Hospital - Midwife-Led Unit - Home Birth Comparison

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We’ve put together some useful information if you are hoping to have your baby in hospital or a midwife-led birth unit or at home. Many women choose to have their babies in hospital where there is everything you need to help you birth your baby. Some prefer to have their baby in a midwife-led unit or birth centre these are halfway houses between hospital and home and as long as everything is going well and there is room; you can go for this option. Just make sure you ask about this early on. And now a-days, many mums are choosing to stay at home as long as possible and because they feel so comfy and safe choose to deliver their baby at home with just their midwives and birthing partners present.

Its best to look at all your options and make a preferred decision with the support of your birthing partner and midwives. Enter labour with an open mind as our babies can be born anywhere and at anytime. As long as you have prepared emotionally, mentally and physically you will birth like the warrior you are! And this is why Clare and I have created this resource centre for you so can be prepared for all the different kinds of situations that could arise so here’s a few things worth exploring:

Where would you like to give birth?

A lot depends on your pregnancy and your health and vitality and your babies health. Many women simply prefer to go to hospital where they feel safer and happier giving birth. It can be reassuring to know that medical help is on hand if you need it. |It your midwife of doctor thinks you need extra care during labour and birth then they will advise you to give birth in hospital.

You may choose to give birth at home or in a midwife-led unit feel assured that if any complications arise you will be transferred to hospital. In hospital you have access to all types of pain relief. Until you are in labour it is difficult to know which one will want to use but you will have immediate access to all of it.

Hospital Birth

Many women like to go to hospital because there is the opportunity for recovery time afterwards, if you have other children at home this time can be precious. Also it can be a great advantage to get the help and support with your baby in terms of feeding and general care if it isn our first child.

We suggest making your hospital visit your own by bringing your own pillow (with a colourful case so it doesn’t get confused with the hospital pillow). Your own blanket anything that will make you think of home and keep you relaxed. Use your pillow and blanket you used when Questing or rewriting your birthing beliefs as this will add that extra layer of ‘home’ to the hospital environment.

Although each hospital has its own policy on how long a labour should take and will offer you intervention at these stages to speed up labour, you can feel empowered enough to ask questions to see if these things are actually needed for you and your baby and then make an informed decision that is right for you.

Some hospitals are better at encouraging an active birth, allowing you the time and space you need to get comfortable during labour and progress at your own unique rate. Remember, when you are in deep labour you won’t be interested or worried about anyone else, you will be in ‘the zone’ and so its beneficial if your birth partner is empowered enough to ask the right questions and make decisions of the back of what they know you would prefer.

A useful tool to apply to all the content presented to you or any research you undertake personally, and crucially when you need to make any choices during birth is B.R.A.I.N:

B = What are the BENEFITS?

R = What are the RISKS?

A = What are the ALTERNATIVES?

I = What does your INTUITION tell you to do?

N = What are the outcomes or possibilities if we do NOTHING?

When faced with a decision, or when at a cross-roads, take a moment to ask yourself and/ or your midwife/doctor questions based on the above, to help you make informed choices.

Facilities in hospital

Most hospitals have adjustable beds, space for you to move around, birth balls, mats, wall bars to help you lean or squat, birth pool, en-suites with baths, some look more homely than others but feel free to bring what you need to make you feel more relaxed. You need to ask in advance if there is a birthing pool and if you can use it. You can dim the lights and play music just make it as comfy and cozy as you can. Some midwives are trained in complimentary therapies to ease labour. Many hospitals are happy for you to have a tour so you can have a good see where you will be and what’s on offer just give them a ring and arrange an appointment. BirthChoiceUK is a great website that will help you make a birthing decision.

How will you get to Hospital?

Its good to come up with a few plans about how you will get to hospital and who will take you there. Babies can decide to come at all times of the day and night so its good to know the roads in case its rush hour, if birth partners are working away, if it’s in the middle of the night; having contingency plans is key. Some women choose to stay at home for as long as possible until they go to hospital; always best to phone your midwife when you know you are ready.

