pregnant woman talking to doctor

You’ve chosen your hospital to give birth in, you’ve been to your antenatal classes but what happens when you arrive? We talk you through what to expect.

What will happen once I arrive at hospital?

If you’re planning a vaginal birth, head to the labour ward when you get to the hospital. Hopefully you’ve been able to visit already, so you’ll have some idea what to expect.

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.

First, you will normally be taken to a labour room. Once you’re there, you might like to change into something cool, loose and comfortable as labour rooms tend to be warm (Tommy’s, 2015a).

Your midwife will ask you what has happened so far and examine you (with your permission). This will include recording your temperature, pulse and blood pressure, feeling your abdomen to check the baby’s position and an internal examination (NHS, 2017a)

An initial assessment shouldn’t include constant monitoring of the fetal heartbeat and uterine contractions at this stage (this is called cardiotocography). That’s because there isn’t enough evidence about whether it’s beneficial at this point. It’s uncertain whether it could result in harm for women and their babies compared with occasional monitoring (auscultation) alone (NICE, 2014).

Your midwife will tell you whether you are in active labour, which means you’re having regular contractions and your cervix is dilated 4cm or more. If you’re not, they might suggest you return home for the time being (NICE, 2014).

What facilities will the hospital provide?

What’s available will vary between hospitals. So again, it’s worth trying to have a tour of the hospital or a chat to your midwife in advance.

Facilities should include a comfortable bed for you and a comfy chair your birth partner (Newburn and Singh, 2003). You might also find beanbags, pillows and mats, temperature and brightness control, and space for you to move around freely during labour. But you’re less likely to find those in a hospital than in a birth centre (Newburn and Singh, 2003).

It is important you feel relaxed and at ease during labour. If you feel tense and feel you’re being disturbed, then adrenaline can cause your contractions to be less efficient (Lothian, 2004). Labour might slow down or stop.

To make the environment feel more homely and comfortable, it’s 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.

Care in labour

If you choose to give birth in hospital, you will normally be looked after by a midwife. It is rare though that you’ll have the same midwife who provided your antenatal care (CQC, 2018)

Depending on how long your labour goes on, more than one midwife might care for you as one shift ends and another begins. Medical students might also ask whether they can come into the room. If you’re not comfortable with this, say so, or ask your partner to tell your midwife. 

If you don't get on with your midwife for any reason you can try asking for another one (WHICH, 2018).

Obstetricians (doctors) will be available if you need their help. If there are complications at any stage, your midwife might ask a doctor to look after you (NICE, 2014).

If all is well, you might be left with your birth partner for varying 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, 2014; CQC, 2018).

Your midwife should encourage and help you to:

  • 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 (unless you’ve had opiates or might need a general anaesthetic)
  • 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
  • talk to you about the risks, benefits and implications of different forms of pain relief like gas and air, opiates or an epidural.

(NICE, 2014)

If you have made a birth plan, make sure you share it with your midwife (NICE, 2014). Your birth partner could also do this if you’re busy.

What will happen during labour?

Once you are in established labour, your midwife will check you every four hours or so to see how you're progressing. This might include taking your blood pressure, pulse and temperature (Tommy’s, 2015b), as well as asking you how you’re feeling emotionally. They could also offer you pain relief if you feel you need it (NICE, 2014).

The midwife should by this stage check your baby’s heartbeat more regularly, usually using a small handheld device to listen to your baby's heart at least every 15 minutes (Tommy’s, 2015b). Sometimes they might offer constant electronic monitoring although this can stop you being able to move around freely. Also, fetal scalp monitoring can be used.

Your midwife will offer you regular vaginal examinations to see how your labour is progressing (NHS, 2017b). Yet it’s worth being aware that vaginal examinations are only one way of finding out how your labour is progressing (RCM, 2012). You can refuse them if you wish as there is no evidence to show that doing them regularly is particularly beneficial (Lewin et al, 2005; Downe et al, 2013).

Your midwife will record their observations on a chart called a partogram (NICE, 2014).

When you are ready to push your baby out, your midwife will help you find a comfortable position for giving birth (NICE, 2014). The midwife will offer much more frequent observations and examinations at this stage, possibly listening to your baby’s heart rate every five minutes (NICE, 2014).   

After the birth

Afterwards, your midwife will continue to care for you and check on you as you deliver your placenta. They should encourage you to have skin-to-skin contact with your baby, so enjoy it and don’t feel rushed. Skin-to-skin contact is great as it helps babies to start breastfeeding and protects against the negative effects of separation (NICE, 2014).

Your midwife should recognise that the time immediately after the birth is when you and your birth partner are meeting and getting to know this new little person. So they should make sure anything they have to do is sensitive to this. They should try to keep you and your baby together and undisturbed (NICE, 2014).   

When you’ve had your baby, you will usually be moved to a shared postnatal ward (RCM, 2015). You’ll stay here while you wait for the appropriate checks and care planning (RCM, 2015).

Often, your birth partner, or whoever is looking after you, will be able to stay with you as much as you want after the birth (CQC, 2018). You might find that different units have different policies in this area so it’s worth checking first.

One survey found that women are most likely to stay in hospital for one or two days after having their baby (CQC, 2018). Fewer women stayed between 12 to 24 hours, and less still stayed for up to 12 hours. If you’re desperate to get home, it’s worth being aware that almost half of all women found their discharge was delayed for some reason so be prepared for a bit of a wait (CQC, 2018).

This page was last reviewed in December 2018.

Further information

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 16th December 2018].

Downe S, Gyte  GML, Dahlen  HG, Singata  M. (2013) 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://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010088.pub2… [Accessed 16th December 2018].

Lewin D, Fearon B, Hemmings V, Johnson G. (2005). Women's experiences of vaginal examinations in labour. Midwifery. 21(3):267-277. Available at: https://www.midwiferyjournal.com/article/S0266-6138(04)00088-9/pdf [Accessed 16th December 2018].

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 16th December 2018].

National Institute for Health and Care Excellence (NICE) (2014) Intrapartum care for healthy women and babies (NICE Guideline 190). Available at: https://www.nice.org.uk/guidance/cg190 [Accessed 16th December 2018].

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 (2017a) At the hospital or birth centre. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/hospital-birth-centre-… [Accessed 16th December 2018].

NHS (2017b) What happens during labour and birth. Available at: https://www.nhs.uk/conditions/pregnancy-and-baby/what-happens-during-labour-and-birth/ [Accessed 16th December 2018].

Royal College of Midwives (RCM) (2012) Evidence based guidelines for midwifery-led care in labour. Available at:  https://www.rcm.org.uk/sites/default/files/Assessing%20Progress%20in%20… [Accessed 16th December 2018].

Royal College of Midwives (RCM) (2015) Understanding experiences in hospital-based maternity settings. A better births summary. Available at: https://www.rcm.org.uk/sites/default/files/Understand%20Experiences%20i… [Accessed 16th December 2018].

Tommy's (2015a) Packing your bag for labour and birth. Available at: https://www.tommys.org/pregnancy-information/labour-birth/packing-your-… [Accessed 16th December 2018].

Tommy’s (2015b) What to do when labour starts. Available at: https://www.tommys.org/pregnancy-information/labour-birth/what-do-when-… [Accessed 16th December 2018].

Which? (2018) Your common questions answered. Available at: https://www.which.co.uk/birth-choice/faqs#can-i-choose-which-midwife-i-… [Accessed 17th December 2018].

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