[{"data":1,"prerenderedAt":17789},["ShallowReactive",2],{"sanity-yIwGiLAzSQ":3,"sanity-HE3g2WrBu1":39,"sanity-iep3OJJQjR":16583},{"mainNav":4},[5,10,14,19,23,27,31,35],{"slug":6,"title":9},{"current":7,"_type":8},"about-us","slug","About Us",{"slug":11,"title":13},{"current":12,"_type":8},"book-an-intro-chat","Book an Intro Chat",{"title":15,"category":16,"slug":17},"Care Packages","Services",{"current":18,"_type":8},"care-packages",{"title":20,"category":16,"slug":21},"One-off Appointments",{"current":22,"_type":8},"one-off-appointments",{"slug":24,"title":26},{"current":25,"_type":8},"birth-stories","Birth Stories",{"title":28,"slug":29},"Frequently Asked Questions",{"current":30,"_type":8},"faqs",{"slug":32,"title":34},{"current":33,"_type":8},"contact-us","Contact Us",{"slug":36,"title":38},{"current":37,"_type":8},"blog","Blog",[40,597,1296,1919,2485,3011,3388,3702,4018,4765,5248,5940,6880,7297,7963,8256,8426,8845,9474,9808,10125,10313,10665,11121,11425,11730,11987,12176,12526,12776,13333,13863,14482,14797,14990,15182,15421,15723,15935,16114,16304],{"_createdAt":41,"seo":42,"_id":46,"title":47,"content":48,"image":585,"_rev":589,"publishedAt":590,"_type":37,"_updatedAt":591,"slug":592,"_system":594},"2026-04-09T12:11:28Z",{"metaTitle":43,"_type":44,"metaDescription":45},"Supporting Twins: Insights from the Twin Birth Magic","seoMeta","A reflective and informational recap of the Twin Birth Magic workshop hosted by Juno Midwives in Folkestone. ","fcd246e0-d3e3-4446-9f23-75c88fdd5282","Twin Birth Magic: What We Learned at This Transformative 2-Day Workshop",{"_type":49,"body":50},"blockContent",[51,62,80,88,96,104,113,125,137,149,173,181,189,199,207,237,256,264,292,307,315,323,331,339,347,355,363,371,379,387,395,403,422,428,436,444,452,460,468,475,483,491,499,505,513,521,529,537,545,565,572,577],{"children":52,"_type":58,"style":59,"_key":60,"markDefs":61},[53],{"text":54,"_key":55,"_type":56,"marks":57},"Twin Birth Magic - A Signature Workshop by Deborah Rhodes","3253d7aae765","span",[],"block","h2","a3b7734eadc7",[],{"markDefs":63,"children":69,"_type":58,"style":78,"_key":79},[64],{"type":65,"url":66,"_type":67,"_key":68},"external","https://www.instagram.com/debsbirthmagic/?hl=en","link","7ee7a313b91f",[70,74],{"text":71,"_key":72,"_type":56,"marks":73},"We’re still coming down from hosting Twin Birth Magic! It was a 2-day workshop, taught by Deborah Rhodes. Debs has 30+ years of midwifery experience - from the NHS and independent midwifery practice in the UK, to traditional birthkeeping in Spain. She has always had a deep interest in twins, stemming from her childhood when her mum was pregnant with her twin brothers. During her career she has been sought out as the midwife to support twin and breech homebirths. Along with providing support to birthing women around the world, Debs also shares her knowledge, wisdom and experience at her signature Birth Magic Workshops. Find Debs over on instagram ","7f93e754860e",[],{"_key":75,"_type":56,"marks":76,"text":77},"d92dbd14bfba",[68],"@debsbirthmagic.","normal","1c0cb316af5e",{"style":78,"_key":81,"markDefs":82,"children":83,"_type":58},"cccc3abb0513",[],[84],{"_type":56,"marks":85,"text":86,"_key":87},[],"There were 8 of us present for this workshop - a mixture of independent midwives, an NHS midwife, a student midwife and a doula. On day 1 we first settled into our circle - introductions were relaxed, allowing everyone to speak without rushing. It was really interesting and inspiring to hear about the varied experiences in the room, including from the two midwives who have been on the NMC register for 40+ years. These elder midwives have seen SO many changes in midwifery and the culture of birth in their time and they’re still offering homebirth care and still attending workshops to learn.","332eee7fbf01",{"_type":58,"style":59,"_key":89,"markDefs":90,"children":91},"57145e0e12c4",[],[92],{"_key":93,"_type":56,"marks":94,"text":95},"eac46db4f520",[],"Identical or Non-Identical: Understanding the Types of Twins",{"markDefs":97,"children":98,"_type":58,"style":78,"_key":103},[],[99],{"_type":56,"marks":100,"text":101,"_key":102},[],"After getting to know one another, we dived straight into the different types of twins - did you know there are 7 categories in total?! We spoke about the differences between non-identical and identical twins (including the several rare variations of identical twins), how common each of the types are and the unique considerations that are associated with the different placentations. We also spoke about the importance of making the language around twins accessible - rather than heavily medicalised - so for this article we’ll try to do the same.","0fac81250b0f","974e62a1e946",{"children":105,"_type":58,"style":78,"_key":111,"markDefs":112},[106],{"_type":56,"marks":107,"text":109,"_key":110},[108],"strong","Here’s a little breakdown of the medical language around twins:","0c1e9b46491c","af2c73675ab2",[],{"style":78,"_key":114,"markDefs":115,"children":116,"_type":58},"08f56c4dbc75",[],[117,121],{"text":118,"_key":119,"_type":56,"marks":120},"DCDA (or DiDi) Twins","688c1e068b96",[108],{"_type":56,"marks":122,"text":123,"_key":124},[]," = Dichorionic Diamniotic - these twins have their own placenta and their own amniotic sac. They are usually non-identical, but about 30% are be identical.","5488c11e402a",{"children":126,"_type":58,"style":78,"_key":135,"markDefs":136},[127,131],{"marks":128,"text":129,"_key":130,"_type":56},[108],"MCDA (or MoDi) Twins","606b4e615039",{"_type":56,"marks":132,"text":133,"_key":134},[]," = Monochorionic Diamniotic - these twins share a placenta but each