You’ve chosen your hospital to give birth in, you’ve been to your antenatal classes but what happens once you go into labour? Here's what to expect.
How do you know when to go to hospital in labour?
Going into labour can be an exciting and anxious time. If it's your first birth, you may not know what to expect or how your body might feel during the various stages of labour.
Research shows that staying at home until labour is established has a positive impact on birth outcomes for women and their babies. If you are unsure about when to go to hospital, you can always phone them for advice, which will very depending on your own unique circumstances (NHS, 2020a).
If you are experiencing contractions but your waters haven't broken, then you may be asked to come in when your contractions are strong and regular. This means they are lasting a minute and are three to five minutes apart (NHS, 2020a).
Some women never get such close contractions but have a strong sense that they need to be in hospital. If you already know you labour quickly, you may wish to go into hospital sooner because second and subsequent labours can progress faster (NHS, 2020a).
You may be recommended to travel to hospital earlier if your waters have broken or if you need to have any checks done for medical conditions (NICE, 2019). Always contact the hospital before you set off and remember any paper or digital notes that you may need (NHS, 2020a).
If you're planning a caesarean birth, the arrangements with the hospital will be slightly different. You can find out more here.
Who will see you in a hospital birth?
If you're planning a birth in a hospital midwife-led unit, which can also be known as a birth centre, then midwives and maternity support workers will be caring for you. These may be midwives you've already met and formed a relationship with during your pregnancy, but this is not usually the case. Doctors do not provide care in hospital 'alongside' midwife-led units.
Midwives have a degree in midwifery, and care and support you throughout your pregnancy and labour. They're likely to be the main health professional looking after you. Maternity support workers are under their supervision to help them look after you, for example they might take your temperature and blood pressure or support you with breastfeeding. Some units also have consultant (senior) midwives.
If you are in the obstetric unit, also known as a labour ward, then you may also see doctors, called obstetricians. While there will be a senior or consultant doctor on the ward, you are most likely to see a registrar or junior doctor. They won't be there all the time but may be called in if their advice is needed. There are lots of other staff who are there to look after you in hospital, including paediatricians, physiotherapists, maternity care support workers, health care assistants and operating theatre staff.
If you move during labour to theatre for additional assistance, you may also see an anaesthetist and other specialist theatre staff.
Keeping track of who is caring for you can make your experience feel more personal. Midwives and doctors should always introduce themselves when they talk to you, and it's okay to ask them to do so if they don't. Some people find it helpful to have their birth partner make a note of who everyone is, and it can be lovely later to write a personal note when someone has been particularly helpful.
What will happen once I arrive at hospital?
Head to the maternity unit admissions desk when you get to the hospital. Hopefully you’ve been able to visit or seen an online tour already, so you’ll have some idea what to look out for.
If you can’t visit, it’s worth asking your midwife in advance what is available and what is likely to happen. That way it’s not all new on the day.
In some hospitals you will go directly to a labour room and in others you will go to an assessment (or triage) room first.
Your midwife will ask you what has happened so far, how you are feeling, and if you want to give permission to be examined. This will include recording your temperature, pulse and blood pressure, and feeling your abdomen to check the baby’s position (NHS, 2020a).
The midwife will listen to your baby's heartbeat using a hand-held device. If there are concerns or the results are unclear, then a machine which can continuously monitor your baby's heart rate may be used (NICE, 2017).
You may be offered a vaginal examination to find out if your cervix has begun to open (NICE, 2017; NHS, 2020a). It is always completely up to you whether to consent to a vaginal examination. It may be helpful to know how open your cervix is for making decisions in labour, but it could feel uncomfortable and may be distressing for some people (NICE, 2017).
Some people find that they are feeling contractions but the cervix has not yet begun to open very much. In that situation, your midwife might suggest you return home and come back to hospital when labour has progressed (NICE, 2017). Strategies that might help at home include breathing exercises, getting into a bath or shower or having a massage (NICE, 2017).
When it's agreed that you will stay in the hospital, if you were in an assessment room then you will move to a labour room. Once you're there, you might like to change into something cool, loose and comfortable as you may be hot during labour and not want to wear anything too tight (NHS, 2020a).
What facilities will the hospital provide?
What’s available will vary between hospitals. So again, it’s worth asking for a physical or virtual tour of the hospital or a chat with your midwife in advance. Many people find that having a familiar, calm, safe and secure environment can help during labour (Nilsson et al, 2020).
