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The Rotunda was the first maternity hospital in dublin to get the national baby friendly hospital award

Preparing for Labour


Labour and the birth of your baby is one of the most exciting journeys that you will ever go through. 

After all the weeks of anticipation and planning, your big day is finally here. At the end of this journey you will get to hold your baby that has been kicking away inside you for months and months.

Birth Plan & Packing your Bag

Birth plans

A birth plan is a way for you to highlight particular requests that you may have for your labour and birth. You do not have to have a birth plan – our aim is for you to have as natural a birth as possible. However, once you have completed your parent education classes, you may wish to make a birth plan. 

It is very important that you discuss your birth plan with your midwife or doctor well in advance of your labour. This discussion will give everyone a chance to go through your requests and agree them with you. If there are any areas where the hospital may be unable to meet a particular request, then you will be given an explanation for this. Once the discussion is completed, your midwife or doctor will sign your birth plan and a copy will be put in your healthcare record. It is important to have an open mind about your labour and birth. We aim to work in partnership with you and to keep you informed and involved in your care during labour and birth.

Packing your bag

Once you have reached the final month of pregnancy, we advise you to have a bag packed and ready for the big day. You need to decide what to pack for yourself and your baby. Please remember that there is limited space available on the wards, so pack lightly. Some women have a bag for labour and birth and another bag for their stay in hospital after birth. Remember that if you forget anything, your partner can get it for you at one of the shops nearby. 

If you have your own healthcare record at home, please keep it with your bag and do not forget to bring it with you when you are coming into the hospital.

Bag for your labour and birth

  • Loose fitting nightdress or an old long t-shirt;
  • Disposable underwear;
  • Warm socks, slippers and a light dressing gown;
  • Hair bobbins and brush;
  • Wash bag with toiletries - shower gel, sponge, toothbrush and toothpaste, deodorant and so on;
  • Maternity sanitary pads;
  • Large, dark-coloured towel;
  • Fresh night clothes to wear after the birth, (ideally front opening for breastfeeding) and a nursing bra;
  • Babygro, vest, cardigan and baby hat and nappies for baby;
  • List of phone numbers of family and friends;
  • Camera and batteries;
  • Money for parking meters.
Mobile phones must be switched off in the delivery suite as they may interfere with essential monitoring equipment.

Bag for your stay in hospital

For mother 

  • Fresh pyjamas/nightdress for every day
  • Disposable underwear 
  • Maternity sanitary pads 
  • Bras and breast pads
  • Panties 
  • Wash bag with toiletries
  • Large, dark-coloured bath towel 
  • Loose-fitting clothes for going home 

For baby

  • Babygros or sleep suits
  • Nappies
  • Vests
  • Cardigan
  • Cotton wool
  • Bath towel
  • Baby hats and bibs
  • Outfit for going home

Signs of Labour

When will labour start?

Most women will go into natural labour between 37 and 42 weeks of pregnancy. There is no way to accurately predict when labour will actually start; what we do know is that first time mothers are more likely to go over 40 weeks. If your pregnancy goes past your expected due date, there is nothing to worry about as long as you are feeling well and your baby is moving and kicking. Be sure to attend all your antenatal appointments especially towards the end of your pregnancy.

Baby movements

Right up to the moments before birth, your baby will be moving around inside you. At the end of pregnancy the type of movements may change and they may feel more like pokes, prods or wriggles. Babies do not stop moving before labour! They may have sleep periods but these will last for no longer than 45 minutes to one hour.

If you are unsure about your baby’s movements, there are a few things you can do to wake your baby up:

 

  • gently rub your tummy and talk to your baby;
  • drink some cold water or eat something sweet; or
  • have a warm bath or shower.
These things will often wake your baby up and normal movements will start again. You will be very aware of your own baby’s pattern of movement. If you have any concerns about the amount or type of movements you are getting, please contact your midwife, doctor or the assessment and emergency unit. Your awareness of your own baby’s movements is very important, particularly at the end of pregnancy.

Waters breaking

For some women, the very first sign that anything is happening is that their waters break. Sometimes, it is obvious that the waters have broken by the fact that you soak your underwear or bed. (In fact, it is a good idea to sleep with a towel under you towards the end of your pregnancy to avoid damage to your mattress.)