has their own amniotic sac. These are identical twins.","00130fc09fb4","cd009524f2c4",[],{"markDefs":138,"children":139,"_type":58,"style":78,"_key":148},[],[140,144],{"marks":141,"text":142,"_key":143,"_type":56},[108],"MCMA (or MoMa) Twins","8d7ed10d2c0f",{"text":145,"_key":146,"_type":56,"marks":147}," = Monochorionic Monoamniotic - these twins share both a placenta and an amniotic sac. These are identical twins.","8c12a080dc9b",[],"ff2c63933155",{"_key":150,"markDefs":151,"children":152,"_type":58,"style":78},"91c36e881131",[],[153,157,161,165,169],{"_type":56,"marks":154,"text":155,"_key":156},[],"Overall about two thirds of twins are ","384b6d88af4f",{"marks":158,"text":159,"_key":160,"_type":56},[108],"non-identical","19ddf8af9f9f",{"marks":162,"text":163,"_key":164,"_type":56},[]," and have their own placenta and amniotic sacs. About one third of twins are ","921493d20721",{"text":166,"_key":167,"_type":56,"marks":168},"identical","71dbdbcf3e60",[108],{"_type":56,"marks":170,"text":171,"_key":172},[]," - coming from one egg (ovum) splitting. Depending on when the egg splits after conception will affect whether they share a placenta and/or an amniotic sac. Non-identical twins are associated with fewer complications than identical twins that share a placenta and/or an amniotic sac.","7837cff2d148",{"style":59,"_key":174,"markDefs":175,"children":176,"_type":58},"0a3e1a735ec5",[],[177],{"_key":178,"_type":56,"marks":179,"text":180},"0e735e7fd4de",[],"Key Considerations When Supporting a Twin Pregnancy",{"markDefs":182,"children":183,"_type":58,"style":78,"_key":188},[],[184],{"_type":56,"marks":185,"text":186,"_key":187},[],"We then split into groups to discuss the unique considerations that exist around supporting twins. This included looking at topics like: breastfeeding, pre-term birth, breech, position of the second twin, place of birth, mode of birth and twin specific complications. This sparked some great discussions and challenged what most of us have been exposed to with the medical model of childbirth. Most women experiencing a twin pregnancy will have consultant-led care in the NHS. That consultant may or may not be a twin specialist. Women should also caseload by a Twin Specialist Midwife - however as far as we’re aware, there’s no requirement for midwives in this role to have necessarily undertaken any further education or training around twin births. In terms of our own midwifery training, twin birth was touched upon but we cannot recall ever having the types of discussion we had at this workshop - highlighting for us how twin pregnancies have been removed from the midwifery scope of practice.","0e490bd034c1","75e9e2e3c99c",{"_type":190,"link":191,"_key":198},"cta",{"blank":192,"_type":67,"text":193,"type":194,"internalLink":195},false,"Our Care Packages","internal",{"_ref":196,"_type":197},"71c683c4-d676-4b1b-ac05-4bdfaf0044e6","reference","473428b9afaa",{"_key":200,"markDefs":201,"children":202,"_type":58,"style":59},"96148fa94614",[],[203],{"_key":204,"_type":56,"marks":205,"text":206},"9d2f4f06fb84",[],"Nutrition For Twin Pregnancy: It Matters More Than You Think",{"_type":58,"style":78,"_key":208,"markDefs":209,"children":216},"45280340ab29",[210,213],{"type":65,"url":211,"_type":67,"_key":212},"https://lilynicholsrdn.com/books/","1fa14024c857",{"_key":214,"type":65,"url":215,"_type":67},"2246ec7624dd","https://shop.lilynicholsrdn.com/products/twin-pregnancy-nutrition-guide",[217,221,225,229,233],{"marks":218,"text":219,"_key":220,"_type":56},[],"On day 2 we looked at nutrition and how this has been neglected in mainstream maternity care - for all women really, but especially for those expecting multiples. Lily Nichols is a US based dietician whose work we return to time and time again. Her book ","ee9281f8ee17",{"_type":56,"marks":222,"text":223,"_key":224},[212],"Real Food for Pregnancy","5d403225646b",{"_type":56,"marks":226,"text":227,"_key":228},[]," is well researched and debunks some of the myths around what you can and can’t eat in pregnancy. Lily also has a ","2a6378a1d482",{"marks":230,"text":231,"_key":232,"_type":56},[214],"twin-specific nutrition guide","d2bbb80e9021",{"_key":234,"_type":56,"marks":235,"text":236},"ef1f5728b2e7",[]," that you can buy from her website - well worth it if you’re expecting twins or you’re supporting clients who are. There are also heaps of free articles on her website for you to peruse to support your nutrition in pregnancy. Being pregnant with twins is a huge load on the body so we need to be more aware of the chance of anaemia and its associated complications too.",{"_type":58,"style":78,"_key":238,"markDefs":239,"children":243},"87f39fe7bfe6",[240],{"_type":67,"_key":241,"type":65,"url":242},"c67472f7349b","https://www.sciencedirect.com/science/article/abs/pii/S0002937803010548",[244,248,252],{"marks":245,"text":246,"_key":247,"_type":56},[],"In terms of twin pregnancies, there has been one (fairly small, but very interesting nonetheless) study back in 2003 that looked into the effect of giving women expecting twins specific nutritional support which included increasing their recommended daily calorie intake, supplementing with vitamins, and dietary education. The results demonstrated a reduction in pre-term birth, pre-eclampsia, and preterm rupture of membranes. It also showed higher birthweights, longer gestations and lower levels of neonatal morbidity. The researchers also followed up the children until they were 3 years and found less hospitalisations and less likelihood of developmental delay. Unfortunately the study isn’t open access (free for everyone to read) but we did manage to obtain