Preparing for an early baby
From 34 weeks, perineal massage can help the perineum, the triangular muscle between the vagina and back passage, to stretch more easily and reduce the risk of tearing during birth. A warm compress during labour, as the baby’s head advances, can further reduce this risk. Midwives may ask for permission to guide the baby’s head with their hands to ensure a slow and safe delivery.
If a water birth is planned, it is not possible for the midwife to guide the head in this way, which slightly increases the risk of tearing. In cases where severe tearing is a concern, an episiotomy may be recommended. This involves a small cut to the perineum, performed with local anesthetic after gaining consent. If significant tears involve the anal sphincter, repair is typically done under spinal anaesthetic to ensure adequate muscle repair.
For more information on perineal massage, visit the Trust website to access the antenatal information leaflet.
Preparing for an early birth can be daunting, especially when it occurs before 37 weeks. Most preterm babies will need additional support, which varies based on the baby’s gestational age and circumstances. To prepare, staff may provide a “PeriPrem passport” detailing interventions that can help the baby adapt to life outside the womb. Discuss with your doctor to determine which elements are appropriate.
Breast milk is especially important for preterm babies as it provides the best nutrition and protection, even for very early or unwell newborns. Mothers may be encouraged to hand express colostrum before birth, and it is critical to start expressing breast milk as soon as possible after delivery, ideally within two hours. Staff will provide the necessary equipment and guidance.
Whenever possible, arrangements will be made for neonatal staff to meet with parents before birth to discuss the baby’s care and answer questions. Leeds Teaching Hospitals also offer accessible YouTube videos covering labour and delivery options.
After birth, immediate care focuses on keeping the baby warm, assisting with breathing, and, where possible, delaying cord clamping for at least one minute. Depending on the baby’s needs, breathing support may include oxygen masks or tubes. Despite the necessary interventions, delivery room cuddles are prioritized when safe, and parents are welcomed into the neonatal unit at any time.
Skin-to-skin contact is encouraged as soon as it is safe, as it fosters bonding and supports the baby’s development. Leeds uses a family-integrated care approach, enabling parents to participate in caregiving tasks like feeding and changing, which has been shown to benefit both babies and parents.
For information on preparing for an early birth and additional support, resources from Bliss and Tommy’s Charities are available. If you have any questions, contact your midwife or the maternity assessment centre, whose number is in your handheld maternity notes.