One thing to take into account is that because you have been practising your birthing breath techniques and yoga poses and actively engaged with our Hypno Birthing-Quests you may ‘sound’ over the phone, like you’re handling the labour well and may give the midwife the wrong impression in terms of how far along you are. So please let them know you have been doing our course and going to our classes and that you are ready to transition to hospital even if you might not sound like it.

It also helps to do a practice run, looking at all routes to hospital and where your birthing partner or driver can drop you of and park and where they will go inside the hospital to find you again. Make sure you have the right money for parking.

What pain relief options do I have at Hospital

All of it depending on what you need and when you need it such as:

Medical Pain Relief

Entonox (gas & air) works quickly and wears off. May cause nausea.

Pethidine - This is an opiate given as in injection in the thigh. It is very effective in relaxing stressed women who have had a long latent phase of labour but, it can cause nausea and vomiting.

Epidural - a local anaesthetic is injected into the epidural space between the second and third lumbar vertebrae. The drug action the spinal nerves to produce a sensory and partial block. It is pain free, women can sleep and good for long labours and complicated deliveries. Mobility, however is restricted and the risk of having further medical intervention and assisted with rises.

Remember: “Everything has a place!”

Examinations

Examinations can really help you know how far along you are in your labour and whether the baby is in a comfortable position. You can choose when it is right for you, it is ok to say no if it is not the right time. Off course sometimes it’s very important that some of the tests are carried out given different circumstances, but you can judge this and decided the necessity. Every hospital has hand held monitors so ask them to use one of these before you are confined to the bed to be monitored. You will then have much more freedom of movement and be able to do some of the Yoga Birthing Moves you have learnt in your LushTums Classes.

Types of examinations:

• Cervical examinations • Electrical Foetal Monitoring

• Monitoring on the baby’s head

Pain Relief Ladder

Before going straight for the medical relief try some of these alternatives first. You will be surprised just how well they go with all of the positive Birthing Mindset tools and techniques you have to birth you baby with ease and love.

• Yoga Birthing Poses

• Birthing Breath

• Massage

• Heat

• TENS Machine

• Reflexology

• Aromatherapy

• Acupuncture

• Bachs Flower Remedies

• Bath/Birth Pool

• Homeopathic Remedies Midwife-Led Unit and

Birth Centres Birth centres are maternity units that are usually staffed by midwives and they aim to offer a homely, rather than clinical, environment. They are especially good at supporting women who want a birth without medical interventions. Most are set up with furniture and facilities designed to help you feel calm and in control.

The aim for birth centres is to treat labour and birth as a straightforward, normal thing to happen, rather than a risky event. You may also hear birth centres referred to as:

• Community maternity units (CMUs) in Scotland.

• Midwife-led units (MLUs).

• Midwifery units.

• Birthing centres.

• Birthing units.

Some birth centres are separate from a hospital (freestanding midwifery unit), but many hospitals have midwife-led birth centres alongside their conventional, consultant-led, maternity units (alongside midwifery unit).

Who can use a birth centre?

You will probably only be able to book into a birth centre if your pregnancy is low-risk, and you have a good chance of having a normal birth, at full-term. Complications during a previous pregnancy or your current pregnancy may mean that the likelihood of being transferred to hospital during labour is increased, and your doctor or midwife may recommend that you give birth in a hospital instead. Some birth centres won't accept you if you are over a certain age, either.

Your doctor or midwife may recommend that you don't give birth in a birth centre, if, for example:

• You have complications such as gestational diabetes, high blood pressure or anaemia.

• You have had complications or interventions in a previous pregnancy, such as preeclampsia, caesarean section, or a baby with shoulder dystocia.

• Your baby has problems that have been picked up during pregnancy.

• Your baby is at risk of being born early.

• You're having twins or more.

Some birth centres accept women from any area of the country. Others will only accept you if you are registered with a local GP, or are under the care of local community midwives. Most birth centres are happy to accept first-time mums whose pregnancies are going well.