However, for a lot of women it may be difficult to be sure if the waters have broken. Many women describe feeling ‘damp down below’ due to the increased amount of vaginal discharge that is normal at the end of pregnancy. If you find that you have to wear a sanitary pad due to the amount of fluid you are losing, you need to consider if your waters could have broken. One way for you to check is to have a shower, dry the vaginal area well and put on a maternity sanitary pad. If that pad quickly becomes damp or wet, it is likely that your waters have broken.

When the waters break, the fluid may be clear or slightly straw coloured. Sometimes there may be a vague tinge of pink in the waters. This is normal and should not alarm you. If your waters have broken, you should come in for a check-up to ensure all is well with you and your baby. If the fluid is green or green/brown in colour or heavily blood stained, you should come into the assessment and emergency unit immediately. Please remember to bring with you any stained sanitary pads you have for the midwife or doctor to see.

Show - as the cervix (neck of the womb) starts to stretch, a plug of mucous may be released. Typically, this plug or ‘show’ is bloodstained and sticky. This bloodstaining will be old brown blood or light pink. Many women describe a show as being like the very beginning or very end of their period. You should not see bright fresh blood. Not all women will have a show before labour starts and a show is not a sure sign of labour.

Pain - very early in labour, you may experience irregular cramping pains, like period pains. You may also have backache and a heavy sensation in your pelvis. This is all completely normal and is an encouraging sign that your body is getting ready for labour.


Restlessness - not being able to focus on one thing, or being unable to sit still but not really being sure what you want to do. Not all women feel like this. 

What to do in the early part of labour

These signs may indicate that you are about to go into labour. However, there is also a chance that everything will stop and you may carry on being pregnant for a while longer. It is important not to get exhausted in the early part of labour so rest is very important. If you are getting period-like pains, have a warm bath and go to bed for a few hours. Even if you cannot sleep, just relaxing and listening to some music may help you later on.

Don’t forget to eat - labour is hard work for your body so you will need food to keep going. Eat what you feel like. You may find that you would like pasta, bananas and other carbohydrate rich foods. Even if it is the middle of the night, cook some pasta and sauce if you fancy it. If you don’t feel particularly hungry, then try some cereal and milk or toast and honey. And don’t forget about fluids. It is so important not to get dehydrated during labour. While at home, keep a bottle of water near you and keep sipping it.

Contractions

couple attending antenatal classThe pains will become more regular and last for longer as labour progresses. Between contractions, you will have no pain. So, if you are getting a contraction every seven minutes, lasting 45 seconds, then for over six minutes you will be pain free! The advice for coping with contractions at home is:


Keep active - movement is great for helping with pain and for encouraging labour. Stay upright during the contraction and try swaying and rocking your pelvis as the contraction reaches the peak. Sitting and swaying on an inflated gym ball is also a great way of staying active.

Use of warm water - in the early stages of labour, many women find a warm bath a great way to relax and to cope with the contractions. Standing in a warm shower with the water directed at your lower back is also helpful.

Breathing - there is no magic formula to describe breathing in labour. The advice is to take slow, easy breaths. Some women tend to hold their breath during a contraction while others breathe too fast. It is always better to breathe slowly - in through your nose and out through your mouth.

Music and visualisation - the use of calm, quiet music is great for keeping you relaxed. Imagine holding your new baby and how happy you’ll feel as your baby is placed into your arms for the first time. Try to imagine your baby’s face and the feel of their skin. Visualisation (imagining) is great for reminding you of the end point of this journey.

Endorphins - your body is designed to cope with labour. As your labour starts, your body produces natural pain relievers called endorphins. These morphine-like substances flood through your system and allow your body to cope with the increasing frequency and strength of contractions as your labour progresses.

TENS machine - the ‘transcutaneous electrical nerve stimulator’ or TENS machine works by delivering small electrical pulses through the skin via electrodes placed on your back. The TENS machine consists of four pads that are placed on your back and a small hand-held battery-operated device. The electrical pulses are thought to ‘block’ pain messages reaching the brain and stimulate the body’s naturally occurring painkillers – the endorphins mentioned above. Women using TENS often report less pain.

