Lochia is present in the days after pregnancy, while your body and mind adjusts to many changes. It's helpful to know what to expect.

As well as knowing what to expect from your first postpartum period, there's the question of the natural bleeding that occurs after childbirth. This natural bleeding is called lochia. The bleeding happens to every new mum, whether their baby was born naturally or through a C-section. Expect it to last for at least a month. "Lochia will last for up to 4-6 weeks, although more than 10% of women will experience bleeding beyond 40 days," says Sharon Gamon, midwife for the South Coast Private Midwives.

We spoke to the experts to gather all the information on the different types, how long it lasts, and the difference between lochia and your period.

Meaning of lochia

'Lochia is a combination of amniotic fluid, tissue and blood and it's completely normal,' says Mr Ellis Downes, consultant obstetrician and gynaecologist at The Portland Hospital in London (a part of HCA Healthcare UK).

"Lochia is a normal fluid passed vaginally after childbirth,' he continues. 'It's your body’s way of removing the excess blood and discharge from the uterus after giving birth. The blood will predominantly come from the area where the placenta detached itself from the uterine wall, leaving behind a raw wound that needs to heal. The endometrial lining, which thickens during pregnancy, is also released in a similar way to having your period,' he explains.

'During the nine months of pregnancy the uterus builds up a thick lining specifically to nourish and grow the baby; this then has to be shed after the birth to bring the uterus back to a non-pregnant state,' adds Tina Perridge, a midwife and co-founder of South London Independent Midwives.

Sometimes period-like cramps – or mini contractions – can come with lochia, especially if you’re breastfeeding, as this helps the uterus to contract back to its normal size. The pain is simply that: the uterus shrinking back to normal and is nothing to worry about. They occur as women experience a surge in the hormone oxytocin. This is the ‘feel good’ hormone that helps mums bond with their babies and also helps stimulate milk production.

Immediately after birth, the bleeding can be heavy – so you’ll need to stock up on maternity pads or ultra-thick panty liners to absorb it. Tampons shouldn't be used at this time as internal protection can increase the risk of infection. The extra padding actually comes in quite useful as many new mums find sitting down painful after giving birth, so this cushioning helps.

It's also better to avoid sex until lochia has finished, as it can put you at risk of infection.

Lochia after c-section: is bleeding different after a C-section?

Lochia after c-section: is bleeding different after a C-section?

Women who have a Caesarean section may have less lochia after 24 hours than mums who have a vaginal delivery. This is not always the case, though. Some mums have reported very light bleeding after undergoing a Caesarean section; others have stated that it lasted longer than with their vaginal births.

If you had a Caesarean section follow the same guidelines and warning signs outlined for vaginal birth deliveries.

Lochia stages: What are the three types of lochia?

Lochia stages: What are the three types of lochia?

'Lochia rubra, lochia alba and lochia serosa are the three different stages of lochia following birth,' says Mr Downes. 'These are the recognised types of lochia, but each woman is an individual and some stages of lochia may be shorter, or longer, than others.'

Lochia rubra

'Lochia rubra occurs on days two to five [post-birth] and is when the bleeding is at its heaviest,' explains Mr Downes. 'Your blood will be red and very heavy. It's also normal to see clots during this stage. However, clots should not be larger than a small plum, so if yours are increasing in size I would recommend seeking advice from a midwife, GP or healthcare professional as soon as possible.'

'Lochia rubra can be quite heavy and, if you've been sitting or lying down then stand up, it will feel like a big rush but should then settle down again,' explains Tina.

Lochia serosa

The next stage is lochia serosa. 'Lochia serosa usually lasts for around two weeks and begins around day four after giving birth,' explains Mr Downes. 'This mixture of blood and discharge will change to a light watery pink. It will be slightly lighter than the previous days. However, as the placental wound is still healing, blood will still be released,' he says.

Lochia alba

'Finally, lochia alba starts from around week two and lasts until you are six weeks postpartum. Once you reach this stage, lochia changes from pink to a yellow/white colour, with just the occasional spot of blood. This discharge is mainly made up of white blood cells leaving the body after they helped heal your uterus following birth,' says Mr Downes.

Lochia smell

Lochia is blood so there will be a smell, which should be mild. 'Lochia odour is similar to that of normal menstrual fluid; some say it smells stale and musty,' says Sharon.

'Vaginal blood loss tends to have a slightly metallic smell; however, this should not be so strong as to make you uncomfortable,' says Mr Downes.

What's important to realise is that if this smell is offensive you may need medical help. 'It shouldn't be a really unpleasant smell as this may be a sign of infection in the uterus, especially if accompanied by pain in the abdomen,' says Tina.

What causes foul smelling lochia?

'Foul smelling lochia with a fishy smell or greenish lochia can be an indication of contamination or infection. Report this to a health care professional immediately,' warns Sharon. 'It can be treated by a course of antibiotics. Other signs of infection include chills, fast pulse rate, pain or tenderness in the tummy and high temperature.'

Mr Downes agrees: 'If your lochia smells offensive, this might indicate an infection – either in the womb or around any vaginal tears you may have sustained during childbirth. Infections may become dangerous if they are not treated, especially if the infected area is around your uterus, as this can lead to complications such as blood clots or bladder infections,' he says.

While this sounds alarming, more often than not an infection is manageable with treatment, but the sooner you get it seen to the better.

'Most often, infections just make your postpartum experience more uncomfortable and take away valuable bonding time with your baby,' says Mr Downes. 'I'd recommend letting your midwife or healthcare professional know,' he advises.

How long does lochia last and when should it stop?

'The duration for postpartum bleeding is different for each new mum,' says Mr Downes. 'However, it tends to last for around six weeks. Sometimes lochia may totally resolve in two weeks, or it may persist for 10. Lochia tends to take slightly longer to resolve after Caesarean section as the uterus may be a bit slow to involute – which means return to normal size,' he explains.

While lochia is harmless don't ignore heavy bleeding. 'If the bleeding carries on for an extended time and is becoming increasingly heavy, this could be the sign of a postpartum haemorrhage. This requires urgent medical attention,' he warns.

Lochia: Here's a guide of what to expect

After one day. Mums can expect to see fresh red or browny-red blood loss. The flow of blood may be quite heavy, soaking a maternity pad every few hours. You may pass one or two quite large blood clots. They may be as large as a plum, or you may pass several smaller ones about the size of grapes. These are just remnants of your placenta.

If you're worried, it can be a good idea to show your midwife when she comes to visit. Don’t feel embarrassed – they've seen it all before. Midwives are there to help you in the first few days of coping with a new baby. Their reassurance is essential and hugely comforting.

After one week. Your blood should now have turned a pinky brown colour. Expect the stain on your maternity pads to get smaller and lighter. You may pass little blood clots. Let your midwife know if you think you might be passing too much blood after a week.

After three weeks. Blood loss at this stage should be pale yellowish-white – or you may find there's no blood at all. Your uterus should now be almost back to its previous size. Cramping or contractions should also be coming to an end.

After six weeks. Some women may experience a small amount of brown, pink or yellowish-white discharge up to six weeks after giving birth. It may appear in small amounts daily or just occasionally. This will be the final stage of lochia discharge and shouldn’t last beyond six weeks.

Is it normal for postpartum bleeding to stop and start again?

'It's quite common for women to stop bleeding for one or so days and then start again,' says Sharon. Tina agrees: 'Yes, lochia is just like a period. It's particularly likely to increase when you start to be more active, or go for a walk early in the postpartum period. Breastfeeding can also increase the flow as the oxytocin produced by breastfeeding creates uterine contractions which push more lochia out,' she explains.

'Although the blood loss will taper off as the days and weeks go by, around a week or two after your bleeding seems to have stopped, it can suddenly start back up again,' says Mr Downes. 'This is part of a normal process where the placental site scab starts to come off. This additional bleeding should only last a few extra days.'

Lochia or period? What is the difference?

'Lochia is used to describe the bleeding and vaginal loss after your baby is born,' says Tina, while a period is the monthly shedding of the uterus lining. There's usually a break between lochia stopping and your period starting, so expect to see your first postpartum period a couple of weeks after lochia has ceased.

If your period doesn't arrive and it's been a couple of months since you gave birth, speak to your health visitor or GP. If you breastfeed, your periods may take longer re-start. It's a myth that breastfeeding is an effective contraceptive – even if your periods haven't returned you can become pregnant again as early as three weeks after childbirth.

When you should you see a doctor

'It's important during the early postnatal period to observe good hygiene,' says Tina. 'So, change your pad frequently and rest to allow the body to recover.'

If you experience any of the following, you should see a doctor as soon as possible.

Continuing to pass large blood clots. If you pass large clots after the first 24 hours, or you continue to pass blood clots after one week, contact your midwife or doctor straight away.

The blood flow increases, rather than decreases. Lochia flow will be heavy in the first few days after giving birth. The amount should gradually decrease over time. If the blood flow suddenly becomes heavier than it was, or continues as a heavy or moderate loss for longer than a week, contact your midwife or GP immediately. The NHS advises mums experiencing heavy blood loss to keep a stained sanitary towel or any clots they have passed so the problem can be investigated.

The lochia smells strange. If your blood loss smells strange or bad, you may have an infection in your womb. Or you could have an infection from any tears you sustained while giving birth, in your vagina or perineum (the bit between your vagina and bottom).

A change in smell, despite having bathed and changed your sanitary towel, may be a warning sign. Let your midwife or doctor know. The discharge may also change colour when this happens.

Pelvic pain. A urinary infection or constipation could cause pelvic pain. In both cases, drink plenty of water and contact your midwife or GP without delay. A gentle laxative or dietary change can help with constipation, which is very common after giving birth.

A serious condition that will cause pelvic pain is an infection in the womb. This will cause mums to feel shivery and unwell. In this instance, contact your GP straight away.

How is a lochia infection treated?

'Postpartum infections most often occur 1-10 days after birth. They are predominantly caused by bacterial infections of the female reproductive tract,' explains Mr Downes. 'If you're experiencing a lochia infection, you may suffer from a fever and chills, as well as offensive-smelling lochia and abdominal pain. Treatment will usually be antibiotics and you should start to feel better in a few days’ time.' he says.

An infection in the uterus can cause a haemorrhage, too – or a piece of placenta that has stuck to the uterus, which prevents it from healing. The area that doesn’t heal keeps bleeding and – because it's small – mums probably won’t see a ‘gush’ of blood. Instead, they’ll see a steady drip. This can become a serious problem (just think how fast a sink fills up if the tap is left dripping).

'If you experience bleeding which soaks through a pad in 15 minutes or less, you should see a doctor immediately. This may represent a haemorrhage due to a small piece of retained placental tissue or blood clot, or a developing infection,' warns Mr Downes.

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Vaginal birth after c section (VBAC),  is where a woman gives birth vaginally after having had a previous caesarean.

Many women who have had a previous caesarean are suitable candidates to attempt VBAC in pregnancy. But, this will depend on you, your current pregnancy and the circumstances of your previous caesarean.

To find out more about what makes for a successful vaginal birth after a caesarean, we spoke to Dr Ihab Abassi, a Consultant Obstetrician for the NHS. He told us, "Whether you choose to have another caesarean or vaginal birth after caesarean, both options are safe. However, neither options are without risks. All birth, even for first-time mums, comes with some risk. Advantages of VBAC in pregnancy include better recovery time for the mum (if labour and birth was uncomplicated) and less likelihood of breathing difficulties for baby compared with caesarean."

Vaginal birth after c section

Vaginal birth after c section (VBAC) is currently recommended for the majority of women who have had a caesarean in the following circumstances:

• Singleton baby pregnancy (not a multiple birth)
• No current health problems in the mother or baby
• The baby has reached term (37 weeks)
• The baby is 'presenting' head down during labour (cephalic)
• Mum has only had one caesarean before
• The previous caesarean was uncomplicated with a lower segment, straight scar (not 't' or 'j' shaped vertical or classical scar)

However, you can still try for a VBAC after c section if you do not fit these criteria exactly - it will mean that you need to look at different risk factors with your obstetrician.

The success rate for VBAC attempts that fit the above criteria is good - according to the UK's Royal College of Obstetricians and Gynaecologists (RCOG), around 72-75 per cent of VBACs will succeed. This success rate increases to between 85-90 per cent, if you have already had a successful vaginal delivery.

Source: RCOG Green Top Guidelines for vaginal birth after caesarean

VBAC after c section is also known as 'trial of labour after caesarean'. An assisted vaginal delivery using ventouse (suction cup) or forceps (large metal 'spoons') to help the baby be born after a previous caesarean is also a VBAC.

Choosing to have a VBAC

For some women, having a VBAC after c section is very important to them. They may feel very unhappy about the circumstances of their first caesarean.

These negative feelings can occur even if the caesarean was a planned surgery, but is more common when women have had a "crash" or emergency section.

Research suggests that emergency caesareans can be a large factor in the development of post-traumatic stress disorder.

"Naomi, a mum of three, who had a vaginal in 2016, C-section in 2018, then a VBAC in 2020 - I was very upset when it turned out I'd need a planned caesarean. I felt like I needed to grieve for the birth I wouldn't have. My caesarean was not what I had imagined and I found it quite traumatic. I was so delighted to manage a VBAC with my third, it was so healing to give birth how I'd wanted." 

The concept of safety in pregnancy and birth does not just affect your physical health. Many people think "as long as baby is healthy, that's all that matters". Of course, the physical health of your child is absolutely crucial, but your mental and physical health is important, too.

For other women, who had a traumatic vaginal birth, or a traumatic birth that ended in an emergency caesarean, VBAC after c section is a challenging idea. They might want to try to give birth vaginally but struggle with the memories from previous births. There is evidence suggesting that up to one-third of women suffer from birth trauma.

Deciding to opt for a VBAC in pregnancy, or a repeat caesarean is a very personal choice. You have the right to ask for either option. Speak to your midwife and weigh up the benefits and risks and how they relate to your personal circumstances.

Mum of two, Jenny, who opted for a second, elective caesarean in 2022 - "There's no way I would have wanted to go through all that again and it just end in yet another emergency caesarean. For me, it made sense for me to be in control and say yes... I want a caesarean again, but this time on my terms." 

Advantages of VBAC after c-section

The advantages of a VBAC after a caesarean are similar to the advantages of a vaginal birth when there is no previous caesarean.

Babies born vaginally:

• Have lower rates of breathing difficulty than those born via caesarean, according to studies.
• Are exposed to beneficial bacteria during birth, which studies show are not available to babies born via caesarean.
• Are better at breastfeeding, according to 2021 research comparing 9,345 breastfed infants born vaginally or via caesarean
• Have lower rates of asthma, allergies and obesity in later life, according to emerging evidence

Mothers who have a vaginal birth:

• Recover more quickly, on average than those who have had caesarean; a major abdominal surgery (Source: NHS Caesarean recovery)
• Have better success initiating breastfeeding, compared with mothers having caesareans. Many studies show that caesareans "are associated with maternal/infant separation, reduced suckling ability, decreased infant receptivity, and insufficient milk supply".
• Are less likely to suffer from thrombosis (blood clots) according to various studies

A comprehensive review of 29,928,274 births, in 2018 found that pregnancies after caesareans are associated with:

• Increased risk of miscarriage
• Higher risk of stillbirth
• Increased risk of placenta previa (the placenta covers some or all of the cervix)
• Higher risk of placenta accreta (where the placenta embeds too deeply into the uterus, sometimes in a previous scar)
• Increased risk of placental abruption (the placenta comes away from the uterine wall)

These risks increase further with the more caesareans a woman has. However, these risks are all small and are, of course, outweighed by the needs of a baby and mother when emergency caesareans are required.

Is VBAC safer than repeat caesareans?

Whether or not VBAC is safer than repeat caesareans depends on your definition of "safer" and your point of view. For the majority of women, it's arguably a better option to have a VBAC than a caesarean. This is because the recovery time is shorter and easier for most who have an uncomplicated VBAC after c section.

Other factors that affect the comparison of safety:

• Your desire for more children. Repeat caesareans affect your womb as scars cause adhesions (scar tissue) to form. These adhesions can cause your placenta to form abnormally, creating additional risks in pregnancy.
• A VBAC avoids all the risks of surgery, including infection (internal, and of the scar).
• Babies usually fare better after vaginal delivery than c-section: studies show fewer babies born vaginally need help breathing than those born via caesarean.

What are the risks of VBAC?

• Tearing of the vaginal area
• Need for emergency caesarean (25% of vaginal deliveries in the UK)
• Pelvic floor injuries
• Urinary incontinence
• Need for an assisted delivery (using metal spoons called forceps or a suction cup, known as a ventouse) - according to RCOG this is 1 in 8 births.
• The risk of episiotomy (cut to the vaginal area) to help the baby be delivered

Sources: 2018, major review of 29,928,27 births.

Risks of VBAC in pregnancy are broadly similar to the risk of vaginal birth, with the additional (small) risk of uterine rupture, as covered in the safety section above. The risk of uterine rupture, according to RCOG, is 1 in 200 (0.5%).

Uterine rupture

VBAC in pregnancy comes with a small risk of uterine rupture. This can be fatal for mum, baby or both. Uterine rupture causing death in either baby or mother is a very rare event, according to UK studies.

The UK Obstetric Surveillance System's study of found uterine rupture occurred in just 0.2% of births.

"Uterine rupture is a severe but thankfully very rare complication. We found that many of the hospital maternity units across the country don't even see one case a year," - Professor Marian Knight of the National Perinatal Epidemiology Unit at Oxford University

In most cases of uterine rupture, it is identified early and both mother and baby are fine, after some medical support.  NHS Consultant in Obstetrics and Gynaecology, Dr Abassi told us, "Uterine rupture, when it happens, is very dangerous. However, your healthcare team will monitor you and your baby very closely during a VBAC, to look for any signs of rupture."

Studies show uterine rupture can happen in first time mums with no history of caesarean, as well as non-pregnant women.

Risk of uterine rupture

The risk of uterine rupture, according to RCOG, is 1 in 200 (0.5 per cent). RCOG also say the "absolute risk of birth-related perinatal death [of mother and/or baby]" associated with vaginal birth after caesarean is "extremely low [and] comparable to the risk for [first-time mums] in labour".

RCOG's Guidelines for vaginal birth after caesarean also say having had a previous vaginal delivery is also "associated with a reduced risk of uterine rupture".

Studies show that the risk of uterine rupture increases:

• Each time a woman has another caesarean
• If labour is induced
• If there is a short interval between birth and the next pregnancy

Factors affecting VBAC success

RCOG say you are more likely to achieve a vaginal birth after caesarean if you:

• Have a healthy BMI (high BMI can reduce your chances)
• Already gave birth to at least one baby vaginally ("the single best predictor of successful VBAC")
• Had a planned caesarean
• Previously had a caesarean because of the baby's unfavourable position (not head down - breech - or transverse: sideways)
• Have a single, previous lower segment caesarean scar (not a "t" or "j", vertical or "classical" shaped scar)
• Have reached term (37 weeks)
• Present with a head-down (cephalic) baby

VBAC after two caesareans (VBA2C)

If you have had two or more Caesarean sections previously, you are likely to still be able to have a VBAC.

You will need to discuss your chances of success with your obstetrician. They should look at your individual factors, your history and any other health considerations to help you make an informed decision.

Royal College of Obstetricians and Gynaecologists say:

"[Studies show] there was no significant difference in the rates of uterine rupture in VBAC with two or more previous caesarean births [...] compared with a single previous caesarean birth."
"Women with two previous caesarean deliveries who are considering VBAC should be counselled about the success rate (71.1%), the uterine rupture rate (1.36%) and the comparable maternal morbidity to the repeat caesarean delivery option."

Why you shouldn’t have a VBAC?

Firstly, you shouldn't have a VBAC if you don't want one. If you feel you cannot have a VBAC for any reason, including anxiety and trauma, then you should not feel you should. It's acceptable to opt for a planned caesarean whether you have had a previous c-section or not.

Remember: you have the right to request a caesarean, according to NICE guidelines.

There are a few factors which would make vaginal birth after caesarean inadvisable, or very dangerous:

• Placenta previa (where the placenta covers the cervix partially or entirely)
• Previous uterine surgery (unrelated to caesarean)
• Historical caesarean scar which is not lower segment ("t", "j", "classical" or vertical caesarean scar)
• Previous uterine rupture
• Macrosomia (very large baby)

If these factors apply to you, discuss everything with your healthcare to fully understand your risks.

Source: RCOG guidelines for VBAC

VBAC induction

In the majority of cases, induction is not advised if you are attempting vaginal birth after a caesarean.

According to the RCOG guidelines on VBAC, there is an increased chance of uterine rupture in drug-induced VBAC (2-3-fold increased risk). Drug-induced labour is done using synthetic hormones given vaginally (via a pessary) or intravenously (via a drip).

In some cases, you can be induced using "mechanical methods". These include:

• Amniotomy (or artificial rupture of membranes) - where your waters are broken by a doctor
• Foley catheter (also known as a cervical balloon) is a method to dilate your cervix

RCOG says mechanical induction is associated with a lower risk of scar rupture and emergency caesarean.

However, all the risks and benefits of induction for VBAC will be discussed with you and every case is different. You should talk about all your decisions with your family, friends and your healthcare team to help you make any decisions.

VBAC criteria - who is eligible?

According to the Royal College of Obstetrician and Gynaecologists (RCOG) guidelines for vaginal birth after caesarean, most women are eligible to try.

UK RCOG Guidelines, VBAC - "There is a consensus (National Institute for Health and Care Excellence [NICE], Royal College of Obstetricians and Gynaecologists [RCOG], American College of Obstetricians and Gynecologists [ACOG]/ National Institutes of Health [NIH]) that planned VBAC is a clinically safe choice for the majority of women with a single previous lower segment caesarean delivery" 

Mental health support after a traumatic birth

Further support for birth trauma is available from the Birth Trauma Association.

You should also be able to seek help with perinatal mental health from your midwife. You could also enquire about whether your hospital offers a "Birth Reflections" or "debriefing" session, to examine what happened in your last birth.

Your GP can also advise if you feel you need additional help or medication. You can also usually self-refer for NHS psychological therapies.

Related video: How to ease stitches after birth

While every woman will labour differently, every mum-to-be wants to know: what do contractions feel like? How can I tell whether I'm in labour?

The very first contractions you feel may be 'false labour pains', often called Braxton Hicks. Whilst they might feel worrying, Braxton Hicks contractions do not follow a pattern and will usually not increase in frequency. They aren't a sign that the baby is coming and will usually go away if you change position.

Real contractions vary in intensity as labour progresses and some women say early contractions feel like period pain. When labour is in full swing, contractions feel like powerful surges that are intense and rhythmic. These contractions get closer together and more powerful as they dilate your cervix and push the baby down. Some women in labour will feel different types of contractions but all real labour pains have a pattern. They will come closer together and last longer as you start the process of meeting your baby. Whilst many women will feel excited, others can feel anxious about labour. To understand more about what different contractions feel like, we interviewed Registered Midwife, Anneke Holloway.

What do contractions feel like?

• Mild period pain that increases
• Rectal pressure, like you need to have a bowel movement
• Powerful, intense surges or waves that make your stomach rock hard
• Intense pelvic pain
• Pressure that starts in the back

Contractions can feel different for all labouring women. Many describe contractions as feeling like they needed to have a bowel movement, with pressure in the rectum. Contractions that push the baby down, once you are fully dilated, are very intense. You won’t be able to talk until they’ve passed the peak. Some women say these contractions feel like waves or surges.

Whatever they feel like, contractions will make your stomach very hard and they usually start from the top of the uterus. In late pregnancy, the uterus starts underneath your breast bone (ribs) and the contractions will then ripple down your stomach, pushing the baby down.

Midwife Anneke Holloway says there is a real range of different sensations. “It’s not unusual for contractions to feel like period pains in the early stages. Contractions can feel like a dull ache in your pelvis, rectum or back. Rectal pressure is commonplace for contractions to feel like they’re starting. Braxton Hicks contractions feel like tightenings that don’t last very long, with no pattern.”

You might feel worried about how you will cope with the pain, but don't worry, because there is a range of options available for pain relief in labour. Your midwifery team will help you work with the contractions and every contraction brings you closer to meeting your new baby.

First-time mum Sarah, 25, was surprised by her labour: “my contractions woke me in the night. We had talked about contractions in antenatal class. That’s why I thought I would instantly recognise what contractions feel like when they started. Because I was half asleep, at first I thought it felt like a period starting. Then my waters broke, all over the bed. Not long afterwards, the contractions were too intense to cope at home, so I headed to hospital.”

What causes contractions in pregnancy and labour?

There are different types of contractions and different triggers for them. Contractions can be triggered by orgasms, overexertion and being dehydrated. Braxton Hicks contractions feel like uncomfortable pains that are irregular. Research shows, that they are usually unpredictable and rarely follow a pattern.

Doctors don’t know exactly what causes Braxton Hicks, as there is currently no definitive evidence on their causes. However, they are a normal part of pregnancy. They are more likely to happen when you’re dehydrated, need to urinate or when you’ve done lots of activity. So if you're starting to worry you're having Braxton Hicks contractions, sit back, relax and have a drink.

How does labour start?

The exact biological mechanism that triggers labour contractions is still currently unknown. However, in most pregnancies, the baby’s gestational age is a major factor in starting labour. Labour is also triggered by the ageing of the placenta. Recent studies suggest labour might be related to the maturation of a baby’s lungs.

Contractions begin after a complex set of steps that initiate labour. The exact trigger for spontaneous labour (that begins without any prompt) can vary.

One study of nearly 700 women found most were unaware of what started their contractions. But, for those who did know the trigger, it was found 32% stated physical activity (usually walking) as the cause.

A total of 24% were medically triggered, 14% had some other physical trigger (including sex), 12% ingested something, 12% experienced an emotional trigger and 7% had a maternal illness.

When labour starts, according to research, the brain prompts the release of a hormone named oxytocin.  Oxytocin, often called the “love hormone”, prompts the contraction of the myometrium. The myometrium is the smooth muscle tissue of the uterus. 

How do contractions help you give birth?

A contraction is defined as the tightening and loosening of a muscle. When you flex any of your muscles, you’re contracting them. As the strongest muscle in the human body, the uterus has a lot of work to do.

Contractions open and thin (efface) the cervix by putting pressure on it. Once the cervix is fully dilated, contractions push the baby out. Some women say their contractions feel like waves or describe them as surges. This is because they gradually rise in intensity, peak and then fade away. The pain usually stops in between each contraction. The strength of contractions increases throughout labour to thin and dilate the cervix.

One study found that some of the strongest contractions occur when you’re about 6cm dilated. However, the strength of contractions throughout labour will differ in each woman.

How do you know you’re having real contractions?

Some women feel contractions as early as their second trimester. These are often known as “practice contractions”, or Braxton Hicks. The key difference between real contractions that start labour and these practice ones is timing, pattern and intensity.

Real labour contractions will feel like a regular pattern of pressure that increases to a peak and then fades away. Your abdomen - all the way from your ribs to your pelvis - will harden. Contractions will feel like they’re increasing in intensity as you progress towards baby's birth. When you’re in labour, the contractions will also feel like they are getting closer together, in a pattern. Changing position, taking pain relief or having a drink won’t stop genuine labour contractions.

Midwife Anneke Holloway says “the key distinguishing, differentiating factor is your movement. If you change position during a contraction, if it is a Braxton Hicks contraction, it will stop. Braxton Hicks are involuntary muscle tensions and have no pattern. Contractions that increase in intensity and become more frequent, whatever you do are the real thing. In active labour, contractions feel like they’re so intense, you can’t talk through them”. If you're ever worried about anything, don't hesitate to contact a healthcare professional for advice.

How to ease contractions: your pain relief options

Many women use heat, massage and hypnobirthing techniques to help them cope when labour contractions feel at their most intense. Others prefer to use pain killers like paracetamol, epidurals and gas and air. There are a range of options to help you manage pain relief in labour. Once you're in hospital, you will have access to many different medications, but managing pain at home is the first step of labour.

The very earliest contractions feel like period pain, so a warm bath or hot water bottle can be very soothing for easing discomfort.

When you call your maternity unit for advice, your midwife might suggest that you take paracetamol and wait a little longer until contractions are closer together. Sometimes they might also suggest the use of TENS machines (Boots | £39.99). TENS machines are small, portable machines that use mild electrical signals to help with pain relief. Safe in pregnancy and labour, these machines have pads that you stick where you're most uncomfortable and you can easily control the frequency and strength of the current.

Hypnobirthing to cope with contractions

Midwives will often teach you how to use breathing techniques to control your reactions to contraction surges. Some women find hypnobirthing techniques help them control what contractions feel like.

Midwife Anneke Holloway agrees hypnobirthing is a great way to help you control your reaction to what contractions feel like: “practising hypnobirthing will help you enter a quiet, meditative state. You can breathe through the contraction and visualise getting closer to meeting your new baby. Hypnobirthing helps you see that contractions feel like a surge or wave that you can ride.”

Mum of two, Jodie, said “I didn’t realise I was in labour to start with. I was a little bit overdue and I felt some back pain. My boyfriend suggested a bath would sort me out. As soon as I got in, I felt so much better. He brought me a nice cup of tea and we had a lovely chat. Feeling warm and loved meant I was relaxed and I soon realised that the contractions felt like when I first gave birth. They were getting stronger and coming more rapidly. Our little girl was coming!"

When contractions feel like they're too much to handle

Your pain relief options will depend on where you are birthing your baby. In hospital you will have access to the full range of pain relief, including an epidural. An epidural will usually stop you feeling contractions, or reduce their intensity. Other pain relief options include pethidine, a strong painkiller. If you are worried your contractions feel like they’re too painful, ask your midwife for advice. Your midwifery team can advise you on pain relief in labour when you write your birth plan. Of course, you can always change your mind on what you need during labour. 

Does the baby move during contractions?

Many mothers are surprised to learn that yes, babies often can move and kick during contractions. But you might not always feel them kicking because contractions do limit their movement. Contractions squeeze your uterus and, of course, your baby too, pushing them towards the exit. Some studies have found that a baby’s movement is greater during contractions than in between them. Baby movements during contractions can make them feel like they last longer, too. 

Your midwife will usually monitor your baby’s reactions to contractions using a doppler. This machine tells the midwifery team whether the baby’s heart rate is getting faster or slower. Some women will have "continuous fetal monitoring" whereas in other labours, this will be intermittent (every so often).

Doctors will listen carefully for any heart rate patterns that indicate the baby is getting distressed.

Midwife Anneke told GoodToKnow, “the amount of space in your uterus is reduced during a contraction. That means babies don’t have as much room to move. You’re unlikely to be aware of baby’s movements, as contractions feel very intense. Your midwife will ask you if the baby is moving in between contractions. That is one of the ways to be sure baby is coping well with labour”. 

https://www.youtube.com/watch?v=wEyHd_Dc8t8

Timing contractions before going into labour

The timing of your contractions is a reliable indicator of how far along in your labour you are. Midwives will monitor your contractions carefully for their intensity, duration and frequency. Early labour pains might not form a pattern and these contractions feel like period pains.

In early labour, you may not see much progression. The early stages of labour can be very long. Midwife Anneke advises that you focus on breathing through contractions and feel for how they are changing. She says “If you can still talk through your contractions, it’s usually a sign that there is still quite some way to go.”

As your contractions feel like they are getting stronger, and more frequent, they are dilating your cervix. When you are fully dilated, contractions start to push your baby down.  Whilst the length of all labours will vary, when contractions are close together and very intense, you are getting closer to birth.

Many women find that timing their contractions with a stopwatch can be difficult when they’re experiencing pain and heightened emotions. There are a range of apps that can help. Midwife Anneke Holloway co-founded the My Mindful Midwife app (download for Apple | Android) as a way to help women monitor their contractions. “It’s so important that you can stay relaxed during contractions and trust your instincts about when it’s time to visit the hospital”, she says.

When should you seek medical advice?