If you would really like to use a birth centre, but have some complications or other risk factors, ask to meet a senior midwife or consultant at the hospital. They'll be able to talk you through your options and help you work out whether a birth centre is right for you.

What do birth centres offer?

Birth centres offer a compromise between home and hospital. They offer a relaxed atmosphere, and are well-equipped and staffed with highly skilled midwives. Birth centres often offer facilities that aren't available in hospital, such as:

• Comfortable, low-tech birthing rooms.

• A calming interior, with soft mood lighting.

• Labour aids, such as birth balls, padded flooring and birth stools.

• Complementary therapies, such as aromatherapy and massage.

• Accommodation for your family.

• A birth pool.

You may be more able to relax into the sensations of birth, cared for by supportive midwives, and using nothing stronger than gas and air (Entonox). Your midwife will encourage using natural coping strategies, such as immersion in warm water. She will also encourage you to have an active birth by moving around and using different positions. Everything that you have learnt at our LushTums Pregnancy classes or within this Birthing Resource Centre will support you to birth your baby naturally.

Compared with some hospital labour wards, a birth centre is likely to give you and your partner:

• More privacy.

• One-to-one midwife care. • A more homely, calm environment.

• Better facilities for your partner, such as a place to sleep and access to a kitchen.

Some birth centres offer antenatal care and classes, as well as regular clinics with a visiting obstetrician.

Free-standing birth centres sometimes also offer a high standard of care after your baby is born. You may have a private, en-suite room, so that you can relax with your baby in peace and stay until you feel ready to go home. Some of your family may be able to stay overnight, too. You'll also get plenty of help with breastfeeding.

However, some centres only offer care during and immediately after labour and birth. So you may be transferred to a postnatal ward on the main maternity unit after you've given birth.

What pain relief options do I have at a birth centre?

Most birth centres offer the following forms of pain relief:

• Gas and air (Entonox).

• Diamorphine or pethidine injection.

• Water birth in a birth pool.

• TENS machine – not all birth centres have TENS machines so you might have to hire one.

Some birth centres also offer acupuncture, which can reduce the need for other kinds of pain relief. There are also other alternative pain relief methods that are often supported in birth centres, such as the hypnobirthing you’ve been doing in this Birthing Resource Centre.

This is an important conversation to have with your midwife before you choose where you want to give birth, as pain relief options could be a deciding factor.

What facilities won't I get at a birth centre?

You won't have immediate access to highly skilled obstetricians, anaesthetists, or neonatal nurses. Some stand-alone birth centres may have cover from these specialists, but most don’t; but many birth centres sit right next door to hospitals.

This means that you're unlikely to be able to have an epidural while under birth centre care. Similarly, if you need extra help from a healthcare professional with particular training, you may need to be transferred to hospital.

Why do transfers to hospital usually happen?

Transfers are fairly common, particularly for first-time mums. About one in three low-risk first-time mums are transferred, compared with about one in 10 mums who've had a baby before. You may be slightly less likely to be transferred if you give birth in an alongside birth centre than a free-standing one.

You'll need to be moved to a consultant-led unit if:

• You need strong pain relief, such as an epidural.

• Your labour isn’t progressing well, and your baby needs help to be born, for example by forceps or ventouse, or caesarean section.

• Your baby needs special care after the birth, and you're in a free-standing birth centre.

Try not to worry about being transferred, but do prepare yourself for it. If you do need to be transferred, your midwife will arrange it, and she'll also go with you, so you'll be well looked-after every step of the way.

You may be transferred by trolley, wheelchair, or bed if you are in a birth centre attached to a hospital. From a free-standing centre you will be transferred by car or ambulance .

If you are transferred, you should be offered some choice in the practicalities, such as if you want to walk to the ambulance, or would prefer to sit or lie down. Your birth partner should be able to come with you in the ambulance if you want, or he can follow you in the car. Remember to bring all your things with you!

Some women feel relieved to be transferred, while others feel disappointed, depending on the reason for the transfer. You may miss the more personal atmosphere of the birth centre. However, you should still receive one-to-one midwifery care in hospital, and you'll know you're doing what's best for you and your baby.

