The birthing journey is a very special time in a woman's life. Whatever path your birth takes, your ability to make decisions that are right for you and your baby depend on you being an active participant. Increasing your knowledge to better understand your choices, are all part of the process of your journey.

At our hospitals we provide women centred care which means it's all about your unique needs, expectations and aspirations. We offer a variety of measures to assist you to feel as comfortable as possible. If everything is going as planned, you can expect to be looked after by a midwife with doctors on call 24/7 should the need arise.

• Preparing for labour
• Active birth
• Support people
• Monitoring your baby
• Vaginal birth after caesarean (VBAC)
• The first breastfeed

Preparing for labour

Women use all kinds of things to help them to prepare for labour. Many women find that the techniques mentioned below help them to cope with labour and reduce the use of drugs for pain relief. Having encouraging and supportive people caring for you is also very important. Some women find the following methods helpful to best prepare them physically and emotionally:

• yoga
• relaxation exercise
• hypnotherapy - a state of relaxation
• childbirth education - for you and your support person
• reading about pregnancy and birth
• speaking about your fears with a trusted maternity health professional.

Active birth

Being active through your labour and birth can help you to manage the surges or contractions and to relax your mind and body as much as possible. This will assist with the release of the body's natural opiate-like substances, known as endorphins. They are manufactured by our bodies in the presence of pain and act as a natural analgesic.

Some techniques for managing surges or contractions have been well researched while others have been adopted by women and cultures through generations. They may not be proven ways to manage pain but women find them very effective. It is important to understand the benefits, risks and alternative methods available when deciding which techniques to use. Your support people can assist you with some of these techniques. Knowing your options assists you to make a choice that is right for you. These may include but are not limited to:

Being active

Benefits: being upright and active uses gravity to support effective contractions and helps baby move into position. It can also act as a distraction to the contractions

• Varying positions during labour such as: standing, walking, lying on your side, leaning on your partner or support person or on a bean bag or squatting
• Changing positions through out your labour
• Taking fluids to prevent dehydration
• Placing a hot pack over the area where you feel most pain
• Acupressure and acupuncture
• Sterile water injections

Being relaxed

Benefits: promotes endorphin and oxytocin production, reduces the production of adrenaline which can cause the fight / flight response slowing labour down.

• Breathing the tension away during and between the surges or contractions
• Women need a quiet and safe place in which to birth their babies so it is important to keep the noise and disruption in the room only to what is required
• Listen to music that you find calming
• Aromatherapy (concentrated essential oils added to massage oil or oil burner)
• Use your breathing as a focus
• Dim the lights in your room
• Have someone give you a massage
• A warm bath or shower
• Use visualisation - positive imagery to assist relaxation
• Hypnotherapy - using hypnosis as a state of relaxation, to achieve changes in psychological aspects of pain and anxiety.
• Choosing your support people carefully, make sure you discuss your birth preferences with them and have support people who support your decisions

Support people

It is important to think about who you want with you in labour - your support people. Usually you have your partner and maybe one or two other special people. Don't feel pressured by what is expected, rather choose the people that will make you feel comfortable, support you, know what you want if you can't tell us at the time, and that you want to share this special time with.

You will find a maximum of up to three support people should provide you with adequate care and support.

It is advisable to make a list of the telephone numbers of people you may wish to phone after your baby is born. Then designate one person whom a support person will telephone with information regarding your progress during labour and the details after the baby is born.

Your support person can:

• support you in upright and active positions
• help to make you physically comfortable
• assist you with your breathing techniques
• offer emotional support and provide positive encouragement
• hold a hot pack in place
• be there for you.

Monitoring your baby

Monitoring your baby's well-being in labour is performed using a Doppler or a CTG machine and performed either intermittently or continuously. This is dependent on you and your baby's condition. The Birthing Suite staff will discuss with you, the most appropriate method for your labour.

A Doppler is used to check the baby's heart rate during antenatal visits and in labour. The baby's heart rate is checked intermittently throughout labour. If labour is progressing normally than this type of monitoring is suitable.

Cardiotocograph (CTG) is a machine that monitors and prints out a continuous recording of your baby's heart rate and your contractions. This type of monitoring is often necessary when labour becomes complicated. Examples include but are not limited to:

• induction of labour 
• labour is slower than expected
• when you have an epidural
• baby's heart rate needs closer observation.

Vaginal Birth After Caesarean (VBAC)

If you have had a previous caesarean section (C/S), you may plan to birth your baby either via a VBAC or a repeat elective C/S, depending on the initial reason you had your first one. A VBAC is when a woman has a vaginal birth after having one or more previous C/S. A repeat elective C/S is where a woman plans another C/S to birth her baby. Both VBAC and repeat elective C/S have risks and benefits to be considered when deciding the best option for you and your baby. These risks are largely dependent on your individual situation including the reason why you had the first C/S.

• A decision aid for women on VBAC

The first breastfeed

How babies are born has a big effect on how well they can breastfeed. Pain relief choices, length of labours, skin to skin contact immediately after birth and your baby's first breastfeed are all important.

We go to extra effort to keeps babies happy until they can have their first breastfeed. Routine activities like weighing the baby, doing routine baby checks and giving babies their Vitamin K injections are all delayed to allow mum and baby the best chance to get off to a good start. Read more on skin to skin contact or discuss this with your midwife.