It's important to seek help as soon as you are worried at any point during your pregnancy or labour. You should call immediately if you experience smelly or discoloured waters, bleeding or pain that you cannot manage at home. If you notice your baby is moving less than normal at any time in your pregnancy or labour, always call the Maternity Assessment Unit immediately.

When to call for advice during labour contractions:

• when your waters break
• if your baby is not moving as often as usual
• your waters are smelly or discoloured
• there is vaginal bleeding
• pain is unmanageable
• the pain is constant/ it doesn't stop between contractions
• you can feel pain in your scar if you have had a previous caesarean
• if you are having intense contractions before 37 weeks (premature labour)

Midwife Anneke Holloway notes there are a few key things to be aware of during contractions: “If you experience pain in between contractions, this could be very concerning. Contractions feel like they have a start and an end. When there is no period of relief in between contractions, this is something to look out for. Mums who have had a previous caesarean who experience scar pain must call for advice straight away. Always get advice if you’re concerned about anything at all. You know your body and if something feels wrong, trust your instincts.”

If you are having painful, regular contractions before you have reached term (37 weeks), get in contact with your emergency midwife helpline. They will need to assess you for preterm labour.

If you are at term, congratulations, you will soon meet your baby! You might be unsure whether your contractions feel like the start of labour. Perhaps you are experiencing other early signs of labour.

Related video: How to bring on labour

A cesarean section is a procedure that allows your baby to be delivered through a cut in your abdomen. Also known as 'c sections', some mothers prefer to call it either an abdominal or surgical birth.

Around 1 in 4 women have a caesarean in the UK. There is a range of reasons you might be advised to have a caesarean or might need one. These can include problems with your health, the health of your baby or risks for you both. You can also decide if you want to have an 'elected caesarean'.

To understand everything you need to know about having a caesarean section, we talked to NHS Consultant Obstetrician and Surgeon, Dr Ihab Abbasi. He told us, "A Caesarean is a safe way to birth a baby, but like all surgeries, it is not without risk. Every birth comes with risk, including vaginal birth. If you want to have a caesarean, then discuss this with your consultant. They will want to discuss everything with you, to know you're fully informed before you go ahead with the operation."

Different types of caesarean sections

A planned caesarean

There are several reasons a doctor may suggest a planned caesarean for your health, or your baby's. This will be recommended when:

• Your baby is in an unfavourable position for birth - this can include breech positions (head up, rather than head down) or if your baby is transverse (laying across your uterus)
• You need to deliver early for your own health  - these conditions vary, but gestational diabetes and pre-eclampsia might sometimes mean earlier delivery is better for you
• Baby's exit is blocked by a low-lying placenta - known as placenta previa (which covers your cervix)
• You are expecting multiples (twins or triplets) - twins and triplets can be birthed vaginally, but this will depend on your pregnancy
• Baby is very large (known as macrosomia) -  with their growth estimated as bigger than 97% of other babies

An unplanned caesarean

As outlined by the National Institute for Clinical Excellence, you might need an unplanned (emergency) caesarean if:

• Your baby is showing signs of distress
• Your labour isn't progressing and medications to help you give birth (induction methods) have not worked
• Something happens during labour which causes a risk to you, your baby or both of you. Rare examples include uterine rupture (tearing of the womb) or placental abruption (the placenta comes away from the wall of the uterus.

Dr Abbasi, NHS Consultant Obstetrician, explains, "There are a lot of reasons that I might recommend a caesarean, but I'll always discuss all the reasons, risks and benefits with the woman and her birth partner. Whatever the indications for a caesarean, you should have the chance to ask all your questions. Very few times is it the only option, so you can always ask what the alternatives are."

An elected caesarean: can you ask for a caesarean section?

In the UK, and in many other countries, yes you can as for a caesarean. NICE guidelines say that maternal requests for caesarean must be explored, discussed and recorded.

If you request a caesarean your healthcare team will discuss:

• Risks and benefits of caesarean
• Risks and benefits of vaginal birth
• Your personal reasons for requesting a caesarean
• Informed consent and your understanding of the operation
• Recovery from a caesarean
• Impacts on future pregnancies and births

Where your reasons for a caesarean are around anxiety or tokophobia (fear of childbirth), you will be offered a referral to a perinatal mental health professional.

However, this does not mean you have to take that offer of help, nor that you cannot have a caesarean. Dr Ihab Abassi explains: "If your healthcare team don't agree with your request, that doesn't mean you can't have a caesarean. NICE guidelines say that they must refer you to another obstetrician that will perform your caesarean. I haven't ever turned someone down. It's not me who is going through this - it's the patient. My job is to make sure she understands everything that's involved. If she's giving truly informed consent, that's what is important."

NICE Guidelines on Caesarean, UK - "If a vaginal birth is still not an acceptable option after discussion of the benefits and risks and offer of support (including perinatal mental health support if appropriate; see recommendation 1.2.28), offer a planned caesarean birth for women requesting a caesarean birth" 

Cesarean delivery: How to prepare for c-section

In the weeks leading up to a planned caesarean, you will be given the opportunity to discuss all your concerns with your midwife and ask several questions about what's involved. Keep a note of any questions you have, and save them for your later antenatal appointments. It's likely you will have some pre-operative instructions, which vary by hospital, and you might need to have some routine blood tests, too.

Just because you're having a caesarean, doesn't mean you can't think about a birth plan. Some things might be already mapped out, but you can still choose many things.

• Who to have with you in the theatre
• Your playlist - some theatres have a sound system so you can birth your baby to your favourite album.
• Whether you want immediate skin to skin after birth, or for your birth partner to hold baby (this may depend on your hospital and reasons for caesarean. Discuss with your healthcare team).
• How much information your theatre team give you - do you want a running commentary, explaining all? Or would you prefer silence as baby is born, so they hear your voice first?
• If you'd like to see baby's birth. Some hospitals allow a mirror or lowering of the drapes so you can witness the birth.

Consultant Obstetrician Dr Abassi says, "Follow all your pre-operative advice and read all the information you're given. But also think about what parts you'd like to remember from your baby's birth. Bring some music and your camera - usually one of the team will be happy to take photos of you, your birth partner and your baby. Even if it's an emergency, in most cases."

Kelly, mum of three - "All I could remember from my midwife friend is ‘a hydrated uterus is an effective uterus’ so I was guzzling fluids like no tomorrow before hand. I recovered so well from it that they were really surprised. One midwife told me afterwards that they’d started trialing fluids before to help recovery and it had reduced recovery times in planned sections. I’m convinced that helped me. - 

Before the day of your planned caesarean, you'll have the opportunity to discuss various aspects of what to expect with your healthcare team. Sometimes you might even be offered the opportunity to meet an anaesthetist in their clinic. This will depend on when the decision to have a caesarean is made.

On the day of your planned caesarean, you will be given a consent form that will detail the surgery as well as the risks. You will also meet your surgeon and your anaesthetist before you see them in theatre. It's also important to note you will need a urinary catheter inserted into your bladder before a caesarean.

Caesarean operation: What happens during the procedure?

Before the caesarean operation, you will need to be anaesthetised (for pain relief). There are a few different options and your anaesthetist will explain them to you.

Anaesthesia options include:

• Spinal anaesthesia
• Epidural anaesthesia
• Combined spinal and epidural anaesthesia
• General anaesthetic (in rare cases, where this is absolutely necessary. General anaesthesia will mean you are unconscious when your baby is born.)

Exactly which pain relief is right for you will depend on the reason for your caesarean and whether it's a planned or emergency procedure.

Once the team are confident you cannot feel it, the surgeon will make an incision (cut). This cut is made about 3cm above the area called the symphysis pubis (just above your bikini line).

You will be able to feel some movement inside you, though there shouldn't be any pain. Once the baby is out and safe in your (or your partner's) arms, the surgeon will remove your placenta. A midwife will usually inspect it to make sure it's complete and nothing has been left behind.

Dr Ihab Abbas explains, "We cut the skin and then the layers underneath to reach the womb. We'll then break the waters and you might hear some suction noises as we remove the fluid. Then we take your baby out. We delay cord clamping - I tend to leave it until the cord has stopped pulsating, so all the blood from the placenta goes back into the baby. Then we clamp and cut (or the partner cuts the cord if preferred). The midwife will check the placenta while we check the womb and ovaries. Then we close up and it's done."

Caesarean section recovery

Recovery from a caesarean section is different for everyone. It can also depend on whether you had a planned or emergency caesarean. You will need to take it easy for several weeks, so it's useful if friends and family can provide assistance as much as possible.

Following the procedure, you will be taken to the recovery area so that you can be monitored for a few hours, before moving to the postnatal ward. After 12 hours, your urinary catheter will be removed. You will then be encouraged to get up to the toilet yourself and let midwives know you've managed an independent wee. They want to check that your bladder is working as it should, as studies show catheters can sometimes cause urine retention.

Many hospitals now prefer to use the "advanced recovery" pathway. This means you will return home the day after your operation if you and baby are well. Your dressing will usually be removed around 24 hours after your caesarean.

Medication following a caesarean

Pain killers - While in hospital, you will have access to a greater amount of pain relief than at home. You may be offered opiate medication, like morphine, that can help with initial pain relief. You can also have paracetamol in hospital, and at home.

Blood-thinning medications (to prevent blood clots after a caesarean) - These are usually recommended to protect you from the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). DVTs are blood clots that usually form in the legs, due to inactivity. They can cause PEs; blood clots in the lungs. Both conditions can be damaging and, in some cases, PEs can be fatal.

Source: Royal College of Obstetricians and Gynaecologists

Real mums words of advice on caesarean recovery

Danielle, who has two children told us - 1. Take your own pillow in. Not just for comfort - I slept almost entirely upright so the extra pillow really helped. 2. Get up and moving ASAP. I had my daughter at midday and was up in the shower at 7pm, as soon as the numbness had worn off. 2. Don't overdo it though: I did and then crashed majorly and was a shaking, sicky mess for a few hours. Vomiting after surgery isn't fun. At all. Little and often was the key for me.

Amy, a mum of two, told us, "Take a pillow with you for the way home. The car journey home can be quite uncomfortable, so hold it against your stomach for any speed bumps. Same when you go for a poo, sneeze or cough. You might feel great about a week later and think you are back to normal. But don't be tempted to do too much. It's major surgery and should be treated as such."

Mum of three, Danielle, told us, "On the subject of painkillers, don't be a trooper. It's major abdominal surgery. Take the medication and take it all, exactly when you should for as long as you need it."

How long does a caesarean scar take to heal?

The actual scar on your skin doesn't take long to heal. Your stitches will be removed within 5 days, but NHS Obstetric Consultant Dr Ihab Abbas says the actual wound will heal "within 48 hours".

Overall recovery takes longer because internal healing will take weeks. The length of time that you need to heal internally will depend on many factors including:

• Whether the operation was complicated or straightforward
• If your caesarean was an emergency or planned
• How long you usually take to heal

What are the risks of caesarean section?

Risks to the mother can include:

• Wound site pain for 1-10 days after surgery
• Infection - this is common after caesarean and can take days to weeks to heal
• Development of blood clots (DVT) in the legs that can travel to the lungs (known as Pulmonary Embolism/PE)
• Needing to have another Caesarean with subsequent pregnancies

Rare complications of caesarean

• Damage to your bowel or bladder
• Total hysterectomy (removal of the womb - an extremely rare complication)
• Scar adhesions (internal scar tissue)
• Placenta accreta (where the placenta embeds too deeply, sometimes within the previous caesarean scar)
• Uterine rupture in future pregnancies (tear in the womb)

Risks to the baby can include:

• Temporary breathing difficulties - babies are not "squeezed" during caesarean section in the way they would be during vaginal birth. This means that the amniotic fluids can get stuck in their airways and they may need some help to breathe. This is something your paediatric team will be expert in resolving, so don't worry too much if your baby needs a little assistance to begin with.
• 1% to 2% of babies will be cut during a caesarean. The cut is not usually deep and usually heals without leaving any visible scar.

Risks section source: RCOG patient advice on Caesarean section

Birth and pregnancy after a caesarean section

You may be wondering how soon after a caesarean you should wait before having another baby. The answer is that it depends on you, your body and your previous caesarean(s).

The NHS does not have any specific recommendation on the spacing between pregnancies, so this should be a discussion between you and your GP. They will understand your health factors and considerations.

Studies suggest that waiting at least 12 months between pregnancies is best for reducing overall risks to both mother and child.

Many people think that having a caesarean will mean all subsequent births will have to be Caesarean sections. However, this is not the case for all women. Many women will be able to have a Vaginal Birth After Caesarean (VBAC).

If you are worried about giving birth next time, speak to your obstetrician or midwife about how it will affect your next birth.

Related video: Our favourite twin baby names

Pethidine is a painkiller that's often offered to mothers during labour.

Lasting for around 4 hours, it can be prescribed by a midwife as pain relief in labour.  Like any medicine, it has advantages and disadvantages. To find out more about pethidine in labour, we talked to Consultant Obstetric Anaesthetist, Dr Simon Jones. He told us, "Pethidine is a strong, opiate painkiller that can make you feel sedated (sleepy) and sometimes a bit sick, so it's important to fully understand the side effects".

What is pethidine?

Pethidine is from the opiate family of painkiller medications and is given as a muscular injection. Like other opiates, including morphine and codeine, it works by blocking pain receptors in your brain. Pethidine is only legal for use in the UK with a prescription from a doctor or midwife.

Pethidine is most commonly given to British women having a hospital birth, with studies suggesting around 25% of labouring UK mums accept Pethidine as pain relief.

Often used before having an epidural (pain medication that numbs your body from the waist down), it can be used with other painkilling medications, like gas and air (Entonox).

What are the side effects of pethidine in labour?

Common side effects of pethidine in labour include:

• Nausea
• Vomiting
• Dizziness
• Sleepiness (sedation)

Common side effects of pethidine after labour:

• Itchiness
• Difficulties urinating
• Constipation
• Shallow breathing (respiratory depression)

Source: Pethidine Patient Information Leaflet

In rare cases, studies show pethidine can cause seizures, which is why it is not recommended for women with epilepsy.

Sedation and efficacy of pethidine

A 2020 review of various painkillers used in labour found that pethidine is more likely to make you feel sedated (drowsy or sleepy) than other painkillers. Many women find that pethidine can make them feel less in control of their labour because of this sedation.

Some studies have found that pethidine only has a modest pain-relieving effect.

Real mum's experiences of pethidine

Sheree, mum of one told us

"Pethidine didn't really control my pain as much as I was hoping. However, it did make me really sleepy, all I wanted to do was go to sleep. I didn't really feel present at my own labour, so I don't think I would use it again."

Davina, who has four children, really liked pethidine during her first labour and found it helped her relax.

"I had a small dose of pethidine which really helped me relax and brought down my blood pressure. The idea of giving birth had worried me for months before. Pethidine was really helpful because the sedative effect was just what I needed to relax into labour".

How does pethidine in labour affect the baby?

As pethidine is an opiate drug, it can cross into the placenta through the umbilical cord and therefore affect your baby. If you use pethidine in labour, it's important not to use your placenta for placenta encapsulation.

Pethidine use in labour can cause:

• Your baby's breathing (respiratory depression) to be affected
• A less alert baby at birth (likely more sleepy)
• Baby to be less interested in feeding for the first few hours

Source: Lactmed Database, 2021

It's best to use pethidine in the early stages of labour. This will reduce the likelihood of any side effects in your baby. You might worry about taking pethidine because of the potential effects on your baby. However, your healthcare team will know when it's right to use pethidine and when it's not advisable. Remember that your obstetric team have lots of experience in using pethidine for pain relief in labour.

Obstetric Anaesthetist Dr Stephen Jones explains, "Pethidine can build up in the baby's blood and that's why I would only recommend having one or two doses. Usually, there's no problem with giving pethidine early in labour. We will need to monitor baby after birth if you have pethidine just before you deliver".

What happens if my baby is affected by pethidine?

Most babies born after pethidine is used in labour are unaffected. Worries about your baby are natural, but it's rare for pethidine to cause major issues.

If your baby needs assistance to breathe, this will mean some time in the neonatal unit. As pethidine is short-acting, it really won't be long until your baby is completely normal again, back in your arms.

Doctors can give your baby medication (naloxone) to reverse the effects of pethidine. However, the evidence for naloxone used in this way is low-quality, according to this review from 2018.

Paediatricians will be on hand right away if needed. They will make sure your baby is looked after and know exactly what to do.

How long does pethidine last?

Pethidine works quickly, usually within about 10 minutes. It will last for 2-4 hours (Source: UK Medicines Compendium).

If you have a long labour, you can be given pethidine again once it has worn off.

https://www.youtube.com/watch?v=qFv-YiyouEQ

Is pethidine in labour suitable for everyone?

Pethidine may not be suitable for you. It's important to talk to your midwife and/or consultant about pain relief while you're writing your birth plan.

You should not take Pethidine if you have a diagnosis of:

• Some liver or kidney issues
• Epilepsy
• Asthma, sleep apnoea or Chronic Obstructive Pulmonary Disorder (COPD)
• Low blood pressure (hypotension)
• Myasthenia gravis (which causes muscle weakness)

Source: Pethidine, British National Formulary, National Institute of Clinical Excellence (NICE)

When to discuss pethidine in labour with your health team

You must discuss pethidine with your healthcare team if you have any other illnesses. Especially if these conditions affect your muscles, breathing or neurological abilities.

If you are taking other medications, you will need to know if there are any worrying drug interactions. Interactions happen when drug side effects combine in a way that can make you unwell. If you have certain long-term, chronic illnesses, your healthcare team will help you understand which pain medications are a good choice.

Pethidine: the pros and cons

Video: Old Wives' Tales to predict the sex of your baby

Gas and air - also known as Entonox - is a medical gas, commonly used for pain relief in labour. Breathed in using a mouthpiece, it gives relief within just a few seconds and only lasts for the duration of each contraction.

Gas and air can be used in all birth locations: at home births, at midwife-led units and in hospitals. Although it can make you feel nauseous or giggly, it has relatively few side effects, which makes it a popular choice for labouring mums.

Consultant Obstetric Anaesthetist, Dr Simon Jones told us, "Gas and air is a really common option for UK mums and it's safe and easily available wherever you give birth. It's most effective when you have a good technique, timing breathing with contractions. Some mums get through their whole labour with gas and air whereas other women use it with other medication, too" 

When do you use gas and air in labour?

Gas and air can be used as often as you like once you've been admitted in labour. It's used to relieve the pain of contractions, so is most useful when they come on - rather than in between each contraction. Hospitals have it supplied to most labouring rooms, through a wall port. If you are giving birth at home or in a midwife-led unit, you will use a mouthpiece attached to a metal canister.

Entonox is composed of 50 per cent oxygen and 50 per cent nitrous oxide - also known as laughing gas. As it can be prescribed by a midwife, it's available for use at whichever location you choose to birth (home, midwife-led unit, or hospital?).

Studies show it works similarly to other painkillers, which stop pain receptors in the brain from working. It's rated very highly by labouring mums and 77 per cent of mums use it, according to research by the UK's Care Quality Commission (CQC).

Dr Jones, Consultant Obstetric Anaesthetist, told us, "Gas and air is a very effective pain reliever in labour. A lot of labouring mums, like gas and air because it makes them feel in control of the pain. The pain-relieving effects kick in seconds after you breathe it in, so you can time it just right, as a contraction begins. "

Side effects of gas and air

• Nausea
• A feeling of being high (euphoria)
• Dizziness
• Dry mouth
• Sleepiness

Source: British National Formulary, National Insitute Clinical Excellence (UK).

Most side effects are temporary and will go away quickly after you stop breathing it in. Commonly used in early labour, it can also be used with other labour pain relief options, like pethidine, and before having an epidural - a highly effective, spinal pain relief for labour.

Gas and air does not affect your baby. Because gas and air is breathed in, it goes straight to the pain-relieving receptors in your brain. Studies show that there are no appreciable effects on babies at birth from using gas and air in labour.

How long does gas and air take to wear off?

Within 30 seconds after breathing in Entonox, there is a fall of about 35 per cent of the drug in your body as you breathe it out, as verified by the manufacturer.

Most people feel completely normal within about 5 minutes of stopping Entonox, according to a study by Zacny et. al.

Is gas and air better than an epidural?

Weighing up the use of Entonox versus an epidural isn't a simple question: it depends on your point of view. It's important to remember that you can have an epidural and use gas and air together. Some women go through their entire labour using gas and air, whereas others later choose to have an epidural.

Gas and air is most commonly used in the first stages of early labour.

Only a few studies have directly compared epidural with gas and air. When it comes to weighing up pain relief alone, studies in 2018 have shown that epidurals are superior to gas and air for pain relief. This is especially true in the later stages of labour.

However, epidurals have more side effects, which can include:

• headaches (1 in 100 women will have a headache in labour)
• longer labour according to some obstetric anaesthetics advice

Only you can answer the question of whether Entonox is better for you than an epidural, after weighing up the evidence. This is harder to do if you're a first-time mum, with no reference to what labour is like.

You might think you would prefer to have only gas and air. Then, when labour starts, you might find the pain is worse than you expected. It's ok to be flexible in your approach. Remember that your birth plan for pain relief is not set in stone. There's no shame in changing your mind and many women do, once labour begins. Your medical team will always support you in making decisions. Every labour is different. Even if you went through previous labours without an epidural, you might decide that you want one this time.

Dr Stephen Jones, an expert in anaesthetics for labour says "We don’t judge people for changing their mind - your pain relief choices don’t have to be absolutely fixed in place. It’s always worth finding out the pros and cons of each option. However, if you would like an epidural, it's usually easier to do when you're in the earlier stages of labour. If you think you do want an epidural, discuss it with your midwife sooner rather than later."

Gas and air pros and cons

Pros

• the effects do not last very long (a few seconds or minutes)
• Some mums say gas and air gives them a sense of control over their pain
• You can stop taking it when you want to
• It does not affect the length of labour
• It has no impact on your baby
• Mums say it's very effective and quick pain relief
• Use gas and air at home, at a midwife unit or in a hospital

Cons

• Entonox can make some women feel sick
• Repeated use can make your mouth feel dry
• Nitrous oxide impacts the environment, according to climate research on the ozone layer it "will remain in the atmosphere for more than 100 years.”

Related video: Old wives' tales for predicting the sex of your baby 

Having an epidural is an injection into the back, which is given to women during childbirth. One of the most effective types of pain relief in labour, it can only be given by an anaesthetist, when you choose to give birth in a hospital.

It goes into the "epidural space" in your spine and will usually numb all sensation, from the waist down. According to research by the UK's Care Quality Commission, around 30% of women opt for an epidural for pregnancy. We talked to Consultant Obstetric Anaesthetist Dr Simon Jones to find out all you need to know about epidural side effects and how they work. He told us, "There are lots of myths about epidurals and their effects. Most of those have been disproven. We know epidurals are very safe, for you and your baby. Epidurals are also the most effective form of pain relief for labour, what's known as the "gold standard".  Dr Simon Jones, Consultant Obstetric Anaesthetist

What is an epidural for pregnancy?

An epidural is given as an injection into the 'epidural space' in the spine. Epidurals stop you from experiencing pain in labour. Once they have given you the anaesthetic and painkillers, your anaesthetist will leave a small plastic tube (catheter) inside your back. This is so that the medicine can be "topped up", when necessary.

Epidurals are considered the most effective type of pain relief for labour, according to studies.

Some evidence suggests that epidurals for pregnancy can increase the length of labour and make it more likely that you will need an assisted birth. Assisted birth means using forceps (large metal 'spoons') or ventouse (suction cup) to help you birth your baby.

Dr Simon Jones, a consultant anaesthetist, told us "epidurals work on the pain channels in the spinal cord and central nervous system. We use a combination of anaesthetic and painkillers (analgesic) in epidurals."

Are epidurals painful?

A lot of women are worried about getting an epidural for pregnancy and how much it might hurt. It's normal to feel worried about a medical procedure you've never had before.

The good news is that your anaesthetist will numb the area before they insert the needle. The procedure to numb your back ready for the epidural might feel a little uncomfortable. Some women feel a stinging or burning sensation. However, the initial anaesthetic used will work quite quickly to stop you from experiencing any pain when the epidural needle and catheter is placed.

In some cases, the insertion of the epidural needle can cause a sharp, "shock" feeling. This doesn't happen to everyone but can be surprising. It happens when the needle hits a nerve. It is momentary but quite intense.

How long is an epidural needle?

It can sound scary, but an epidural needle is longer than the ones used for vaccinations. The needle is also wider than other hypodermic needles, as it is used to insert the plastic catheter.

The sizes of needles used for epidurals vary. Medical guidance suggests the most commonly used needles are 3.5 to 6 inches long. Your anaesthetist will choose which needle to use on the day, based on your body.

If you have a high BMI, you will be offered the chance to see an anaesthetist to discuss your birth plan. They can assess you in clinic and discuss your epidural for pregnancy. Your anaesthetist might need to use a slightly longer needle to reach the 'epidural space', )(where the medication is injected), than in those with a lower BMI.

The catheter in your back will stay there until your baby is born. This is so that medication can be given to you throughout labour. You will also need a urinary catheter and an intravenous drip for fluids.

https://www.youtube.com/watch?v=Bi0u8ARwev8

Epidural side effects

Epidural side effects vary from woman to woman. Some of them are more common and others are very rare. It's important to weigh up all the epidural side effects before you consent to the procedure.

1. Low blood pressure (hypotension)

Studies show that epidurals for pregnancy can lower your blood pressure, which can make you feel dizzy and sick. However, your blood pressure will be checked regularly throughout labour and after birth. If your blood pressure drops too low, your healthcare team can give you fluids and medications to make you feel better quickly.

According to the Epidural Info Card by the Obstetric Anaesthetists' Association (OAA), 1 in every 50 women will have a significant drop in blood pressure.

2. Difficulty having a wee

As an epidural numbs your lower body, you won't be able to walk to the toilet. When you opt for an epidural, a nurse will put a urinary catheter into your bladder, through your urethra. This will direct urine into a bag next to your bed. The amount of urine will be monitored to make enough is coming out. Sometimes, after an epidural, some women might struggle to feel when they need to urinate. Usually, this effect wears off quickly.

A study by BMC Pregnancy Childbirth shows that in some rare cases,  epidurals can cause postpartum urinary retention. This means women sometimes struggle to empty their bladders (urinate).

3. Severe headache

Considered uncommon for the majority of epidurals (around 1/100 cases), some people will have a severe headache after an epidural. This is known as a "post-dural puncture" headache (PDPH). It is caused by a puncture to the dural sac, which contains fluid within the spine. This results in a leak of fluid, which can cause a very painful headache. However, this will usually get better over a few days.

If you have a PDPH, seek help from your midwife or GP. More about PDPH and treatment is available from the Obstetric Anaesthetists Association in their leaflet.

4. Ineffective pain relief

In a small number of women, the epidural does not work properly. Sometimes you might need the epidural to be repeated. You may be offered other types of pain relief in labour. This happens in 1 out of every 8 women according to the Epidural Info Card, Obstetric Anaesthetists' Association (OAA)

Other side effects include:

• Temporary drowsiness
• Feeling itchy
• Nausea

In extremely rare cases, some women might experience severe injuries. A study published in the British Journal of Anaesthesia suggests an incidence rate of around 1.8 per 100,000 cases. This is so rare that it's not something that many anaesthetists have any experience of.

Speak to your midwife about your birth plan if the chance of rare side effects is causing you anxiety.

How long does an epidural last?

It takes about 20 minutes for an epidural to begin working and it will last for the entirety of your labour. This is because the epidural catheter stays in your back the entire time. An epidural ensures continual pain relief. If you decide you would like to stop receiving epidural drugs, it can be removed quickly.

There isn't much evidence on exactly how long epidurals last after removal. The effects of an epidural can vary for everyone, depending on how long you have been in labour and which drugs were used. Recovery from an epidural also depends on how long you've been receiving anaesthetic and painkillers.

According to the NHS, you will usually start to regain feeling in your body within a few hours once it is removed. You must not drive for at least 24 hours after an epidural.

At what stage is an epidural given?

Usually, doctors recommend you are not given an epidural until you are in "active" labour. The NHS definition of active labour is when your cervix is around 3-4cm dilated.

Some studies, including this 2021 research, suggest that having an epidural before you are 6cm dilated can increase the length of your labour.

Dr Simon Jones, Consultant Anaesthetist in Obstetrics recommends asking for an epidural early. He says "A epidural is more likely to be effective when you're not really struggling with the pain. Early is better, so if you do want an epidural, put it in your birth plan. Ask your midwife about pain relief as soon as you arrive at the labour and delivery suite."

How many cm is too late for an epidural?

Though it's recommended that you ask for an epidural early, that doesn't mean you can't have one later in labour. Some women might start labour feeling that they don't want an epidural, but then change their mind. There's no shame in changing your birth plan, especially if labour has been very long and tiring.

Consultant Anaesthetist Dr Simon Jones confirms "it's never really too late to give an epidural, unless the baby is arriving." He explains, "what's important is having the time to establish an epidural before the baby arrives. Otherwise, you get all the risk of the epidural, for none of the benefit. The other thing to consider is whether you can sit still while we safely provide the epidural. This is far harder to do if you are in advanced labour."

Can you feel the baby coming out with an epidural?

Some women worry that an epidural will stop them from connecting with their labour. Whether or not you will be able to feel the baby coming out with an epidural  for pregnancy depends on various factors, including

• How long the epidural has been in place
• When you received the epidural (early or late in labour)
• How effective the epidural is for you

Some women will not feel anything after an epidural, whereas others will still feel the pressure of contractions.

Is an epidural right for me?

It's important to let your healthcare team know what you want from an epidural for pregnancy. Some women will want total numbness, so they can feel as little of the pain and discomfort as possible. Others may want to know that they will feel more when it's time to push.

Discussing your pain relief threshold and what you expect from labour with your midwife will help you decide whether an epidural is right for you. You can change your mind and accept an epidural, or go into labour and decide you don't want one. The decision on pain relief in labour is always up to you.

Related video: Old wives' tales for predicting the sex of your baby 

While some women are keen to make use of all available drugs to make labour pain-free, others won't want any. There is no one right path for any labouring mum and you can always change your mind. Whether you want to go with the flow and see how things happen or opt for pain relief from the start, it’s entirely up to you.

Bear in mind, that the pain relief options available to you in labour will depend on where you have your baby. If you’re giving birth in a hospital, you will have access to the full range of drugs for pain relief in labour. You can also use more holistic approaches, like relaxation techniques or water birth. If you’re giving birth in a midwife-led unit or at home, your options will be more limited. That’s because some pain relief drugs can only be given by a doctor. For example, an epidural can only be given by an anaesthetist at a hospital. However, some medicinal pain relief in labour, like gas and air, pethidine and morphine, can be prescribed by a midwife during a home birth or at a midwife-led unit.

To find out more about the different types of pain relief available to labouring women, we talked to consultant Simon Jones, an obstetric anaesthetist from Northumbria and Benash Nazmeen, a midwife in Sheffield.

Pain relief in labour

Back massage and a warm bath

Staying comfortable in the early stages of labour is important to help you relax and keep labour going. Bear in mind, that you’ll likely be without medical support at this time, as you’ll need to wait until your contractions are closer together before you head to the hospital (or your midwife arrives for a home birth). Many women find gentle back massage soothing for those initial labour aches and pains. A warm bath is also very relaxing and helpful for first contractions. Some labouring women describe these as feeling like period pains.

Mum of three Anna told us, “There’s something so soothing about stepping into warm water. As it envelops you, the weight of the water holds you like a hug and any movements you make are slow and steady. In water, there are very few restrictions on your movement like there can be on a bed. It’s the softness of it all really, which I think helps you to focus inwards and on what your body is able to do.”

It’s important to make sure that you call the midwife when your waters break. They will ask you to keep an eye on your labour timings and call back when contractions are close together and becoming more intense. You should also call for advice if your baby’s movements change, you’re unable to deal with the pain or if pain doesn’t fade away in between contractions. Smelly or discoloured waters or any vaginal bleeding also means an immediate call for assistance.