At what point do transfers usually happen?

Transfers are rarely emergencies, so there's usually plenty of time for a calm transition. First-time mums-to-be are much more likely to be transferred during labour than after the birth, for the reasons mentioned above.

Sometimes, a transfer is needed after the birth, rather than during. Reasons for a postnatal transfer include:

• Stitches for a perineal tear or episiotomy.

• Heavy bleeding.

• Retained placenta.

If you're an older first-time mum-to-be, it can increase your chance of transfer. But if you've had a baby before, your age won't make a difference.

What are the benefits of having my baby at a birth centre?

Birth centres usually only accept you if you are likely to have an uncomplicated labour and birth. So you probably already have a higher chance of having a straightforward, rewarding experience, if you're booked into one.

At a birth centre, you're more likely to:

• Manage your labour and birth without strong pain relief.

• Have a straightforward vaginal birth.

• Avoid having an episiotomy or c-section.

• Be satisfied with your birth experience.

The midwives at the birth centre will offer you plenty of support with breastfeeding, too. So you'll be more likely to get off to a good start, and breastfeed your baby for longer.

Are birth centres safe?

Having your baby in a birth centre is no more or less risky than in hospital, although you are less likely to need an assisted birth in a birth centre. If you're a first-time mum, having your baby at a birth centre is slightly safer than giving birth at home. But if you've already had a baby, giving birth at home is just as safe as a birth centre or hospital.

Rates for serious problems during labour and birth in the UK are very low, so wherever you have your baby, it's highly likely to be a safe experience.

Can I pay for private care?

Maternity care in NHS birth centres is free of charge, but if you want to pay for your care, there are some private birth centres in London and other regions of the UK. As a rough guide, one private birth centre in London charges between about £7,000 and £9,000. Much depends on how early in your pregnancy you start your care with them.

What should I ask when choosing a birth centre?

You may want to ask the following questions to find out if a birth centre will accept you, and whether it's right for you:

General information

• Do you accept women from my area?

• Do you accept women of my age?

• How many women do you help to give birth each year?

• How many first-time mothers book with you?

• What is the average length of stay?

• Do I have to be registered at a local GP practice?

• Does the birth centre ever have to close? If it does, where will I go?

Questions about labour and birth

• Will I have one-to-one care from a midwife throughout labour?

• Can my family and children be with me at the birth?

• What percentage of normal vaginal births do you have each year?

• How would you monitor my baby during labour?

• What pain relief is available, including non-drug methods?

• Is there a time limit on the second (pushing) stage?

• Is there a midwife trained to use ventouse?

• What percentage of women have an episiotomy?

• Are complementary therapies available, and are they practised by qualified practitioners?

• Can I eat and drink during labour?

• Is there a birth pool available?

Questions about transfers to hospital

Sometimes circumstances mean that you need to be transferred to hospital. You may want to ask:

• How many women are transferred to hospital during labour?

• What are the main reasons for transfer?

• Which maternity unit would I be transferred to in labour?

• Which hospital would my baby be transferred to if he needs special care?

• What are the average journey times to these units?

• Would the midwife caring for me carry on looking after me in hospital?

Questions about postnatal care

• What kind of help will I get with breastfeeding?

• Do you have facilities for a postnatal stay?

• How long will I be able to stay?

• Can members of my family stay with me

Keep asking those important questions every step of the way so you can make informed decisions which will positively impact on your postnatal recovery.

Home Birth

If your pregnancy has been straightforward with no complications you ought to be able to have your baby at home. If you have had a baby and experienced complications during that birth or if you have a medical condition you may be advised to have your next baby in hospital, but this doesn’t mean a home birth is out of the question. Use B.R.A.I.N and ask about the risks and benefits and make your informed decision.

