving birth. Does this often happen?

A Most women have a few days of feeling weepy about three to five days after they give birth. This is called the baby blues and is completely normal (it’s thought to be connected to the hormones in your body changing now that you are no longer pregnant). These feelings usually go away on their own within a few days.

For some women though, feelings of lasting depression and anxiety develop in the months after birth and don’t go away for many months. This is called postnatal depression and if it happens to you, it’s important to get help.

Talk to someone close to you about how you feel, and also tell your doctor or health visitor. They can arrange for you to get help and support, usually through talking to a counsellor, referring you to support groups where others are also feeling depressed or by taking medication.

It’s really important to get help as it can be a difficult thing to cope with on your own.