Breathing and relaxation techniques

Many women use relaxation techniques to “breathe through” their contractions and help them stay focused during early labour. Midwife Benash Nazmeen told us “Breathing and visualisation techniques are great for getting you in a calm state and feel like you have an awareness of what is happening for you. Guided relaxation can be helpful as well - so some people imagine flowers opening and flourishing to give them the idea of a sense of journey or progress as their contractions increase in intensity.”

Breathing techniques are one of the most common methods of pain relief. There’s not been a lot of research on how effective breathing techniques are for pain relief in labour. However, one study of 2,400 mothers, discovered 48 per cent found breathing techniques useful. Another study by Yuksel et al found breathing exercises reduced perceptions of pain and “recommend breathing exercises” for “pain management and shortening the duration of labour”.

Hypnobirthing

Hypnobirthing is the idea of using positive statements, (“affirmations”) with relaxation and “visualisations”. Hypnobirthing teachers recommend practising relaxation through pregnancy, so when labour starts, you can have a relaxed state of mind. It was originally developed by hypnotherapist Marie Mongon in the 1980s.

Midwife Benash told us, “Some people think that hypnobirthing is a bit airy-fairy and not for them. It's all about self-management and self-soothing. Relaxation techniques of hypnobirthing can stop you from going into the “fight or flight” reaction. This reduces the chance of adrenaline slowing down your labour. Not all techniques work for everyone. You can find out what works for you when using hypnobirthing to relieve pain in labour”.

Liza, mum of 5, who used hypnobirthing told us, “I simply imagined I was like a lotus flower as each surge or contraction happened. I knew I just had to get through each one and each powerful brought me closer to meeting my beautiful twins. I know that hypnobirthing helped me stay calm. The doctors didn’t realise how far I’d progressed until they noticed baby crowning. I seemed far calmer than they had expected”.

One of the largest studies on hypnobirthing for pain relief in labour was Werner et al’s 2013 study. This study found women using hypnobirthing rated labour as better than those who did not use the techniques.

A 2016 review of nine studies - taking into account the experiences of 3000 birthing women - found that women who did hypnobirthing were 27 per cent less likely to use drugs for pain relief. However, the researchers did not find a reduction in the use of epidurals and there wasn’t enough evidence to conclude it made a significant measurable difference in pain relief in labour.

Recommended hypnobirthing books

Position and movement

Many TV shows and movies show labouring women on their backs, with their feet up in stirrups and a doctor waiting to catch the baby. In fact, around 68 per cent of women report giving birth in this position.

However, this position, (“lithotomy”) is one of the worst positions to give birth in. If you look at your anatomy, lying on your back angles your pelvis. This means your baby and you have to work against gravity.

Research on MRIs of pregnant women shows us that the pelvis is wider when squatting and on hands and knees than on the back.

The upright position in labour

A 2017 study reviewing positions for women in labour found the upright position:

• Made labour happen faster
• Reduced the need for assisted deliveries (using instruments to help birth)
• Meant fewer episiotomies (cuts to the vaginal area to assist birth)

However, these differences were quite small and the evidence was not found to be overwhelmingly strong. They concluded that more research is needed on the benefits of positioning in labour.

Birthing balls for position in labour

Many women find the use of large, inflatable birthing balls (Amazon | from £22.95) useful for pain relief during labour. Bouncing on the ball during pregnancy and early labour can:

• Be meditative
• Give your abdomen support
• Help with back pain
• Reduce overall labour pain

One Taiwanese study showed birthing balls help mothers with reducing pain and shorten labour. The study said birthing balls mean a “shorter first-stage labour duration [and] less epidural analgesia”.

A larger study also studied the evidence on birthing balls. It looked at 220 labours and discovered birthing balls:

• Reduced how much pain women experienced
• May help support the perineum (the area between the vaginal opening and anus)
• May increase the effectiveness of contractions
• Help gravity to enhance the movement of the baby through the vagina
• Decreases pain in the back
• Distracts labouring women from labour pain
• Promote comfort and relaxation

TENS machines for pain relief in labour

TENS (transcutaneous electrical nerve stimulation) machines (£29.99 | Boots)  are a drug-free method of pain relief for pregnancy and labour. They use a small, battery-powered machine to deliver small amounts of electrical stimulation to nerves. The theory is that the electrical signals stimulate the natural painkilling response. This releases hormones called “endorphins”. These are often known as “feel-good” chemicals as they reduce pain and enhance mood.

When using a TENS machine you will feel a mild buzzing sensation and you can easily control the level and frequency of the machine.

You cannot use TENS machines in or near water, or with heat. They can be stopped or started at any time and can also be used during pregnancy without adverse effects on you or your baby.

One large study from 2017  concluded there was limited evidence that TENS machines provide any relief from pain in labour. Smaller studies, including research by Shahoei concluded TENS machines do reduce labour pain.

Waterbirth for pain relief in labour

Waterbirth was first recommended by the UK Department of Health for pain relief in labour in 1993. It’s become increasingly popular ever since. The Care Quality Commission’s 2019 survey showed 19 per cent of women used a birthing pool during labour.

There is a lot of research and evidence about both the safety and benefits for mother and baby when it comes to waterbirth:

• Many large studies of several smaller studies (a meta-analysis) show that waterbirth is as safe as “land birth”.
• One study conducted over 12 years, showed waterbirth reduced tears and postnatal bleeding.
• A major review of 15 studies looked at 3663 women’s labour in water, concluding that water birth reduces your likelihood of having an epidural.
• Research by Declercq et al. and a study by Eberhard et al concluded water birth was as effective for pain relief as opioids.
• A study by Gayiti and other research by Thoeni found water birth shortened labour and provided good pain relief.
• A study reviewing over 18000 water births concluded water birth is safe for mother and baby. Research on waterbirth has been shown to provide good pain relief in labour, meaning women ask for less pain relief  (Nutter et al).

However, water birth is less common in America. In April 2021, the American College of Obstetricians and Gynaecologists stated they are against birthing in water.

The UK’s guidelines for women in labour recommend the use of water birth for pain relief in labour.

What should I do if I want a waterbirth?

If you decide you'd like to have a water birth, you should discuss this with your midwife. Depending on where you want to have your baby, you can have a water birth in hospital, a birth centre or even at home.

If you want a home birth in water, you will need to buy or arrange a pool rental. Some doulas provide birth pool rental services and your midwife may be able to recommend a reputable place to buy one.

Some mums enjoy birthing in a pool that other local babies have been born in. If you're using a preloved birthing pool, you will need to buy a birthing pool liner (Universal Pool Liner, Home Birth Supplies| £27.99).

Pain medications in labour

Gas and air

Gas and air, also known as Entonox, is one of the most common forms of pain relief used during labour. It is safe for both mother and baby. Composed of 50 per cent oxygen and 50 per cent nitrous oxide, midwives don’t need a doctor to prescribe it. You can use gas and air when birthing at home, in a midwife-led unit or in a hospital. Consultant in Obstetric anaesthetist, Dr Simon Jones told us, “Gas and air is one of the most common forms of pain relief in labour. Some people get through all of labour using it but it relies on a good technique. Timing its use with contractions is important for maximum effectiveness”.

Nitrous Oxide is the active ingredient and works when you inhale it. Similar to opioid painkillers, research shows it works on receptors in the brain to reduce pain sensitivity and perception.  In the UK, the most recent CQC report reveals gas and air is the most popular form of pain relief in labour: 77 per cent of women use it when giving birth.

Pros of gas and air

• short-acting, meaning the effects do not last very long (seconds to minutes)
• many women like the sense of control over their pain
• Stop taking it when you wish
• No impact on labour progression
• No impact on the baby
• Very effective and fast at relieving pain
• You can use gas and air wherever you choose to give birth
• No need for extra monitoring

Cons of gas and air

• Can make you feel sick
• May dry out your mouth
• There are major concerns about the effects of nitrous oxide on the environment. Research reveals it can impact the ozone layer. The report suggests "nitrous oxide (gas and air) used by women today during labour will remain in the atmosphere for more than 100 years."

Epidural for pain relief in labour

Safe and effective, epidurals have been around since the early 1920s, when Spanish doctors first described anaesthetic injection into the “epidural space”. This area is filled with cerebrospinal fluid, just outside the spine’s nerves.

Having an epidural is when a fine tube (catheter) is placed in your back. Through this tube, local anaesthetic and painkillers are delivered to your spinal cavity. The epidural catheter will remain there for the duration of labour. It takes about 5-10 minutes for the anaesthetist to do. Epidurals are what Consultant Anaesthetist Dr Simon Jones calls “the gold standard” in pain relief for labour.

As epidurals are complicated, they can only be performed by a highly trained anaesthetist in a hospital. It's recommended you ask for an epidural early in labour, because it can be more difficult to put in as contractions get stronger.

Pros of epidural for pain relief in labour

• Studies show an epidural is the most effective form of pain relief in labour
• Quick to place, it has a relatively fast onset of pain relief in labour
• Limited side effects - they will not make you feel sick or drowsy
• Usually no effect on the baby
• No higher risk for caesarean

Cons of epidural for pain relief in labour

• You may need to have your baby's heart rate monitored
• An epidural will limit your movement
• Can cause low blood pressure
• Epidurals can cause an increase in your temperature
• You can have difficulty passing urine
• 1 in 100 women will experience a severe headache in labour
• Some women may experience temporary (1 in 1000 women), and severe or permanent nerve damage (1 in 24,000 women). Yet this evidence suggests this is rare.
• Can make it harder for you to push during labour
• Might not work well (1/10 times it may need replacing)
• Can be harder to place in women with a high BMI
• Research shows epidurals can increase the length of labour

Pain-relieving opioid drugs

There are a few different opioid drugs that may be offered to you during labour. Not all drugs are available at all hospitals. It may depend on your local health authority which drugs you are offered. Opioid painkillers all work in a similar way - they block the pain receptors in your brain.

Given as an injection into your muscle, opioid painkillers can be given by a midwife and common ones used in labour are morphine, diamorphine and pethidine. These drugs are not available if you are giving birth at home.

Obstetric anaesthetist Dr Jones says that opioids might not be right for everyone as pain relief in labour. “For some women, these medicines can make them feel like they’ve had a bit of a ‘funny turn’. They can act as a sedative, though diamorphine is less likely to do that. Diamorphine is more popular for that reason - it is a purer version of the drug and it’s more predictable in terms of its side effects”.

Pethidine is commonly used as pain relief in labour. However, this drug can have an effect on the baby's ability to breathe and feed. That's why it is best used in the earlier stages of labour. Most opioid drugs can be used alongside gas and air. However, if your baby is affected, don't worry as the doctors will be prepared for this and will help your baby with any extra support they need.

Pros of opioid injections

• Opioids can help you relax and relieve anxiety
• Most opioids do not affect the baby when given at the right time in labour
• Effects are usually quick, but short-acting

Cons of opioid injections

• Some studies have found that opioids are less effective than gas and air and
• Research reveals that Pethidine only has a modest effect
• Diamorphine has been rated as a ‘poor’ painkiller in some studies
• They can make you feel sleepy or sick
• Opioids may slow your breathing

PCIA: Patient-controlled intravenous analgesia (remifentanyl or fentanyl)

If you cannot have an epidural, you might be offered Patient-Controlled Intravenous Analgesia. This might be called PCIA by your doctor or just "Remi".

The drugs used in this type of painkiller are very strong opioids. You will have a needle in your hand, attached to a pump. When you feel pain you can press a button to request a “top-up” of the drug.

Remifentanyl is the most powerful of the opioid drugs available in labour.

Dr Jones, an expert Obstetric Anaesthetist, says "It can disconnect you from the experience of labouring and make you very drowsy, so it’s not right for every labouring woman”.

Remifentanyl is very potent and has a powerful effect. That's why it's not right for everyone. Research shows it’s short-acting, lasting for a contraction or two, but it is incredibly strong. You need strict, one to one care and sometimes oxygen is needed to help you breathe. This is because there is limited evidence it can impact on the mother's breathing.

If you do need to use it, because you can't have an epidural, you will be monitored very carefully by a team of professionals. There's no shame in needing such a strong painkiller, especially if you have a medical condition that means you will need it to help you give birth.

Pros of remifentanyl/fentanyl PCIA

• You control the amount of pain relief given
• Can be used with gas and air
• Works very quickly and is very strong
• Useful if you cannot have an epidural, but need strong pain relief

Cons of remifentanyl/fentanyl PCIA

• It may affect the baby when it is born (slow breathing)
• Baby might find first feeds difficult
• Monitoring for the baby during labour might be required
• Extra oxygen may be needed
• It can make you feel sleepy or sick
• May increase the need for forceps

What’s the best method of pain relief in labour for me?

Many women start labour with a clear idea of what they want from pain relief in labour. Others decide to simply “go with the flow” and see what pain relief in labour they need at the time.

Whatever you decide during planning, it’s important to understand things can change. Whether it’s your first labour or even your third or fourth baby, every labour is different. It’s common to change your mind as time goes on. Your medical team will always support you in your decision.

Some women decide they want to have a drug-free labour, and then find they struggle with pain. Remember that it is not a competition. There are no prizes for getting through labour without drugs. It’s really ok to change your mind at any time. Don’t feel like you’ve ‘failed’ if you decide that labour is too painful. Every baby and every mother’s labouring experience is different. Even if you sailed through previous birth experiences, it doesn’t mean you can’t accept pain relief now.

What the experts want you to know about pain relief

Many pain relief options during labour are fast-acting and can provide almost instant relief. Consultant anaesthetist Simon Jones does recommend asking for an epidural early. It is far harder to do an epidural when contractions increase in frequency and strength.

Simon Jones, Consultant Anaesthetist told us: “Seeing a mum who wants an epidural at the last minute isn’t ideal and it can make putting one in really challenging, meaning it’s less likely to be effective. No one will judge you for changing your mind.  It’s worth considering the pros and cons of each option so you can give truly informed consent. Start small and work your way up, until you feel your pain relief during labour is well managed.”-

Midwife Benash Nazmeen says: “Making a calming environment, wherever you are birthing is essential. This will help you control your pain relief in labour. You need to cocoon yourself. Turn the lights down and have a holistic approach to comfort. Take care of all your senses and trust your birth partner to advocate for you. Ask lots of questions during pregnancy and in labour to get that sense of control. Use a range of pain relief methods during labour to find what is right for you”.

Every woman’s experience is different and whatever you choose will be the right decision for you at the time. What's important is being aware of all the pros and cons. You should talk to your birth partner about what you do and don’t want to be offered during labour, and always be prepared to change your mind.

Michelle, who had two epidurals, said “I had an epidural and I was able to relax and rest and then my labour progressed without issue. I had another epidural in my second labour without hesitation and it was great, enabled me to rest.”
Hannah, who has a two year son, said “I only wanted gas and air because I was really curious what contractions felt like and wanted to experience them. Also I didn't really want an epidural. The thought of having to keep still while in pain was much much scarier to me than the thought of being in pain.”

Which pain relief in labour will I have access to?

Your pain relief in labour options will depend on where you choose to give birth.

Remember, your pain relief choices are flexible and you can change your mind at any point. Midwife Benash told us, “There are a lot of tools in your kit. Pain relief during labour relies on staying calm, so the only tension there should be is in your uterus, during contractions. Use things that make you happy to create that calming environment and use all of your senses to comfort and ground you. Concentrating on the pain or discomfort can amplify it. You won’t feel it as intensely if you’re able to focus and use your own self-soothing techniques alongside any medications you might want. Find what works for you to allow you to be calm and as relaxed as possible to meet your baby”

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As you get closer to your due date, you may begin to wonder about all the different types of contractions in pregnancy. Perhaps you're experiencing contractions now and you're not sure what to do. We've spoken to registered midwife Sheena Byrom about what to expect. 

Sheena Byrom of All4Maternity, who has been a Registered Midwife for over 40 years, compares contractions in pregnancy. Recognising and distinguishing between types of contractions in pregnancy can be confusing. You might start feeling some contractions in pregnancy as early as the second or third trimester, but these usually won’t be the start of labour.

Sheena told us, "Distinguishing between types of contractions is about frequency, duration and intensity. Early contractions feel like period pains. They can usually relieved easily to start with. However, active labour contractions are very intense. They help dilate and thin (efface) the cervix. They are powerful surges that push your baby down.”

Contractions in pregnancy

1) Braxton Hicks contractions

Braxton Hicks contractions are often known as 'false labour pains'. Although they happen when the body is getting ready for labour, they don't indicate that labour has actually started. Midwife Sheena Byrom says Braxton Hicks contractions in pregnancy "can be very confusing". However, she explains, "Braxton Hicks contractions don't increase in intensity. They're rarely painful, they're temporary and rarely have a pattern."

Braxton Hicks contractions in pregnancy are tightenings that many women will find uncomfortable. Medical studies show they can start at 6 weeks but won’t be felt until you’re in your second or third trimester. Sometimes known as “practice” contractions in pregnancy, they help your uterus ready itself for labour.

Recognising Braxton Hicks contractions Braxton Hicks contractions in pregnancy vary in strength and how long they last. They do not form a recognisable pattern. They happen infrequently and are uncomfortable rather than painful.

What do Braxton Hicks contractions mean? Studies show that Braxton Hicks contractions in pregnancy can happen when you’ve not been resting enough, you have a full bladder or you have not had enough to drink. They don’t mean that you are about to start labour. They are completely normal, but not all women will experience them.

How to deal with Braxton Hicks contractions If you’re feeling uncomfortable because of your Braxton Hicks contractions, visit the toilet, sit down and have a drink. If you’re worried about your contractions and you have any vaginal bleeding, your waters break or you are in a lot of pain, contact your maternity unit immediately.

2) Early labour contractions

Early labour contractions are an important first step towards meeting your new baby. Midwife Sheena Byrom explains, “They may feel uncomfortable, like period pains, and they differ from Braxton Hicks because they will eventually increase in their intensity. The earliest contractions in pregnancy don’t necessarily open your cervix. These early contractions soften and thin (efface) your cervix. This helps it move it into position, ready for the later stages of labour”.

Why can early labour contractions start?
According to many experts, “the exact sequence of events that leads to uterine contractions is still largely unknown”. However, studies show that hormones, including oxytocin, progesterone and oestrogen, play an important part in starting labour. Early labour contractions in pregnancy can be accompanied by other early signs of labour. These include loss of the mucus plug, back pain and sometimes even diarrhoea. Some women will find their water breaks before contractions start, whilst others might not. The individual experience of early labour is different for every woman and every pregnancy.

When should I be concerned about early contractions?

Most women won’t experience these first early labour contractions in pregnancy until they reach the third trimester. However, some women might experience them too early. If you start to feel early labour contractions that are painful and regular earlier than 37 weeks, contact your maternity unit immediately.

When to tell your midwife you are in labour

If you are at term (37 weeks onwards) then you are likely to welcome labour, even if you are a bit anxious. It won’t be long until you meet your new baby. Call your maternity unit for advice if you’re worried. Always call for help if you experience smelly/discoloured waters, a change in your baby’s movements or you are bleeding.

If you are planning to give birth in hospital or a birth centre, your midwife will tell you to stay at home until your contractions are in a regular pattern. They will tell you what you should be looking for in your contractions. They'll help you recognise the pattern in terms of frequency, duration and intervals between contractions. However, if your contractions are strong and you need pain relief, don’t hesitate to get in touch with them.

3) Labour contractions

The contractions in pregnancy when you are in full, active labour can be very intense. “Contraction timing is the way that midwives measure how far along in your labour you are. Contractions, in general, get more and more frequent and last longer. Some women can have a very fast labour, whereas others will take longer,” explains Sheena, who has seen many births in her 40 years as a Registered midwife.

If this is your first labour, contractions in pregnancy may last from 8 to 12 hours. Labour contractions in pregnancy differ from early labour contractions in that they open your cervix. Your cervix must reach 10cm dilation before your baby can be born vaginally. This is what midwives mean when they talk about being “fully dilated”.

What do labour contractions feel like?

Labour contractions are a far more intense version of the earlier contractions. Some women prefer not to refer to them as painful, and talk about “surges”. Most women opt for pain relief to help them cope with the experience. Contractions begin at the top of the uterus, which is just under your ribs when your baby is fully grown. They squeeze your uterus to press your baby down on your cervix. This helps dilation and will eventually push the baby out. Many women find that they are unable to talk during the most intense labour contractions. They may even make noises that they find quite surprising.

Dealing with labour contraction pain

If you are having a hospital birth you will have access to the full range of pain relief. . This includes an epidural, pethidine and gas and air. If you are having a birth centre birth or a home birth, your options vary. You might be limited to gas and air, paracetamol and the natural relief of water birth.

Everyone’s experience of labour is different. The amount of pain experienced is individual to the mother. It can really vary depending on how many babies she has birthed and baby's position. There are a range of pain management options for dealing with contractions in pregnancy. Take a look at our advice on pain relief in labour.

“When I gave birth for the first time, I found that making low, deep noises like a cow was actually quite helpful in regulating my breathing. My husband and I were quite surprised by it and it made us laugh in between the contractions. Just call me Daisy, I said!” - Naomi, mum of three.

5) Back contractions

Studies show that around 33% of women will experience low-back pain in labour. However, not all women will have back contractions in pregnancy. Back contractions happen when your baby is head down, but facing towards your stomach. Whilst this is a variation of a normal position for a baby, it can be quite uncomfortable. Sometimes your baby will turn to face your back before labour starts. However, when your baby stays in this position, it can cause back contractions in pregnancy and labour.

What do back contractions feel like?

Your baby’s head will be pressing against your spine and your tailbone as you progress through your labour. This is what makes back contractions in pregnancy painful. The contractions will be felt in your lower back, just above your tailbone. Your obstetrician or midwife may be able to help you rotate your baby to relieve back labour pains. Sometimes the back pain will increase during a contraction. Some labouring women find that the pain doesn’t change in between their contractions. A warm bath can be helpful for easing back contractions in pregnancy. You might also benefit from over the counter pain relief and TENS machines.

How will back contractions in pregnancy affect my birth?

Whilst back labour is often described as more painful, this is not true for everyone. Every labour and birth experience is different. Giving birth to your baby is unlikely to be affected by this variation of a normal baby position. If you are finding back contractions painful, ask your midwife for the pain relief you need.

When to worry about back contractions

If you start to feel back labour contractions earlier than 37 weeks, contact your maternity unit immediately. Speak to your midwife if you are in the early stages of labour and you are experiencing high levels of pain. They may advise you to come in earlier or give you advice for dealing with the pain at home.

Nina, 35, a mum of two sons, experienced two labours with back contractions: “I spent so much time in the bath when I was pregnant with my boys. The warm water really helped in early labour. I also used a TENS machine, which felt miraculous at times. The relief it gave me was so helpful.”

6) Sex contractions in pregnancy

Unless you have been told not to have sex or to masturbate during pregnancy, it is safe to do so. It can be a great way to relieve stress, connect with your partner and enjoy yourself. However, many women find that having sex can lead to discomfort afterwards. This might be in the form of contractions. This is caused by the hormone oxytocin, which is involved in increasing contractions in pregnancy during birth.

After-sex contractions in pregnancy are normal and usually nothing to worry about. They are usually caused by oxytocin, which is often called the “love hormone”. Oxytocin is often increased after an orgasm. A rise in oxytocin can also be prompted by the sensual touch involved in making love to your partner. Masturbation is also usually safe in pregnancy. It can cause the same contractions in pregnancy for similar reasons - an increase in oxytocin.

What do after-sex contractions in pregnancy feel like?

The contractions prompted by sex or masturbation are usually not painful. They can be uncomfortable and should subside fairly quickly. Similar to Braxton Hicks contractions, they may feel like period pain.

Can having sex cause labour contractions in pregnancy?

Some women might find that they go into labour after sex. There are lots of myths around natural ways to induce contractions in pregnancy. However, having sex seems to be one of the few ways to do so with any evidence that it works. There are many conflicting studies, but some scientists think labour could be prompted by prostaglandins naturally present within sperm. Prostaglandins are one of the hormones involved in starting labour. They are present during natural labour and used in medical inductions.

Having sex is unlikely to help you to go into labour and start contractions in pregnancy too early. It’s not advisable to have sex after your waters have broken due to the risk of infection.

When should I be concerned about contractions in pregnancy after sex?

If you are less than 37 weeks of pregnancy and you experience contractions, get in touch with your emergency maternity helpline. This is especially important if they do not go away or increase in intensity.

If you are at term - 37 weeks of pregnancy and contractions after sex continue and intensify,  you are probably going into labour. Get comfortable and monitor their frequency and intensity. Always contact your midwifery unit for further advice.

Comparing the different types of contractions in pregnancy

Many women find understanding the difference between the different types of contractions difficult, especially if this is their first birth. There is no universally-agreed definition of all the stages of contractions in pregnancy and labour within the field of medicine.

The defining differences between types of contractions in pregnancy are the intensity, frequency, duration and interval of time between them.

Why and how should I track my contractions in pregnancy?

The timing of contractions in pregnancy is an important indicator of how far along you are in labour. They also indicate how well you are progressing. Midwives will use this information to judge when to advise you to come into the birth centre or hospital. If you are having a home birth, your contractions in pregnancy and labour will influence when they are called out. You can time contractions with a stopwatch: simply write down what time they start and stop. However, when you are experiencing a combination of emotions, this might not be the easiest way of tracking your contractions.

Many women find that modern technology helps them keep control of what’s happening. There are many apps that will help you keep track of your contractions. One that has had plenty of recommendations is the Freya app. The app won the Made for Mums award in 2020. Designed by the Positive Birth Company, it helps you relax in between each contraction while you time them.

Understanding your contractions is key to keeping calm and staying in control. A positive mindset is crucial for staying calm and keeping contractions increasing in intensity. The app will even make a recommendation of when to contact your midwife.

DOWNLOAD - FREYA APP | £2.49

Related video: Old wives' tales to predict your baby's gender

Why do women give birth lying on their backs? Well, you might be surprised to learn that it seems to have much more to do with history rather than biology. 

If you're pregnant, you'll have lots of questions about childbirth, especially as you get closer to your due date and start to formulate a birthing plan. One of these - why do women give birth lying on their backs? - crops up a lot and you're not alone in questioning if it has always been this way, and if there are other positions that might make labour easier. Knowing the history about why so many women give birth lying down might help you make a better informed decision about how you want to give birth and we asked experts for their input too:

Why do women give birth lying on their backs?

The idea of women giving birth lying on their backs on a bed wasn't actually introduced until around the 1700's, according to hypnobirthing expert Katharine Graves.

Writing in her well-known publication The Hypnobirthing Book, Katharine explains that women only began to give birth flat on their backs because King Louis XIV wanted to see his mistress give birth - not because it aided labour.

At the time, women generally laboured squatting on stools, and the midwife would usually be at floor level to meet the baby.

'But kings don't grovel on the floor, so it all had to be frightfully proper and his mistress had to lay in a bed,' Katharine writes.

Women in the King's court copied this, and midwives found they had much more difficulty getting babies out when mothers lay flat, so doctors were called in a lot more often.

Soon word spread and everyone started giving birth whilst lying down, believing that if it was done in the royal household then it must be for the best.

This trend for lying down has stuck, particularly in the Western hemisphere. Interestingly, the media often perpetuates it.

'I think the reason we see less squatting these days is because so many women now choose to birth in hospital,' says birth educator and yoga instructor Lucy Flow. 'We see in movies and on TV that women go to hospital to give birth and lay on their backs. So, a pregnant woman giving birth in hospital is likely to do what she's seen since she was little,' she explains.

'Women have only started to birth on their backs in relatively modern history,' adds women's health expert and founder of Forage Botanicals Natasha Richardson. 'When birth was an event which occurred in the home, surrounded by other women, a pregnant person was likely to move into whatever position suited them,' she says. 'Often, they'd crouch or be on all fours. This promotes a posture where gravity can do a lot of the work.'

'We continue to give birth on our backs because of the physical design of hospitals and beliefs about birth,' adds Natasha.

Is it better to give birth squatting or lying down?

Katharine, who is a leading hypnobirthing teacher and associate member of the Royal college of Midwives, claims that squatting is one of the best and most natural positions for childbirth, because "you have gravity on your side and you have the maximum pelvic capacity [in this position]."

Squatting can help to deliver a baby more swiftly. During childbirth the baby moves down towards the coccycx, which has a natural curve up. When squatting, this flexes and moves as your baby makes its way down the birth canal.

'Lying on your back whilst giving birth decreases contractions,' says Natasha. 'It makes a back-to-back birth more likely, makes gravity work against you as the baby is pushed towards your back and needs to come out over your coccyx (you're essentially pushing uphill), and it decreases the baby's pressure on the cervix and therefore decreases cervical dilation,' she argues. 'Squatting is better as it does the opposite of everything I've mentioned.'

But if lying down can make giving birth harder, why is it an option? One reason is that it can help medical staff. 'Giving birth on your back is convenient for caregivers,' explains Lucy. 'Especially if there's a medical reason for requiring a better view, such as the woman consenting to an episiotomy, a vaginal examination, or forceps.'

'Personally, I recommend women give birth in any position that opens the pelvis and uses gravity,' she continues. 'Most importantly, it should be a position the woman feels comfortable in. Sometimes that position is squatting. We are mammals. Mammals are designed to give birth upright. Evidence shows that being upright and using gravity has much better outcomes for the woman. This is not only physical. Lots of women report feeling more confident, in control, and positive about their birth experience when using upright positions.'

'If a woman wants to be on her back because she feels good there, then of course she should. Often it's more a case of her not realising the benefits of being upright,' adds Lucy.

Many women find that having a water birth allows them to move about upright more freely, but what about other positions? 'Lying on the side can let you rest without creating the same amount of pressure on the coccyx as being on your back,' says Natasha. 'While being on all fours helps the baby swing around so its back is away from your back. If the mother then rests her upper body on a surface (such as a birthing ball, £22.95, Amazon) – so her chest is above her hips – this helps the baby slide towards the cervix, increasing oxytocin and contractions,' she advises.

'Standing is also a good posture but you might find this difficult in later stages of labour,' she adds. 'Therefore, holding onto your partner's neck like you're on a dance floor may help. Essentially keeping your chest above and forwards from your hips is usually the most beneficial position.'

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Water birth might be becoming a bigger trend but what should you take into consideration before deciding if you should have one or not?

The pros and cons of a water birth are widely discussed, with many mums saying the benefits they experienced included having a more relaxed labour.

A water birth is the process of giving birth in water. This could be in a deep bath or birthing pool, and can be in a hospital, birthing centre, or at home. In some cultures, water births also take place in the sea or a river.

Being in water during labour can help with pain, but mums who haven't experienced a water birth before may be concerned about potential risks.

What is a water birth?

'A water birth is when a baby is born under water, usually in a specifically designed birthing pool or bath, or it is when the mother is in the water for the birth,' says Katie Headlam, midwifery sister at the Fatima Allam Birth Centre, which is part of Hull University Teaching Hospitals NHS Trust.

'Some women spend their labour in the pool, then come out to give birth, while others stay in the pool to give birth. It will all depend on what suits you at the time,' says Mervi Jokinen, practice and standards professional advisor for the Royal College of Midwives.

'Your midwife will monitor your baby throughout labour and the birth,' she continues. 'It is possible the midwife may ask you to come out of the water for short periods for examinations, such as for a vaginal examination, although you can stay in the water for these if you choose.'

'Don’t worry about your baby being born in the water: the midwife will be there to bring them gently to the surface,' she adds. 'Your baby will breathe when it comes out of the water and meanwhile will be getting their oxygen through the umbilical cord. You can stay in the water to birth your placenta as well.'

Who can have a water birth?

'Most NHS trusts will have a guideline recommending that women choosing to labour and give birth in water should be in good health, have experienced a normal pregnancy with no risk factors and should be in spontaneous labour at term,' says Katherine Hales, a senior midwife and national coordinator for the Association of Radical Midwives.