A community midwife will come out to your home to see how you are getting along, she’ll watch a few contractions and talk to you and your birth partner and she may examine you if you’d like her too, to see how far along you are. You can ask her to sit with you or in a different room while you and your birth partner concentrate on birthing. A second midwife will be called to join her for the birth of your baby. Ideally two midwives ought to be present when your babies born. Then, if there’s an emergency, one midwife can look after you and the other one looks after your baby.

What equipment do I need?

Not much!

• Plastic sheeting or bin liners to protect your floor, bed or sofa.

• Old towels or sheets to cover the plastic sheeting.

• A couple of containers, in case you are sick during labour.

• A warm blanket or throw, in case you get cold. • Bin liners for dirty linen and rubbish.

• Old sheets or towels can create a covered path between where you labour and give birth, and the toilet.

• Clean warm towels, a baby blanket keep your baby warm after she's born.

• Clothes for baby & nappies.

• Bottles and Baby formula.

• Boobies for breast feeding!

Otherwise you’d need the same things you would pack for your hospital birth, (see Hospital Bag PDF) clean comfy clothes for you and your baby, toiletries, home comforts, snacks, foods, water, beverages, and because you’re at home candles, music, incense, low lighting anything that will make you really comfy!

Placenta Delivery

Once the placenta is delivered, your midwife will check to see if you have a tear that needs stitching. Most tears can be stitched up by your midwife. If the placenta doesn't come away, or if you have a very bad tear, you'll need to go to hospital.

If all is well, the midwives will probably leave you and your partner alone with your baby for a while. Then they'll check your baby over and weigh her. Whether you are breastfeeding or formula-feeding, your midwife will help you with the first feed, if you need it.

Your midwife will stay until she’s happy that you are comfortable and well. She'll see you into bed, and clear up any mess before leaving.

Your newborn will have a physical examination around three days after the birth. A midwife or doctor may call to do this or you may have to take your baby into hospital to have it done.

You may have more visits from your midwife or a maternity support worker until your care is transferred to a health visitor. In some areas, you may have the choice of going to a clinic or children's centre for your postnatal checks.

What pain relief options do I have at home?

• Gas and air (Entonox).

• Water birth in a birth pool if you have hired one.

• TENS machine if you have hired or bought one.

What happens if I need to go to hospital in labour?

Most transfers from home to hospital during labour or just after birth are not urgent but they are very common. One reason why home birth is as safe as it is in the UK is because women are transferred to hospital when they need extra help.

A large study of home births in England found that for low-risk pregnancies, about 20 per cent (one in five) of mums-to-be were transferred to hospital.

The transfer rate was lower for women who'd had a baby before, at 12 per cent (about one in eight). It was highest for first-time mums, at 45 per cent. It is common to feel some disappointment if you have to be transferred to hospital, either before, during or after your baby’s birth. Although you’re much less likely to feel this way if you are well informed about why the decision has been made.

The two most common reasons for transfer to hospital, whether you've had a baby before or not, are if:

• Your labour is taking a long time.

• Your baby becomes distressed during labour.

• You need an epidural.

Although this all sounds like it’s happening at the last minute, be reassured that your midwife will monitor you and your baby during labour. If she suspects a problem is developing, she'll recommend that you transfer into hospital in good time.

If you are transferred to hospital, it will be by ambulance, so you won't have to worry about traffic or parking. If your transfer is considered non-urgent, you’ll probably be in hospital in less than an hour. If your transfer is considered urgent, it’s likely to be much quicker than this. Your birth partner may be able to travel in the ambulance with you although it may be beneficial if they were to follow in the car with your ‘just in case hospital bag’.

Make sure you have a hospital bag packed and ready. Put the things you'll need just for the birth in one place, in a box or plastic container. Then you can still use them at home, but they'll be ready to put in a bag at quick notice. This would be a good job for your birth partner, if you have one.

Once you get to hospital, your home birth midwife may carry on caring for you, although it’s more likely that other midwives on the labour ward will look after you. Ask your midwife what the set-up is in your area.

Who will be with you at the birth?

