The Information - Birth

Giving birth is likely to be one of the most intimate and major life changing experiences of your life. As with any life changing event, the extent to which you feel supported, listened to and involved during your labour will affect your feelings about your birth experience. This title looks at the diverse forms of support that can help you, not only from midwives, but also from a partner, relative or friend, as well as services offered by the private sector. These might include self-employed midwives, as well as birth supporters in the form of doulas and complementary therapists.

This title looks at approaches to observing and recording your baby's well-being during labour through the monitoring of their heart rate. The methods of listening to, and observing the rate and pattern of your baby's heart rate in labour range from 'listening in', usually with a midwife's stethoscope (called a 'Pinard stethoscope') to the use of more complex electronic devices that use sound (sonic) waves. These can vary from a small hand-held ultrasound machine called a 'Doppler' or sonic aid, to a cardiotocograph (CTG) machine that can measure and print out the baby's heart rate pattern and record the frequency of your contractions.

No one knows for sure which position is best for you and your baby when you go into labour. Many women say they have an urge to stay upright, mobile and adopt a certain range of positions, which helps relieve the pain of contractions. Will you lie-down, stand up, sit or squat - or perhaps a mixture of all four? In order to help you decide what is right for you and your baby, this title gives you the information about any potential advantages or disadvantages that there might be when it comes to choosing your position for labour and birth.

How much pain we can cope with is very personal, it varies between individuals and is affected by a number of physical and emotional factors. This title is about the use of 'epidural' pain relief, which is a method of blocking pain from your contracting womb to specific nerve endings; this means that you should no longer feel the pain from the contractions during your labour. While it is the most effective method for ensuring a pain-free labour, it is also one of the most invasive methods and given the technical nature of epidurals, requires specialist services. It is therefore vital to understand the advantages and disadvantages of having an epidural so that you can make an informed choice about this option when you are in labour.

Between 2-3% of babies that are born in England and Wales are found to have a major problem with their development - these defects are called `congenital abnormalities`. They may take the form of a problem with the development of a certain part of the baby`s body or an organ, for example, the heart, which results in a problem in its structure that then affects the way it works. However, other congenital abnormalities may be caused by problems or defects in the genetic make-up of your baby that are passed on through family members (called hereditary disease). Abnormalities may also be caused by problems that occur in the very early stages of pregnancy when the egg (ovum) has been fertilised and errors occur in the development and structure of the rapidly dividing cells. These are called chromosomal abnormalities and they may or may not be hereditary. Some of these conditions cannot be treated and their effects are life-long. For these reasons, nearly every pregnant woman is offered screening tests in pregnancy. This title explains what these tests are able to check for as well as those conditions they are not able to detect. Choosing whether or not to have screening tests in pregnancy is an important decision for you and your family. The information in this title will help you to make your decision and to think about what the results might mean for you, your pregnancy and your baby.

Most babies move into a 'head down' position during the last few months of pregnancy. Where this isn't the case, and the baby's position is 'bottom down', it is called a 'breech presentation'. The information in this title will help you to understand what this means for you and your baby and what options you have for your baby's birth.

You may not have been aware that you have a choice when it comes to the place where you give birth to your baby, because the general assumption is that all pregnant women, especially those pregnant for the first time, will have their baby in hospital. However, birth is generally very safe for both women and babies, which is why you should be offered a choice of where you want to give birth, whether this means planning a home birth, giving birth in a midwifery unit or at a hospital obstetric unit. This title tells you about the choices that will be offered to you early in pregnancy about where to have your baby. It includes evidence about safety, the potential advantages and disadvantages associated with each option and how women feel about different birth settings.

Water use during labour and birth ranges from a woman in early labour using her bath at home for pain relief, to women giving birth in a specially designed birthing pool in a maternity unit or in their own home. The use of water during labour and birth has become increasingly popular, as it's believed to help with relaxation, pain relief, and also helps to maximise feelings of control. However, opinions differ, which means you may receive conflicting advice about how safe it is, even though most studies have not found a link between water use and harmful outcomes for a mother and baby. This title tells you what is currently known about water births, whether the use of water will really make your labour easier, and what your maternity unit is likely to offer you.

The very word 'labour' suggests that there is some effort involved in giving birth. Pain relief options for labour that focus on preventing 'suffering' rather than completely eliminating pain, have been shown to build your confidence and help you to maintain a sense of control and well-being during your baby's birth. You do not always have to have drugs in order to manage pain in labour and get safely through childbirth. Options that can help include: the person(s) you choose to have with you (your birthing partner), the positions you adopt, use of water, use of drugs and therapies, and your general feelings of comfort and relaxation. Having information about all of these in advance of your baby's birth can affect how useful you may find them once your labour begins. This title explains the choice of non-epidural pain relief methods, giving you the advantages and disadvantages associated with all the choices available.

For many women, labour that is allowed to take its natural course, where it starts and continues without interference, will usually be followed by a vaginal birth, also known as a 'normal delivery'. However, with the increasing use of medical interventions and rising caesarean section rates, fewer women are able to achieve the normal birth they had hoped for. In order to help you decide what is right for you when it comes to giving birth, this title gives you information about the potential advantages and disadvantages of the delivery options available to you.

A caesarean section (also sometimes referred to as `caesarean`) is an operation where a cut is made into the mother's abdomen in order to deliver the baby. Women are over four times more likely to have a caesarean birth now than 30 years ago. Caesareans (C/S) are much safer now than they were 60 years ago, which is why doctors, when balancing the risks during labour, choose to perform a C/S where there is concern about the health of the mother and/or her baby. This may occur when the mother becomes ill, or when the conditions inside the womb become unhealthy for the baby.

There are four main blood groups: A, B, AB and O and alongside your blood group is the Rhesus factor (Rh), with the D antigen (a substance that stimulates your immune system to produce antibodies) being the most important. If you have this factor (your midwife/doctor will tell you after a routine blood test) you are described as being RhD positive, and if you do not have it you are RhD negative. This title gives information about being Rhesus negative and its relevance to your pregnancy, your baby's well-being and what options you have for your baby's birth.

This title gives you information about a condition called iron deficiency anaemia. This is where the amount of iron present in the body's red blood cells is lower than it should be. This can lead to health problems for the mother and/or her unborn baby. Iron deficiency anaemia is the most common cause of anaemia in the United Kingdom (UK). There are other causes of anaemia but these are usually as a result of loss of blood or as the result of pre-existing medical conditions, for example, sickle cell anaemia and thalassaemia. You can find more information about these conditions in the title, Sickle cell and thalassaemia disorders: screening offered to mothres and babies.