'Women who wish to have a water birth should explore any risks and benefits and discuss these with the clinical team,' she adds. 'Generally speaking, there are some situations where a water birth may be definitely unadvisable. These include if a woman has a condition which puts her at risk of loss of consciousness or seizures. Or there are concerns that the baby is compromised or premature.'

'Most women can have a water birth and spend all or part of their labour in water,' says Mervi. 'Unless your baby is in a breech position, if you are having twins or triplets, or if your labour is induced.'

If you're not sure whether you'll qualify, Katherine recommends that 'any woman who is interested in labouring or giving birth in water should explore the possibilities with her midwife.'

Is it safe to have a water birth?

'If you birth in water it will be a vaginal birth,' explains Mervi. 'But they are just as safe as a birth out of water. You would need to come out of the water, however, if you need an intervention such as ventouse or forceps.'

'There are situations where there may be risk if there are pre-existing medical conditions or the suspicion of these,' adds Katherine. But aside from that a water birth could actually be of benefit. 'There is evidence that using water in labour and birth may reduce the level of medical interventions in labour. And one may improve overall outcomes for the mother and baby.'

Water birth pros and cons: What are the benefits and the risks?

Water birth benefits

• Positive birthing experience
• More relaxed and comfortable labour
• Eases pain of contractions and labour
• Aids mobilisation for the birth
• Immediate skin-to-skin contact with baby
• Greater sense of privacy
• Babies born in water can be calmer
• Less likely to need medical interventions (such as a ventouse birth or episiotomy)

While it may not be for everyone, there are numerous reasons to consider a water birth. 'The main benefits of a water birth relate to the positive birthing experience,'says Katie. 'In particular, in terms of a woman’s level of comfort and control.'

'The water can also aid mobilisation for the birth,' she adds. 'And most babies born in water also have immediate skin to skin contact with their mothers, which has many benefits in itself, such as better thermoregulation, which can help with breastfeeding.'

'There is likely to be a sense in which the woman feels that she has more privacy and safety in the water due to the fact that she is generally alone in the pool,' adds Katherine. 'Midwives don't usually aim to join her in the water. The importance of this is due to the fact that the optimal interaction of the hormones needed for labour to progress well rely on the woman feeling safe and private; anything perceived by her to be an invasion or giving her alarm may cause labour to slow down or stop.'

She adds: 'And, anecdotally, babies born in water often seem calmer and in very good condition at birth.'

'Many women find that birthing in water helps them to relax, helping to lower blood pressure, and say it eases the pain they feel during contractions and the birth, so they need less pain medication,' says Mervi. 'Also, because you are buoyant in the water, it's easier to move into positions that suit you and help you to feel more comfortable.'

'The evidence also suggests that if you labour in water, you are less likely to need interventions such as a ventouse birth and you may be less likely to need an episiotomy,' says Mervi. 'This is where a doctor or midwife may need to make a cut in the area between the vagina and anus (perineum) during childbirth to help prevent tearing of the vagina during the birth.'

Risks and 'cons'

• Unpredictable availability of birthing pools in hospitals
• You cannot have an epidural or opiate pain-relief drugs if having a water birth
• Can slow down your contractions
• Small chance baby may try to take a breath spontaneously under the water
• Getting in and out of the water for pain relief may add stress to the process

'There is a very, very small chance that a baby may try to take a breath spontaneously under the water themselves before being brought up to the surface,' says Katie. 'However, if this occurs midwives take appropriate action to help.'

If there are concerns that the mother will bleed she will require a normal birth. This is because 'midwives are not able to measure blood loss after the birth as accurately in water,' says Katie. 'Other risks and complications may apply if a woman has a water birth when it's not been recommended,' she explains.

'Risks may exist where there were concerns about the health and wellbeing of the mother or the baby,' says Katherine. 'If caregivers are concerned, the woman would be requested to leave the pool and continue on "dry land". This is with a view to further monitoring or intervention if required.' she explains. 'Opiate drugs would not be given to a woman in water because of the effect on her ability to move and react quickly.'

'Sometimes labouring in water can slow down your contractions,' says Mervi. 'Though if this happens you can come out of the water to continue your labour.'

Is a water birth less painful and can you have a water birth with an epidural?

'Some women report that labouring in water eases the contraction pains and the pain of the birth itself,' says Mervi. 'Unfortunately, if you have an epidural it is not possible to have a water birth. This is because of the need to monitor the epidural site and keep it sterile and secure. You can have gas and air while in the water but you'd need to come out if you have a pain-killing injection such as pethidine, which can make you drowsy. You can get back in after a couple of hours once the effects of the injection have worn off.'

Having a water birth in hospital - what to expect

If you decide to have a water birth in hospital there are some positives and some drawbacks.

Hospitals have fully equipped birthing suites and some women feel safer in a hospital environment as there is quick access to intervention should they need it.

'If you're giving birth in a midwife-led unit or hospital they'll have dedicated rooms with a specialist large bath where you can give birth, or to get into to help relieve labour pains,' explains Mervi. 'These birthing pools have a special plumbing system. They often have mood lighting in and around the birthing pools,' adds Katie.

'However, there may be situations in hospital where there are not enough staff or pools available,' says Katherine. 'So there may be more constraint placed on the woman to ensure she doesn't enter the pool "too soon" before labour is established. This is to prevent a pool being blocked by a woman who turns out not to be quite established in labour,' she explains.

'Hospitals and birth centres may discourage partners from getting into the birthing pool,' says Katie. This won't be an issue at home.

What to expect if having a water birth at home

At home, a birthing pool is usually inflatable and it's the birthing partner’s responsibility to fill it, empty it and clean it after.

'It's still possible to have a water birth at home by hiring an inflatable pool,' says Mervi. 'Your midwife will take your temperature from time to time to make sure you are not getting too hot. You don’t have to stay in the water all the time. You can get in and out as it suits you. Just make sure you have someone to help you in and out in case you feel a little wobbly. Your partner can get into the pool with you if you want.'

'Labour often slows or stops when women are feeling nervous or uncertain,' says Katherine. This is something that can happen when a woman leaves her home to head to hospital. 'While labour at home is often less subject to that effect as the woman is in her familiar environment. Partners and other family members are free to move around and there is access to food and drink more readily. This will be the right decision for some women. Others may feel more confident to be in a hospital or birth centre.'

How much does a water birth cost?

'In the NHS, all births are free. No matter what type of birth you have or where you give birth,' says Mervi.

'At home, some people choose to purchase a birthing pool for a home birth. This usually costs a few hundred pounds, or around £30-£250 for birthing pool hire,' says Katie.

Most women use an NHS midwife, although there are private midwifes that will charge: 'The cost of booking a midwife to provide care requires on-call commitment. It can be 24 hours a day for up to five weeks depending on when labour occurs. And attendance for the labour,' says Katherine. 'She would also provide antenatal and postnatal care and other aspects of maternity care such as routine screening. The cost for this service depends – expect it to be around £4,000-£6,000 for a whole antenatal, birth and postnatal package,' she explains.

You could also hire a doula, although they aren't hired to deliver a baby but to provide support for the mother throughout childbirth, or postnatally.

If you've had a vaginal birth, you'll know that the stitches you might need after birth can be uncomfortable and sometimes painful. 

Some women even say that the soreness from their stitches after birth - especially in the first 24 hours after birth - is on a par with the pain of labour.

Even if you've had a particularly tough delivery, fear not. There are several ways to soothe the soreness and help you manage the pain until your stitches heal.

There are also preparations you can make during your pregnancy that could help reduce the likelihood and severity of trauma from giving birth, such as practising perineal massage from 34 weeks in pregnancy or applying warm compresses for an easier labour.

However, if you do sustain a tear or an episiotomy and require stitches after childbirth, knowing how to look after your body will help you with the healing and recovery process. Whether you have experienced a tear or not, soreness around the perineal area after vaginal birth is extremely common and giving yourself time to recover properly is key to ensuring a smooth transition into motherhood.

Here, Lesley Gilchrist, registered midwife and co-founder of My Expert Midwife, shares her top tips on how to best to look after the perineum after the birth of your baby to ensure optimal recovery.

How to soothe stitches after birth

Keep the area clean

First and foremost, Lesley recommends keeping the area where you’ve had stitches very clean by bathing or showering at least twice a day, as this will minimise the risk of infection. It's best to use plain warm water or specialist Epsom Salts. My Expert Midwife bath Soak for Bits contains premium Epsom Salts as well as tee tree, bergamot and calendula essential oils to provide instant pain relief, and arnica to soothe muscle aches and reduce swelling or postnatal perineal discomfort. After your bath, carefully pat your stitches dry and avoid rubbing with a towel. Your midwife or GP will be able to advise further on this.

Use soothing products

An icepack wrapped in a cloth, or clean muslin can be used to tackle perineal discomfort by gently pressing it on the painful area. Be sure not to apply too much pressure though, and always be gentle with yourself.

Another option is to apply soothing (natural) products to the area. For instance, My Expert Midwife’s Spritz for Bits provides instant relief for perineal soreness, bruising and swelling after childbirth, and is safe to use immediately after birth.

Change sanitary pads regularly

Change your sanitary pads at least every four hours as this reduces the likelihood of getting an infection in the area. You can buy maternity pads which are softer, longer and more absorbent. The good thing about maternity pads as well is that they're a lot less likely to irritate stitches, as they don't have the same plastic coating that regular sanitary pads do.

Start pelvic floor exercises as soon as you feel able

Pelvic floor exercises will strengthen your muscles and help you to feel in control of your bladder and bowel, both in the present and later in life. Start practicing your pelvic floor exercises as soon as you feel able - start gently and build up the intensity gradually.

Keep an eye out for abnormalities

If you feel as though the pain is worsening as the days go by, or if you notice an unusual smell, swelling or oozing from the area, make sure you contact your midwife or GP for advice. If it is becoming infected, you may require a course of some antibiotics.

Wash your hands

It seems obvious, but make sure to wash your hands before and after going to the toilet to limit the spread of bacteria. It's important to maintain a good level of hygiene when recovering, to prevent risk of infections or irritations. 

Take regular pain relief

Whether or not you have had stitches, childbirth is a demanding experience, and you will feel the effects of it in the following days. Remember to take regular pain relief that you’ve been prescribed or bought over the counter- this will help to relieve any soreness and keep you more comfortable.

Eat healthily and drink water

A diet high in soluble fibre and vitamins (with plenty of fresh fruit and vegetables) will help your body to heal from any wounds, such as an episiotomy or a tear. Fruit smoothies are a great option. Drinking plenty of water will also aid the healing process and help to make bowel movements easier to pass.

Take time to rest

While not always easy, as a new mum, taking time out to rest and recover is vital for the healing process. Try to sit or lie in positions that feel most comfortable for you. You may need to change these regularly to ensure maximum comfort.

If you have any concerns and stitches after birth contact your midwife or GP

Most importantly, if you have any concerns about the progress of your recovery, contact your midwife or GP for a check up and advice. They are always on hand to make your transition into motherhood as easy as possible.

Video of the week:

If you're wondering whether to hire a doula for your birth, or what role the midwife plays, then we've got all the answers for you.

A doula and a midwife have a unique and important role to play in your birth plan. A midwife is a specialist who's qualified to deliver babies and care for a woman and her baby during pregnancy, labour and after the birth. A doula, on the other hand, can offer support, guidance and practical help throughout your birth and beyond. Some doulas may be trained midwives, but the term itself refers to a role that's not medically qualified.

Some women choose to have a midwife, others have a doula, or you can receive guidance from both. Anthonissa Moger, Founder of The Hypnobirthing Midwife explains: "A midwife looks after the clinical picture including observations of the baby’s heart rate, your blood pressure, documentation and managing any issues or complications. A doula’s role is to focus on your emotional wellbeing and support normality during the birth process. Although the roles cross over, it is wonderful to have both so that all of your needs are fully supported."

Should you get a doula or midwife? Here's what you need to know.

What to expect from your midwife What is a private midwife? What does a midwife do? What is a doula? The two types of doula What does a doula do? How do I find a doula?

What to expect from your midwife

A midwife is a medically qualified specialist who will support you and deliver your baby. Midwives can deliver your baby at home, in the hospital, or in a midwife-led unit (MLU).

Midwives don't have to call in a doctor unless there's a problem that requires medical assistance. A midwife can therefore provide total care from early pregnancy onwards, throughout childbirth and for both the mum and her newborn until the baby is 28 days old.

Midwives are closely supervised and have rules and standards from the Nursing and Midwifery Council which they must abide by in order to work legally as a midwife.

You and your baby's needs are a midwife's primary focus. She should share information with you and empower you to make decisions about your own care. Women who feel involved in the birthing process are more likely to feel in control of their pregnancy and birth, and therefore have a more satisfying experience. The Standards for competence for registered midwives from the Nursing and Midwifery Council, outline that among other things a midwife should:

• Communicate with women throughout their pregnancy, labour and the period following birth
• Determine and provide programmes of care and support for women which: are made in partnership with women and are appropriate to the needs, contexts, culture and choices of women, babies and their families
• Listen to women and help them to identify their feelings and anxieties about their pregnancies, the birth and the related changes to themselves and their lives.

What is a private midwife?

Some women choose to employ an independent midwife and opt-out of the NHS system. Private midwives guarantee the same point of contact throughout the process, rather than dealing with different NHS midwives at every appointment. Reports from the Royal College of Midwives have shown that continuity of care significantly increases the healthy birth rate and reduces Caesarean delivery. With continuity of care, mothers feel more supported, relaxed, and more empowered to have the birth they want.

Private midwives are often more experienced with complicated pregnancies and births such as VBAC, breach or twins. Private midwives can also deliver your baby at home or in your local hospital.

The cost of private midwife care varies. A complete package of care throughout pregnancy, birth and the postnatal period can cost between £2,000 and £5,000 according to the Independent Midwifery association (IMUK). IMUK is also a great resource to find a local independent midwife or for more information on independent midwifery.

What does a midwife do?

Before birth your private or NHS midwife will:

• Have regular antenatal appointments to check up on your health and the development of the baby
• Measure your bump, blood pressure, take urine or blood samples if needed, and check the baby's heartbeat regularly
• Answer any questions you may have about pregnancy or birth
• Run postnatal information sessions on how to breastfeed and care for your baby
• Help you make a birth plan
• Identify any high-risk issues such as the baby's position after 32 weeks
• Show you around the midwife-led unit if your hospital has one

During the birth your midwife will:

• Admit you into hospital or the MLU once you're sufficiently dilated
• Monitor you and the baby's health during labour. This could involve a membrane sweep or external monitoring.
• Consult you on any medical decisions if an intervention is needed
• Keep medical records of the labour and birth
• Deliver the baby safely

How to contact your midwife: You will be given the mobile number of one midwife or a team of local midwives to contact. At your first antenatal meeting your midwife will explain how best to get in touch with them. Some midwives are happy for you to text any non-urgent queries, or you may leave a message for a call back. "Do not worry about calling the midwife," says Lesley Gilchrist, Registered Midwife and Founder of My Expert Midwife. "They would much rather you contacted them for advice rather than stayed at home becoming worried and anxious!"

It's also useful to have your labour ward's direct number in your local hospital. If you need to speak to a midwife urgently, you can call the labour ward where they can advise you.

Can I change my midwife? Yes, if you don't feel comfortable with your midwife you can ask for a different midwife. Write or call the Head of Midwifery at your local maternity unit or call the hospital switchboard and speak to a Supervisor of Midwives. You can request a different midwife, and you don't have to give a reason unless you want to.

A midwife should be your advocate, give you appropriate advice, support you in your choices, and help you have a positive birth experience. If you don't feel this is the case, then you should report it immediately.

In case you don't feel happy with your midwife when you're in labour, it's essential that you ask for a new one. If you're not happy with your care, then either you or your birth partner can speak to the midwife in charge of the labour ward. It is within your rights to politely but firmly state that you'd prefer to have another midwife care for you.

Getty Images

What is a doula?

Doulas provide a similar service to midwives, as they advocate and support women throughout pregnancy and birth. However, they are not medically qualified and they usually work alongside medical professionals. You'll be assigned a midwife on the NHS, but there are only a small number of NHS-employed doulas, so you'll often have to hire one independently.

The World Health Organisation recommends that all women should have a companion present during labour and childbirth. The report showed that outcomes for women and babies were improved in the presence of continuous support, such as a doula.

What does a doula do?

A doula will meet with you, get to know you and your birth partner if you have one, and understand what kind of birth you would like to have. Whether it's at home, in hospital, or in a midwife-led unit, and if you're hoping for a gentle caesarean, vaginal birth after caesarean (VBAC), or a vaginal birth. They can also help you work through particular worries or doubts, and ensure they're not triggered during the birthing process.

Most importantly doulas advocate for you during the birthing process. The doula deals with any practical issues that arise such as liaising with midwives, doctors or administration, which means the mother can concentrate on giving birth, and the birth partner concentrates on supporting the mother. It's essential that mothers feel safe and supported during birth to maintain oxytocin levels and progress labour effectively. It's the doula's job to make that possible.

As Doula UK – the non-profit association of doulas in the UK – explains: 'The services offered by a doula vary greatly according to the needs of the women, couple or family that she is working with.' Doulas can just offer emotional advice and support, or they can be in labour with you and hold your hand every step of the way.

If a private midwife is out of your budget, doulas offer a continuity of care, which can complement and strengthen the midwifery services offered by the NHS.

What does a doula do during labour and birth?

Services during labour might include:

• Massaging the mother's back, shoulders, or points of tension
• Squeezing hips to relieve pressure
• Keeping water in the birthing pool the right temperature
• Getting the birthing partner or mother food and drink as needed
• Supporting the mother with breathing techniques
• Holding the mother in comfortable birthing positions
• Answering any questions the mother or birth partner might have
• Keeping the atmosphere feeling calm as possible
• Liaising with the midwives and doctors if there are any questions or concerns
• Helping the mother achieve her birth plan as much as possible

Can a doula deliver my baby?: Doulas are not hired to deliver babies, although in an emergency an experienced doula may well assist a birth.

Should I get a doula?: Only you can answer this question. If you are curious about the role a doula could play in your birth, you should contact a local doula to have an informal chat. There is no obligation to hire them, and it will give you a sense of value for money as well as the emotional value they might bring.

The two types of doula

There are two main types of doula:

• Birth doulas: support women and couples through pregnancy, labour, birth and the immediate postnatal time. These doulas often assist with alternative births and pain relief techniques.
• Postnatal doulas: support women and couples after the birth of their child in their own homes. Some doulas are able to fulfil both of these roles, whereas others specialise in a particular area.

Doulas are not regulated in the same way as midwives. They, therefore, cannot offer professional medical advice, only counsel and support. You may want to check that your doula has taken a Doula UK approved qualification and speak to their previous clients to check their credentials. You should also check your doula's insurance policy and sign a contract to ensure you receive a full, professional service.

How do I find a doula?

Doula UK has a database which you can search by postcode to find an available local doula. Most doulas work within a 25-mile radius, although some will travel further.

Initially, you just need to know your doula's fees and availability. You may want to have a no-obligation phone call to make sure their philosophy and attitude to birth suits you. Once you've settled on a doula, you can go into more detail about your birth options and the type of support you'll need. Birth doulas will meet with you at least twice, then be available via phone or email for questions during your pregnancy. At 38 weeks, they go 'on-call', so that you can let them know when you're in labour and they will attend immediately.

Postnatal doulas will start working with you after birth, and for as long as you wish. They can help you with various tasks, from successful breastfeeding techniques to help around the house. As Doula UK notes: 'Unlike a maternity nurse, a doula is not there to take care of the baby for you. Instead, a postnatal doula supports you to be the parent you want to be.'

Actress Danielle Brooks from "Orange Is The New Black" takes a real-life look at doulas, midwives, and the difference between them:

https://www.youtube.com/watch?v=O9zLvSRbV_E

Related video: Old wive tales for predicting the gender of your baby 

Why won't that niggling backache just go away? We look at the early signs that might mean that you're going into labour.

You can't predict exactly when you're going to go into labour when you're pregnant, but you can keep an eye out for signs of labour. Very early signs can begin up to a week before you give birth, so you can prepare yourself for the impending arrival.

Just as every labour is different, every woman's experience of the lead-up to labour varies. Some women don't notice any warning signs, while others have all the symptoms and realise that labour isn't far away. For most women, however, things start off slowly and build up until labour finally arrives.

What are the signs of labour to look out for? Make sure you read our guide on everything you need to know about spotting labour signs, including:

How do I know if labour has started? What is false labour What are signs of labour? Lower backache and feeling the baby has 'dropped' Contractions in early labour What happens when your waters break Is diarrhoea, vomiting and passing wind a sign of labour? Nesting in early labour What is a ‘show’ as a sign of labour When should to call the midwife

How do I know if labour has started?

You may experience some of the following early signs of labour up to a week before your labour starts. However you may not experience all of them, so don't feel like you have to tick everything on the list.

Do not worry if you've gone past your 'due date'. If you've had a healthy pregnancy, then your baby will arrive when it's good and ready. Whilst there are ways you can induce labour naturally, studies show that first-time pregnancies most often happen up to nine days past the 'due date'.

If you've had a healthy pregnancy, try not to become anxious about every twinge: you're better off relaxing and allowing nature to take its course. Once you really are in labour, you will most certainly know about it.

What is false labour?

The long latent phase, or false labour as it's often unhelpfully called, is when your body begins to show signs of labour and then eases off again. This is perfectly natural, and nothing to become disheartened about.

"It’s normal for labour to start slowly and build up gradually over a few days in a ‘stop start’ way," says Milli Hill founder of the Positive Birth Movement and author of the bestselling Positive Birth Book. "But sometimes this can worry people if they've seen dramatic births on TV where it’s all a chaotic emergency from the very first contraction!

"Sometimes labours that can’t get going are due to the baby being in a difficult position, but more often than not it’s just the body getting ready, like an orchestra tuning up before the big concert. If this happens to you, just try to relax and enjoy it. Get plenty of rest, eat well or get out in nature. Follow your body’s lead; if you feel like walking, walk, and if you feel like resting, rest. It’s a real gift to have a labour that starts slowly, as it gives you a chance to get mentally, emotionally and practically ready for what’s to come."

What are the first signs of labour?

Signs of labour starting are usually early indications that your body is preparing for birth. This includes the baby moving down and putting different pressure on your body, as well as hormonal changes necessary for birth to begin. Read our week-by-week pregnancy guide to understand how your body changes throughout pregnancy.

The most common signs that labour is on its way include:

1. Feeling that the baby has 'dropped'
2. Contractions or tightenings of the uterus
3. Urge to nest
4. Waters breaking

There is no one, definitive sign of labour. You may have one, all or none of the below before your labour journey begins. It is likely that you will experience some of the below, however. So if you're looking for signs of labour, here's what to expect:

Lower backache and feeling the baby has 'dropped'

Lower back pain is an early sign of labour. You might think that when labour is imminent that you'll have pains in your abdomen, but for some women, labour pain starts in their back. This could just be a dull ache, or a feeling of increasing pressure which is a good sign. Try to do some gentle stretches, or cat-cow yoga stretches on your hands and knees, to ease out that tension.

If you can suddenly breathe more easily it may be that your baby has dropped further down into the birth canal, which is a sign that the baby is preparing for birth. You'll also feel more pressure on your bladder, and need to go to the toilet more regularly.

Contractions in early labour

What is a contraction? A labour contraction is when the uterus muscles tighten and contract to open and widen the cervix. Contractions are also called a surge, rush or tightening to help birthing mothers maintain a positive mind-body connection.

Contractions build the muscle fibres up at the fundus, at the top of the womb, which creates a strong piston to move the baby down and through the birth canal. In hypnobirthing, you may hear the early stages of labour being described as the 'up stage', as contractions pull the muscles of the uterus up, which in turn opens and thins the cervix. This is followed by the 'down stage' once the cervix is fully dilated and the baby begins to descend the birth canal. Hypnobirthing practitioners recommend 'up' breath and 'down' breathing to help you navigate the contractions through this transition.

What do contractions feel like? Contractions feel like a tightening across your stomach and in your uterus. They move in a wave-like pattern through the uterus as the cervix begins to open and soften. Period pains are mild contractions, so they feel like stronger versions of those. In the first stage of labour, or the latent phase, you might feel irregular contractions. It can take several hours (or even days) before established labour begins with regular, strong surges.

What's the difference between Braxton Hicks and contractions?

You may have experienced some Braxton Hicks during your pregnancy, which is when the womb contracts. They are not 'real' contractions, but an indication that the body is getting ready. They may become closer together, more intense and more uncomfortable in the lead-up to labour.

Labour contractions are frequent and last longer than 40 seconds. When you're in full labour, contractions last about 30 to 90 seconds and come about five to 10 minutes apart. Braxton Hicks feel like contractions, but they are more irregular and don't follow such a fixed pattern or grow in intensity like true contractions.

Your waters will break as a sign of labour

Waters are the amniotic fluid inside the sac that protects the baby from infection or injury. When the baby is ready to be born, the sac breaks and the fluid leaves the body through your vagina. If you're leaking urine you should have some control over the flow. Also amniotic fluid smells different to urine. A single sanitary liner won't be able to absorb all the liquid.

Labour usually starts within 24 hours of your waters breaking, but it can take up to 48 hours for labour to start naturally after your waters break. On the other hand, for some women contractions start immediately after the waters break, which then grow in intensity until they're full-blown contractions.

What should you do when your waters break? If you think your waters have broken, or even if you're not sure, call your midwife or labour ward. They will determine whether you need to go to hospital. If your waters have broken early, you and your baby might be at risk of infection if you don't then go into labour. Your midwife may ask you to come into hospital.

Will my waters breaking hurt? No, breaking waters don't hurt. You might feel a pop and then a trickle or a gush of water. The liquid is clear and straw-coloured. If it's brown, green or any other colour you should contact your midwife as this could be a signal that the baby is in distress.

How much liquid is there when my waters break? Hypnobirthing Coach Annabel Hargrave says that "Sometimes water's breaking can be a trickle, sometimes it can be a gush. Interestingly women often think they are 'not in labour' until their waters break, which is not true. You can be in labour and your waters remain intact." This is called an 'en caul' birth. Either way, when your waters break it won't be a huge amount of water like you see in the movies.

Is diarrhoea, vomiting and passing wind a sign of labour?

This is thought to be because the body is clearing itself out in preparation for birth. You may also feel the need to go to the toilet more as the baby's head presses on your bowel as it moves down the birth canal. Yogabirth teacher and Hypnobirthing Coach Annabel Hargrave says that "The most common comment I get is a period-type pain or draggy discomfort. An upset stomach is quite typical too, as hormonal changes are asking the body to empty so some women can feel a bit sick.

Needing the toilet or passing wind can be a sign of labour coming. Sam Nightingale, clinical academic midwife at University Hospitals Coventry and Warwickshire NHS Trust and researcher at women’s health research charity, Wellbeing of Women advises: "Sometimes women experience loose stools in the early stages of labour. This can be associated with passing wind, but will not be experienced by everyone."

Nesting in early labour

Do you have an urge to tidy the house or cook up a storm? Pregnant women often have an urge to create a nice, safe home for their new arrival. This could be very practical, or it might feel more primal. But if you get this urge near your due date, it could be a sign that labour is on its way.

What is a 'show' as a sign of labour?

When you're pregnant the cervix is sealed by a plug of mucus to protect the baby. Birth is imminent when the plug releases from your cervix, perhaps with a bit of blood which is why it's also known as a bloody 'show'. Some women experience a show a few days before labour gets going and in some cases it's just a few hours before.

The plug is made of mucus, so it looks jelly-like and may be stained with a little blood or be brownish in colour. It could come away in one go, or in parts. you may notice it when you go to the toilet or on toilet paper after passing urine. If there's a lot of blood or the discharge is red, green or brown it could be a sign of complications. Call your midwife or your hospital straight away.

But, is white discharge a sign of labour? Yes, increased or thicker vaginal discharge can be a sign of labour. It might also be the mucus plug coming loose incrementally rather than all at once.

When should to call the midwife

If you think you're entering the early stages of labour, don't panic. Call your midwife or labour ward for advice. They will ask you a few questions and confirm whether you need to go in for a check-up. Even if they check you and send you home again, you'll be reassured that labour is progressing.

Lesley Gilchrist, Registered Midwife and Founder of My Expert Midwife, says: "It can be difficult to know when to call the midwife when labour begins, especially if it is your first baby. Labour is likely to continue more smoothly if you stay at home for as long as possible during the early stages. This is because hormones which help labour and birth progress work more efficiently when your body and mind are in a relaxed and comfortable environment.

"As an approximate guide, contractions should be coming around every three minutes and lasting around a minute. Although in women who have had a baby previously, the advice would be around every five minutes. Always call the midwife if you have any concerns such as baby’s movement patterns changing or bleeding.

"Do not worry about calling the midwife. They would much rather you contacted for advice rather than stayed at home becoming worried and anxious!"

Things to remember

Ultimately your baby will arrive when it's ready. You can try these natural ways to bring on labour, but if you've had a healthy pregnancy so far you might be better off resting and conserving your energy.

• Early signs of labour may be on and off again in a long latent phase. But do not be disheartened.
• Take time to rest and conserve your energy once you get any of the above signs of labour.
• You may not get all of the above signs before your labour begins.
• Carry on as normal

Anthonissa Moger, Founder of The Hypnobirthing Midwife and author of Holistic Hypnobirthing advises that "Early labour (0-4cm dilated) is often the longest part. The body is deciding whether to commit to going into labour and the cervix has to go soft and thin before it really starts to open — which is a big job to do!

"It is very common to have some niggles for a few days on and off. A good approach is to carry on as normal and try to relax and enjoy the last few days of pregnancy. All of the work your body is doing is valuable and you will get there."

If you're wondering what a membrane sweep is, whether you have to have one, and how painful it is, we've asked the experts, and the mums who've gone through it, and have everything you need to know.

Pregnancy naturally throws up so many questions such as what are the early signs of pregnancy, can you use nub theory to predict gender and what pregnancy cravings mean. And one such question you might have as you progress into the later months of your pregnancy is about the membrane sweep - a phrase you might have heard your midwife mention if you are past 40 weeks.

A membrane sweep, also known as a pregnancy sweep or cervical sweep, involves your midwife or doctor gently separating the membranes around your baby from your cervix. This aims to encourage the release of prostaglandins, which are hormones that can help bring on labour.

Membrane sweeps are offered to women in their first pregnancy from 40 weeks of pregnancy. Having a sweep is entirely your choice and is not routinely recommended. It's just one method you'll be offered for bringing on labour.

We look at the research and speak to expert midwives to understand the pros and cons of membrane sweeps, what they involve and how successful they are in triggering labour,

Pregnancy can be a transforming, confusing, exciting, and scary time for many women. That's why our guides are there to support and inform you through the journey, from the early signs of pregnancy and the cravings you can expect to our explanation of what causes that strange dark line on your pregnancy bump - the linea nigra.

What is a membrane sweep?

A midwife or doctor will use their finger in a sweeping motion to separate the membranes of the amniotic sac surrounding your baby from your cervix. The idea is that this will help to release hormones that will hopefully kick-start your labour. 

Whoever is doing the sweep will ask you to lie down with your feet together and your knees to each side. They then insert a finger and pass it around your cervix opening.

Sometimes, your midwife or doctor will suggest a 'Stretch and Sweep'. This means you're not quite ready for a membrane sweep, so the midwife will stretch and massage your cervix instead. This may begin to 'ripen' your cervix before a full sweep at your next appointment. 

If you're going for a sweep, wear a pantyliner or maternity towel in case of any spotting afterwards.

Anthonissa Moger, Founder of The Hypnobirthing Midwife and author of Holistic Hypnobirthing, says that the body must be ready for a successful sweep: "A sweep is the least medical of the induction pathway. It may be worth trying in order to avoid induction, but you can decline if it doesn’t feel right for you. A sweep will only work if your cervix has already started to soften, open, and come forward because your body is getting ready to go into labour. If your body hasn’t started to change the midwife may not be be able to reach your cervix at all."