This is a very important question to think about. It’s very popular to have the Dad step into the role of birth partner but they don’t necessarily have the right skills emotionally, mentally and physically to support you in birth. It may be that you choose someone else to be your support and that they are there to simply be present. Or it may be that they are the best person to support you in what will probably be the most life enhancing experience ever!

Whomever you choose they need to play an active supportive role so it is imperative that when you create your Birthing Wish List of the back of digesting all of this information, that they are privy to it and can stand up and, in some cases take a stand, on your behalf. You need to trust in them explicitly that they have your back and will action your birthing wishes, needs and demands on your behalf. It’s important for all birth partners present to remain calm and collected and be in full support of you as the birthing mother, even if you go off “plan” and change your mind about anything on the Birth Wishes list. It is your body and your decision, and birth partners need to be able to hold that space openly and with a compassionate and kind heart - fully supporting you in those moments where you may change your mind about what she would rather have happen.

In preparing for birth, a couple should discuss the role of a birth partner, and ensure everyone understands the expectations. Some couples may decide together that a friend or family member may be better suited to this role - and that’s okay. Better to discuss this before hand!

You may also want to consider hiring a doula to have an extra pair of hands and provide that additional emotional support and consistency. Statistics show having a doula onboard reduces the need for medical intervention by 60% and it is now the recommendation of the World Health Organisation (WHO) that doulas attend all births.

Doulas

A doula is a professional trained in childbirth who provides emotional, physical, and educational support to a mother who is expecting, is experiencing labor, or has recently given birth. The doula's purpose is to help women have a safe, memorable, and empowering birthing experience.

Your relationship would ideally start a few months before your baby is due. Giving your enough time to develop a relationship in which you feel safe, nurtured and empowered to give birth.

Doulas do not provide any type of medical care but their knowledge in many aspects of labour and delivery is extensive and in most cases, priceless.

A doula acts as an advocate for the mother, encouraging and helping her fulfil specific desires she might have for her birth. The goal of a doula is to help the mother experience a positive and safe birth, whether in hospital, at home, in a midwife- led unit and especially with cesarean.

We highly recommend having a Doula with you as studies have shown that intervention decreases massively, the cesarean rate decreases by 50%, the length of labor by 25%, the use of oxytocin by 40%, and requests for an epidural by 60%.

We have a great relationship with Kate Woods from Conscious Birthing so for more information and to find a Doula near you go to http://www.consciousbirthing.co.uk

Induction - natural and / or medical?

• Walking/Circling - moving pelvis to stimulate the baby moving down and connecting with your cervix.

• Raspberry Leaf Tea - up to 8 weeks prior to your due date - will strengthen the uterus and can soften the cervix.

• Have sex / make love. Semen contains a prostaglandin, which stimulates the cervix. It took oxytocin to make the baby - it takes the same hormone to birth them too. If things start to happen, but slowly, then encourage more Oxytocin around your body try connecting and cuddling with your partner and getting a bit intimate. Oxytocin increases dramatically when nipples are stimulated.

• Go quiet, dim lights, be still - let baby know all is well and safe - Relax, it’s natures way of helping women give birth in safe environments.

• Water /bath/aromatherapy - all aid relaxation and calm.

• Eat hot, spicy food. Capsaicin in chilli peppers stimulates endorphins and chillies can stimulate labour.

• Acupuncture or reflexology can help, as can homeopathic remedies.

• Pulsatilla 6c to progress and Caullpphyllum to start it - consult a qualified Homeopath.

NOTE: 60% of baby’s are born around day 10, so might be worth discussing with your midwife to make induction day, day 11 0r 12 instead. About 4% of baby’s come on their due date; It ought to be called ‘Birth Month’.

Episiotomy

Sometimes a doctor and midwife may need to make a cut in the area between the vagina and anus (the perineum) during childbirth. This is called an episiotomy and makes the opening of the vagina a bit wider, allowing the baby to come through it more easily. Sometimes a woman's perineum may tear as the baby comes out. An episiotomy can help to avoid a tear or speed up delivery.