a copy of it and you can read the abstract ","2c64c98a6488",{"text":249,"_key":250,"_type":56,"marks":251},"here","fd08ad8c36ac",[241],{"_type":56,"marks":253,"text":254,"_key":255},[],". The study is over 20 years old and based on a US population, but given the positive results it seems crazy that further studies haven’t been done on the effects of nutrition and twin pregnancy outcomes.","411f3fa0e339",{"children":257,"_type":58,"style":59,"_key":262,"markDefs":263},[258],{"text":259,"_key":260,"_type":56,"marks":261},"The Risk of Stillbirth for Twins: Understanding the Statistics","332feccac069",[],"5dd0da47b568",[],{"children":265,"_type":58,"style":78,"_key":288,"markDefs":289},[266,270,275,279,284],{"_key":267,"_type":56,"marks":268,"text":269},"e1dfbc40709e",[],"Another interesting topic of discussion that came up was around the mainstream management of twins. Current",{"_type":56,"marks":271,"text":273,"_key":274},[272],"ea52391e2879"," UK guidelines","91dbd9c27616",{"marks":276,"text":277,"_key":278,"_type":56},[]," recommend birth of uncomplicated identical twins, who share a placenta but not an amniotic sac (MCDA), by 36+6 weeks and those that share both a placenta and an amniotic sac (MCMA) by 33+6 weeks. For uncomplicated non-identical twins (DCDA) birth is recommended by 37+6 weeks. This is because the chance of stillbirth increases for each of these types of twins after these gestations. However, as with lots of guideline recommendations when you take a deeper look at the research and the stats, the risk of stillbirth is overall still very small. The NICE guidelines simply say, ","a265b470044e",{"marks":280,"text":282,"_key":283,"_type":56},[281],"em","‘explain to women that…continuing the pregnancy beyond [insert appropriate gestation] increases the risk of fetal death’","1c06a505153d",{"_key":285,"_type":56,"marks":286,"text":287},"f953108235be",[],", without saying what the actual risk is. This isn’t very helpful to women and birthing people who are considering their options for the birth of their twins.","184adc1f04fa",[290],{"_type":67,"_key":272,"type":65,"url":291},"https://www.nice.org.uk/guidance/ng137/chapter/Recommendations#timing-of-birth",{"_key":293,"markDefs":294,"children":298,"_type":58,"style":78},"6e48b290ec9e",[295],{"url":296,"_type":67,"_key":297,"type":65},"https://pmc.ncbi.nlm.nih.gov/articles/PMC12935485/","a0436509070c",[299,303],{"_type":56,"marks":300,"text":301,"_key":302},[297],"One piece of research","2b30fdb7a398",{"text":304,"_key":305,"_type":56,"marks":306}," from 2015 looked at a large cohort of multiple pregnancies from the US (454,626 twins were included!) and the chance of stillbirth when complicating factors such as high blood pressure (hypertension), gestational diabetes and growth-restricted babies (IUGR) were excluded from the analysis. So essentially women who were expecting twins but who had otherwise healthy pregnancies. ","9a943b439fcb",[],{"markDefs":308,"children":309,"_type":58,"style":78,"_key":314},[],[310],{"marks":311,"text":312,"_key":313,"_type":56},[108],"Here’s what the study found:","cd900ff52e22","3aa8662a1531",{"style":78,"_key":316,"markDefs":317,"children":318,"_type":58},"57d726fd541e",[],[319],{"_key":320,"_type":56,"marks":321,"text":322},"0faabbdb0dc8",[108],"Stillbirth rate:",{"style":78,"_key":324,"markDefs":325,"children":326,"_type":58},"76be24b1998b",[],[327],{"marks":328,"text":329,"_key":330,"_type":56},[],"37 weeks = 6.7:10'000. (0.06%)","d8899afc0f06",{"children":332,"_type":58,"style":78,"_key":337,"markDefs":338},[333],{"_type":56,"marks":334,"text":335,"_key":336},[],"38 weeks = 17.3:10'000 (0.17%)","211130433ef7","9ac460d47f09",[],{"_key":340,"markDefs":341,"children":342,"_type":58,"style":78},"541bd5b33470",[],[343],{"marks":344,"text":345,"_key":346,"_type":56},[],"39 weeks =14:10'000 (0.14%)","03ed1574d924",{"_type":58,"style":78,"_key":348,"markDefs":349,"children":350},"c8679f35cdc4",[],[351],{"text":352,"_key":353,"_type":56,"marks":354},"40 weeks = 46.6:10'000 (0.46%)","a7f3b32a72cd",[],{"markDefs":356,"children":357,"_type":58,"style":78,"_key":362},[],[358],{"marks":359,"text":360,"_key":361,"_type":56},[],"Any stillbirth or neonatal death is tragic and we don’t mean to take away from that, knowing that behind these statistics are real families who have suffered a great loss. But we also can’t ignore that the chance of having a stillbirth is used to pressure women into accepting an early birth (either by being induced or having a planned early caesarean birth). As you can see from the figures above the chance of actually having a stillbirth is overall very small, \u003C1% where the pregnancy is otherwise uncomplicated. This study wasn’t able to differentiate between chorionicity (identical or non-identical twins) which would be really helpful information for any future research and might show even more favourable outcomes for non-identical twins, for example.","ebc8f379a8cf","581e772573d7",{"children":364,"_type":58,"style":78,"_key":369,"markDefs":370},[365],{"marks":366,"text":367,"_key":368,"_type":56},[108],"For comparision, the risks of stillbirth in an uncomplicated pregnancy with one baby are:","c94b66d17d96","5758662b5501",[],{"markDefs":372,"children":373,"_type":58,"style":78,"_key":378},[],[374],{"_type":56,"marks":375,"text":376,"_key":377},[],"37 weeks = 3.11:10’000 (0.03%)","a7e9ec732077","661bb5d7bb85",{"_key":380,"markDefs":381,"children":382,"_type":58,"style":78},"ccbdad5c74a2",[],[383],{"_key":384,"_type":56,"marks":385,"text":386},"be08e3a45cd2",[],"38 weeks = 3.62:10’000 (0.03%)",{"style":78,"_key":388,"markDefs":389,"children":390,"_type":58},"b59f0a27e5dd",[],[391],{"_type":56,"marks":392,"text":393,"_key":394},[],"39 weeks = 4.53:10’000 (0.04%)","8f7a62643ba2",{"markDefs":396,"children":397,"_type":58,"style":78,"_key":402},[],[398],{"_type":56,"marks":399,"text":400,"_key":401},[],"40 weeks = 6.2:10’000 (0.06%)","46dcdbe1f21e","6b3f03003c22",{"_type":58,"style":78,"_key":404,"markDefs":405,"children":409},"4c27deae27ab",[406],{"_type":67,"_key":407,"type":65,"url":408},"9b1852879297","https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002838",[410,414,418],{"text":411,"_key":412,"_type":56,"marks":413},"These statistics are from ","2992516d4d14",[],{"_type":56,"marks":415,"text":416,"_key":417},[407],"this piece of research ","246c4ca35f9e",{"marks":419,"text":420,"_key":421,"_type":56},[],"from 2019.","9508ac5c34f6",{"link":423,"_key":427,"_type":190},{"text":424,"type":194,"internalLink":425,"blank":192,"_type":67},"Read Sophie's Twin Birth Story ",{"_type":197,"_ref":426},"1dd979de-b1ab-4067-8f70-a2feeec89a14","efb11e405946",{"_key":429,"markDefs":430,"children":431,"_type":58,"style":59},"22b25c0a354f",[],[432],{"text":433,"_key":434,"_type":56,"marks":435},"The Problem with Risk in Pregnancy","e298c2f3958c",[],{"_type":58,"style":78,"_key":437,"markDefs":438,"children":439},"94734b56e2fe",[],[440],{"_type":56,"marks":441,"text":442,"_key":443},[],"The risks of induction or caesarean birth, in our experience, can be understated and often there’s not much thought given to long-term outcomes. For example, if babies are born before they’re naturally ready, say at 37 weeks - how is their long term health affected? How does it affect their breastfeeding journey? And if they encounter breastfeeding issues how does that affect their overall health and the wellbeing of their mother / birthing parent? And if a woman chooses an induction that leads to a caesarean - what’s the impact of that on her long term health and wellbeing? Too often obstetrics is focussed on the short term outcome of a live mother and a live baby - which is obviously what we all want, but we also want women and babies to be absolutely thriving without any long-term health consequences as a result of birth.","368b80acb8b4",{"style":78,"_key":445,"markDefs":446,"children":447,"_type":58},"da443711ed37",[],[448],{"_type":56,"marks":449,"text":450,"_key":451},[],"Given that the chance of experiencing a stillbirth is \u003C1% in an uncomplicated twin pregnancy - do we need to rethink the guidance that recommends early induction of labour or caesarean section? Do the potential benefits of these interventions outweigh their risks?","ae861557e244",{"style":59,"_key":453,"markDefs":454,"children":455,"_type":58},"cef7363e4b18",[],[456],{"marks":457,"text":458,"_key":459,"_type":56},[],"The Position of the Second Twin: It Matters Less Than You Think","ae820220b711",{"_key":461,"markDefs":462,"children":463,"_type":58,"style":78},"91e9c6a49335",[],[464],{"marks":465,"text":466,"_key":467,"_type":56},[],"We spoke about the position of the second twin - and how it doesn’t really matter until the first twin is born. The second twin will get itself into its position once the first twin is out of the way - this might be head down or bum down (breech). The importance of being confident in breech birth cannot be understated when supporting twin birth - there’s about a 40% chance the second twin will be breech!","05a28f85e454",{"_type":58,"style":78,"_key":469,"markDefs":470,"children":471},"05dc5b4e5965",[],[472],{"text":473,"_key":467,"_type":56,"marks":474},"Breech extraction is a midwifery and obstetric skill, not frequently required but that can be life-saving - whereby the second twin is essentially pulled out where there are concerns about its wellbeing. It’s a significantly quicker way of getting a baby out and poses less risks to the woman. We spoke about how this skill has been lost by midwives and obstetricians and questioned if this could change outcomes in scenarios where the first twin is born vaginally and the second twin is then a caesarean birth. There’s an amazing example online of midwife Kristine Lauria doing a breech extraction at a triplet homebirth in the US, when it was found that the third baby had a low heart rate. These are skills that we hope to never have to use, but need to know about because it could just be the difference between life and death - particularly at a homebirth.",[],{"markDefs":476,"children":477,"_type":58,"style":59,"_key":482},[],[478],{"_type":56,"marks":479,"text":480,"_key":481},[],"Medical Management of Twin Pregnancy and Birth: Where’s the Evidence?","341a46774e8e","0228c397dfbe",{"style":78,"_key":484,"markDefs":485,"children":486,"_type":58},"4347188224c0",[],[487],{"marks":488,"text":489,"_key":490,"_type":56},[],"The medical model has quite a strict criteria for managing vaginal twin birth in hospital settings - it’s a protocol that includes things like: induction of labour, recommending continuous fetal heart rate monitoring, recommending an epidural in case theatre is needed for the second twin, breaking the waters of the second twin, using the hormone drip (syntocinon) to bring on contractions after the birth of the first twin to speed up the birth of the second twin, manually stabilising the second twin (this usually looks like an obstetrician placing their hands on the woman’s abdomen and ‘holding’ the second twin in position). Some hospitals advise that the birth even happens in theatre, again - just in case a caesarean birth is needed. It’s worth knowing that none of this is evidence-based, rather it’s considered ‘best practice’ - but it doesn’t always make sense. For