Find out if the birth environment you've chosen provides:
- a space you find comfortable
- control of light and temperature
- comfortable pillows and seating
- private toilets, baths and/or showers
- space for you to move around freely
- medical equipment that is concealed rather than visible in the room. (Newburn and Singh, 2003; Nilsson et al, 2020).
It is helpful to feel relaxed and at ease during labour. If you feel tense or like you’re being disturbed, this can slow down or stop labour (Lothian, 2004; Nilsson et al, 2020).
To make the environment feel more homely and comfortable, it can be a good idea to bring things from home. You might like to take your own pillows, floor mats or bean bags if the hospital doesn’t have them, and maybe some music to help relax you. You can read more about packing a hospital bag here.
Care in labour
While you are in labour, you will be looked after by a midwife. Hospitals usually try to ensure you have the same midwife with you throughout labour, although there may be instances where a change in shift or staffing arrangements means the person caring for you could change.
If you have made a birth plan, make sure you or your partner share it with your midwife, and discuss any questions you may have (NICE, 2017).
Your midwife should encourage and help you to:
- discuss your birth plan
- move around and get into whatever positions you find most comfortable throughout labour
- have support from your chosen birth partner
- feel you are in control, listened to and being cared for with compassion
- keep eating and drinking if you want to. If you’ve had opioids or might need a general anaesthetic, the midwife will explain that clear fluids are fine but solids may not be such a good idea in case of sickness
- use coping skills and pain relief techniques that you’ve planned, such as breathing, relaxation, massage, acupuncture, acupressure, hypnosis or playing music of your choice
- think about the risks, benefits and implications of different forms of pain relief like gas and air, opiates or an epidural.
In addition to your midwife, medical students might ask whether they can come into the room. If you're not comfortable with this, say so, or ask your birth partner to tell your midwife.
Obstetricians (doctors) will not routinely visit you but will be available if needed (NICE, 2017).
If all is well, you might be left with your birth partner for short periods of time, particularly during early labour. Yet you should never be left alone at a time that worries you and you should always be shown how to call for help if you need it (NICE, 2017; CQC, 2018).
It's important you feel comfortable throughout your labour. If you don't get on with your midwife or doctor for any reason you can ask for another one. It's always okay to ask for some time to think about a decision before you make one or speak up if you have any concerns.
What will happen during labour?
Once you are in established labour, your midwife will be there to observe you. They will record their observations on a chart called a partogram (NICE, 2017). This might include taking your blood pressure, pulse and temperature (NICE, 2017; NHS, 2020a), as well as asking you how you’re feeling emotionally.
Your midwife will listen to your baby's heartbeat for a minute every 15 minutes (NICE, 2017). Sometimes they might offer continual electronic monitoring if more detailed information about your baby's wellbeing is needed, although this may reduce your ability to move around freely (NICE, 2017; NHS, 2020b). Also, foetal scalp monitoring can be used to get a more accurate measurement of your baby's heartbeat if there are any concerns (NICE, 2017; NHS, 2020b).
Your midwife will offer you a vaginal examination every four hours to see how your labour is progressing (NICE, 2017). This information may help make decisions about what you want to happen during labour, but you can also decline a vaginal examination. There are many reasons a woman might wish to decline a vaginal examination and you don't have to explain your reasons. There are other ways to assess the progress of labour and the evidence is unclear that doing a vaginal examination regularly is beneficial (Moncrieff et al, 2022).
Throughout labour, you can talk to your midwife about any concerns that you have (NICE, 2017). They can also provide pain relief if you feel you need it.
When you are ready to push your baby out, your midwife will help you find a comfortable position for giving birth (NICE, 2017). The midwife will make more frequent observations at this stage, listening to your baby’s heart rate every five minutes (NICE, 2017).
What if there are complications in labour?
If there are any concerns during labour, your midwife will discuss what support may be helpful (NICE, 2017). Every situation is different, but you can find out more in our article hospital birth complications: what may happen.
After the birth
After you give birth is a special time for you and your birth partner to get to know your baby. They should be able to stay with you as long as you want after the birth. However, different hospitals have different policies so it's worth checking first.
Your midwife will continue to care for you and check on your baby at this time (NICE, 2017). If it's possible, they will encourage you to have skin-to-skin contact with your baby and begin breastfeeding them if that's what you choose to do, and they may place a towel or blanket over both of you to keep warm (NICE, 2017).