TENS machines work best if used early in labour. TENS machines can be rented prior to labour and can be used at home and left on when coming into hospital. If you are considering hiring a TENS machine, you should contact your local supplier for further information. It is a good idea to become familiar with the instructions for placing the pads on your back and how to work the machine before the big day.

When to Contact the Hospital

There are midwives on duty in the assessment and emergency unit, 24-hours a day, and they are only a phone call away at 01 817 1700. The midwife will ask you some questions. If you have your healthcare record at home, the midwife may ask for some details from the record. The midwife may advise you to stay at home and to ring again when your labour is stronger. Very often the reassurance of speaking to the midwife will give you the confidence to know that all is well and that you can stay at home for another while. If your healthcare record is in the hospital, the midwife will make sure your healthcare record is available when you come in.

You should contact the assessment and emergency unit if you have:

  • been advised to come straight to hospital once labour starts by your doctor or midwife;
  • contractions every 5 - 7 minutes, with pains lasting more than 45 seconds;
  • any vaginal bleeding that is not a ‘show’;
  • concerns about your baby’s movements;
  • severe, lasting abdominal pain;
  • headaches or blurred vision;
  • been feeling generally unwell;
  • your waters have broken; of if you have
  • any other worries or concerns about yourself or your baby.

When you arrive in the Rotunda

Once you arrive in the Rotunda you will be taken to the assessment and emergency unit. The midwife will take a history from you and carry out some observations and assessments on you and your baby.

Blood pressure examination prior to giving birth

As part of the assessment, the midwife will:

  • take your temperature, pulse and blood pressure and do a urine test;
  • palpate (feel) your tummy to check the position of your baby and listen to your baby’s heartbeat;
  • start a continuous monitoring of your baby’s heartbeat for 20 minutes;
  • examine you internally (vaginal examination) to check how much your cervix has opened.

The midwife will discuss this assessment with you and your partner and plan the next stage of your care. If you are in established labour you will be transferred to the delivery suite. If you are in early labour and the observations are all normal, you have the option of returning home to await events or we can admit you to the general prenatal ward. If there are any concerns about you or your baby you will be seen by the doctor.

Delivery Suite Environment

Delivery suite environment

The delivery suite rooms are designed to provide an environment that is relaxing, personal and calm. The birthing rooms are very well equipped; they are nicely decorated with homely touches and have low lighting, mats, birthing beds, monitoring and emergency equipment available. There is an annexe suite, which is mostly used for women who are scheduled to have their labour induced. The annexe has separate bathroom and toilet facilities. There is an operating room in the unit, which is used for emergency caesarean sections.


Staff caring for you

The team on the delivery suite consists of midwives who are the main care providers, doctors, care assistants and non-clinical support staff. Student midwives, care assistants and medical students are supervised by the midwives.

Medical teams are always available if there are any concerns about your own or your baby’s health and wellbeing. The obstetric medical team carry out ward rounds several times a day in the delivery suite and are kept up to date by the midwife about your progress or any concerns about you or your baby.

If you are attending for private care, the midwife will be in contact with the consultant during your labour to inform them of your progress and they will attend the birth. If you are attending for semi-private care, the midwife will be in contact with the registrar on duty, informing them of your progress. The registrar may attend the birth and may undertake any perineal suturing (stitches) that is required.

Delivery suite staff

The anaesthetic team provides a 24-hour epidural service and provides anaesthetic support if surgery is needed. Paediatricians provide care for your baby at birth and afterwards.

We think it is very important to help you to make choices that are right for you and your baby when you are in labour. The staff will keep you informed of your progress in labour and they will discuss various options of care available to you. The health and safety of you and your baby is always the most important consideration when care options and choices are discussed.


Birth partner

nurse speaking to pregnant lady and her birth partnerAt the Rotunda, we support your right to choose a birth partner. Whoever you choose to be with you during your labour can help and support you. They can keep you company during the early stages of labour by holding your hand, giving you sips of water and helping you to find comfortable positions. They can provide massage and touch, give you encouragement and help you to relax and concentrate on your breathing.

 

They can also speak on your behalf so it is important that they know and understand your wishes for labour and birth. Your birth partner might be the baby’s father, a close relative or friend. It’s your choice. However, we can only let one named birth partner stay with you during labour and birth as we have to comply with health and safety regulations and infection control procedures.


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