If you find you have a concern outside of your schedule antenatal visits, you may wish to access the Call a Midwife Advice Line on 0300 123 5473. This is a designated telephone advice and triage line for pregnant women to access advice and support 24 hours day, 7 days a week from a midwife. The line is available for women during pregnancy, labour and following the birth of their baby. For example, you should call us if you feel labour is starting, your waters have broken, or if your baby’s usual pattern of movements has changed.
If you are over 37 weeks and are booked for either a homebirth or the Abbey Birth Centre then you should contact the Abbey Birth Centre midwives directly on 01932 723761.
Homebirth Service Reinstated
We are pleased to advise that Home Birth Services will be reinstated in Surrey from midday on Thursday 12 January 2023 for those women and birthing people who choose this option, following the temporary suspension of home births in December 2022.
Despite the demand on South East Coast Ambulance services remaining high, we recognise that having a home birth is an important choice to provide. Our midwifery staff want to help women, birthing people and their partners to make a birth plan that feels right for them which is based on relevant, up to date information.
Early signs and symptoms of labour
One of the first signs that labour may soon be starting is a “show”. This is a blood–streaked mucous plug which is passed out of the vagina when your cervix (neck of your womb) begins to change. This is not a very reliable sign and not all women see this. For those women who do see a show, labour maybe as much as a week or so away. The most common indication that labour has begun is the start of painful contractions. These help soften the cervix, and then the cervix will gradually open to about 10 centimetres. The contractions can range in intensity from a mild irritating discomfort to a strong pain that maybe felt low in your back or like waves moving across your abdomen. It is important to time how often these come and for how long they last.
When contractions are regular (coming every 5-10 mins) and lasting 45-60 seconds we would advise you to call the labour ward for advice before coming into hospital. Do bear in mind the distance that you live from the hospital (Hospital birth) or how long it may take for the Community Midwife to get to you (Homebirth) if you have had a baby before the next birth may be quicker.
The bag of water surrounding your baby may break before labour starts. If your waters break, you will notice either a slow trickle from your vagina, or a sudden gush of water you can’t control. If your waters break you will need to be seen and assessed by a midwife either in Triage or on the Labour Ward.
Contact the Call a Midwife Advice Lineon 0300 123 5473 if:
- You think you are in Labour
- Your Waters may have broken
- You have any vaginal bleeding
- Contractions are regular, every 5-10 minutes
- You are worried that baby is not moving as much as usual
- You have any other anxieties or queries
Induction of Labour
Sometimes, labour must be started artificially. This is called induction. Labour may be induced if there’s any sort of risk to you or your baby’s health. For example, you have high blood pressure, or if your baby’s failing to grow and develop.
Induction is usually planned in advance, so you’ll be able to discuss the advantages and disadvantages with your midwife or doctor, and find out why they think you should have it.
Contractions can be started by inserting a pessary or gel into the vagina, or by a hormone drip in the arm. Sometimes both are used. Induction of labour may take a while, particularly if the neck of the womb (cervix) needs to be softened with pessaries or gels. Once labour starts, it should proceed normally, but it can sometimes take 24 to 48 hours to get you into labour.
Towards the end of pregnancy, most women want their baby to be born at the time it is due. Some even ask for their labour to be started then. If your pregnancy goes to 41 weeks, your midwife or obstetrician will discuss with you the benefits and disadvantages of induction. However, we strongly advise against induction before 41 weeks unless medically indicated.
What to Wear During Labour
We suggest that you wear loose clothing which allows freedom of movement. We do have hospital gowns should you require them but most women prefer wearing a large T-shirt or an old nightdress. You are free to wander around when you are in labour so you may want to bring in some warm clothing. Please bring in slippers or comfortable shoes for when you are walking about.
For information about pain relief during labour, please see our pain relief section.
Monitoring in Labour
Every baby’s heart beat is monitored throughout labour. We do not, as a rule continuously monitor the baby’s heart beat when you are in labour. We sometimes take a recording lasting 30-65 minutes on admission to Labour Ward. We will then listen in to the baby’s heartbeat at regular minutes intervals when you are in established labour using a Pinard or a hand held sonic aid. If you are having a homebirth the community midwife will again use a pinard or handheld sonic aid.
Eating in Labour
If all is well with in your pregnancy and labour we advise women that, if they feel hungry they should eat a light diet. i.e. tea, toast or a sandwich. We do advise that women avoid spicy and fatty foods. Isotonic (sports) drinks can also be of benefit.
If at any point your labour becomes complicated or if you have Pethidine or an Epidural, we recommend that you do not drink anything further. Your midwife will advise you.