The National Institute for Health and Care Excellence (NICE) recommends that an episiotomy should be considered if:

• The baby is in distress and needs to be born quickly

• There is a clinical need, such as a delivery that needs forceps or ventouse, or a risk of a tear to the anus

If you have a tear or an episiotomy, you'll probably need stitches to repair it. Dissolving stitches are used, so you won't need to return to hospital to have them removed. If your doctor or midwife feels you need an episiotomy when you're in labour, they will discuss this with you, it is ultimately your decision.

We’re seeing a reduction in the need for intervention such as forceps or ventouse in our ladies who attend our LushTums Pregnancy Yoga and Preparing for Birth Intensive Workshops (see our website www.lushtums.co.uk for details). With the use of the different kinds of Birthing Breathe and Yoga Poses we are finding mums are consciously holding their babies int he birthing canal and breathing them down and out without the need of intervention.

Dad or birth partner to deliver the baby, cut the cord?

Whether you have a home birth, hospital birth or birth in a midwife-led unit your birth partner, Dad of other Mum can deliver the baby and cut the cord. This needs to be discussed before hand and written into your Birthing Wish List. Of course they can change their mind at the last moment and the midwife or doctor will deliver the baby.

The Delivery of the Placenta - Physiological Third Stage or Actively Managed?

It’s very exciting when the baby has been born and many want to share the good news straight away, with pics and phone calls. But this next stage, the third stage is probably seen as the most important from the Doctors point of view; the delivery of the Placenta. With this in mind, enjoy your baby and take the time to connect and bond rather than jumping on your phone to share the news.

You have two choices in how you deliver the placenta, naturally or with medically helped.

Physiological - can take up to an hour. No drugs given. Umbilical cord is left attached to baby and the Mother births the Placenta with Uterine Contractions and pushing.

Active Management - This can take up to 30 minutes, although it is usually much faster. Syntometrine is given via and intra-muscular injection into Mother’s leg, which causes the muscle constriction and the placenta to be expelled.

Delayed cord clamping

THE GOLDEN MINUTE - the first 90 seconds after the birth gives the baby the oxygen they need and the iron for growth, so it is very important to leave the cord unclamped for around this length of time - or until the cord has finished pulsating. This ensures the remaining 1/3 of the baby’s blood which resides in the Placenta and cord has the time to transition into baby.

It’s estimated that a 2 or 3 minute delay in cord clamping can increase your baby’s blood supply by up to 30%. This can mean your baby has 60% more blood cells. This is usually the standard procedure but it is good to add this to your ‘Birth Wish List’. If there are any complications or the baby needs medical assistance this may not be possible.

What to do with the Placenta?

• You can take your Placenta home with you. Many people bury it and plant a rose bush or tree over it.

• Offer it over for stem cell research.

• Get it encapsulated.

• Let the hospital dispose of it.

When is Vitamin K needed - injected or oral?

Vit K helps blood to clot which some babies are deficient in. Vit K is passed through breast milk and by day 8 the baby’s reserves of Vit K are up to ‘normal’ levels. Vit K comes in a shot or oral if low risk, over a few weeks or can come as a single does injection. Again do some more research so you can make an informed decision when the time comes.

• Babies born before 37 weeks

• Babies born by forceps, ventouse or c-section

• Babies have been bruised during labour

• Babies who have breathing difficulties

• Babies with liver problems at birth

• Babies whose mothers have taken drugs during pregnancy for epilepsy or to prevent clots of TB.

Skin to Skin

Skin to skin with mum is very important not only for bonding but to regulate baby’s heart beat. And whilst sometimes it is necessary for baby to have skin to skin with dad in the first 30 mins of being born, it doesn’t have the same effect in terms of regulating the heart beat and connection with mum. If it can happen with mum first, then make sure they have good quality bonding time together before dad gets a cuddle.

Quiet time after baby is born, for a little while, before calls are made and photos sent. You can also ask to delay weighing and measuring to allow for this important bonding time. It is good to note that all tests, including the hip test can be done right next to you. The baby does not have to be taken away from you for these tests to be carried out, unless off course there is some kind of emergency.