What happens when I go into labour?
If you think you are in labour you should telephone the Maternity Assessment Centre to speak to a midwife. They will ask you a few questions and tell you whether you need to come into hospital.
If you have any bleeding, your waters have broken, or you are worried about yourself or your baby please contact MAC straight away.
Maternity Assessment Centre telephone numbers
– Leeds General Infirmary – 0113 3926731
– St James’s Hospital – 0113 2065781
Getting to the hospital
You will need to provide your own transport to get to the hospital to have your baby so please plan ahead. There are places for cars and taxis to drop off outside our hospitals. In an emergency, a midwife may arrange an ambulance for you.
When you arrive at the hospital you will go to the Maternity Assessment Centre (MAC). From there, a midwife will talk to you about your labour and what will happen next.
Where is the Maternity Assessment Centre located?
Leeds General Infirmary – C Floor, Clarendon wing
St James’s Hospital – 5th Floor, Gledhow wing
What are the stages of labour?
Early labour
Active labour and delivering your baby (second stage of labour)
Active labour and delivering your baby (second stage of labour)
Once you are in established active labour you will receive one-to-one care from a midwife.
If you are choosing to have your baby at home, you can have as many birth partners as you wish.
If you are choosing to have your baby in hospital, we ask you that you have no more than two supportive birth partners with you in labour.
Once you are in active established labour, the midwife that is providing one-to-one care will need to regularly monitor the frequency of your contractions and baby’s heartbeat. There are two different ways we can monitor contractions and baby’s heartbeat during labour.
One way of doing this is intermittent auscultation of baby’s heartbeat. Baby’s heartbeat would be listened to using a doppler device that your midwives use in community. If you are receiving intermittent auscultation, your midwife will monitor your contractions by placing a hand on your tummy and feeling the strength of your contractions, with your consent.
The second way of monitoring contractions and baby’s heartbeat during labour is to use a monitor. The monitor contains two belts, one around the bottom of your tummy that would pick up baby’s heartbeat, and one around the top of your bump that would monitor the frequency of your contractions. The monitor cannot tell us how strong your contractions are. For us to be able to know how strong your contractions are, we would take into consideration how you are expressing those contractions feel, and how we can feel them by touching your tummy. If you are on the monitor, the monitor provides a continuous trace of baby’s heartbeat.
The end of the first stage of labour is when you reach fully dilated, or 10 centimetres dilated, and this means all the cervix has moved out of the way and baby is ready to be delivered.
Once you reach fully dilated you may feel an overwhelming urge to push or to have your bowels open. This is normal and means that labour is progressing, and you are ready to push. Sometimes you don’t feel an urge to push and in this instance a limited amount of time can be given to enable baby’s head to move down and for you to be able to feel the urge to push.
Pushing your baby out can take a varied amount of time, and it’s when you push baby moves forward and when you stop pushing baby slides back, so it’s sort of like two steps forward one step back, and this is normal baby is rocking back and forth underneath your pubic bone.
Gravity can really help baby progress through the birth canal and around this u-bend, therefore it is important to think about what position you are in to aid with pushing, and it is important that you listen to your body.
Labour not only can be tiring for yourself, but it can be tiring for baby too.
If you are not fully dilated, this could mean an emergency caesarean section.
If you are fully dilated depending what position baby’s head is in and how low down baby’s head is depends what we would do to help quicken up the delivery.
It may be necessary to perform an episiotomy with your consent, which is a small cut in your perineum, or it may be necessary to have an instrumental delivery.
An instrumental delivery is where a doctor uses an instrument to help deliver your baby. The doctor will work with your pushers to deliver baby vaginally. The doctor will discuss with you the options available and will suggest which instrument is safest to use for the delivery of your baby. Sometimes it may be necessary to go to theatre to have an instrumental delivery.
If you do have to go to theatre for the delivery of your baby it is recommended that only one birth partner go with you into theatre.
Delivering your placenta (third stage of labour)
Delivering your placenta (third stage of labour)
Once you have delivered your baby, we need to wait for the delivery of your placenta which is known as the third stage of labour.
There are two ways that you can choose to deliver your placenta.
With a physiological third stage of labour we are waiting for your body to deliver the placenta naturally. This may take up to an hour. No hormones are given so we wait for your body to produce its own hormones which will cause a large contraction of the uterus. You may feel pressure and the need to bear down or push and you would deliver your placenta.
Once the placenta is delivered we would clamp and cut the cord.
Sometimes it is recommended that you have an active third stage of labour. This means we would actively control the delivery of the placenta.
Indications for an active third stage of labour would be if you’ve had your labour induced and have received hormones to control your labour or if you are bleeding a little bit more than we would like.
With an active third stage of labour you would receive an injection into your thigh as baby is being delivered so if you are frightened of injections you don’t tend to know that you have received this injection, however consent would have been obtained prior to receiving it.
If you wish, delayed card clamping can still occur with active management of delivering the placenta.
If your third stage of labour is actively managed it tends to be over within five to ten minutes following the birth of your baby.
If you receive the hormone injection and have an actively managed third stage of labour the injection can cause sickness, nausea and quite severe tummy cramps and it is important to bear this in mind.