example, we know that CTG monitoring leads to more interventions. We know that epidurals increase the chance of needing an assisted birth. So in trying to prevent complications, the medical model often has a blind spot when considering how these interventions might actually lead to more interventions and or complications. This is true for all women, not just those expecting twins, and written with the understanding that for SOME women and SOME babies intervention is needed.","da566fe5ac61",{"_type":58,"style":78,"_key":492,"markDefs":493,"children":494},"a6d40faca0f7",[],[495],{"_type":56,"marks":496,"text":497,"_key":498},[],"We spoke about how the medicalisation of childbirth - and especially multiple births - means that women are presented with risks over and over again, losing trust in their bodies ability to grow, birth and feed twin babies. How clinical the care can be, with things like hands-on abdominal palpation (an essential midwifery skill) not being used because scans are offered regularly. How women are told they’re not allowed to plan to birth at home or on a midwife-led unit because it’s too risky - instead of thinking how we can safely support women to plan the birth they want. Modern maternity care puts so much focus on the wellbeing of the baby, with very little attention truly given to that of the woman or birthing person and this is even more apparent for those expecting twins.","5bc75754ace7",{"link":500,"_key":504,"_type":190},{"type":194,"internalLink":501,"blank":192,"_type":67,"text":503},{"_ref":502,"_type":197},"e8889a64-6bbb-4f25-b78a-90ffb536b503","Looking for a Second Opinion?","f5d6c78ffb9d",{"children":506,"_type":58,"style":59,"_key":511,"markDefs":512},[507],{"text":508,"_key":509,"_type":56,"marks":510},"Reclaiming Midwifery Skills and Supporting Women’s Choices","6a06ebeea16c",[],"fbf2fea4e3c0",[],{"style":78,"_key":514,"markDefs":515,"children":516,"_type":58},"502ed01bdd4e",[],[517],{"_key":518,"_type":56,"marks":519,"text":520},"47201fd4d6d7",[],"The 2 days were full of inspiring stories, wisdom and knowledge. Whilst Debs has a focus on homebirth, the workshop wasn’t purely about supporting twin home birth. Hopefully you can see from this that it was about how we can support women and birthing people expecting twins better - from nutrition in pregnancy, to advocating for them when necessary, making sense of the statistics around stillbirth and the importance of getting to term. It was about how we can support these women when they birth their twins - whether that’s at home or in an operating theatre - remembering that birth is a huge life translation, not a medical event. It was about reclaiming midwifery skills and our voice when it comes to supporting twin pregnancies. Midwives have been silenced for centuries and we continue to be so and this not only negatively impacts us as a profession but impacts the care that women and babies receive and even their outcomes. There’s so much more to say on twins, but hopefully this gives you a taste of what the workshop was like!",{"children":522,"_type":58,"style":78,"_key":527,"markDefs":528},[523],{"marks":524,"text":525,"_key":526,"_type":56},[],"","9906fc1f7847","a28d82c700bf",[],{"children":530,"_type":58,"style":78,"_key":535,"markDefs":536},[531],{"_type":56,"marks":532,"text":533,"_key":534},[],"We rounded off these two glorious days with reflections on what we had learnt and how we felt after being in the space together. Everyone left feeling more hopeful, more knowledgeable and more ready to support twin pregnancies and birth. We are grateful that people like Debs exist, boldly challenging the status quo, supporting birthing women and passing on her skills and knowledge for the better of all midwives, doulas, birthkeepers and ultimately women.","72d746723038","8c65f629efe1",[],{"_key":538,"markDefs":539,"children":540,"_type":58,"style":59},"9373b3e5aecc",[],[541],{"_type":56,"marks":542,"text":543,"_key":544},[],"Juno Midwives Support Twin Pregnancy and Birth","92b4a89c0c2c",{"markDefs":546,"children":551,"_type":58,"style":78,"_key":564},[547],{"internalLink":548,"blank":192,"_type":67,"_key":550,"type":194},{"_ref":549,"_type":197},"7a340e12-4004-413a-8989-f193f64a1e93","17a51e628fd4",[552,556,560],{"text":553,"_key":554,"_type":56,"marks":555},"If you’re expecting twins and are looking for more personalised care and support for your pregnancy, why not book a ","9900bea2d73d",[],{"_type":56,"marks":557,"text":558,"_key":559},[550],"free intro chat","d88389bdf2f1",{"text":561,"_key":562,"_type":56,"marks":563},"? We support those planning homebirth or hospital birth - respecting your rights and choices every step of the way.","0d523a1f9742",[],"a41a8d95a19a",{"markDefs":566,"children":567,"_type":58,"style":78,"_key":571},[],[568],{"_key":569,"_type":56,"marks":570,"text":525},"d09aee150f8b",[],"98349ea08432",{"_key":573,"_type":190,"link":574},"a657425bc37a",{"type":194,"internalLink":575,"blank":192,"_type":67,"text":576},{"_ref":549,"_type":197},"Ready for Personalised Midwifery Care?",{"markDefs":578,"children":579,"_type":58,"style":78,"_key":584},[],[580],{"_type":56,"marks":581,"text":582,"_key":583},[],"\n","70745a9aedf3","9717fd863770",{"_type":586,"asset":587},"image",{"_type":197,"_ref":588},"image-76ca5b90ecb011c6efe5a637b45bfb6effe2c38c-1200x1600-jpg","8tp2CwkU3bIEZ6rfCjXnWU","2026-04-09","2026-04-09T12:50:04Z",{"_type":8,"current":593},"twin-birth-magic-what-we-learned-at-this-transformative-2-day-workshop",{"base":595},{"rev":596,"id":46},"SWxP5mOxU9b5wtuJpCBli3",{"title":598,"image":599,"publishedAt":602,"slug":603,"_rev":605,"seo":606,"_updatedAt":609,"_system":610,"content":614,"_type":37,"_id":613,"_createdAt":1295},"Can't