What are the positive signs that show a membrane sweep has worked?

We spoke to registered midwife Lesley Bland, of My Expert Midwife, to find out what other signs. apart from labour starting, of course, shows the membrane sweep has been successful. 

"It is always difficult to say if a membrane sweep has worked because we don’t know if labour signs would have begun without it," says Lesley. "However, a sweep is said to have worked if either labour begins or pre-labour signs start within 48 hours of the procedure."

Signs Lesley suggests looking out for include:

• period-type pain or cramping, usually in the lower back or lower abdomen
• losing the mucus plug or having a blood-stained show
• contractions starting

Find out more about the most early signs of labour starting so you know when to get ready to meet your baby.

Does membrane sweep causes mucus plug loss?

Yes, a successful membrane sweep can lead to a 'show' or losing your mucus plug. 

Midwife Lesley says, "The mucus plug is a jelly-like substance which forms in the cervix to stop harmful bacteria and infections from travelling up the birth canal to your unborn baby."

"As the cervix starts to soften in the period leading up to labour, that mucus can start to come away. Sometimes it comes away as a single whole plug, while other times it may come away bit by bit. It might look like a clear or lightly bloodstained snotty substance in your underwear, or you might notice it when you wipe after a wee."

However, Lesley warns that the mucus plug coming away isn't always a sign that labour is starting. "There is no indication that losing the mucus plug means labour is imminent, but it can be an early sign that things are starting to change."

In fact, you may not even notice a mucus plug at all, even if labour is starting, according to Lesley. "It can be common for a mucus plug to be reabsorbed into the body once it has been dislodged from the cervix, meaning the woman will never see it. Our bodies are incredible, aren’t they?"

When will I be offered a membrane sweep?

Your midwife may suggest having a membrane sweep once you're more than 40 weeks pregnant if you're a first-time mum and at 41 weeks if you've had a baby before. However, they may discuss having a membrane sweep with you at one of your antenatal appointments, usually at around 38 weeks of pregnancy. Your midwife may offer you two or three sweeps before they suggest inducing your labour.

If you decide against a membrane sweep, you can wait for labour to start naturally or use a more formal method of induction if your midwife or doctor offers it, such as prostaglandin. 

However it's important to remember that any such medication is also optional. Induced labour can be more painful than a labour that begins of its own accord, because the body receives a relatively swift dose of hormones rather than a gradual increase naturally. Some mums find induction labours are more intense and painful. 

Remember, you can ask for a sweep, but you can also say no if you'd rather wait. If you do decide to wait, the midwives may want to keep an eye on your progress and the baby's health - but your main priority should be relaxing and not worrying about the fallacy of due dates.

Do I have to have a membrane sweep?

No, membrane sweeps are not compulsory and they do not form part of a routine examination. Medical staff should always ask your permission before conducting a sweep. They should also explain the process and implications to you. A midwife or doctor should never pressurise you into having a sweep.

"It’s absolutely your choice," says Milli Hill founder of the Positive Birth Movement and author of the bestselling Positive Birth Book. "You don’t have to feel any pressure to have a sweep if you don’t want one. But if you are happy to have one, then that’s also up to you."

What is the success rate of the procedure?

Research over the past 15 years suggests that membrane sweeping can be successful in inducing labour within 24-48 hours in approximately 20-30% of women at full term.  However, it's a hard stat to pinpoint. Registered midwife Lesley says, "It is almost impossible to attribute success ratings to a membrane sweep because we can't know whether it was the sweep that kickstarted labour or if the woman was going into labour spontaneously anyway."

"It’s one of those areas where we don’t have enough evidence,’" says Milli Hill. "A Cochrane review (which is a very reliable source) suggests that sweeps ‘might' reduce induction, but more research is needed on timing and efficacy."

Rebecca Dekker, the founder of Evidence Based Birth says that membrane sweeps potentially reduce the length of your labour, but only by four days: "If your membranes are swept at 41 weeks, this can lower your chance of having to go past 42 weeks and needing an induction at 42 weeks. It decreases your chances of going to 42 weeks from 41 percent down to 23 percent."

Because the cervix has to be slightly dilated to conduct a membrane sweep, the body is already in the process of initiating labour. So, some experts believe it's an unnecessary intervention.

Lesley agrees. "The closer to your due date you are, the more favourable your cervix is - meaning a membrane sweep is more likely to work." She also points out that if you've gone through labour before, your cervix may be more responsive to a sweep. 

You should always feel fully informed and supported about your decision to have a membrane sweep or not as part of your birth plan. It's important to understand the implications for having a caesarean too.

"We always advise women to discuss the procedure, if offered one, with their own caregivers using the BRAIN acronym," says Lesley. 

• B – Benefits associated with having a sweep.
• R – Risks associated with having a sweep.
• A – Alternatives to having a sweep.
• I – Intuition/Instinct – what is your intuition telling you?
• N – Nothing – what happens if you do nothing? In this case, if you don’t have a sweep.

Are membrane sweeps painful?

Unfortunately, yes. Membrane sweeps can be painful. One medical study found that 70 percent of women found that membrane sweeps were associated with significant discomfort, and one third of women complained of significant pain. Membrane sweeping can also cause slight bleeding and make your uterus irritable and with irregular contractions. Women have described the discomfort as something similar to a painful smear or period pains, to stronger cramping sensations.

Sam Nightingale, clinical academic midwife at University Hospitals Coventry and Warwickshire NHS Trust and researcher at women’s health research charity, Wellbeing of Women, warns that sweeps can sometimes trigger trauma too: "Some women find sweeps very uncomfortable and distressing. This is more likely if the neck of the womb is still quite far back, or also if a woman has experienced sexual trauma or previous birth trauma." If you are concerned about birth trauma, you can contact The Birth Trauma Association.

Mum Jo tells us, "I had one membrane sweep, which was really painful. To top it off I felt really sick afterwards - they had to put me in a bed to recover for half an hour until I could stand up and not feel like I was going to puke! It didn't work either - I ended up being induced and then had an emergency caesarean. So it doesn't work for everyone."

How long after a membrane sweep does labour start?

"How long labour may take after a sweep is impossible to be exact about," says Sam Nightingale. "It varies depending on how ready the neck of the womb is to be fully thinned out, central, soft and starting to open. These are all physiological processes that happen prior to labour and this is what the sweep aims to encourage."

You would expect positive signs of labour within 12 to 48 hours of having a membrane sweep, however. If it takes longer than this, it likely to mean that the membrane sweep hasn't worked and your body is not yet in labour.

What are the pros of having a membrane sweep?

Here are some potential pros, or benefits, of having a membrane sweep:

• You may avoid having a formal induction: Sweeps can allow labour to begin naturally, avoiding medical interventions like artificial rupture of membranes or prostaglandins.
• You may avoid a prolonged pregnancy: A successful sweep may prevent you from going too far past your due date, which increases certain risks to you and your baby. 
• No serious medical risks: When done properly, membrane sweeps are considered very low-risk compared to other induction methods.
• It may help you feel empowered: Having the option may help you feel more in control of your labour.
• It takes just a few minutes: There's little to no downtime compared to other options.

What are the cons of having a membrane sweep?

Here are some potential cons, risks or downsides, to having a membrane sweep, including:

• It can be painful: A membrane sweep can cause cramping or irritation as the membranes are separated from the cervix. Some women find this uncomfortable or painful.
• You may have some bleeding: There may be light bleeding or spotting afterwards.
• It might not induce labour: Sweeps don't always kickstart labour. The success rate of inducing labour within 48 hours is around 20-30%. So you may go through the process with no results.
• It might trigger ineffective 'tightenings': According to registered midwife Lesley Bland, sometimes a sweep can result in "exhaustion, multiple hospital admissions and, potentially, increased levels of intervention."
• You might need multiple sweeps: If labour doesn't start, some doctors and midwives recommend repeating the sweep 2 or 3 times, which can increase your discomfort. 
• It can be an invasive procedure: Some women feel membrane sweeps are an uncomfortable and invasive procedure they prefer to avoid.
• Your waters might be inadvertently broken during the sweep: "If this happens and you do not go into labour within 24 hours, most NHS Trusts will advise you to have an induction of labour – which you may consent to or decline," says Lesley.

Your midwife is there to reassure you. While some spotting and cramps are normal after a membrane sweep, you should contact your midwife or GP if you experience any unusual bleeding or severe pain. If you experience heavy bleeding, call 999. 

"You will be provided with information about things to look out for before you consent to a membrane sweep," says Lesley. "These include bleeding, your waters breaking, baby’s movements, pain, or signs of infection. You should alert your caregivers if you experience any of these red flags or have any other concerns following a sweep."

Still unsure? Watch this video to understand the pros and cons of a membrane sweep:

What happens if I don't have a membrane sweep?

If you have a healthy pregnancy it's OK to not have a sweep and wait until you go into labour. If your baby is breech or there are other complications, then you should speak to your doctor or midwife. You might want to try one of these 20 ways to have an easier labour too.

What other mums told us:

'I was dubious over whether a sweep would work or not. But I went in for the procedure and a few hours later I was in labour. It was a quick one, and in less than 24 hours I had my baby girl.'

Jo B

'I had two or three sweeps with my first baby and it was useless. A very unpleasant experience too. Some say it works but you never know if the baby was just ready.'

Lorna C

'I considered having a sweep for my first pregnancy, but I waited a little bit longer. Our gorgeous baby boy was born of his own accord just a few days later.'

Charlotte J

Getting ready to meet your new arrival? Get ideas and inspiration for baby names, including unique baby names and names inspired by nature. Plus, if you've not purchased your first buggy or stroller yet, check out our top recommendations.

From home birth to birthing centres, here's everything you need to know about birth plan options and what to expect in each environment.

Many women assume that they'll give birth at their local hospital, but there are several birth plan options available to choose from.

During your pregnancy, your midwife should discuss all the available options with you, regardless of whether this is your first baby or what sort of birth you've previously had.

Many celebrities including mum-of-two Sam Faiers have opted for home births and it was thought Kate Middleton would try it with her third pregnancy too.

Here we consider the pros and cons of home births, hospital births and birthing centres, to help you make the decision that's best for you.

Birth plan options - everything you need to know

Home birth plan

All the evidence, (and there's a great deal of it!) shows that in a straightforward pregnancy, it's as safe to opt for a home birth as to have a hospital delivery.

Women often think that any complications they had with a previous delivery will affect the birth this time round. But the fact is that mums-to-be who stay at home to have their babies will have far fewer interventions and are more likely to end up having a 'normal' birth.

Your midwife will be trained in resuscitation, and carries oxygen to administer to the mum or baby in an emergency. They also carry drugs that will help control any excessive bleeding that may follow the birth.

What are the pros of a home birth?

• You're in a familiar, comfortable environment without the elements of uncertainty and fear that can sometimes occur when a woman arrives at the hospital, and these may inhibit or prolong labour. Being at home means you and your partner are more in control.
• You have the freedom to move around as you wish.You can have as many people with you as you choose, including any other children you have. Likewise, you may prefer the intimacy of knowing that random members of staff aren't going to walk in.
• If you're transferred to a hospital in labour, you're still less likely to have a Caesarean than a woman who's booked in for a hospital birth.
• You'll get one-to-one care from a midwife throughout your labour, and towards the end of labour a second midwife will arrive to give extra support.

What are the drawbacks of giving birth at home?

• Pain relief is limited, you can't have an epidural at home.
• You'll have to hire (or buy) a pool yourself if you want a water birth.
• If there are any complications, your midwife will quickly arrange for you to be transferred to a hospital.
• While being in your own home can often help to relax a woman, some mums-to-be still find it more reassuring to be in hospital.

Questions to ask before having a home birth What's your community midwife's homebirth rate? How many women have they transferred to hospital in labour? What's the episiotomy rate? Will they look after you in labour?

Hospital birth plan

Hospital is the safest place for mums-to-be who are considered high risk. This could include women who have medical conditions, such as a heart problem, insulin-dependent diabetes, or problems during pregnancy such as pre-eclampsia, or premature birth.

If it's anticipated that a woman or her baby will need a high level of medical care or a special care baby unit, a hospital is the appropriate place to give birth.

What are the pros of a hospital birth?

• Obstetricians work in the hospital, which means that there are the facilities to look after women who need a higher level of intervention with their care.
• There's the facility to do instrumental (forceps/ventouse) deliveries or a Caesarean.
• The full range of pain relief options are available, including epidural, which is sited by an anaesthetist.
• If you have other children at home, you may want a night or two away in hospital just with your new baby.

What are the drawbacks of having a hospital birth?

• You're more likely to end up with interventions such as an episiotomy, instrumental delivery, Caesarean section, a drip to speed up contractions, pain relief, and also have a higher risk of infection.
• You're less likely to get one-to-one care or care from a midwife you know, midwives on the labour ward may have several women to look after.

Questions to ask before having a hospital birth What's the Caesarean section rate? What proportion have normal births? What's the induction rate? Is there a shortage of midwives? What's the episiotomy rate?

Birthing centre birth plan

This is usually a much smaller unit with care provided by midwives. They're sometimes located in the same hospital as the maternity units where the obstetricians work, but often occupy a separate building.

They're not considered high tech, and are aimed at women with uncomplicated pregnancies and no anticipated problems in labour.

Are birthing centres safe?

This is a safe option for a low-risk pregnancy. Some units assess women to see if their health is appropriately 'low risk'. Emergency equipment and drugs are available, but a woman needing intervention would be transferred to a consultant-led unit.

What are the pros of a birthing centre?

• A 'normal' birth is more likely when women are cared for by midwives in a birthing centre or at home.
• You have access to a birthing pool.
• If you share housing: live with friends or family members, you may feel more comfortable using a birthing centre than staying at home.
• Birthing centres are often less 'clinical' than hospitals, described as a 'home from home'.

What are the drawbacks of giving birth in a birthing centre?

• There's no epidural facility.
• You'll need to transfer to hospital in labour if complications arise (although quite often it's nearby).

When to decide

Some women prefer to have a clear plan laid out, but if you're unsure about where to have your baby, you can wait until you're in labour before you decide. It might sound last minute, but once the midwife has been to your home and checked you over, see how comfortable you feel. If you're relaxed and everything seems to be straightforward, then there's no rush to go anywhere. But if you suddenly feel you need to be in hospital, then that's also fine.

There's no essential 'kit' to get in for a home birth, but a few old towels can be useful. You can always tell your midwife that you're planning a home birth, but see how you feel on the day. Nothing is written in stone!

The most important thing is that you feel comfortable with wherever you decide to have your baby. It may be that you're a perfect candidate for a home delivery or having your baby in a birthing centre. But if, after talking with your midwife, you don't feel comfortable with these options, keep on looking. Eventually, you'll find what feels right for you.

How did you decide where to give birth, did your plan go ahead or did your little one cause a last minute change? We'd love to hear your experiences and tips so head over to our Facebook page! 

Doctors warn against growing trend for lotus births and here's the reason why...

Medical professionals are warning against the growing trend for lotus births. With some even asserting that there are 'no medical benefits' whatsoever to the alternative birth method.

Lotus births have gained momentum because of the belief that it helps the baby to continue absorbing prenatal nutrients as well as enhancing the bonding experience between mother and baby.

Some healthcare professionals are now claiming the lotus births are simply a fad, and shouldn't be taken as medical advice.

What is a lotus birth?

A lotus birth is believed to have originated in the East. Traditionally newborns are not separated from their placenta, meaning a lotus birth is the practise of leaving the umbilical cord and placenta attached to the newborn baby. This allows it to come away naturally on its own, usually after a few days.

Is a lotus birth dangerous?

Dr. Jennifer Gunter, who works as a women's health practitioner in the USA, maintains that there are no tangible health benefits to lotus births, and even warns of 'substantial risk.'

'Why anyone with an understanding of modern microbiology would promote leaving a newborn attached to dead, decomposing tissue that could be a [source of] infection is beyond me,' she told news outlet ATTN in an email.

'Bacteria grows very quickly in dead tissue and stagnant blood,' she continued. 'Historically, [the placenta] has been discarded. I think if it had benefit, that wouldn't have become the norm.'

Why would you have a lotus birth?

Champions of the method often speak of the 'metaphysical' or spiritual benefits. Keeping your baby attached to, quite literally, their lifeblood. The concepet of a lotus birth has a sizeable social media movement. You only have to search #LotusBirth on Instagram to get an idea of the growing. It seems to be mostly young and first time parents following the practise.

But despite supporters' advice on how to keep the placenta fresh and sanitised outside of the womb (which is largely to do with salting and preserving the organ in essential oils, or 'placenta bags' to keep it contained), some doctors say that a discarded organ left outside of the body for a substantial length of time is likely to result in rotting and, consequently, infection.

https://www.facebook.com/homesweethomebirth/photos/a.467042760031219.1073741826.112316658837166/958179364250887/?type=3&theater

Newborns can benefit from staying attached to the placenta for a period of time after birth but this generally means anywhere from 30 to 60 seconds.

Midwife Anne Richley shares her 20 ways to help you be as prepared as possible for labour. 

Let's face it - for pregnant ladies, the prospect of giving birth can seem scary, it's the unknown. As a new mum especially,  you may wonder, can there really be any ways to have an easy labour?

Not only are you on red alert for spotting the signs of labour, but there are the different stages of labour and you've probably heard horror stories about it too. Read on to discover the ways to make labour easier when it does arrive...

20 ways to have an easy labour

1. Getting your baby ready

From around 34 weeks, you can encourage your baby to get into the right position for birth. Try regularly kneeling on the floor over a birthing ball or if you don't have one, use a chair.

'My midwife said to avoid lying on my back and keep my knees lower than my bottom. This would help turn my baby into the correct position for birth,' says Camilla Hicks, 33, mum to Keith, nine weeks. 'I also went swimming once a week. I had no difficulties during labour, so it was definitely worth doing.'

2. Stay focused on coping

One of the best techniques to get through labour is to focus on the fact that you are coping with the situation.

'Pete kept leaving the delivery suite to try and find the doctor, which stressed me out and distracted me far more than the painful contractions,' says Emma Sabine, 29, mum to Danny, nine weeks.

'After I politely asked him to stay in one place, i.e. with me and just hold my hand, I found that I coped with labour much better.'

3. Stay fit and strong

Mums-to-be who are generally fit and healthy tend to have a more straightforward labour.

Try and go for a short walk each day (without becoming short of breath), or ask your midwife about local yoga or aquanatal classes in your area.

4. Massage your perineum

From around 34 weeks, start gently massaging your perineum (the area between the opening of your vagina and your anus) using wheatgerm oil or sweet almond oil, to help prevent tears.

'I was very nervous about tearing, so I massaged my perineum regularly and my husband helped too,' says Victoria Howes, 36, mum to Gaelle, eight weeks.

'During the birth, I felt more confident of my own body's ability to cope and was more relaxed when I pushed. The birth was hard, but luckily I didn't tear.'

5. Keep an eye on the monitoring

Continual monitoring is not recommended in a 'low-risk' labour, as it means you're not able to move around. This can then cause anxiety, slow your labour down and make it more difficult to cope with each contraction.

6. Stay active

If you walk around during labour, you should need less pain relief and are more likely to actually have a shorter labour.

'My husband told me the midwife said that they'd run out of bedpans, so I'd have to get off the bed and walk down the corridor to the loo,' says Lorna Kirk, 21, mum to Caitlin, five weeks.

'I'm not sure if it was true but it did make me walk around more rather than lying down!'

7. A midwife led home birth is possible and safe

Mums to be who have had a straight forward pregnancy and then opt for  a homebirth or in a midwife led unit, are known to have fewer interventions and more likely to have a normal delivery.

8. Boost and maintain your energy levels

You use up a lot of during labour, so it's important that you build up your stamina and feed your muscles throughout.

Snacking regularly and drinking plenty can make a massive difference.

'I felt like a little squirrel before hibernation as I arrived at the labour ward with my bag filled with cereal bars!' says Karina Gibson, 36, mum to John, four months.

9. Trust and try hypnotherapy

During hypnotherapy, you'll be taught relaxation, breathing and visualisation techniques. These can help get rid of the fear, tension and pain in labour.

10. UFO

This stands for Upright, Forward and Over - a great position for labour.

If you're having a home birth, stand and lean forward over your kitchen worktop or, if you're in hospital, pile up the pillows on the bed and stand and lean forwards over them.

The baby's head puts pressure on your cervix, which can in turn, make labour shorter and easier.

'I was able to stand for most of my labour, but whenever I got tired, I moved and knelt on the bed, burying my head in the pillows,' says Amie Richards, 28, mum to Tom, 3 weeks.

'As Tom was born, I was still on the bed in the kneeling position and the midwife passed him to me through my legs. It was a wonderful experience.'

11. Consider hiring a doula

Doulas (birth partners who are experienced mothers and offer emotional and practical support during pregnancy and labour) may be a great help.

Benefits can include a shorter labour and fewer painkillers.

12. Great support

Women with good support often cope better in labour and feel their experience of birth was a positive one.

'Mark constantly told me how proud of me he was and how well I was doing during labour. He was full of encouragement,' says Serena Thomas, 29, mum to Iain, seven weeks.

'When friends ask what pain relief I used, I say, 'My husband!'

13. Drink raspberry leaf tea

Drinking raspberry leaf tea can help to prepare your womb for labour. Drink it four times a day after 36 weeks of pregnancy.

Evidence shows that women who drink raspberry leaf tea have shorter labours and need less pain relief.

14. Breathe right

Breathing slowly and deeply helps you relax, helping to prevent tension in your muscles and allowing your cervix to dilate. 'My midwife told me to breathe in and deep with every contraction.

The gas and air helped with this, too. And every time I frowned, my midwife told me to relax my face. It's quite hard to tense your muscles when your face is relaxed!' says Caren Leigh, 30, mum to Mikey, three months.

15. Know your stuff

If you read plenty of pregnancy material (like now!) and have plenty of information to hand, you're much more likely to be able to make decisions about your baby's care and to feel in control of your labour.

16. Take a nap!

During labour, your contractions can often stop when you're fully dilated. If your baby is comfortable and stable, don't feel as if you have to 'hurry things along' with the aid of a hormone drip. Instead, ask the midwife to dim the lights and have a doze, and before you know it you'll get a surge of energy ready for the final run.

'When my contractions ground to a halt, the midwife switched off the lights and left us for a while. I dozed off instantly as I was quite tired, but 10 minutes later I had an overwhelming urge to bear down and 15 minutes later, Michael was born,' says Jo Swain, 25, mum to Michael, four weeks.

17. Water works

Research shows that mums-to-be who use a birthing pool for labour often experience an easier, more relaxed labour.

'The pain was mainly concentrated in my back, but moments after getting into the pool it went,' says Elaine Lau, 31, mum to Euan, five weeks. 'The water was so soothing and relaxing.'

18. Set your own pace

Labour can take quite a while for some women, so don't feel that you have to leap out of bed at 3am to make sure you're 'upright and mobile'. If so you'll be exhausted by the time the action really starts to kick off!

'Every time I went for a lie down, the contractions stopped, and when I stood up, they started again! This was great because it meant that I could really pace myself,' says Simone Janet, 28, mum to Chris, nine weeks.

19. Listen to your body

Many mums-to-be like to think of 'breathing' their baby out. Go with your body.

If everyone is all hyped up encouraging you to hold your breath and 'plush!', you'll only go purple in the face and get exhausted.

Push when you're ready and save your energy in between.

20. Take gentle exercise and climb the stairs

Walking up and down stairs can help your baby to move through the pelvis.

'Every time my contractions came, the midwife got me to go up and down the stairs,' says Julie Faith, 24, mum to Lucie, seven months.

'I could feel my baby's head getting lower, until I just made it back into the lounge and gave birth. It was amazing!'

Video of the Week:

Every woman's birth experience is different, and every expectant mum deserves the birth that's right for her.

However, there's a lot of misconceptions around many of the options that are available to help you bring your child into the world - not least, says expert Katharine Graves, when it comes to hypnobirthing.

From not being allowed medication to having to give birth at home, Katharine talks us through what it's really like to have a hypnobirth, and busts the most common myths about the method...

1. Does hypnobirthing mean you can't have drugs?

'You are always in control of your own body and it's up to you if you want to have drugs or other pain relief or not. Drugs are certainly not frowned upon but they do carry risks,' Katharine explains.

'Hypnobirthing breathing techniques support your body in accessing its own pain relief which is much more potent than morphine. Of course, gas and air, opiate drugs and spinal blocks will work effectively alongside hypnobirthing should they be needed. Everyone is different and there are no rules!'

2. Does hypnobirthing mean you'll have a pain-free birth?

'Whilst hypnobirthing is effective in supporting mums throughout birth using breathing techniques designed to maximise oxygenated blood and boost essential painkilling and relaxation hormones within the body, it doesn't not mean pain free for everyone,' she continues.

'Pain is such an individual thing and we all have our own threshold. Many mums report that they do feel a reduction in pain (if it is their second birth and they did not use hypnobirthing first time around) and some report that they simply feel pressure and not any pain and some experience orgasmic births!'

'Your body is perfectly designed to give birth - the systems are already in place. What prevents calm, comfortable births is fear. When we are afraid, our oxygenated blood diverts from the muscles (for birth, the uterus) in preparation to give flight. Adrenaline blocks oxytocin and it's oxytocin alongside oxygen that allows for the uterus to work gently and efficiently with pain that is bearable and manageable.'

3. If I didn't fall asleep, will the hypnobirthing CD still work?

According to Katharine, most hypnobirthing CDs are a special mix of hypnosis and NLP which works on the subconscious. 'Our subconscious is like an iceberg and we only know what we think we know therefore our subconscious will absorb all of the CD whilst you sleep and the key is in the repetition and practice so that our subconscious creates new patterns and opinions all by itself,' she says.

4. Is hypnobirthing just for 'hippies'?

'Hypnobirthing is for everyone!' Katharine exclaims. 'The name can be a barrier to some people as it does suggest that only 'hippies' will benefit from it - the name can conjure up images of incense and chanting but it couldn't be further from the truth!'

'Hypnobirthing classes usually take place in bright and airy yoga studios, church halls or in the privacy of your own home. Whilst relaxation scripts where you will be guided into a deep state of meditation, you will be learning essential breathing techniques and everything you could expect to learn in other antenatal education classes.'

'Hypnobirthing is a complete course, we cover everything! The relaxation is actually a very tiny part of the course (and you're in charge of this at home) because the emphasis is on understanding the labouring woman's physiology and how hormones interplay during birth plus interventions, decision making with your care providers and active birth preparation including positions and birthing environment.'

5. Is hypnobirthing just breathing?

'Hypnobirthing is a complete education programme - the emphasis is on breathing as it is the breathing that produces the oxytocin and carries oxygen to the uterus,' she adds. 'The boost of oxytocin and oxygen to the uterus is essential because it is these factors that dictate the length, strength and frequency of surges (contractions) and can reduce or increase pain sensations depending on the amount of measured, slow breathing directed down to where baby is.'

6. Do I have to have a home birth if I do hypnobirthing?

'Nope! Whilst hypnobirthing works wherever you are, our mammalian brains take over during acts such as sex, orgasm, going for a poo and having a baby!' Katharine reminds us.

'This means that to achieve the best of the aforementioned, our primal brain which has not caught up with modern day living due to being around for zillions of years, wants a quiet, calm, safe space free from observation. This is why many women end up doing beautifully at home but once at hospital are told they're not far enough along, go home and give birth in the car park or the loo!'

'Once free of strangers, noise, and observation birth hormones will kick back into relaxation mode and birth will speed on ahead. When mums feel frightened, we shoot into fear mode and adrenaline spikes blocking the birth hormones needed to make your birth comfortable and relaxed.

'Home birth provides everything your mammal brain wants, and many women who do a hypnobirthing make the decision to stay home for that reasons however many women opt for birth centres and labour ward and are still able to have wonderfully positive Hypnobirthing experiences. Birth centres are completely au fait with the mammal brain and as such design their birth centres to reflect the needs of our subconscious and allow birth to flow smoothly.'

7. Can I do hypnobirthing if I'm having a C-section?

Katharine says it's quite the opposite - in her course, there is a special CD for C-section mummies and the benefits are still abundant. 'The breathing not only makes surges more effective and less painful, but it also provides relief in between surges to baby, giving them the space in a tension free womb to move into the best position,' she details.

'The reduction in adrenaline benefits the baby too as all of our hormones affect baby's wellbeing - being calm and relaxed can only be beneficial for baby and allows them to enter the world in a calm manner.'

We've rounded up some of your most embarrassing pregnancy questions. From labour to birth - we've got the answers to all those embarrassing questions you don't want to ask...

Not too keen on your partner being at the birth? Worried you'll poo yourself when it comes to the big day? Or how about all that gas? Don't worry, you're not alone!

Our midwife, Anne Richley is here to answer all of your awkward embarrassing questions you might be holding back from asking.

Scroll down to see all those embarrassing questions you don't want to ask...

I want my partner to be at the birth but I'm worried that he'll see me differently afterwards. Does it put some men off sex?

If you're worried about your partner's reaction to being at the birth, the two of you need to discuss it. If you're still concerned, ask him to stay at the 'top end'. Your partner can offer just as much support wherever he decides to stand or sit, and you need to feel comfortable with this.

Most partners describe the birth as the most amazing experience ever. And if he sees you differently afterwards, it's with wonder and respect at what you've managed to produce! It's important to acknowledge, though, that not all men feel comfortable being at the birth. Ultimately, the woman in labour needs a birth partner she can rely on and who can comfort and reassure her, and it may not be him.

I'm dreading giving birth in case I poo myself. Does this always happen in labour?

Not always, but many women do open their bowels during labour, and if it's going to happen, there's nothing you can do to stop it. Fear and 'holding back' will only make you feel more uncomfortable, so just go with your body. During the second stage of labour, the baby's head puts pressure on the rectum so you'll feel as if you need to poo, even if you don't. Opening your bowels in labour is normal, it's a positive sign that birth isn't far away.

I've heard that sex can induce labour. Will the midwife know I've had sex when she examines me?

During pregnancy, vaginal discharge is increased, and believe it or not, when a man ejaculates, there is less than a teaspoon of semen. So, by the time it comes to a vaginal examination, there's no way a midwife would be able to know if you'd had sex. Sex can kick-start labour, but only if your body is ready.

I'm scared of 'losing control' during labour and making grunting noises. Should I have an epidural to prevent this?

Women often worry about whether or not they'll make strange noises or behave out of character during labour. It's usually during the second stage of labour that mums-to-be become more 'vocal', because they have an overwhelming, involuntary urge to 'bear down'.

Although women may make noises, it doesn't mean they're out of control. In fact, you may feel more out of control with an epidural if you can't feel what's actually going on. The reality is that, at the time, you're so focused on giving birth you won't notice what noises you make.

If you do start to make involuntary sounds, it's a positive sign you're approaching the second stage of labour and, therefore, usually suggests that you're making good progress. No one cares how much noise you make, and when it comes to it, neither will you!

I hate the thought of internal examinations in labour. Do I have to have them?

An internal examination can only be done with your consent, and if you're sure you really don't want one, then your wish should be respected. By doing an internal examination, the midwife can tell how dilated your cervix is and what position your baby is in. Women usually want to know about their progress in labour and will ask the midwife to examine them. By using breathing exercises or gas and air and by emptying your bladder first, it shouldn't feel too uncomfortable.

However, in a straightforward labour, a midwife should still be able to tell that you're making good progress without frequent vaginal examinations.

I've been having really vivid dreams, some of them X-rated, while others are more horrific and are to do with pregnancy and the baby. Is this normal

Yes, it is. We don't know why this happens, but it's most likely to be the change in hormones, as well as the disturbed sleep that you experience in pregnancy, being woken up regularly by a full bladder or your baby deciding it's time to kick.