As soon as your baby is born, the midwife will assess their health using the APGAR scale. You can read more about this and the other checks of your baby's health in our article on postnatal care: checks for babies.
The midwife will also check your health. For example, if there are concerns about damage to your perineum during labour then an examination may be offered, and stitches may be given with appropriate anaesthetic (NICE, 2017).
After your baby is born, the placenta also needs to be born. Your midwife will discuss with you the options to birth your placenta and will advise you on the benefits and risks of each (NICE, 2017). Once it is born, the placenta will be examined by the midwife to ensure it has been removed and will check your temperature, pulse and blood pressure (NICE, 2017).
How long will I stay in hospital?
How long you stay in hospital after the birth can vary. One survey found that women are most likely to stay in hospital for one to two days after having their baby (CQC, 2018). But in some hospitals, women are encouraged to leave after a few hours if they are well and happy to do so. If you feel you need to stay longer for any reason, you can express that to the staff.
Before you are discharged from hospital, a midwife should have checked:
- your physical and emotional wellbeing
- the placenta is complete and nothing remains in your uterus
- your uterus and bleeding (lochia), which is usually similar to period-like blood loss for around a week after birth
- your perineum
- you have emptied your bladder
- your baby has had at least one feed
- your baby has had a poo
- you understand what community care is available for you
- you understand about the importance of pelvic floor exercises
- you understand what to expect and who to contact if anything is worrying you. (NICE, 2017; NICE, 2021)
Some women will need to stay in hospital on the postnatal ward after giving birth. This is because either they or their baby needs additional care. You can say if you would prefer to stay or not.
Infant feeding support in hospital
Depending on how you plan to feed your baby, you may want support with breast or bottle feeding while in hospital. If your baby is poorly, or you have had a caesarean, you may need some help with expressing.
All midwives and maternity support workers are trained in basic support for feeding, and some have chosen to specialise and have additional training. If the hospital has BFI (UK Unicef Baby Friendly Initiative) status, all maternity staff will have comprehensive training for feeding.
Think about what kind of support would be helpful for you and keep asking for it. If the support is not working for you, remember that our Infant Feeding Support Line is open 8am to midnight every day of the year. You can always give our friendly, non-judgemental Breastfeeding Counsellors a call on 0300 330 0700.
This page was last reviewed in August 2022.
Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.
We also offer antenatal courses which are a great way to find out more about labour and life with a new baby.
Make friends wit other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.
Care Quality Commission (CQC). (2018) NHS patient survey programme: 2017 survey of women’s experiences of maternity care. Available at: https://www.cqc.org.uk/sites/default/files/20180130_mat17_statisticalre… [Accessed 5th August 2022].
Moncrieff G, Gyte G, Dahlen H, ThomsonG, Singata-Madliki M, Clegg A, Downe S. (2022) Routine vaginal examinations for assessing progress of labour to improve outcomes for women and babies at term. Cochrane Database Syst Rev. (7):CD010088. Available at: https://doi.org/10.1002/14651858.CD010088.pub3
Lothian JA (2004). Do not disturb: the importance of privacy in labor. Journal of Perinatal Education 13(3):4-6. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595201/ [Accessed 6th August 2022].
National Institute for Health and Care Excellence (NICE) (2017) Intrapartum care for healthy women and babies (NICE Guideline 190). Available at: https://www.nice.org.uk/guidance/cg190 [Accessed 6th August 2022].
NICE. (2019) Intrapartum care for women with existing medical conditions or obstetric complications and their babies (NG121). Available at: https://www.nice.org.uk/guidance/ng121/ [Accessed 10th August 2022]
NICE. (2021) Postnatal care [NG194]. Available at: https://www.nice.org.uk/guidance/ng194/ [Accessed 16th August 2022]
Newburn M, Singh D. (2003) Creating a better birth environment: an audit toolkit. National Childbirth Trust. Available at: https://www.nct.org.uk/sites/default/files/related_documents/BBE_report_311003.pdf [Accessed 16th December 2018].
NHS (2020a) What happens at the hospital or birth centre. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/hospital-birth-centre-… [Accessed 5th August 2022].
NHS (2020b) The stages of labour and birth. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/what-happens-during-labour-and-birth/ [Accessed 16th August 2022].
Nilsson C, Wijk H, Hoglund L. (2020) Effects of birthing room design on maternal and neonate outcomes: a systematic review. HERD. 13(3):198-214. Available at: https://doi.org/10.1177/1937586720903689