Get an NHS Home Birth in Kent? Your Local Midwives’ Guide to Your Rights and Options",{"_type":586,"asset":600},{"_ref":601,"_type":197},"image-b779a164f82d68e4f96ba5a8cd698e42324d1164-1024x682-jpg","2026-04-02",{"current":604,"_type":8},"can-t-get-an-nhs-home-birth-in-kent-your-local-midwives-guide-to-your-rights-and-options","SWxP5mOxU9b5wtuJpCSuGh",{"metaTitle":607,"_type":44,"metaDescription":608},"How to Have a Homebirth in Kent ","What can you do when NHS homebirth services are restricted or suspended in Kent? Explore hiring an independent/private homebirth midwife. ","2026-04-09T13:05:38Z",{"base":611},{"rev":612,"id":613},"uSt5DSrf5hRvtFLJvlXsDx","8f9b22b0-3d1e-4fcc-b5a3-e17b1f1b7986",{"_type":49,"body":615},[616,625,644,653,672,680,696,714,721,729,736,766,774,782,805,813,821,828,836,844,874,882,897,904,912,922,930,938,946,954,962,970,977,985,1007,1014,1022,1030,1038,1045,1053,1083,1091,1099,1107,1115,1123,1131,1150,1158,1185,1193,1201,1209,1217,1225,1233,1241,1249,1266,1274,1282,1287],{"markDefs":617,"children":618,"_type":58,"style":623,"_key":624},[],[619],{"_type":56,"marks":620,"text":621,"_key":622},[108],"What's Happening to Homebirth Services in Kent?","62e84390fdec","h1","62e026e929da",{"markDefs":626,"children":630,"_type":58,"style":78,"_key":643},[627],{"type":65,"url":628,"_type":67,"_key":629},"https://www.ekhuft.nhs.uk/services/labour-and-delivery/planning-your-birth/#birth-location-homebirth","b9f4efce6504",[631,635,639],{"_type":56,"marks":632,"text":633,"_key":634},[],"Locally in Kent there are informal restrictions on NHS homebirth services. Whilst the service hasn’t been formally suspended and the East Kent Hospitals ","75c20757df0a",{"text":636,"_key":637,"_type":56,"marks":638},"website","9330f9949e09",[629],{"text":640,"_key":641,"_type":56,"marks":642}," says that they do offer homebirth, we know from experience that it’s frequently disrupted meaning that it really is down to luck as to whether there will be midwives available to support you to have a homebirth.","ff77ca4e7b5d",[],"1fd0c679a29c",{"children":645,"_type":58,"style":650,"_key":651,"markDefs":652},[646],{"text":647,"_key":648,"_type":56,"marks":649},"Why are services being suspended?","1c9a79397826",[],"h3","3f90cb938aeb",[],{"_type":58,"style":78,"_key":654,"markDefs":655,"children":659},"68cfc4e326be",[656],{"_type":67,"_key":657,"type":65,"url":658,"blank":192},"82471fdf2547","https://www.hsj.co.uk/news/covid-crisis-forces-suspension-of-maternity-services/7029261.article",[660,664,668],{"marks":661,"text":662,"_key":663,"_type":56},[],"Homebirth services are usually disrupted or suspended due to staffing shortages. Our local Trust doesn’t have a dedicated homebirth team and instead relies on two community midwives assigned to be on-call every day to attend anybody planning a homebirth. However, if the hospital is short staffed the on-call midwives can be pulled into the unit to support staffing there, which means that the homebirth service cannot run. If one of the community midwives is sick (life happens!) then the homebirth service also cannot run. There always has to be two midwives available to keep the homebirth service running in East Kent - and this will be the case nationally too. During the covid pandemic there were national issues with ","339d7774ed3d",{"marks":665,"text":666,"_key":667,"_type":56},[657],"homebirth services suspended ","82159376d6d7",{"_type":56,"marks":669,"text":670,"_key":671},[],"due to ambulance shortages, as in this scenario there was no safe way of transferring to hospital in the event of a true obstetric or neonatal emergency.","d00b2aa38563",{"style":59,"_key":673,"markDefs":674,"children":675,"_type":58},"8231482c6d35",[],[676],{"_type":56,"marks":677,"text":678,"_key":679},[108],"Is This Just Happening Locally - or Is It a Wider Problem?","5d8cccb00f57",{"style":650,"_key":681,"markDefs":682,"children":683,"_type":58},"3c998883fe1e",[],[684,688,692],{"_type":56,"marks":685,"text":686,"_key":687},[],"What the Birthrights 2025 ","95ba4de6f70e",{"_type":56,"marks":689,"text":690,"_key":691},[281],"Access Denied","365cc6e797b9",{"marks":693,"text":694,"_key":695,"_type":56},[]," report tells us","63574f677376",{"children":697,"_type":58,"style":78,"_key":710,"markDefs":711},[698,702,706],{"text":699,"_key":700,"_type":56,"marks":701},"Homebirth suspensions and/or restrictions are not unique to Kent. Birthrights published a report into homebirth services in 2025, called ","fb1242dfbd8c",[],{"text":690,"_key":703,"_type":56,"marks":704},"ad13a6307e18",[705],"f28fa7f05087",{"_type":56,"marks":707,"text":708,"_key":709},[],". They looked at data between October 2023 and November 2024 from 119 NHS trusts that responded to a freedom of information (FOI) request. They found that 66% of Trusts had service suspensions, strict restrictions or frequent interruptions in their homebirth services. Some Trusts had applied blanket suspensions of homebirth services, ranging from two months to four years. The report paints a pretty dismal picture of homebirth services in the UK, highlighting that women and birthings people's choices about where they wish to give birth are limited.","3737ff8d4dcf","bc933e6f2122",[712],{"url":713,"_type":67,"_key":705,"type":65},"https://birthrights.org.uk/wp-content/uploads/2025/03/AccessDeniedBirthrightsFinalReport-1.pdf",{"style":78,"_key":715,"markDefs":716,"children":717,"_type":58},"be8dc27cb21f",[],[718],{"text":525,"_key":719,"_type":56,"marks":720},"a04662943bbf",[],{"_key":722,"markDefs":723,"children":724,"_type":58,"style":650},"8299550c7e25",[],[725],{"text":726,"_key":727,"_type":56,"marks":728},"The