Women sometimes feel at their most feminine and sexual when pregnant, which could account for the sexual dreams, so just enjoy them! If you talk to other mums-to-be, you'll find that most of them are having similar dreams.

Try to relax before bed, with a warm bath, gentle music and a milky drink. If there are things that you're worrying about but have been keeping to yourself, talk to your midwife about them.

It might be that by expressing your emotions you'll relax your mind and have a less disturbed night's sleep.

My breasts are small. Will I be able to breast-feed?

The size of your breasts has nothing to do with your ability to breastfeed. Whatever their shape or size or whether you have inverted nipples, the important thing is early skin-to-skin contact, with frequent feeding and good positioning in those early days. Big breasts are made up of a large proportion of fatty tissue, which doesn't affect milk production.

I'm 28 weeks pregnant, and every time I doze off, I wake up dribbling. Is this normal?

Many mums-to-be experience an increase in the production of saliva and wake up dribbling after a sleep. No one knows the exact reason for this, but as with most problems in pregnancy it comes down to the changes in hormones.

Women who feel nauseous often produce more saliva, in an attempt not to swallow, which can be distressing. Try having frequent sips of water throughout the day or chewing sugar-free gum.

I've never had such terrible wind. Is this just because I'm pregnant?

We seem to blame our pregnancy hormones for everything, but they are responsible for most of the various symptoms. The hormone, progesterone, relaxes the bowel, slowing it down and causing constipation and wind. To relieve this, try exercise, particularly yoga, the gentle stretches encourage the bowel to become less sluggish.

When you eat, chew the food slowly, and give it time to digest, drinking peppermint tea is also supposed to help relieve trapped wind. If constipation continues to be a problem, ask your midwife if she can recommend a mild laxative.

I'm worried my waters are going to break in public. Does anyone else feel like this?

This is a common worry. Most mums-to-be find that their waters break when they're in labour at the height of a contraction. But if they do go beforehand, it often starts as a trickle rather than a gush. Many women aren't even sure if their waters have broken, as it can easily be confused with 'leaking' some urine towards the end of the pregnancy. If you're unsure, contact your midwife, who might advise you to wear a pad and see if it continues to trickle.

From relaxing yoga poses to tweaking your nipples, we've got lots of suggestions to bring on labour naturally.

Wondering how to bring on labour naturally is perhaps the most persistent worry for women as they reach 40 weeks of pregnancy. 

Well-meaning friends and relatives will be pestering you for updates on the birth, and you may feel under pressure as you go past your due date. But the best thing you can do is relax, look after yourself, and maybe try a few of these natural ways to induce labour.

These natural ways to induce labour aren’t scientifically proven, but they have helped mums-to-be in the past. Doctors advise against trying to induce labour until you’ve gone full term, as the last few weeks of pregnancy are essential for your baby’s development. A complex set of hormonal changes and physical developments trigger birth naturally, and your baby will certainly let you know when they're ready.

How do I stop being overdue?

Don’t get too attached to your due date, if that’s what’s making you want to eat curry and pineapples. Less than five percent of babies are born on their due date, according to a 2013 study in the International Journal of Gynecology & Obstetrics of about 18,700 women in Australia. Which means the whole idea of babies being ‘late’ or ‘early’ is a bit misleading. The majority of first-time babies are often ‘late’: The Evidence Based Birth website investigated accuracy of due dates, and a study showed that 75 percent of first-time mothers gave birth nine days after their ‘due date’. So you’re in good company.

Here are 12 tips that might help bring labour on in the meantime:

1. Try relaxation exercises
2. Swimming
3. Have sex
4. Nipple stimulation
5. Yoga 
6. Eat a curry
7. Walking
8. The Miles Circuit
9. Eating pineapple
10. Bouncing around
11. Drink raspberry leaf tea
12. Inhaling clary sage

1. Try relaxation exercises

Relaxation is one of the most powerful ways to bring on labour. Exercising and eating pineapples might feel like a welcome distraction in those final few days, but your body knows when it’s ready to give birth. If you’ve had a healthy pregnancy so far, spend any extra time resting and treating yourself to nourishing food and lots of sleep instead. Most importantly, once the baby arrives you’ll need all the energy you’ve got. 

Milli Hill founder of the Positive Birth Movement and author of the bestselling Positive Birth Book and Give Birth Like a Feminist recommends relaxing and enjoying this time: "When waiting for a baby and trying to beat the induction clock, the temptation is to ‘do stuff’. Pregnancy forums are filled with women sharing ideas on how to kick start labour and therefore ‘avoid induction’. Often this is because induction is not presented to them as a choice. They therefore feel they ‘have to’ be induced if labour doesn’t start by a certain date. So out come the spicy curries, bumpy car rides, acupuncture… you name it! Doing nothing is one possible option in a world where the usual advice is to ‘do something’. It’s a reminder to women that it’s OK to do nothing and just trust their bodies."

If you find it hard to relax, try hypnobirthing techniques before you go to sleep or whilst you’ve got your feet up. Don't believe the myths about hypnobirthing, as it can prepare you for a more positive birth. Hypnobirthing teacher Sophie Kirkham from Calm Hypnobirthing recommends conserving your energy and maintaining a positive mindset. "Rest, go gently, and surrender to your body and your birthing. Surround yourself with people who fill you with confidence and make you feel comfortable, as this will help labour progress naturally."

2. Swimming

Gentle exercise and moving through warm water is thought to be good for starting labour. In fact, it’s what the Duchess of Cambridge, Kate Middleton, did in the lead up to the birth of her second child, Charlotte. Of course, she does have the luxury of nipping to Buckingham Palace to use their pool rather than wading through armbands and verruca socks at the local swimming pool.

3. Have sex to encourage labour naturally

Semen contains prostaglandin, which softens the cervix and helps open it for the birthing process. Likewise, female orgasms release oxytocin, which stimulates uterus contractions and gets you ready for labour. At 40 weeks pregnant, sex might not be top of your agenda, but just being intimate and close with your partner can help initiate labour. Even cuddling and taking time together in bed will release the ‘love hormone’ oxytocin. So don’t feel obliged to get jiggy if you don’t feel like it.

Note: Don’t have sex after your waters have broken because it can increase risk of infection.

4. Nipple stimulation

Gentle, attentive nipple stimulation releases the hormone oxytocin which is essential in early stages of labour. Tweaking nipples might not sound sexy, but in her book, A Guide to Childbirth, legendary midwife Ina May recommends loving nipple stimulation and kissing before and during birth. This helps shorten the active labour stages, contract the uterus, and encourages the cervix to dilate.

5. Yoga for natural labour

Gentle pregnancy yoga can help bring on labour by opening up the hips and helping you relax and connect with your body. Don’t start doing headstands or complicated lotus positions; you just want to rest in wide legged poses and gently release any tension in your lower back.

Doula Emilie Joy Rowell recommends gentle movement for instance: "Working with gravity and the biomechanics of your body is ideal. Cat-cow yoga pose, forward leaning inversions, calf stretches, dancing and resting are beneficial and can help your baby get into a good position."

Try these easy yoga poses to help bring on labour:

http://www.youtube.com/watch?v=7SkbHdjPYho

6. Eat curry

The theory is that spicy foods stimulate the gut and bowel, which gets the uterus moving as a result. But there is no medical evidence to support this. Whilst you don’t want to be hungry going into labour, it might not be the best idea to have a stomach full of your favourite korma. Try some of our homemade curry recipes – they’re healthier too.

7. Walking to bring on labour

Going for a gentle walk produces labour-inducing chemicals, which can speed the process up. Additionally, walking increases the pressure the baby’s head puts on the cervix and helps move it into the right position for labour. This is one of the safest methods to try – there’s no harm in a gentle stroll, but take your phone or have someone with you in case it works.

8. Try the Miles Circuit

The Miles Circuit was designed by an American midwife to help progress labour and get the baby lined up in the left occiput anterior (LOA) position both before and during labour. It involves a series of exercises which takes about 90 minutes to complete. These include lying on your front with your bottom in the air, on your side cushioned by pillows, and walking up the stairs sideways. Check with your midwife or doctor before trying any of these exercises.

http://www.youtube.com/watch?v=UQ1jKbvyER4

9. Eat pineapple

Fresh pineapple contains the chemical bromelain which is thought to soften the cervix and potentially speed up early labour. Unfortunately, there is no scientific evidence to back this up and you might have to eat seven fresh pineapples to feel the effects. 

10. Bouncing around to bring on labour naturally

Gentle bouncing helps bring the baby down and increases pressure on the cervix to kick start labour. Taking a bumpy car ride has been known to start contractions. Corrie’s Tina O’Brien even reported that bouncing on a trampoline helped bring on labour for her. If this sounds a little too gymnastic, a safer option is gently bouncing on a birth ball or try one of these birth ball exercises to help bring on labour:

http://www.youtube.com/watch?v=oHGJENdy2h4

11. Drink raspberry leaf tea

Raspberry leaf tea doesn’t actually induce labour, but it does help prepare the muscles of your womb for labour. Raspberry leaf tea is made from the leaves of the red raspberry plant, as opposed to raspberry flavoured black tea. One study found that women who drank raspberry leaf tea in the last few weeks of their pregnancy had a faster second stage of labour than those who didn’t. It tastes like hot ribena, but if that’s not your thing, raspberry leaf can also be bought in capsule form.

12. Inhaling clary sage to bring on labour

Clary sage, or Salvia sclarea, is a powerful essential oil that’s thought to induce labour naturally by increasing oxytocin. While there is little controlled scientific evidence to support this, many women and midwives swear by inhaling the oil on a handkerchief or in an aromatherapy burner before and during birth. Many birthing women find deep inhalations, candles, and gorgeous scents relaxing during the birthing process, so this may also contribute to the effect. Do not use clary sage before your due date.

Doula Bridget Teyler shares her tips for aromatherapy with clary sage, and a recipe for her secret Midwives Brew tea to help bring on labour:

http://www.youtube.com/watch?v=h9ezX3TgI9k

Things to remember when bringing on labour naturally

• If you’ve had a healthy pregnancy, try to be patient. It’s easier said than done, but letting your body and the baby decide when they're ready can lead to a more positive birth experience. 
• Talk to your doctor or midwife before trying to induce labour with any of these methods. Particularly if you’ve had complications during your pregnancy.
• Relax and enjoy it. You will meet your baby soon.

READ MORE: Try Milli Hill's A to Z of pain relief techniques during labour

Can giving birth be painless? Or cause haemorrhoids? We asked experts to answer all of those important questions mums-to-be want answered before giving birth!

Giving birth is understandably a very daunting prospect for many expectant mothers - and throws up a whole host of questions, especially for first time mums, that range far beyond whether to have a hospital birth or home birth.

To help take some stress out of the situation, we've asked the experts to answer your most Googled questions about labour and birth - from whether the process can be easy and painless, to whether it can cause a variety of health problems.

Can giving birth be easy?

It hardly comes as a surprise that many women google 'Can giving birth be easy?' in the run-up to their little one's arrival.

But because labour is very much a personal experience influenced by a multitude of different factors, medical professionals may struggle to give a clear cut answer on whether giving birth can be 'easy'.

Midwife Annie Richley does, however, explain there are a number of things that a mum-to-be can do to prepare for the process.

Read more: The 20 ways to have an easier labour (according to a midwife!)

According to Annie, it's possible to encourage a baby into the right position from about 34 weeks – which will help when it comes to giving birth. To do this, she suggests kneeling on the floor over a birthing ball.

Annie also recommends taking short walk or engaging in a spot of yoga as pregnancy advances because some evidence suggests that women who are active may be less likely to experience problems in later pregnancy as well as during labour.

Can giving birth be painless?

When a woman goes into labour, she'll experience contractions. Described by the NHS as being similar to 'extreme period pains', they intensify as the situation progresses. As labour gets going, contractions become longer and more frequent.

How much pain a woman will feel while giving birth totally depends on the individual.

According to Dr Asha T Herbert - who works as a GP locum in an urgent care centre and A&E department as well as running a private clinic in Hitchin - there are many different techniques that can be employed to try and help control pain.

'Pain relief can be achieved by relaxation, breathing exercises, using water in a bath, or in birthing pool [if you choose a water birth]. A TENS machine could also be used,' she tells us.

'Pain relief such as gas and air or paracetamol are the most basic form and an epidural the most invasive, but both can offer pain relief during delivery.'

Can giving birth cause IBS?

Irritable bowl syndrome is a long-term condition affecting the digestive system that can cause constipation, stomach cramps, bloating and diarrhoea.

The severity of symptoms varies between individuals. It's thought that 1 in 5 people will suffer from IBS at some point in their lives and women are twice as likely to be affected as men.

The exact cause of IBS is unknown but there's lots of evidence to suggest that stress, certain foods and hormones can play a part.

'Pregnancy and birth are not thought to increase the risk of developing IBS, although IBS usually presents in women of childbearing bearing age,' comments Liz Halliday, Deputy Head of Midwifery at Private Midwives.

'Bowel issues such as constipation and diarrhoea can be prevalent in pregnancy, but this is a side effect of pregnancy and not IBS related. Of course this does not mean that you cannot develop IBS or be diagnosed with IBS in pregnancy.'

Can giving birth cause fibromyalgia?

Something that causes pain all over the body, fibromyalgia typically develops between the ages of 30 and 50.

As well as experiencing widespread tenderness, someone with fibromyalgia might also find themselves sensitive to light, smoke and certain foods.

In news that's sure to make pregnant women breath a sigh of relief, Dr Asha T Herbert says that no link between giving birth and the onset of fibromyalgia has been found.

She does however go on to state that expectant mothers who already have the condition might struggle, both as the baby arrives and in the nine months before.

'There is no evidence that finds delivery causes fibromyalgia - although women with fibromyalgia could find both pregnancy and delivery more difficult,' she reveals.

Can giving birth cause cervical cancer?

In its early stages, there are often no symptoms of cervical cancer. Abnormal bleeding - which can occur in between periods, following sex, and after the menopause - is however experienced by some with the disease.

'There is no evidence that giving birth causes cervical cancer,' states Dr Asha T Herbert.

Liz, however, is keen to point out that experiencing a full-term pregnancy before the age of 17 and having 3 or more full term-pregnancies can increase the risk.

'No one knows exactly why this is the case. It has been suggested that the chance of infection with the HPV (Human Papilloma Virus) is higher in these cases, as is the chance of infection with Chlamydia (which has also been linked to increased risk of cervical cancer),' she comments.

'Another suggestion is that the hormonal changes of pregnancy and the physiological decrease in the immune system that happens in pregnancy may allow for changes in the cell structure of the cervix leading to abnormal calls.'

Can giving birth cause haemorrhoids?

It's an unfortunate fact that both pregnancy and birth can cause haemorrhoids, swellings in and around the bottom made up of large blood vessels.

'In pregnancy, the hormonal changes that take place can result in a weakening of the walls of blood vessels, making it harder for blood to return to the heart, which can be further affected by the weight of the gravid uterus,' Liz explains.

'In addition, hormonal changes often affect the gut, and constipation can be a symptom of that. Straining on the toilet and passing large, hard stools provide another risk for haemorrhoids.'

And regarding giving birth, a combination of pushing, constipation and hormonal changes can result in piles forming.

'Excessive pushing during the birthing process is a strong factor in post-partum haemorrhoids,' she continues.

'Valsalva pushing (otherwise known as midwife led pushing, or purple pushing) where a women is advised to hold her breath and push for long durations of time is not advisable for many reasons, and the chance of developing haemorrhoids is one of them.'

To soothe any discomfort, Liz suggests staying hydrated by drinking lots of water and eating plenty of fresh fruit. Grains high in fibre will also help regulate bowel movements and make the passing of stools less painful.

Can giving birth cause MS?

While few studies have sought to establish a relationship between giving birth and multiple sclerosis – a neurological condition that affects nerves – it's unlikely that welcoming a baby is a risk factor.

'We do know that women who already have MS but have not been diagnosed before a pregnancy, are more likely to receive a diagnosis during pregnancy. And that women who have MS often experience a reduction in symptoms and are less likely to experience relapse during pregnancy,' reveals Liz.

'However, if a women is experiencing symptoms of MS and is feeling unwell she should always consult her GP.'

A mum has shared her amazing birth story after delivering her one in 80,000 baby.

Not only was he born en caul - still in his amniotic sac, something which usually only happens with c-section babies, Raelin Scurry's newborn son, Ean Jamal Vanstory Jr., was delivered in the car by his mum during a dash to the hospital.

In the caption alongside the incredible pic, Raelin explained that it was early August when she started experiencing contractions, but as she was only 29 weeks and 4 days into her pregnancy she shrugged them off as Braxton Hicks and decided to wait it out.

However, after about 45 minutes they were increasing in intensity, so she threw some clothes on, dropped her daughter off at her godmother's house and headed to the hospital.

[instagram]

the drive, the contractions continued to get closer together and more intense and before long, Raelin felt the need to push.

'I called 911 because I was so scared. They couldn't understand me between the screams with contractions,' she explained.

Handing the phone to her fiancé, Raelin pulled her pants off and reached down, and the baby's head was right there.

'I pushed one time and my miracle baby was here,' she continued. 'When I looked down I realized he was still completely wrapped in the amniotic sac.'

At first the baby was still and all the new mum could do was pray he would be okay: 'I rubbed his face with my thumb and he pulled his little hands and feet up to his face as if he understood my prayers and wanted to reassure us he was okay.'

About 7 minutes passed as Raelin held her 'miracle baby' in her hands until they made it to the hospital.

She added of her baby being born in his sac: 'This happens 1 in every 80,000 births. Usually during c-section.'

'I know he's going to be an awesome little man! ❤ he is truly a miracle baby. We are so blessed to be his parents.'

[instagram]

his birth the tiny tot, who was just 3lb 1oz when he arrived, has come on leaps and bounds.

Mum Raeline has since shared another shot captioned with: ‘EJ is making such great progress! He is 4lbs 3.8oz. He is starting to get some of his feeds by mouth and I got to put him to breast.'

Most mums-to-be go through pregnancy feeling a little nervous about the birth, and it's totally normal to start feeling more preoccupied with it closer to your due date.

No matter how carefully you prepare for your birth, it doesn't always work out the way you expect - lots of mums have plans to give birth naturally, and then have to go in for emergency C-sections. Lots of women want to avoid pain relief, but complications mean that turns out not to be an option.

Whatever happens during childbirth, welcoming a healthy baby into the world is one experience that mums typically agree is worth the pain - but some go through more extreme experiences than others. For Tracy Jones, suffering with Post Traumatic Stress Disorder (PTSD) for years after the difficult birth of her daughter left her unsure about conceiving ever again.

Here, she shares her birth story, and explains how she's now managed to turn her ordeal into a positive.

It was in the 'early' stages of my labour that I overheard the doctor say: 'She's expecting something for nothing. There's nothing happening at the moment'.

It was as though I was making a big fuss over nothing, which left me feeling really panicked - it was my first child and so I didn't really know what to expect. I thought 'if this isn't labour, how am I going to cope when it is?'

My pregnancy had been okay - I'd been getting some irregular heart rhythms which I'd spoken to the midwife about. She looked into getting me some blood sugar tests, and that came back as positive for gestational diabetes. I'm not diabetic, and there's no family history of it either, so it came as a shock.

Managing the condition was stressful - I had to check my blood sugars six times a day, before and after every meal. I was working at the time as well so trying to juggle the rest of my life at the same time was a big commitment. When I was diagnosed, the consultant told me how some women turn up for a routine check up and find the baby has 'drowned in sugar' inside the womb, and did – this was a constant image in my mind, and meant I was terrified of eating anything remotely sugary through the pregnancy.

On my due date, the nurses said I'd have to be induced because of the diabetes. During the afternoon I started to have some mild labour pains, but they were just brushed off by the midwife who said they were just niggles; it all just felt so dismissive. The early labour pains were becoming more and more intense, but even then I was told that my husband would have to leave in an hour when visiting times finished. I was really worried about that - obviously I didn't want things to start up without him.

There was one healthcare assistant who did seem to realise I was in a lot of pain, and told me to go and have a bath, which I did. I remember crying in the bathroom knowing that my husband was going to have to go soon - but as soon as I got in the bath, my waters broke. It was only then that they realised I wasn't making as big of a fuss as they originally thought I was.

It was a big rush then - out of the bath, getting me into a wheelchair and wheeling me down to delivery, bashing into all of the door frames on the way down, and then when I got there they realised that I was over 7cm dilated and things were happening really really quickly; it was too late for pain relief.

They'd worked out that the induction had actually caused an overstimulation effect on the uterus, so what was happening was, rather than having the strong contractions and then a break, there were no breaks in between at all. It was almost just one, long contraction. The baby by this point was in distress - obviously it was difficult for me, but for her as well. She wasn't getting any breaks in between either, so it was very intense for her. The paediatrician was called, and they were very concerned about her. At one stage, her heartbeat was dropping quite dramatically.

Thankfully, she was born and was okay, but about a month afterwards I realised that I didn't feel right. That was when I started feeling really anxious - I was getting flashbacks of the birth, and at times, my husband told me that I would actually start to act as though I was giving birth again. I was in a real heightened state of anxiety. It was something completely new for me, I'd never experienced anything like that before.

The doctors had originally diagnosed it as depression, but I think that I was depressed because of the anxiety and the trauma. Initially I was given antidepressants, but then I found the Birth Trauma Association whilst looking online, and everything that was on there was exactly as I was experiencing it at the time. I took the information along with me to one of my appointments and that's when they started to listen to me, and realise that there might be something more than depression going on.

At that point I felt so low, because I thought no one understands what's going on, and no one else has ever experienced this; it was only afterwards that I was referred to a different hospital and a different psychiatrist and she said straight away that it was PTSD. My daughter was about 10 months old at this stage, and I just hadn't realised that PTSD after birth could be 'a thing'. I really did feel so alone; people would say, 'People just said, just be thankful that you're okay and the baby is okay'. Of course I was, but having all this going on and having no explanation made it really difficult.

I didn't have any problems bonding with my baby - in fact I felt that she kept me together during the day. It was when she went to bed in the evenings that was when I'd really fall apart and struggle. But even during the day I had to have a lot of support from family - my husband would drop me off on his way to work at my mum's house, because I just felt like I couldn't stay on my own in the house. So I would spend the whole day there from 7am to 6pm, with my mum for support; my husband would pick me up on the way home, and we'd spend the evening at home; it was really a strange, challenging set up.

During this time I couldn't work, I couldn't even stay in the house on my own to look after my daughter. It had a really big impact on my own life and my husband and my daughter – I am so grateful that my husband was so understanding and supportive throughout, and I know it was very difficult for him too. I also feel lucky that I had such strong support from my parents and family as some people suffer this with no or little support.

Though I'm completely recovered now, I'd say my daughter was three-and-a-half before I started feeling like me again. I found a treatment called Eye Movement De-Sensitization reprogramming (EMDR), which helps you to process the trauma more effectively, and that really aided my recovery. What happens is, you go through the traumatic incident in your own mind and there's no need to verbalise anything, and in the meantime the therapist will encourage you to move your eyes in different directions. It encourages the whole of the mind, the whole of the brain to process the traumatic event and allow it to be filed away as it should be as a memory, so it's no longer affecting you on a daily basis.

I'd been undecided about whether to have any more children because of everything that had happened - I was very nervous and anxious, but eventually it got to four years and I just thought that maybe we could do... but I knew I had to do something different that time, I knew I couldn't do that again. I thought, if I could have a natural birth that was more positive, then maybe it would be even more psychologically healing for me, really.

Despite my fears, I went on to have a son five years later as well, and I did a hypnobirthing course which made a huge difference. It teaches you to where the pain in childbirth actually comes from, which is often fear, and teaches you how to deal with it really and relax through it, and deal with any anxiety leading up to birth as well.

I also went to a different hospital and was under a different team, because I just wanted things to be completely different.

I'm a hypnotherapist myself now, and because of my negative experience I feel like I'm more able to understand people who have anxiety, and lots of different issues. I support people via email, through the Birth Trauma Association, and I've encountered so many women over the last few years who have had similar kinds of experiences to myself. I want to do more work with the charity going forward, and I've mentioned to them about helping midwives to become more aware of the issue.

I think it's so important for them to understand that for women who are giving birth it's such an immensely vulnerable and important time, and just the wrong remark or just something dealt with insensitively can have such a huge impact.

Having twins is a completely different experience than most single-baby pregnancies and births - from the physical effects to the emotional impact and everything in-between.

Louise, 38, works for the charity TAMBA (Twins and Multiple Births Association), which supports parents of twins and multiple births, helping to inform them and fundraise for research which will improve outcomes for multiple births.

She spends her days helping women through their own experiences in her role as a bereavement counsellor - but she's also been through a tough multiple birth herself, when her daughters Connie and Scarlett entered the world three years ago.

Here, she shares her own birth story, opening up about her girls' difficult arrival, and the dangers all mums of multiples can face...

When I became pregnant with the twins I already knew it would be completely different from when I had my first daughter Daisy, now seven.

Hers was a plain sailing pregnancy - I had a water birth, it was absolutely amazing and everything went to plan.

I'd already been warned that being pregnant with twins would be a new experience, and that because there was two of them I may have to have a caesarean - but I was convinced that I wanted a natural birth.

Then 35 weeks in, a week before I was planning to go into hospital and have the twins, I suffered a massive bleed.

The bleeding started at 11pm and at first I just thought my waters had broken as it was dark, but once I turned the light on I realised I was bleeding - quite heavily.

I remember calling the labour ward saying: 'We're just going to pop in as I've had some bleeding' but they told me to phone for an ambulance straight away.

That's when I started to panic. What if something happened to one of my babies? They scanned me straight away when I got to the hospital but couldn't figure out why the bleed had happened - the twins weren't breech and seemed happy enough. But, just in case, they kept me in hospital for observation.

After four days of monitoring my waters did actually break, but as soon as the consultant came in the next morning I burst into tears and just said 'I need to get these babies out of me - I've had enough' and begged him for a caesarean.

Thankfully, he knew how much a natural birth meant to me. 'No, I believe in you, you can do this,' he said. 'You've wanted a natural birth this whole time so we're going to give you one.'

'I'll do a deal with you,' he continued. 'I'll give you an epidural and we'll induce you and if nothing happens then we'll give you a caesarean.'

But the birth wasn't as straight forward as I'd wanted it to be. Scarlett had to be brought out by forceps. She was the smaller of the two at 4.3lbs, but she was fine.

A couple of minutes later, Connie also got stuck, and she had the umbilical cord around her neck. It turned out that it had actually been her placenta that had bled away when I had the bleed. She'd made a massive turn in the womb and was breech, but once I made it to hospital she had turned back around again and her head was down. She had now turned again, and they had to use forceps to get her out too.

When Connie finally came out she wasn't breathing, and I was petrified that she wouldn't make it. It felt like an hour but it was only a matter of seconds. I knew she wasn't breathing when she didn't cry straight away - you see it on telly, rubbing them to make them breathe, but nothing was happening. Thankfully, it wasn't long until we heard her cries, but those few seconds were amongst the scariest of my life.

Once both twins were born, after a five hour ordeal, I finally managed to relax, but then we found out Connie had to go into SCBU (special baby care unit). The bleed has caused her blood levels to become really low, so she had to have a full blood transfusion.

She was in SCBU for around a day and a half - it was hard splitting my time between both babies, as they both need me as much as the other. Thankfully we got to take them home after a few days - and both were happy and healthy.

As a bereavement counsellor for TAMBA, my job means I'm there to listen to people grieving - obviously I can't do anything, but I'm there to give them support when they need it. If there's any sort of support we can give them when they're grieving then we really want to be there for them.

I listen to stories every day of loss, stories very similar to mine. At the time of the twins' birth I don't think I appreciated what had happened, but the hospital were very good at down playing everything and not worrying me. Now, I realise that it could have gone a completely different way - and I'm so grateful to have my girls here, happy and healthy.

Birth is a completely unique process for each woman who goes through it.

Whilst everyone hopes for a smooth, trouble-free labour, it's no secret that complications can and do occur, and when they do, you rely on those tasked with your care - doctors, midwives and doulas, or other professionals - to look after you as well as they would look after your baby.

Unfortunately, for some new mothers, that care never comes, and labour becomes an incredibly traumatic experience, leading to suffering, both at the time and for many years afterwards.

This was the case for Joanne Page, a mum-of-two from Kent who endured horrific injuries during the arrival of her first son, Elliot, and is still dealing with the outcome 22 years later.

Here, she tells her birth story, and explains why she wishes she'd spoken out sooner.

'I'm going to have to cut you,' the doctor said. My baby was stuck, she explained, and he needed to come out now.

I said it was fine, and at the time, I truly believed it was. I'd had an epidural, so I couldn't feel anything anyway, and all that I cared about in that moment was making sure that my child came into the world as quickly and safely as possible.

He was my first child, you see, and the first grandchild for both sets of grandparents too. I had the perfect marriage, the perfect house, and now we were eagerly awaiting the arrival of our perfect little boy to complete the equation.

I'd had a good pregnancy, issues with pre-eclampsia in my third trimester aside, and my labour, at a week overdue, had been smooth at first too. Now things had taken a turn for the worse, and it was touch and go whether I'd even get to meet my little one at all. So here I found myself, legs up in stirrups, with the doctor using forceps to tug so hard on his head that I feared that it would pop off altogether.

'No baby can survive this,' I remember thinking to myself as she pulled, climbing back up the bed just for her to drag my body back down again. But mercifully, he did survive, and I was so thankful to see a healthy, albeit slightly bruised, baby boy come out into her arms.

As Elliot, as we'd chosen to call him, was whisked away by the midwives, the doctor told me that although she had cut me, I'd also torn my anal sphincter muscle quite severely, and I'd need stitching up. Normally this is a procedure that would be done in a theatre, but it was already busy, so because I was already numb she could do it for me where I was.

I agreed - I had no reason not to - and she then asked my mother in law if she would help her by putting her finger up my back passage so that she could work around it to get a tight stitching. I know it sounds strange, but neither of us questioned it - when a doctor asks you to do something, you trust them and you do as you're told. The procedure took about an hour and a half, but once it was done, it was okay, and I was even able to go back to the ward.

Two days passed, and I hadn't been for a wee. At first I put it down to swelling and all of the other side effects that come with pushing out a child, yet looking back, it was my first indication that something might not be quite right. Other parts of my body were swelling too - my ankles looked like they belonged to an elephant.

A midwife examined me and said that the forceps had damaged my urethra tube, to the point where no wee could get out because it was so swollen, so they had to catheterise me. This was traumatic, but no way near as traumatic as what was to follow.

My wound started to smell - so badly that I had to be moved to a separate room - and it was then that the staff discovered that I was ravaged with an infection so strong it had dissolved all of my stitches. Listening to their diagnosis, I started to realise that something truly terrible had happened to me.

'Can you stitch it back up?' I asked naively, but they just replied, no, sorry, we can't. It's like material that's been stitched together and then ripped; you can't then bunch it up and stitch it back up, because it would be too tight. I would have to wait 18 months for the tissue to granulate naturally.

I was exhausted by the infection, full of antibiotics, still catheterised and hooked up to a drip, and they'd essentially told me that I'd have to spend the next 18 months weeing and pooing out of the same hole, and caring for my wound whilst also caring for a newborn baby. It was devastating.

As it happened, I couldn't face caring for Elliot at all. He was looked after by the midwife because I didn't even want to look at him. Doctors advised me not to breastfeed - after all, I could hardly keep myself going, let alone myself and a baby. The chance to build a connection was taken away from me because I had to spend so much time looking after myself.

I was having to measure how much fluid I was drinking, to then measure how much was coming out in the catheter, and I had to be on laxatives, because I couldn't risk having constipation. I needed to shower my wound and dry it with a hairdryer at least eight times a day. The doctor would come around and flush my wound with saline on a daily basis, but when I later checked my notes, she'd written that she'd only done it once. Clearly she knew how wrong things had gone.

After five days, Elliot and I were allowed to go home, but ultimately, it made very little difference. My schedule still revolved around showering, drying myself with a hairdryer, wearing massive sanitary towels. I also had to have salt baths, four times a day, to keep things sterile.

