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You have waited a long time for this moment to begin, perhaps 40 weeks or perhaps a lot longer than that. All of a sudden, that thought crosses your mind; could this be labour? 

Your labour may begin in a number of ways:

  • You may begin to have contractions, which feel like a belt being tightened around your waist, causing a painful cramp in your low abdomen and back. 

  • Your waters may break, giving you a feeling of wetting yourself as you get a gush of clear water. Your waters may also break slowly, causing a leak of fluid wetting your underwear and making it slightly harder to distinguish. 

  • For some women labour doesn’t start on its own and you have an induction of labour at the hospital or at home. 


You will know it is time to go to hospital or your birthing unit when any of the following happen:

  • Your contractions have been coming every 3 minutes regularly for more than an hour (if it’s your first baby, wait as long as you can or until you strongly feel the need for pain relief) 

  • Your waters break – if it is clear water then there is no need to rush but attend hospital when you can to confirm your waters have gone and to get a plan for when to retuen 

  • If there is any yellow or green colour in your waters, or you experience bleeding then attend hospital more urgently. 


How should I get there?

It goes without saying that you shouldn’t be driving yourself anywhere when you are in labour. Most hospitals charge for car parking, or will give you a short amount of time free while you are in labour but you will usually be in hospital for a while after the permit expires. To save yourself and your partner from stress, the easiest thing is to get someone else to drive you or take a taxi. Remember to bring your notes and hospital bag!

If you can, take a tour of your unit before your due date. Find out where you need to head when in labour, but it will usually be maternity triage. If you don’t know, head for labour ward and they will direct you.


What happens when I get there?

You will be assessed by a Midwife first. She will ask you for a sample of your urine, listen to the baby’s heartbeat and then do a vaginal examination to see if you have dilated. 

If you are a low risk pregnancy, you may be eligible for birth centre. You will be transferred there if you are more than 4cm dilated, meaning you are in active labour. Birth centre favours active birth positions, moving around in labour and gives the option of a water birth. There are no doctors or monitors. One thing to be aware of is that you cannot have an epidural on birth centre.

If you have any risk factors for your pregnancy meaning you need monitoring, or want an epidural, you will go to labour ward. You will still have your own room and midwife but there are doctors around should you need it. 


What happens now?

If your labour is progressing well, you will have a vaginal examination every 4 hours. You will continue to have contractions which help your cervix to dilate more. Move around as much as you can and take pain relief if you need to.

Once your midwife or doctor tells you that you have reached 10cm, or fully dilated then you are nearly ready to push. They may advise you to wait a little longer so your baby’s head comes lower. When you are ready you can begin to push. Your midwife will teach you how and it is important to listen to his/her guidance as much as you can as they will also tell you when to stop pushing as the head is crowing. This is to stop you tearing.

Eventually the head of the baby is delivered and with the next contraction the baby’s shoulder and body comes together. You will feel instant relief as your baby is put onto your skin.

Soon after your midwife will help to deliver the placenta and ask you for one more push. After this all the hard work is over and you can finally rest! 


Is there anything else I need to know?

Sometimes labour doesn’t progress exactly like this. If labour slows down or you are pushing and the baby doesnt deliver then the doctors may be asked to come into the room. If they are concerned they may advise you to have a caesarean or an instrumental delivery to deliver the baby sooner. They will explain everything you need to know about the benefits and risks if the situation arises, and in most situations your partner can stay with you. 

After the delivery is over, you may be moved to the postnatal ward and you will have a baby check by a doctor or midwife. Once mum and baby are doing well, you will then be discharged home. 

Dr Brooke Vandermolen is a practicing obstetrician, who has worked and trained in a variety of London NHS maternity units. She is experienced at dealing with all aspects of pregnancy, including performing complicated deliveries and providing antenatal and postnatal care.

Through social media and her blog Brooke communicates insights and tips around pregnancy, gynaecology and birth and explains medical stories from the media. 

Recently she became a new mum herself, where she began to see the view from the other side of the desk. She realised her passion for supporting women and their partners as they navigate this new journey of labour, early parenthood and feeding and teaches antenatal courses in London.

Follow Brooke on Instagram @theobynmum 


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