scale of the NHS midwifery shortage in England","633fafb13182",[],{"children":730,"_type":58,"style":78,"_key":734,"markDefs":735},[731],{"_key":732,"_type":56,"marks":733,"text":525},"19c52cb4ce5b",[],"32ee44a4a60b",[],{"style":78,"_key":737,"markDefs":738,"children":745,"_type":58},"0bca24043eda",[739,742],{"_type":67,"_key":740,"type":65,"url":741},"556cbd525cb2","https://rcm.org.uk/media-releases/2024/06/midwives-give-100000-hours-of-free-labour-to-the-nhs-per-week-to-keep-englands-maternity-services-safe-says-rcm/",{"_type":67,"_key":743,"type":65,"url":744},"e8c8dd7e8ac3","https://news.sky.com/story/newly-qualified-midwives-struggle-to-land-job-despite-chronic-staff-shortages-13509805",[746,750,754,758,762],{"marks":747,"text":748,"_key":749,"_type":56},[],"According to the ","797ae9455bbb",{"marks":751,"text":752,"_key":753,"_type":56},[740],"Royal College of Midwives (RCM)","9e06702fe847",{"text":755,"_key":756,"_type":56,"marks":757}," in the UK there is a shortage of around 2500 full time midwives - a number which has remained consistent for over a decade. Even more worrying is the ","2f8403fc5b97",[],{"_key":759,"_type":56,"marks":760,"text":761},"eea23f1c7194",[743],"news",{"_type":56,"marks":763,"text":764,"_key":765},[]," that newly qualified midwives are struggling to get jobs, with 31% unable to find a job. Maternity has long been underfunded and as long as it remains so, we’ll continue to see these staffing issues which have a direct impact on the care that women, birthing people and their babies receive.","f6e9698f833a",{"_type":58,"style":59,"_key":767,"markDefs":768,"children":769},"d7069e90e1c9",[],[770],{"_type":56,"marks":771,"text":772,"_key":773},[108],"Do You Still Have the Right to a Home Birth?","b0c3a6da6e88",{"markDefs":775,"children":776,"_type":58,"style":650,"_key":781},[],[777],{"marks":778,"text":779,"_key":780,"_type":56},[],"What the law says about your right to choose where you give birth","ab041bb0c7ed","dc12b49db435",{"_key":783,"markDefs":784,"children":788,"_type":58,"style":78},"0981376e4ccb",[785],{"_key":786,"type":65,"url":787,"_type":67},"e3de5398ea0c","https://birthrights.org.uk/factsheets/choice-of-place-of-birth/",[789,793,797,801],{"marks":790,"text":791,"_key":792,"_type":56},[],"Human rights law protects your right to bodily autonomy and allows you the right to make choices about the circumstances in which you give birth. This includes ","969ed02b9e1b",{"marks":794,"text":795,"_key":796,"_type":56},[281],"where ","f36045604bd5",{"marks":798,"text":799,"_key":800,"_type":56},[],"you plan to give birth. Birthrights have excellent information on your right to choose where you give birth, which you can access ","153612a3f3c8",{"_type":56,"marks":802,"text":803,"_key":804},[786],"here.","795f22c07214",{"_type":58,"style":650,"_key":806,"markDefs":807,"children":808},"09d3ecf5a1e3",[],[809],{"_type":56,"marks":810,"text":811,"_key":812},[],"What happens when your NHS Trust suspends services - can they do that?","0f075954f2d8",{"children":814,"_type":58,"style":78,"_key":819,"markDefs":820},[815],{"marks":816,"text":817,"_key":818,"_type":56},[],"NHS Trusts can suspend homebirth services. The NHS doesn’t by law have to provide a homebirth service - but they are expected to. Homebirth services should only be suspended if a Trust has explored all other options for keeping the service open (e.g. this could include using independent midwives) and where the decision is considered proportionate - although that is open to subjectivity.","115cd674051a","d143caa4ced2",[],{"_key":822,"markDefs":823,"children":824,"_type":58,"style":78},"9a97e2488145",[],[825],{"_key":826,"_type":56,"marks":827,"text":525},"5568bf35019a",[],{"markDefs":829,"children":830,"_type":58,"style":59,"_key":835},[],[831],{"_type":56,"marks":832,"text":833,"_key":834},[108],"Your Options When NHS Home Birth Isn't Available in Kent","98b511221e54","50202d3c9593",{"_key":837,"markDefs":838,"children":839,"_type":58,"style":650},"6dd56df7ac32",[],[840],{"_key":841,"_type":56,"marks":842,"text":843},"9b65fe7d1519",[],"What is an independent midwife and how is it different from NHS care?",{"_key":845,"markDefs":846,"children":853,"_type":58,"style":78},"6b12ecbf5712",[847,850],{"_key":848,"type":65,"url":849,"_type":67},"2c6b2b462733","https://www.nmc.org.uk ",{"type":65,"url":851,"_type":67,"_key":852},"https://www.nmc.org.uk/standards/code/","4007cb25a820",[854,858,862,866,870],{"marks":855,"text":856,"_key":857,"_type":56},[],"As independent (or private) midwives, we are hired by women and birthing people to provide midwifery care throughout pregnancy, birth and into the early postnatal period. We are ","09fc11d8ed4d",{"marks":859,"text":860,"_key":861,"_type":56},[848],"NMC","645c04a5c2d4",{"_key":863,"_type":56,"marks":864,"text":865},"68189e1188c6",[]," registered midwives who have undergone the same formal university training, but who have chosen to work outside and alongside the NHS system. Like all midwives, independent midwives must abide by the ",{"marks":867,"text":868,"_key":869,"_type":56},[852],"NMC Code of Conduct","87c6d5b01ac8",{"_type":56,"marks":871,"text":872,"_key":873},[],". A couple of the key differences between independent midwifery and NHS care is that we are not bound by hospital policies and we have significantly more time to spend with clients. This time allows us to go through all your options, supporting you to make the choices that feel right for you. If you’re curious about working with us, why not book a free intro