My quality of life hit rock bottom, and I barely left the house. I had a baby that I'd feed and change, ready to go out, but then I'd need to go to the toilet because I was on so many laxatives, then I needed to shower after each bowel motion, and by the time I'd done all of that he would need feeding again. It was a constant thing; every hour of every day was reduced to just going to the toilet and keeping the wound clean.

The granulation was a slow process, but when we reached the 18 month point, I hoped things might improve. Then I was told that my wound had healed, but not properly, so I was left with an extra hole in my back passage. Not only did I have to dig faeces from the hole, to stop sores, many of my previous issues actually weren't fixed at all.

I didn't tell anyone what had happened to me, not even my own mum, who hadn't been with me in the delivery room at the time. I was too embarrassed. I also didn't want to go and have anything done because I knew I'd have to have further surgery, and the whole situation had left me terrified of going into a hospital under any circumstances. My coping mechanism was to push everything to one side and pretend it had never happened. Deep down though, I was destroyed. I couldn't talk about birth with my friends, I couldn't even watch it on TV. I just told people that I had a bad time, but never gave details. I was just so ashamed.

It also had a massive impact on my other half - he was distressed by what he saw when I was in labour, then distressed again by what I was having to go through afterwards. I'd walked in that hospital one person and walked back out another. I had all of these things wrong, I couldn't cope with him and looking after a baby, and sex was out of the question. Inevitably, our marriage broke down.

All everyone says to you when you become a mum is 'your baby is alive and you've got a healthy baby'. Yes you have, and yes that's amazing, don't get me wrong, but if they knew what you had to go to through when you have a birth injury, they'd understand that it's not all that matters.

Eventually we managed to rebuild our relationship, and five years later, despite my ongoing battle with the outcome of my first birth, decided to have another baby. Looking back, I don't know how I did it, but I was an only child, and I was adamant that I didn't want my son to face the same fate.

Elliot meeting his little brother Hugo

Carrying Hugo, my second son, was drastically different to what I'd gone through with Elliot. I had to carefully monitor my weight, to ensure I didn't gain too much, and a C-section was booked for my 37th week of pregnancy because I can never give birth naturally again. When he arrived, of course we were thrilled and loved him deeply, but I also had an incredible sense of guilt, because I hadn't wanted anything to do with his big brother at the same time in his life.

My condition has held me back a lot as a parent, particularly when the boys were younger. Even when we did manage to make it out as a family, all of sudden we'd have to pile into the car and race to the toilet.

'Mummy's got something wrong with her tummy,' I'd say gently if they asked, but I was always conscious of telling them the whole truth, particularly when it came to Elliot. How do you explain to a child that in the magical moment when you became his mum, it caused injuries so extreme that your whole life had been turned upside down?

Over the years, my doctor and I have tried various options to help me process what I've endured - I've had cognitive behavioural therapy, I've been on tablets, I've been referred to a mental health team - but I don't feel that I'm a depressed person. I have post-traumatic stress from everything I went through, and am still going through now.

If I was an alcoholic, soldier, an anorexic, there would be a dedicated team who could help me, but the truth is that there is nowhere to turn for birth trauma. If I'd been raped, I'd be referred to a specialist, but in my eyes, it's comparable to a rape - you're being violated, down in that area, and that is never going to be the same again.

My family are amazing, and all support me where they can - the boys know just by the look on my face that I need to get to a toilet, and will always find one for me in a hurry! But it wasn't until about three years ago that I decided enough was enough, and that I wasn't going to suffer in silence any more.

I told my mother, who was heartbroken that I hadn't opened up to her sooner. I've taken steps to get the surgery that I still need - despite my anxieties around hospitals, I know that it's time for me to help myself now, and this is the only thing that can make the difference that I'm hoping for. I've even reached out to a charity called MASIC, and am going to attend their next seminar and share my story to medical professionals so that they'll better understand the needs of women in my position.

I've also discovered online birth trauma groups, which made me realise how many of us out there have been through the same thing, but are too afraid to speak out. I've spoken to 30-year-old women with colostomy bags, just because they've given birth. Others, like me, gave birth years ago, but are still feeling the affects of their birth trauma every single day.

It's like you've been robbed of a part of your life, but I've decided that that doctor's mistake is not going to rule mine any more. This isn't my fault, someone did this to me and I'm determined to raise awareness of the trauma that thousands of women go through every year.

And if I stop even one mum-to-be from going through the experience I did, it'll be worth every twinge of embarrassment and every moment of fear, because no woman should ever have their lives ruined just because they had a baby.

For some women having a doula present at the delivery of their baby is a crucial part of their birthing experience and something they couldn't possibly be without. For others, they might be left wondering 'how is a doula different to a midwife?', and it may not something they have ever really considered.

After facing challenges in her first three births, Lynsey, who now runs her own doula business Mothing Matters, knew it was time to tap into the doula support network - so much so that she ended up becoming one herself!.

Each birth of my four babies has been different but I had always planned to give birth at home for all the children.

As a first-time mum I planned a home birth. A medical birth was something I really wanted to avoid. After recovering from previous surgeries and being poked and prodded around I really wanted to avoid the surgical route or any kind of medication. I wanted a home birth because I wanted to stay away from hospital. I felt fearful of that environment and fear is the thing that makes labour difficult. I needed to feel safe and home was a safe space for me.

However, when the time came, I ended up transferring during labour to hospital for slow progress. I thought I was near the end but I wasn't at all; in fact, it took so long my midwife had to go off shift! My labour had to be augmented, I was given pethidine and an epidural but despite all that I was able to have a normal vaginal birth.

My second birth was at home. It was simple, straight forward and speedy. I gave birth on the living room floor after about six hours and only used a little bit of gas and air right at the end. What was really special was having my actual midwife with me, which is quite rare.

It was really special for me and I have a strong connection with her, even more now because of my work. I knew after my first birth that if things don't go to plan you just transfer to hospital and I had so much confidence, because even in less than ideal conditions I had been able to give birth naturally.

It was my time to do it my way. But then when it came to my third birth, everything changed again - and it proved to be a turning point for me in more ways than one.

Having delivered in my previous pregnancies at 41 weeks, it surprised me when in my third pregnancy I got to 41 weeks and nothing happened. I began to feel mounting pressure to be booked into the hospital for an induction, because protocol is that you offer an induction in time deliver your baby at 42 weeks.

I was adamant I didn't want to be induced. I knew that I tend to be a bit later anyway, I was savvy, I had worked as a breastfeeding support worker, I'm articulate and the sort of woman who will stand up for myself.

So when faced with having an induction when I knew I was fine and that things would happen naturally, I declined the induction and went in for monitoring. But as 42 weeks came and went, I would have doctors come round and tell me my baby was at risk if I didn't give birth today, and that risk was death.

It's a very difficult thing to be told that your baby could die and you're risking their life. You're being made to feel you're putting your birth experience over the health of your baby which is a tricky navigation. It isn't a simple choice between having a home birth and a live baby - that isn't the decision you're making. I was heavily pregnant, I was hormonal, my nerves gave out and I accepted the induction.

I knew that once labour started I would be fine and I would give birth normally and that's exactly what happened - I had my third baby and I just came home straight afterwards. But although that birth was straightforward and in hospital, I felt really sad about that compared to my first one which had been nothing like what I had hoped for. I was disappointed because I knew in my heart that everything would have been fine, with or without the induction.

I wasn't really, truly supported in my wishes, and I felt I was pressurised into doing something I wasn't comfortable with. I thought if I had a doula, things might have been different. I might have had that space and support to really reflect on what I wanted to do without looking at my husband wavering and worrying.

So after a year, I decided to train as a doula myself.

I joined Doula UK and went on the three-day course, worked through the reading list, learnt what to do if a problem arises in birth and prepared myself to be that practical and emotional support for pregnant women in a non medical way.

Then I got pregnant again - and I had this wonderful network of doulas I knew and had a wonderful rapport with. Although I was confident I was going to have a home birth and would be fine, I wanted that emotional support in case I went overdue and was pressured into an induction.

I approached a doula that I knew and asked her to come and support me and she said she would love to. This time, I actually only went two days overdue, which took me by surprise entirely. Whilst I was in labour and I called my doula and said come sooner rather than later as she lives an hour away and I was well underway at that point.

I was coping so well I was able to chat in-between contractions; when she walked in I was already in the pool. She crept in quietly not wanting to disturb the birth and I just knelt up and went, 'Oh hi! So I think I'm in transition but I don't really know because it doesn't feel like I've worked very hard to get to this point!'

I didn't want my midwife to arrive too soon as I like my privacy. My husband was umming and ahhing about ringing her and kept saying, 'you're really nearly there now'.

Eventually he said, 'so do you want me to ring her now?' and I shot him a glance that said, 'you're not meant to ask that, you're meant to wait for me to say!'

I told him no and then as soon as I got another contraction I thought, 'okay yes, actually that does feel like the baby is on its way!'. By the time he was on the phone to the midwife I was starting to push and I knew there was no way the midwife would get here on time - I was more worried about him missing the birth by being on the phone!

If it had been my first baby I would have been a bit worried but having my doula there, even though I knew she wasn't medical and wouldn't have been able to do anything if I had needed medical assistance, her presence made me feel safe. I knew she would indicate in some way if she thought things weren't right which gave me the confidence to trust in what I was feeling.

You can never be supported too much, and I think all women that want a doula should have one. I've never had any feedback of a woman that's regretted having a doula and I think the way that midwives are expected to work in the NHS system now has eroded a lot of the emotional support that traditionally a midwife would be offering. I think one of the reasons doulas have become more popular is because women are becoming more educated about the need for this emotional support.

The research shows that having a familiar caregiver whilst you're giving birth reduces your risks of complications and makes your birth a simpler and better experience. That's to do with that feeling of being safe and a doula bridges that gap, so even if the midwife is unfamiliar, the woman feels like she has that familiar support still around her.

Giving birth is a subject that often incites fear into mums-to-be, with painful horror birth stories circulating between friends and in online forums.

For most, the instinctive attitude is 'give me the epidural!' with few imagining a birth with zero pain relief. But mum-of-two Felicity Miller is determined to change that.

As part of our #MyBirthStory series - where a group of mums share their own stories to prove that there is absolutely no such thing as the perfect birth - she explains how giving birth using hypnobirthing techniques with NO pain relief helped her reclaim her body after experiencing a traumatic first labour, and why she'd recommend it to others too...

I have two children, my daughter, Evelyn, is eight years old and my son, Jack, was born just six weeks ago. Although I was overdue with both my babies, and they both tipped the scales, their birth stories couldn't be more different.

With Evelyn, because she was my first and I was younger I just did as I was told. She was overdue and I felt a lot of pressure to go along with what the doctors suggested. They said, 'you're late now so we're going to induce you' - and that was the way it was. They mentioned risks, but they didn't really go into it and when it comes to your baby, you just don't want to take any risks at all.

I agreed to being induced and I had a lot of interventions. The second time around I wanted a more positive experience, with my son Jack I looked at what my options were and came across hypnobirthing.

Knowledge is power and, for me, hypnobirthing fed into that.

It helps you to be prepared and know what your options are, so whichever way the birth goes, I wanted to do as much as I could to make my own choices and decisions to try and get a better birth experience - and fortunately, it worked!

I went overdue again and they started making noises about an induction, but this time I said I didn't want to be induced for the sake of it, I wanted to find out more about the risks to assess it on an individual basis. I was thinking, this is me, this is my circumstances as an individual, my pregnancy, my baby.

I know some people can get pushed. My midwife was really nice and warned me that if you go to the hospital they will try and scare you. It's terrible that this happens. You're pregnant, you're already vulnerable and it's already a stressful time. Nobody would do anything to put her baby in danger and suggesting otherwise I think is really unfair.

Eventually, I went into labour naturally and was able to stick to my hypnobirthing plan.

Hypnobirthing uses techniques like breathing and relaxation to control your reactions. It starts off being a physiological awareness of what labour is and how you give birth in a physical sense. If you go into labour expecting it to be painful, you're going to be stressed and anxious which releases stress hormones. The idea is the more calm and relaxed you are, things should progress more naturally.

The hypnobirthing we did was a four-week course and it starts by explaining the physical side of labour and birth and how to maximise the best outcome with a positive mental approach by imagining the best scenario. They say prepare for the worst and it might not be as bad you as you expect, but if you imagine the best and hope for the best then you're not afraid and you've already imagined it the best way you can hope it can be. Birth is a good experience, something to look forward to; it's a natural process and we shouldn't be afraid of something that's natural.

In hypnobirthing you don't use the word pain, you call it physical sensations. Whether it's pressure or uncomfortable but don't think of it as pain. If you're not allowing yourself to acknowledge it as pain, it's not as painful. I definitely found that it worked.

I was relieved to start labour and I felt really good when I realised I was half way there already and I hadn't had any pain relief. With my daughter I had the epidural at about five centimetres so I could really feel the difference.

At the hospital I tried to make the environment as personal as I could. We had some nice music, some electric candles, a diffuser to mimic the aromatherapy smell that I had at home. It's about the feeling of controlling your environment, feeling safe and letting yourself relax.

Even when things picked up a bit, I had to lean on my partner but it was never unimaginable. You have breaks in-between your contractions and it's about focusing on those breaks.

I was breathing through it and went into a bit of a trance. I was aware of what was happening and people talking to me, I could reply but I wasn't saying much. I was just focusing and trying to stay in the moment. I took it one contraction at a time. It was like a dream like place, still aware but just doing my thing.

Having done research and gone through the course I was aware what was happening as it was happening. I could feel the baby coming down and felt it bump past the muscles of the cervix, felt the pressure at my lower back and remembered the pictures from the course of how the baby descends and the routes it needs to take.

At that point I thought this is actually happening and I've got this far. There's nothing else I can actually do now and there's no drugs or pain relief.

I wanted to get the head out slowly to avoid tears or grazes and I thought I'll push with the next contraction and that will be the head. Then I'll push again and the baby will be out. But actually I pushed once and he just shot out - we were all quite surprised that he was actually there!

I felt dazed that suddenly the baby was here and I had done it without anything. It wasn't easy and it was tough at the end but it was manageable and I was in control of it; aware of what was happening and why.

The whole time I kept thinking 'maybe the next contraction I will need something', but it never happened.

It's about controlling your thinking and controlling your mindset. Having my first birth so medicalised and then to do it on my own without any intervention was amazing. It was such a nice birth and such a nice experience for me and for my partner - he didn't feel scared, he felt calm and that what he was doing was useful.

Since he's been born, Jack has been relaxed and calm. The midwives have commented in his checks about how chilled out he was, which makes me think that hypnobirthing goes beyond the birth. We've had a brilliant experience, feeling really positive with no trauma or drama.

Different births go different ways, and some of the people in our hypnobirthing group did end up having interventions, but you can still use the techniques to help you feel better about yourself. I would definitely recommend it, I think everyone should do it if they can.

Have a #MyBirthStory of your own you want to share? Talk to us in the comment box below!

After dealing with a previous three-day labour, the last thing Jodie McGolpin expected was a surprise home birth with her second child.

In true super-mum spirit, the 34 year old powered through contractions all day, picked her child up from the childminder and waited for her husband to come home, thinking that established labour was possibly days away.

As part of our #MyBirthStory series - where a group of mums share their own birth stories to prove that there is absolutely no such thing as the perfect birth - she tells us how her birth went from nought to sixty in a matter of minutes, forcing her to give birth at home with no pain relief, but also giving her a sense of empowerment she never expected...

Two days before my due date, pains started, but I just took them to be Braxton Hicks - although looking back, I'm not sure why!

That afternoon I continued to paint some bits for the garden, and then went off to pick up my toddler from the childminder. On the way home the pains were getting stronger but I just tried to get on with things - namely keeping my son entertained.

My first birth had been very long, with contractions that were painful enough to keep me awake at night starting on the Friday, not reaching established labour until the Sunday. With this as my previous experience, I couldn't have guessed how quickly things would move this time around.

Around 4pm I rang my husband and suggested he tell his boss that he might not be in tomorrow as things were starting. He asked if he should leave now and I even said "no no, you know how long my first labour was!" Less than an hour later I was back on the phone to him with a drastically changed tune, begging him to "please come home!"

Luckily a friend offered to come round, which I happily accepted as I grimaced through another contraction whilst trying to serve fish and chips to my little boy.

With my friend and my mother-in-law around me I started breathing through contractions, which at this point, were four minutes apart and one minute long.

I thought that I'd better call the hospital, but they told me: 'you can come in but if you're not dilated we'll send you home. You can try a bath - it'll either intensify things or calm them down'.

I waited for my husband, who got home just after 6pm and ran me a bath, and within just a few minutes I could feel pressure. I got out and called the hospital to say we were coming in, getting dressed as fast as I could, but before I knew it, my waters had broken and I felt the pressure build even more.

Could we make it to hospital? I wasn't certain - so we made the decision to stay at home and asked if a midwife would come to us.

As I got onto the bed things progressed even further - I didn't have access to pain relief but I didn't have time to think about it either! I could feel the pressure, I could feel the baby coming and I was just focusing on what my body was doing.

I could feel myself gritting my teeth and hear myself shouting: 'I should be in hospital' - I think even the neighbours may have heard!

I knew I needed to push, and even though my husband protested that the hospital were telling him that I shouldn't and to breathe through it, suddenly the baby's head had appeared and within seconds she was delivered.

It wasn't for another 20 minutes that the midwife and paramedics arrived, as I just lay staring at my little girl. I was completely shell-shocked - I had never considered a home birth, and to my surprise it was an amazing experience.

I was worried about something going wrong; it never even entered our minds that we would have delivered the baby at home and by ourselves, ever. I always wanted to be in hospital, purely because if anything does go wrong you're in the right place with the right people around you.

With my first birth I let the gas and air take over my body, unable to feel what it was telling me. Because I was scared and apprehensive I was just convinced that gas and air was there to help me, and so I was concentrating more on breathing it in than what my body was doing.

This time I felt empowered and I listened to my body. I didn't love it at the time but I love it now. I think I was more relaxed because I was in my own home - I knew this was happening and I was just focused.

It's weird, but I felt so in tune with my body. I let nature do its thing and although it was painful, I felt in control, which was a brilliant and empowering feeling. My second labour was brilliant compared to my first.

It's been eight months and I still can't believe it happened, but it was an incredible experience and one I am proud to tell.

Have a #MyBirthStory of your own you want to share? Talk to us in the comment box below!

When a newborn enters the family, it's an arrival that affects everyone.

It can change the dynamics of your brood and even incite some sibling jealousy - but some mums believe that they can overcome this by including their first born in the birth of their second.

Mum-of-two Rosamund involved her daughter in her birth story in one of the most immersive ways possible - stood in the birthing pool, shoulder to shoulder with the midwives!

As part of our #MyBirthStory series - where a group of mums share their own stories to prove that there is absolutely no such thing as the perfect birth - she explains why she decided to include her three-year-old in her water birth, and how it's strengthened their family bond even further.

I'm quite an anxious person, and with my first birth, the stress of getting to the hospital, particularly because my husband doesn't drive, was something I found really difficult.

That's why I knew that second time around I wanted a home birth. The maternity centre near us had closed and so the thought of an even longer route to the hospital was stressful. I felt it was safer to give birth at home and have a planned home birth than to risk a side of the road birth.

It had been planned months before that Ramona would be part of the birthing experience, and preparation for that happened organically. Whenever she showed an interest and wanted to chat to the baby, we started gradually talking about it and when I was about six months pregnant I started showing her videos on YouTube.

Some showed women making noises and some didn't. She knew that mummy would have to roar to help push the baby out and that it wasn't scary noises that I was making.

Throughout my labour, she was an active part of my birthing journey; she held up my birth affirmation cards for me to read and tried to give me the gas and air, just wanting to be helpful.

It really helped me focus and keep calm as well. You get to that transition phase where it's a bit scary and having her there in the room really helped me centre and feel relaxed.

When I started actually giving birth, she was right there between the shoulders of the midwives watching her brother come out. I think my daughter actually saw more than my husband did! He doesn't like to watch the actual coming out bit, he holds my hand and talks to me. We did a little bit of hypnobirthing and he helped me breathe. Ramona was actually the main reason I knew I was crowning, she shouted up 'he's coming he's coming, I see baby's head!' I have never seen anybody give birth, but she seemed to be completely fine with it!

The midwives were really happy about my daughter being there, being so interested and involved. It made the experience a real family event and I think it helped her understand the arrival of her baby brother. He didn't just turn up, she understood what happened and how it had all came about.

Some people might find the idea of a three-year-old watching their mother give birth a bit odd, but luckily I received really positive feedback from everyone I know. Everyone just thought it was lovely, nobody said anything negative at all.

It's been ten months now and she still talks about 'when Mortimer came out of mummy's tummy' and 'mummy was in the big paddling pool'. If anybody asks her what she wants to be when she grows up, she says "I want to help babies come out of mummy's tummy". It's not something that's been put into her head, we give her lots of examples like farmers and doctors, but it's had a really big impact and I can see it's had a positive effect.

There's also not been any jealousy at all - I feel like it's made it easier for her to understand his joining of our family. He's not just turned up one day, she's seen him arrive and I think she feels like she's helped with that as well. Ramona and Mortimer are very close and she's very motherly towards him. She absolutely adores him and tells everyone she meets, 'this is my baby brother'.

I would definitely recommend this to other mums - it was absolutely fantastic. I would suggest having a back up plan because every child is different and you need someone on call to sit in a room and entertain them or take them out of the situation if they need it - but for us, she didn't need that at all and it was just wonderful.

Have a #MyBirthStory of your own you want to share? Talk to us in the comment box below!

As if mums-to-be don't worry about the pain of giving birth enough, imagine having an absolute whopper to top it all off.

That's exactly what happened to Milli Hill, whose second child was a big baby - weighing in at 10lb 4oz!

As part of our #MyBirthStory series - where a group of mums share their own birth stories to prove that there is absolutely no such thing as the perfect labour - author and mum-of-three Milli Hill shares her story of being the birther of particularly large babies and why she actually found it pretty easy...

'How much did they weigh?'

As every woman who's ever had a baby will know, the world is fairly obsessed with this question, and you'll be asked it by everyone from your father-in-law to the postman.

If your answer is less than seven pounds people will say, 'Oh, not too bad then!'; anything over that number and everyone says, 'Blimey', and pulls the sort of face they usually only reserve for groin injury stories after the game on Saturday.

Women like me get the best reaction – it can only be described as a stunned silence followed by just one word: 'Whoah'. I'm a fairly slim girl who can just about squeeze into size 8 jeans, so believe me I was as shocked as the next person when my second baby tipped the scales at 10lbs 4oz.

Perhaps more shockingly still, the birth was easy! That is, if the word easy can ever be applied to birth - it certainly did smart a bit. So when I say 'easy', what I mean is, it happened at home, it didn't hurt so much that I felt I needed pain relief (not even gas and air), the 'pushing' bit lasted about five minutes, and I didn't need any stitches. Easy!

There was no anxiety in my pregnancy about the size of my baby. I had a big bump but according to the midwife's tape measure it was bang on target. So we breezed into a home water birth feeling confident, not knowing what a total chubster was silently biding her time in my ever-expanding uterus.

My first baby had been a little larger than average at 8lb 11oz, and had been born in hospital after I was induced for going past my due date. Now that I've had three babies I've learnt that this is perfectly normal for me – I'm a 'slow cooker'. With both my second and third baby, I took the decision not to accept hospital induction until at least 42 weeks – and both of them were born at 42 weeks on the dot. I've always been the kind of person who likes leaving things 'til the last minute and it turns out that when it comes to gestation, I'm no different.

So – the due date for baby number two came and went. It was May, and quite hot. As the days went by with no sign of my baby, I became increasingly irritable, down-hearted and riddled with doubt. As I'd been induced with my first, I'd never actually gone into labour naturally, and I genuinely started to wonder if I had some kind of cog missing and was actually incapable of getting started without medical help.

Of course, this was not the case: in the early hours of the morning on 27th May, I was woken by some very strong sensations. I had been asleep in bed with my two-year-old daughter, so crept away to my partner and woke him up. Could something be happening? We went downstairs together in the dark and chatted and waited for more and wondered what to do. The tightenings were intermittent, and eventually we put in a quick call to our midwife, who advised we went back to bed.

The next morning, there still seemed to be some activity, but it was patchy. Some sensations felt powerful, others less so, and there was no real pattern. As we had an immersion tank hot water system, we decided to start filling the pool just in case, as we had already had a trial run and it had taken several hours.

By late morning there was still not much happening, and of course, I remained full of doubt in my body and convinced it would all just fizzle out, as had happened to me a few times in my first pregnancy. I felt extremely hungry, and had a huge and sudden craving for a fry up that absolutely had to include sausages. My lovely partner obeyed and once I'd wolfed it down, I took myself off to bed for a nap.

When I woke I felt different. Somehow I just knew this was it. I went to the bathroom and tied my hair back. I can remember thinking – rather vainly – that I had better make an effort to make it look nice as I would be having my picture taken later holding my baby!

While I had been asleep my partner had tidied up the house and put a vase of fresh lilac on the kitchen table, which I found very touching. He also started making vegetable soup – it all sounds idyllic, right?! As he finely diced courgettes I found myself having a really serious, I-mean-business contraction, kneeling on the floor of the living room, leaning on an armchair, with the two year old climbing on my back and the dog, who never likes to be left out, placing a slobbery ball in front of my face. I'm afraid I shattered the moment by yelling, 'Stop making ****ing soup and get rid of this ****ing dog!' at the top of my lungs.

Suddenly we both realised that something really was happening. The dog was banished to our neighbours. My partner's sister came to take care of our daughter. The midwives were called. I lit some candles and put on some music. By myself in the living room, this felt like a good moment! I was actually in labour! I didn't have a missing cog after all!

From this point on, everything seemed to get better, and more and more beautiful. I relaxed into the labour, and once the midwives arrived and I got into the birth pool, I felt totally in my element.

It sounds a bit cheesy, but the room seemed to be full of lightness and love. At one point I asked the midwife if she had dropped a torch in the pool, as it seemed suddenly illuminated in an otherwise fairly dark room. She hadn't, but a chink of light from the evening sunshine had come through the curtains, striking the pool at just the right angle and making it glow an ethereal blue. We all marvelled at this for some time, and even took photos. It felt like a nod of approval from Mother Nature herself.

Shortly after that my daughter returned from a walk with her Aunty, and brought me a bunch of hedgerow flowers – a special moment I will never forget. I had been worried about what to do with her during a home birth, but it couldn't have been lovelier than to have her around, dipping in and out of the birth room and reminding me of what I was working towards. I felt huge waves of love for her, for my partner, and for everyone present!

And then the 'pushing stage' began, the ultimate in letting go. I was not a quiet birther who breathed her baby down into the world in tranquillity. I roared. I gripped hard onto my man's arms, and he gripped mine, and I knelt and I pulled back on his arms with all my might and I roared. I felt extremely powerful, and extremely determined. And of course, my baby felt 'big'. I would wager a bet that every single woman who has ever had a baby has felt that they were 'big' at this stage! But I had no idea that she was any bigger than normal.

My midwife asked me if I wanted to catch the baby. To me this seemed like a ridiculous suggestion! 'Nooooo! I'M... TOO... BUSY!!!' I remember saying, so she gently passed her up to me through the water. We looked to see what we had – a girl. I held her, repeating incredulously, 'I did it! I did it!'. I couldn't believe that it was over and that I had done it all myself. I felt elated.

My partner quickly tore off most of his clothes and joined us in the birth pool, swiftly followed by an amazed two-year-old keen to meet her new sister.

It wasn't until much later that she was weighed and we were all incredulous at the size of her: 10lb 4oz. To this day I have no idea why I grew such a large baby – and I did it again three years later; another home water birth with her brother who failed to steal her title at a slightly smaller 9lb 11oz.

Ironically, all three of my children are now like little sparrows, fine-boned and dainty without an ounce of fat on them! Why they had to grow so big in utero is something that nobody has ever been able to explain.

What I think I can explain is why I managed to give birth to such big chunksters without help or intervention: I knew and trusted my midwife, there was minimal interference in my labour, my birth room was calm and dimly lit, and I was upright and active from start to finish, allowing gravity to help my baby descend though a pelvis I was able to open to its maximum because I was not on my back.

All of these factors have been shown by evidence to improve women's experience of labour and make birth easier – but very few UK women are currently giving birth under these circumstances. Often when birth does not go to plan, women blame themselves and feel they have somehow failed. My feeling is that at the moment we are failing women, by asking them to give birth in circumstances that make it more difficult for them. Add into this a widespread fear and lack of confidence in women's bodies to give birth and what results are far higher rates of caesarean and other interventions than are actually necessary.

We're often told big babies are a big problem. High rates of birth intervention are blamed on women being 'older and fatter', and bigger women making bigger babies gets a regular mention in the birth debates. But again, this rather conveniently puts the blame on women for what is in fact 'system failure'. Regardless of your age, or your size, or the size of your baby, you are much more likely to have a better birth if you know and trust your midwife, stay off the bed and active in your labour, if your environment is dimly lit and undisturbed, and if your care providers are confident enough in you to take a hands off approach unless they're really needed.

'How much did they weigh?' might be our most popular pregnancy query, but in fact, 'Why do some women give birth easily while others struggle?', or indeed, 'Why are some women not being given a fair chance at a normal birth?', might be far more urgent and interesting questions.

Milli's book, The Positive Birth Book, is available to buy from Amazon now

Have a #MyBirthStory of your own you want to share? Talk to us in the comment box below!

Mums-to-be look away now, as a mum from from Kilmarnock in Scotland has taken to social media to speak out about how difficult birth stories

 can be, painting a rather painful picture.

Mum-of-two Jordan Kennedy was watching the hit TV show One Born Every Minute and felt inspired to share what she considers to be the truth about labour.

She posted a brutally honest Facebook status sharing her reality of giving birth, claiming she was 'screaming for someone to just cut your throat and end it all'.

https://www.facebook.com/photo.php?fbid=310654592728973&set=pb.100013533048210.-2207520000.1497610584.&type=3&theater

Jordan began her post saying: 'Just watching one born their and it got me thinking how rotten is it giving birth.. it's some buzz when the baby's out but seriously being in labour has to be one of the most ugly things ever..'

'you start off with your wee clean pj's and matching slippers.. all smiles even a bit of lip gloss ta keep you in gid spirit..then as the contractions start getting heavy the slippers are chuked across the room.. yar hairs scraped back like dog the bounty hunter.. you endup wearing a nappy that could absorb the dean park pond..'

https://www.facebook.com/jordan.phot/posts/309962289464870?pnref=story

The mum then continues to describe what some mothers may find an embarrassing side effect of birthing their baby: 'you try so hard to keep your dignity so your man will still want you despite whats about ta happen but as the hours go on your sucking on the pain relief like a burns mall junkie screaming for someone to just cut your throat and end it all..'

'Then it's time ta push and God forbid you eat anything in the last 8 hour.. your wishing ta god you had just farted in front of your boyfriend coz now he ken's you fart.. but trying to keep your thoughts away fay the fact you just shat the bed you just take the next avaliable pain relief ta block out the embarrassment..'

https://www.facebook.com/photo.php?fbid=292284394565993&set=pb.100013533048210.-2207520000.1497610589.&type=3&theater

The Scotland native referred to the state of a newborn baby as 'blue' with a 'cone head' before admitting new mums can finally relax, 'out pops a giant head and your arse feels like it's been set alight before the shoulders Finnish you aff.. everyones that happy awww the baby...lets just all pretend hes no blue and got a big cone head..'

'you forget it all and then just as you relax and take a moment to yarself some dodgy wee midwife that's no slept in 35 hour trys to set about your vagina with a needle and thread..'

Finally, Jordan signed off her post with a tongue in cheek declaration, calling giving birth 'a pure magical moment for a woman 😊'.

The 25-year-old's post quickly went viral, being liked over 22k times, and receiving lots of attention from thousands of followers sharing the post and calling it 'too funny'.

One Facebook user said, 'I honestly cried reading this 😂😂 too funny!!!!' whilst another said, 'I'm crying at the blue and cone head!'

'This is hilarious!!' a third agreed. 'And it's so true one born is so misleading lol x'

A new mum has shared an image of her newborn baby holding the IUD coil that was supposed to stop her getting pregnant.

Lucy Hellein shared an adorable picture of her baby boy who was born on the 27th April on her Facebook to show her family and friends. But this was a birth story with a difference, as it featured the Mirena device - a brand of hormone-releasing IUD coil - that she was using as birth control to stop her getting pregnant in the first place.

An IUD, otherwise known as the coil, is a small T-shaped plastic or copper device that's inserted into the womb and stops the sperm and egg from surviving in the womb or fallopian tubes.

Mirena is a type of hormonal IUD that's inserted into the uterus as a form of long-term birth control. The T-shaped plastic frame releases a type of progestin - a synthetic hormone - to stop pregnancy. An IUD is advertised as being 99% effective, but as Lucy discovered that 1% room for default shouldn't be underestimated!

Next to the picture of son Dexter, Lucy shares details of his birthday and weight whilst explaining that her IUD was found behind her placenta.

Calling her son a 'miracle', the mum-of-two used hilarious hashtags such as #theforcewasstrongwiththisone to reference the incredible odds that her baby managed to grow despite her being on birth control.

Lucy wrote, 'Mirena fail! Dexter Tyler, 27 April 2017 @ 0840, (His original due date was May 4th, 9lbs 1oz, 21.5in, Mirena found behind my placenta ❤'

https://www.facebook.com/photo.php?fbid=10154835561293962&set=a.427611873961.207718.593053961&type=3&theater

Since being posted less than a week ago, the photo has gone viral and been shared over 70k times.

Commenters have shared their surprise that Lucy was able to get pregnant whilst having the implant, with one Facebook user noting that her baby must have been 'a fighter'.

One Facebook user wrote, 'Just means he was a fighter from the word go.'

Whilst another added, 'I mean he kicked mirenas butt! He's gonna rule the world when he's older!'

A third agreed, 'your little jedi is already taking over the world'

https://www.facebook.com/photo.php?fbid=10154837339323962&set=a.10150277147783962.339338.593053961&type=3&theater

Lucy spoke to the Metro about her story, explaining that she was scared that having the IUD in her body could effect her baby.

'This was actually my third Mirena, my first two worked great. I had this one inserted back in August.'

'I found out I was pregnant in December and I’ll admit I was scared because of the Mirena.'

The mum from Alabama, US, said that although her baby wasn't planned she feels 'incredibly blessed' to have had him.

'My Mirena was no where to be found on ultrasound so my OB assumed that it had fallen out, but I wasn't convinced.'

'Dexter was definitely meant to be. His original due date was May 4th and even the doctor said 'the force was strong with this one'. Although he wasn't planned, my family and I feel incredibly blessed.'

When Jessica McKey's first child was born seven months ago, it was in a 'completely quiet, very calm, restful environment'.

There was no panic, no pushing, and no last-minute dash into surgery, because in fact, surgery is exactly what Jessica had on her agenda all along. At 39 weeks pregnant, she welcomed her daughter into the world through a planned, elective C-section, conducted by the anaesthetists, midwives and consultants of her local NHS service.

Jessica, 30, doesn't have any existing medical conditions or other qualities that mean that she would be a likely candidate for a scheduled C-section. Instead, she simply chose to experience a Caesarean rather than a vaginal birth, and she's adamant that her birth story was absolutely the right choice for her.

'I had a very straightforward pregnancy, and I really enjoyed it, but I didn't properly engage with how I was going to give birth until I started to get quite big,' she says.

'Most women want to give birth naturally - they want to give birth out of their vaginas, because that's what society tells us that we're supposed to do. But I became interested in the numbers around birth injury.

'I wanted to know what percentage of women need stitches or an episiotomy, what percentage of women suffer bladder incontinence, how long does it last for, what percentage of women suffer fecal incontinence?

'My midwife couldn't give me an exact figure; she seemed quite surprised that I wanted to know these things, and I found that in turn surprising. If you were going through any other point in your life where you know your body is going to have to go through so much, you would absolutely be expecting to delve into all of the associated risks.'

Jessica was also surprised about the minimal level of planning she was encouraged to do: 'My midwife kept saying that to me, "don't worry about making really definite plans because it'll all go out of the window anyway!" I just thought, why does it have to be like that? I felt I wanted to take back some control over the whole situation.'

She adds that many of her concerns about a vaginal delivery stemmed not only from worry about birth injury, but also from the fear of lack of postnatal care if it does occur. Although women are priorities to the health service when they're pregnant, she feels that the provision for women after labour is lacking, not only with issues like incontinence, but also pain and discomfort during sex.

'It's not seen as a concern for a woman not to enjoy sex, or for a woman to find sex painful,' Jessica says. 'Some women even report doctors saying: "Well, it's probably better that you have all your children and then we'll sort your vagina out, because there's no point sorting it out now, when you might have more children."'

'Women's assessment of pain is really questioned. There's an element of women being 'hysterical'; don't give them too much information, don't give them too much choice, because they won't be able to cope.'

After conducting her own research, the mum-to-be quickly became disillusioned by the 'obsession with the pain of childbirth as a rite of passage'.

'You're seen as a vain or selfish person if you're not prepared to go through that pain. But in what other scenario are humans encouraged not to take pain relief when something is painful?' she questions. 'If you go to the dentist and someone says they're gong to give you a root canal, under no circumstances would anybody advise you not to have pain relief.

'People sometimes say you opted for the easy option because you had a C-section. Planned C-sections, of course, are very different to emergency C-sections, but nobody gets points for difficulty level - you just want your baby and yourself to be as healthy as possible.

'And even if it was easy, why does that matter? Why do women have to do the hard thing? Why can't we say, actually I want the easy option and I'm really glad I chose that option, because it was easiest for me?'

The route to Jessica's elective C-section actually ended up proving anything but easy, as, like the majority of pregnant women who are young, fit and healthy, she was strongly encouraged to try for a vaginal birth.

Although her midwife was ultimately supportive, one consultant, whom she was required to meet with to get sign-off on the procedure, suggested that her child would be at higher risk of obesity and diabetes should she elect for a surgical delivery (figures she believes he'd miscommunicated, and that actually refer to women who are already overweight and subsequently end up needing an emergency Caesarean).

Her partner, however, was completely in favour of 'the least traumatic option'.

'We as a couple engaged with this together. He would have absolutely respected my decision whatever I wanted to do, but we both looked at the statistics, and that's really what I was focused on. We made the decision together, he was very supportive.

'I had zero worries about bonding. I had my baby on my chest, so did my partner, I was able to hold her. I haven't had the experience of a vaginal birth, so I can't compare the two, but there were certainly no worries about not bonding with her and it was just the most magical experience. They will hand you the baby like they do if you gave birth to them out of your vagina, you still get them placed on your chest. I can't see how it would have been made any better.'

Jessica's recovery from her C-section took around five days, after which point she was 'fine'. Her only difficulties were 'shuffling instead of walking properly', and picking up her baby girl, which she could still do, but with extra care and caution. She has a scar, which she says doesn't bother her at all. 'I don't even focus on it when I look at myself. It's just part of my body,' she shrugs.

'I know that every woman is different and there's no right or wrong, and ultimately what I want for every woman is choice. I'm not suggesting that everyone should have a planned C-section, because that wouldn't be necessary, and lots of women wouldn't want that. C-sections are major abdominal surgery, so it's not like it's without any risks itself, but there's a lot of narrative around pain relief and natural birth that I really didn't identify with at all.

'You definitely get a response when you tell people that you've had a Caesarean and it was a planned one with no medical need,' she admits. 'But the main thing I get is "oh, I didn't know you could get that on the NHS"' - and her main aim in sharing her story is spreading awareness of the fact that every woman is entitled to the birth she wants, on the National Health Service.

'If you want it, it's your choice,' she stresses. 'Lots of people are very supportive of female choice, and they recognise that birth is so personal and so individual that is almost doesn't make any sense to judge somebody else's birth.'

Jessica does acknowledge that there is a debate about NHS resources when it comes to planned C-sections: 'If every woman did decide to have an elective Caesarean, the current NHS set-up wouldn't able to cope with that. I understand resources are important, and there's a practical point around this - how are we going to make this possible if we start making Caesareans more available to people or we start promoting the fact that Caesareans can be an option for you?

'But if that is what you want the NHS is going to have to respond to that, but the NHS should be responding to what women want. It's very responsive to a lot of other patient groups, and it should absolutely be responding to what women need from a birth service. I can absolutely see that if everyone turns round tomorrow and says "we all want Caesareans", that's impossible, but over time, it could certainly be something that the NHS could respond to.

'This has to be about treating women fairly, and that means respecting their choices and wherever possible providing them with the birth that they want.'

A mum-of-two has welcomed her third child while live-vlogging the entire experience on Facebook.

Sarah-Jayne Ljungström, who goes by the name SJ, shared her birth on the Facebook page of website Channel Mum, uploading a series of videos taking viewers from the beginning stages of her birth story to the introduction of her 8lb 1oz newborn daughter, Evelina Blossom.

https://www.facebook.com/channelmum/videos/1289805804391484/

Throughout the live videos, SJ expresses a range of emotions, from 'slightly terrified' when her waters break to 'quite anxious' while waiting at home during her contractions, but remains upbeat and chatty when interacting with her viewers, even joking with them as she films.

'Can somebody else come and do this?' she says at one point during the early stages of labour. 'I don't want to do this bit!'

https://www.facebook.com/channelmum/videos/1289873341051397/

She also shares tips about her pain relief throughout the process, showing her audience the TENS machine she's rented, which she says also helped with her first two births.

While the videos don't actually show the delivery of Evelina, they do pick up as soon as they arrive home from the hospital, where she says that she had 'not too straightforward a labour', as her daughter was back-to-back, and there was no time for an epidural.

However, she adds that: 'I'm very very proud of myself and this little one'.

https://www.facebook.com/channelmum/videos/1290259881012743/

Explaining her decision to publicise the experience after the birth, SJ said: 'I've been vlogging about motherhood and my pregnancy this year so it was natural for me to do the same and share my labour. I find being a mum so rewarding but it can be overwhelming and lonely.

'I was always looking for help and advice especially about the big things like labour and feeding that I was anxious about. Stories from other real mums I could relate to helped me so much.

https://www.facebook.com/channelmum/videos/1291180250920706/

LAST ONE

'So I decided to share my own to show a real everyday labour that other mums and pregnant woman could follow and see how it went. Birth isn't really like the movies so showing a normal everyday labour story was nice.'

Viewers of the videos have since flooded SJ with messages of support and thanks, with one writing: 'Oh SJ, I am so pleased just to see you both at home. Huge congratulations. I'm in tears.'

Another commented: 'Huge congratulations lovely! You have done absolutely amazing!! So so beautiful.'

After losing her own baby, a mum rushed to another woman's side to help her through her stillbirth, despite them being total strangers to each other.

Nene Fulcher, a mum of four who lives in Australia, knows all too well how devastating it is to lose a child during pregnancy, which is why she aims to help others going through the same thing on her Facebook page, Remembering Jacob, named after her stillborn son.

She wrote in a post that she would serve 'as a resource for you should you need it' for any struggling parent, inviting them to contact her if needed.

Nene was then contacted by Sandra, a woman who was dreading the birth of her baby who had already passed away, saying she felt 'scared and anxious' about the delivery.

'She explained to me that she was nearly 24 weeks pregnant and sitting alone in the hospital, waiting for her stillborn son to come into the world,' wrote Nene in a post, explaining what happened that night.

'...She didn't know who to turn to.'

'Half an hour later, I was sitting in room 23 at the Gawler hospital. And that's where I have spent the majority of the last 48 hours.'

https://www.facebook.com/AngelBabyJacob/photos/a.667364710035930.1073741829.661628833942851/932319980207067/?type=3&theater

Nene rushed to the hospital where Sandra and her husband, Michael, were waiting.

'What was meant to be a visit to answer any questions she may have and offer any reassurance she may need in her ability to deliver him, turned into a quickly formed friendship and me witnessing the birth of an angel,' wrote Nene.

'I think having someone there who knows exactly what's coming was what she needed from me, and as weird as it sounds I was quite excited to think that I would be able to use my bad experience to guide someone through theirs.

Nene did have her doubts about putting herself close to a similar situation that had left her so devastated.

'I'm not going to lie.... I was shitting my pants. I was nervous, anxious and wondered if being in there was going to dig up memories I'd subconsciously buried.

'That wasn't the case. Don't get me wrong... I cried. But I wasn't crying for myself or Jacob... I was crying for Sandra and Michael and their precious baby.'

https://www.facebook.com/AngelBabyJacob/photos/a.667364710035930.1073741829.661628833942851/935309779908087/?type=3&theater

She advised the couple to make the most of their time with baby Vincent, the couple's stillborn son.

'The biggest advice I had for her was to collect as many memories as possible. Use every opportunity to preserve his memory as it will bring the most comfort when the bad days outnumber the good.'

Nene also opened up about a struggle she's been facing with her perspective of her own stillborn son's existence.

'One of the hardest things I've battled with personally is pinpointing a "reason" for Jacobs existence. Creating his meaning of life has been my priority.

'I guess in a way I feel like I need to justify my intense grief for him. Why is he so special?

'This is why.'

If it hadn't been for Sandra, Nene would not have been able to see her own tragedy in this new light.

'Who would have answered Sandra's intimate questions and put her mind at ease if Jacob didn't die?

'Perhaps raising money for an organisation wasn't meant to be Jacob's legacy after all. Maybe this was it. Maybe it can be again.'

Nene has no doubts about the experience.

'Would I do it again for another complete stranger? Yes. Was it difficult for me.. Yes! BUT little Vincent has probably changed my life for the better.

'Sandra, your son has been on this earth for barely a day and he's already altered the direction of my life. I hope that brings you comfort.

'THANKYOU for letting me be there to witness the birth of an angel from a different position. You've helped me and you've given me renewed strength to help others.'

https://www.facebook.com/AngelBabyJacob/photos/a.667364710035930.1073741829.661628833942851/901080273331038/?type=3&theater

Since the emotional birth story was shared, Nene's page has seen a lot of likes, shares, comments and personal stories being posted, with the mum replying to every one of them.

'I needed someone like you when my baby boy was born. You are one special woman xx' wrote one follower.

'I'm so sorry you felt alone. And I'm so very sorry you couldn't bring your precious boy home xx' replied Nene, who then offered to speak to the woman about her lost baby.

'I've spoken to a lot of women since writing about Jacob's birth story,' Nene told the Daily Mail Australia.

'But this was the first mum that I have physically been to see. The first birth I've been at that wasn't my own. I would do it again in a heartbeat if I had to.'

We reached out to Sandra to hear her thoughts on her experience: 'I want other parents to know there are options and help. That they aren't alone', she told us.

'Having Nene there was so good. I was able to draw strength from her. I knew by looking at her that no matter the pain I was in I would be able to go on.

'I'd learn to cope and be able to function for Michael and our daughter. The best advice I got from Nene was to acknowledge and remember Vincent. She made me feel hopeful I think.'

Sandra also bravely opened up about how she and her family have been doing since their loss.

'The past week has been incredibly hard. We have our ups and downs but having our daughter has helped keep us grounded. She is a huge part of what has gotten us through.'

She also has an inspiring message for others experiencing anything similar.

'I have a message for people going through and family members of people going through this. Ask for help, accept when offered. Talk about your baby. I am always happy to hear from people who need help advice or anything.'

Most birth stories are far from glamorous, but it's not everyday that someone gives such an honest, and detailed account, of what actually happens in the labour room.

One mum has the given a brilliantly honest account of the whole experience - and how it resulted in a pretty embarrassing moment.

Mum of two Zoe George has revealed how natural childbirth affected her body, particularly her downstairs region.

Writing a post for her blog The Subtle Mummy she said: 'Let me tell you something, my first child broke my vagina and you don't want to know what else, but I'm going to tell you anyway.

‘Yup, it's broken and I need a mechanic trained as a gynaecologist to fix it.'

Zoe admitted that she never realised just what can happen to your body post-pregnancy saying: 'Now you may have heard mummies saying jovially, “haha I can’t jump on a trampoline, I may pee myself” and you think to yourself, wtf that’s just gross and there is no way that will happen to me! Well, that was me. Little did I know there were worse things to be afraid of.'

She then went on to give a completely honest, but also quite hilarious account of her time after labour and what exactly happened to her pelvic floor.

'What they don't tell you is there are three pelvic floors', she said. 'Your ‘pee hole', your ‘love hole' and your ‘exit only hole' (let's call it EOH). Thankfully (kinda) my first two were fine after the birth but I had no idea of the surprise that was to come.'

But it was during a visit from her friends and family, that Zoe noticed something had changed with her body.

'Everyone was happily chatting away and I was feeling thirsty so I poured myself a glass of water and slowly raised the glass to my mouth to have a sip.

'As the glass was nearing my lips, my EOH took it upon itself to start farting!

'I'm not talking a little brrrrt. I'm talking this fart went for at least five seconds. I want you to count those five seconds out now and realise how long that is.'

Naturally shocked by the noise, she said: 'All I could do was hold the sheets down as tight as I could and try not to move for fear of dutch oven-ing my guests'

Zoe then ran to find to the midwife to find out what exactly was happening.

'This poor girl was trying, in her best serious face to tell me it was my pelvic floor and it happens when you push a small melon out of you, seeing as you push as though you're are taking the biggest cr*p of your life', she said.

Fortunately, Zoe did reveal that after 'many butt clenches', she is now almost back to normal, with only a few embarrassing moments. She admitted: 'There are still a few mishaps every now and then, like the time I did one in class and blamed the closest student.'

Can you relate to Zoe's honest account? Would you ever share your labour stories? Tell us in the comments below...

A new mum has hit back against people who described her C sections as the 'easy way out'.

All birth stories are different, and in an honest Facebook post, Raye Lee shared photos of her surgery to show the unexpected pain of having a C section, calling it 'the most painful thing I have experienced in my life'.

https://www.facebook.com/photo.php?fbid=614477965380757&set=a.104445449717347.9744.100004556770788&type=3&theater

In the post, Raye shared photos of the scar left as a result of surgery to highlight how traumatic the process can be. She said: 'I now belong to a badass tribe of mamas with the scar to prove that I had a baby cut out of me and lived to tell the tale. (because you can die from this, you know.)'

Rather than having a cesarean as a 'matter on convenience', Raye had the surgery after being in labour for 38 hours - when the baby went into distress and the contractions were stopping his heart.

She added: 'Having a shrieking infant pulled out of an incision that is only 5 inches long, but is cut and shredded and pulled until it rips apart through all of your layers of fat, muscle, and organs (which they lay on the table next to your body, in order to continue to cut until they reach your child) is a completely different experience than I had imagined my sons birth to be. This was not pleasant. It still isn't.'

https://www.facebook.com/photo.php?fbid=615360635292490&set=a.104445449717347.9744.100004556770788&type=3&theater

Her post also highlighted that the pain doesn't stop when the C section is over, but the recovery after the procedure is an incredibly long and distressing process.

'You use your core muscles for literally everything... even sitting down, imagine not being able to use them because they have literally been shredded and mangled by a doctor and not being able to repair them for 6+ weeks because your body has to do it naturally', she said.

The post has since been shared over 10,000 time on Facebook in just four days, with many mothers sharing their own C section stories to show how the surgery is far from easy.

When you were busy preparing for the birth of your little one, did you ever stop to think about allowing one or all of your other children to be present, or even take part?

Mum and writer Milli Hill investigates the growing trend for allowing your kids to meet their new baby sibling right in the delivery room, and shares her own birth story too...

Letting your children watch you give birth? Won't they be scarred for life?

This is the question the world is asking this week, following Jamie Oliver's cheery revelation that daughters Poppy, 14, and Daisy, 12, witnessed the birth of his son on Sunday, and that they even helped cut the umbilical cord.

Why would anyone want their child to witness the 'horrors of childbirth'? I felt this way once, too. As I prepared for the birth of my second daughter after a fairly traumatic first birth, I felt anxious. I was planning a home birth, and my first-born girl, then aged two and a half, was my biggest worry. She had never been away from me for long – but where would she go when my baby was being born?

My midwives, wise and calm as all midwives tend to be, met my worried gaze and asked me this simple question: 'What don't you want her to see?'

My list was long, and fairly typical of most 21st century women's expectations of childbirth: blood, gore, screaming, swearing, panic, emergency, horror.

Wisely and calmly the midwives met my gaze again and told me, with such quiet conviction that I really believed them: 'Birth doesn't have to be like that. Your birth won't be like that. It will be beautiful.'

Jools Oliver hit the headlines this week, after allowing her two eldest daughters to be present for the birth of her fifth child

And they were right. My labour began in earnest on the lunchtime of a summer's day, and by early evening my daughter was born in the birth pool. My first born, looked after by her aunt, popped in and out of the room throughout the afternoon, but mostly found it boring once she'd been firmly told she couldn't get in the water with mummy. Seeing her during my labour inspired me to carry on even when it was tough, and the moment when she brought me a bunch of hedgerow flowers will be etched on my memory forever.

She watched the birth from a perch half way up the stairs, and jumped in quickly afterwards to meet her sister.

When I gave birth for the third time, I didn't worry at all about what to do with my other children, then aged five and three. They slept through most of my night-time labouring, but ate their cereal in the next room while I pushed my baby out, and then leapt in excitedly to see him, bringing him a large collection of books to read – start them young! The three year old cut his cord and is proud to tell the story to this day.

Ehrin MacRury Wren, from London, gave birth eight weeks ago to baby Alastair with sibling Archie, five, and Hattie, two, present. She feels that the fear of having children around birth is more about our negative expectations than the actual reality of what birth is like.

'I think when lots of people think about birth they think of loud, frightening TV births', she told me.

'Ours was very calm and quiet, and sometimes a bit giggly! We had 80s music on the radio and sang along in the pool. When the baby arrived the other two were ecstatic, singing Happy Birthday to him before they went to bed! If either of them had had a problem they could have gone to another room but as it turned out they thought it was all pretty normal – perhaps because it is', she added.

Ehrin MacRury Wren: 'They all sang Happy Birthday' Image: Ehrin MacRury Wren

Jacque Gerrard, the Royal College of Midwives Director for England, agrees that children will usually take childbirth in their stride: 'Birth is a normal life event and children are often involved in a pregnancy so carrying this on into labour can be quite natural', she told me.

'If it happens in a prepared, loving and supportive environment, having children at the birth is really positive and healthy.'

Cutting the umbilical cord is beautiful, and so positive in terms of the relationship with the new baby.'

In a world that is often so fearful of birth, we also need to challenge our own expectations as we talk to our children about what birth will be like. In my case, I learnt to explain to my girls that the loud noises mummy might make in labour (which I had always found terrifying to listen to myself), were not the sounds of pain or distress, but of 'effort' – 'just like the sounds you'd make if you had to move a wardrobe from one side of the room to the other', I would tell them, feeling secretly reassured by this analogy myself.

So many of us have received such negative messages about birth, from television programmes, overheard comments or the dreaded school video, designed – perhaps - with the sole purpose of putting you off sex and babies for life. But when children attend birth, they don't bring any of this baggage.

Alison Walsingham during labour with son Caelan: 'He totally gets it' Image: Tree of Life Doula Photography

'To my son it completed the whole pregnancy', says Alison Walsingham, from Kent, whose son Caelan was there for the birth of her second baby. 'He didn't go to Grandmas and come home to a new baby or wake up and her be there. He witnessed where his sister came from and he totally gets it.'

Alison Walsingham and son Caelan: 'Mummy sounded like Darth Vader' Image: Tree of Life Doula Photography

'In his words, he says mummy sounded like Darth Vader and he saw his sister come out of mummy.'

Being present for birth is a gift to children of any age. For the Oliver's teenage girls, how wonderful for them to know how simple and normal birth can be, in an age that tends mostly to view the event with dread and fear. I hope that my own daughters will grow up to see birth as 'just something clever that girls can do', rather than, as a Daily Mail columnist described it this week, 'brutal, terrifying... no child should witness it.'

This view is quickly becoming dated, and Jools Oliver's decision not just to welcome her teenage daughters into her birth room, but to share with the world that she did this, is a powerful sign of this turning tide. It's really got people talking, most of all because many people's expectations of childbirth are pretty low – just as mine were once.

In the future, thanks in part to Jools Oliver, the idea of birth as a terror that must be kept hidden from view might well be a thing of the past, helped along by the women lining up to share their stories of calm and positive births using the hashtag #siblingsatbirth.

Jools's action is forcing the world to ask itself some tough questions about our expectations of childbirth. We're forced to consider what it is about birth that we don't want others to see? And more importantly to ask, if it really is so horrific, does it have to be this way?

So what do you think?

We asked you if you'd ever consider letting your child be present for your birth over on the GoodtoKnow Facebook page, and here's what you had to say:

We didn't plan it but my eldest watched her younger brother being born at home. Since then we've also watched horses, lambs, kittens, and a rhino being born online. We're all mammals, we birth live young. There are some really horrible things in the world I would prefer my kids didn't watch, but not nature - it's awesome. - Mel Beard

My eldest daughter who was 14 when her brother now 5 was born, watched and cut his cord. - Tennille Mcconkey

If they're old enough, why not .. Would encourage a beautiful bond ! - Cyn Wray

I dont agree with it but hey each to there own - Emma Grundy

Mother-of-two daughters, Mia and Lily, Lottie Daley speaks to us about her hypnobirthing experience - celebrity fans, horror birth stories, and why it's not all rainbows and fluffy kittens.

Hypnobirthing was still relatively new and not many people had heard of it when I decided to do a course in London with Katharine Graves.

My father-in-law is a hypnotherapist and had heard wonderful things about how hypnosis techniques applied to childbirth helped women have really positive birth experiences.

Then my father gave my husband and I a hypnobirthing course, which we attended together when I was 30 weeks pregnant.

For my first baby I was like many other mums, quite set on a hospital birth as I felt it was right for me. However, once I got into the course and understood what my body needed to feel for birth to be comfortable or even pain free, I changed my mind and opted for a home birth.

I didn't know anyone at all who had done hypnobirthing in 2011. It didn't seem to be very mainstream and certainly no UK-based celebs had caught onto birth's best kept secret - yet.

I must admit I did think it might be a bit hippy with visualising rainbows and fluffy kittens, maybe some chanting about being positive or something silly - the reality was very different.

The first day opened our eyes to how birth could be if I could just remove all those negative beliefs I had about my body's ability to give birth - crucially, removing the ingrained fear.

I had only ever seen horror births on the telly, I hadn't heard one positive birth story at all in my entire life, and no mother I knew had a good word to say about it, beyond saying it was worth every agonising second.

I couldn't understand how it could be different, but it was just so obvious when Katharine explained what my body needed, how powerful my mind was and how I could actually control how things went. I left the first class feeling so positive and excited about the big day!

At the time it was rumoured that Kate Middleton was doing hypnobirthing...

... and judging by her breezy exit from St Mary's after welcoming each of her babies, it would be a fair assumption to conclude that she did!

With my second birth two years later, I immediately dug out Katharine's Hypnobirthing Book - and booked into a local hypnobirthing teacher for my refresher.

By this time, several celebrities were jumping on the bandwagon, people in my class were doing it in conjunction with a qualified hypnobirthing teacher and Katharine had started to train midwifes in University College London hospital so that they were au fait with women practising her method when they came into the birth centre.

My partner was sceptical first time around, and certainly it looked as though half the men had been dragged their by their bits...

However, after class one, when they got to grips with the logic, simplicity and the science part, they were totally on board.

It was a joy to become closer to my partner, and instead of moaning about the men doing nothing, they had 'stuff to do' which men seemed to really revel in.

They weren't a spare part, they were really part of the birth experience and I think this helped my partner bond with our daughter without feeling left out, especially as I was breastfeeding.

Both my labours were very different yet hypnobirthing made an enormous difference - I don't think anyone has ever said they wished they hadn't have done it!

Crucially, you learn how to handle the unexpected if it crops up so you never feel out of control, as so often happens on birth programmes like One Born Every Minute.

My first labour was medicalised as I had a premature birth, which scuppered my home birth plans. But the course taught me that sometimes birth throws a curve ball and when it did, I understood why and was part of the decision making in my unexpected turn.

I'm certain that this made the world of difference and allowed me to view my birth as positive, even though it was far from what I wanted.

My second birth, however, had no complications and I was set for my dream home birth. To be brutally honest, as I had a toddler in the house there was zero time for the zen-like bliss I had seen on the birth videos, infact my toddler spent the entire day in the birth pool! This meant that when she did go to bed, my body relaxed and birth ensued - at super speed!

That's the thing about bodies, when we feel anxious or unsure, our bodies halt labour until we feel it's safe, private, calm and relaxing enough to do so. With my toddler in bed my labour sped up and I must admit, I found it arduous and challenging.

I made lots of weird animal guttural noises and I mooed and I swore a bit too!

It felt really good to use my voice - I discovered that you can be noisy and it still be a hypnobirth!

I guess another one of my preconceptions was that all hypnobirthing mamas were in a trance, sleepy, dreamy and silent, where it was most definitely the opposite at times in our living room!

Lottie with her two children

The surges - Katharine taught us that the word surge was better than contraction as surges ebb and flow just like the sea, which ties in nicely with visualisations - were hard going and I did find them pretty painful.

But compared to my first labour, where I was struggling to cope and requested an epidural at 5cm, I was fully dilated and it was only when I experienced transition - the classic moment women beg for drugs, cry for their mums, insist they can't do it, won't do it, and are actually not going to have a baby at all - did I do pretty much all of the above!

Alas, it only lasts around 10 minutes, pretty normal for many women and is a sign birth is super imminent.

Literally, the moment my baby was ready to be born, the pain disappeared. The reason is that the first part of labour, 0-10cm dilation, the UP stage of labour, was challenging for me, and it's the part of labour where you must surrender to the process and let your body do what it needs to do.

This is where the visualisation is paramount, you focus your thinking brain on the visualisations so that your primal brain can produce the hormones needed to get you to the comfortable part.

Oxytocin is the crucial hormone you need to produce because the more you produce, the more effective your surges will be and the more comfortable the birth will feel. When you hold your breath or feel afraid, you can't produce it, and your uterus sort of ceases up, which is why birth can be excruciating.

Obviously there's far more to it, but you'd need to do the class to find out!

Now my experience isn't everyone's experience, because we're all different, but I coped with the pain, I worked with the pain, and I viewed the pain positively thanks to the tools Katharine taught me.

The hypnobirthing experience that we all imagine before we take the course, that we tend to see on the videos, this happened to me when I was ready to push. All of a sudden, I felt the most insane urge to push, and the pain just went. In its place was pressure, but it was fine.

I then fell into a trance thanks to all the practising I was doing, and I gave birth to her myself in the pool.

Hand on heart, on my daughter's life, I felt no pain!

It was the most amazing experience I've ever had, I felt so empowered, in control and a total goddess! The important thing to remember about hypnobirthing is that the course prepares you for everything.

The control we all seek in birth prep classes comes from within us and when we master that, birth can be the most uplifting, incredible experience you'll ever have.

I'm so fortunate that I found hypnobirthing and I'm so pleased that it is becoming more and more widely available and accepted as a very sound antenatal option for women, birth partners and their babies.

Positive birth is everything, and hypnobirthing really gets to the bones of it, and helps you help yourself to make that happen.

Katharine Graves is the founder of KG Hypnobirthing, a complete antenatal training programme. She teaches both parents to be and new hypnobirthing practitioners the Royal College of Midwives Accredited Teacher Training Course. To find a KG Hypnobirthing teacher in your area please visit our teacher training directory.