chat?","0226f2417dd6",{"_key":875,"markDefs":876,"children":877,"_type":58,"style":59},"469a2d1946df",[],[878],{"_key":879,"_type":56,"marks":880,"text":881},"f279dc266113",[],"The benefits of continuity of care with a known midwife",{"_type":58,"style":78,"_key":883,"markDefs":884,"children":888},"becdeb37f0f5",[885],{"_type":67,"_key":886,"type":65,"url":887},"35b39a9d4c62","https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004667.pub6/full",[889,893],{"marks":890,"text":891,"_key":892,"_type":56},[886],"Research","b44b5caf4b4c",{"_key":894,"_type":56,"marks":895,"text":896},"08364cbd7735",[]," shows that continuity of care from a known midwife results in better outcomes for women and babies. We love working in this way because it allows us to really get to know each other, to build trust and to support you in the best way possible so that you have a positive pregnancy, birth and postnatal experience.",{"markDefs":898,"children":899,"_type":58,"style":78,"_key":903},[],[900],{"_type":56,"marks":901,"text":525,"_key":902},[],"f2446f7b1aec","85f1912e4af7",{"markDefs":905,"children":906,"_type":58,"style":78,"_key":911},[],[907],{"_key":908,"_type":56,"marks":909,"text":910},"63bb5b8d6c66",[108],"Some of the benefits of continuity of care include:","6669aec28d66",{"style":78,"_key":913,"listItem":914,"markDefs":915,"children":916,"level":921,"_type":58},"cb5cdbd25fb6","bullet",[],[917],{"_type":56,"marks":918,"text":919,"_key":920},[],"More likely to have a spontaneous vaginal birth","0c7d09954f01",1,{"listItem":914,"markDefs":923,"children":924,"level":921,"_type":58,"style":78,"_key":929},[],[925],{"text":926,"_key":927,"_type":56,"marks":928},"Less likely to experience an instrumental birth","8f0cfc90b623",[],"4ad76a789d74",{"markDefs":931,"children":932,"level":921,"_type":58,"style":78,"_key":937,"listItem":914},[],[933],{"_type":56,"marks":934,"text":935,"_key":936},[],"Less likely to experience a caesarean birth","fcb9b9708df4","622268e36b3d",{"_key":939,"listItem":914,"markDefs":940,"children":941,"level":921,"_type":58,"style":78},"ca0f610b872b",[],[942],{"_type":56,"marks":943,"text":944,"_key":945},[],"May be less likely to experience an episiotomy","411852f0cf78",{"markDefs":947,"children":948,"level":921,"_type":58,"style":78,"_key":953,"listItem":914},[],[949],{"_key":950,"_type":56,"marks":951,"text":952},"f7d438319bce",[],"More likely to have a positive experience of pregnancy, birth and postpartum","df9ed6bc455f",{"_key":955,"markDefs":956,"children":957,"_type":58,"style":650},"4b7810d183a3",[],[958],{"_type":56,"marks":959,"text":960,"_key":961},[],"Can you still access NHS care alongside an independent midwife?","81e3ce065e69",{"markDefs":963,"children":964,"_type":58,"style":78,"_key":969},[],[965],{"_type":56,"marks":966,"text":967,"_key":968},[],"You’re still entitled to access NHS care alongside an independent midwife. What this can look like is having ultrasound scans or blood tests via the NHS in pregnancy or it might be having a consultation with an obstetrician or giving birth in an NHS hospital, supported by us.","f0e787be1e5d","5632e651f2aa",{"_key":971,"markDefs":972,"children":973,"_type":58,"style":78},"0a6a9e305093",[],[974],{"_key":975,"_type":56,"marks":976,"text":525},"ab5daac0dec7",[],{"children":978,"_type":58,"style":650,"_key":983,"markDefs":984},[979],{"marks":980,"text":981,"_key":982,"_type":56},[],"What about freebirth?","41dd5708cdb5","7c8bf32e1c34",[],{"_type":58,"style":78,"_key":986,"markDefs":987,"children":991},"ff2f14df0f33",[988],{"type":65,"url":989,"blank":192,"_type":67,"_key":990},"https://birthrights.org.uk/factsheets/unassisted-birth/","bfd310ebdc1b",[992,996,1000,1004],{"marks":993,"text":994,"_key":995,"_type":56},[],"You’re legally allowed to choose to freebirth your baby. Freebirth (or unassisted birth) means giving birth without the attendance of any medically trained professionals i.e. a midwife or a doctor. Many people who choose freebirth will have doula support. Freebirth is a valid choice and some people will know in their heart and soul that it’s the right choice for them, other people may feel like it’s their ","7b3ec5e6ddf0",{"text":997,"_key":998,"_type":56,"marks":999},"only","f7354d0a20d2",[281],{"_key":1001,"_type":56,"marks":1002,"text":1003},"2543d40f5e45",[]," option if there are no homebirth services available locally or if they’re unable to access independent / private midwifery care. Read more about your rights relating to freebirth ",{"_key":1005,"_type":56,"marks":1006,"text":803},"166ee61f49d6",[990],{"children":1008,"_type":58,"style":78,"_key":1012,"markDefs":1013},[1009],{"_type":56,"marks":1010,"text":525,"_key":1011},[],"a133e35bda36","c480ecd8fe59",[],{"style":59,"_key":1015,"markDefs":1016,"children":1017,"_type":58},"c5af77f83ba4",[],[1018],{"_key":1019,"_type":56,"marks":1020,"text":1021},"c71435ce8371",[108],"What to Look for When Choosing an Independent Midwife",{"children":1023,"_type":58,"style":650,"_key":1028,"markDefs":1029},[1024],{"text":1025,"_key":1026,"_type":56,"marks":1027},"Questions to ask any independent/private midwife","ec1cf68a6b02",[],"87c6632fa6fa",[],{"_key":1031,"markDefs":1032,"children":1033,"_type":58,"style":78},"9899ffa28318",[],[1034],{"_type":56,"marks":1035,"text":1036,"_key":1037},[],"You need to find out if your values align with that of the midwife. For example, is your midwife comfortable to support you if you choose care ‘outside of guidelines’? Other useful things to ask might include, what’s their experience of homebirth transfer? How do they manage emergencies at home? How can they be contacted? Who do they use as their ‘second’ midwife for births?","627fc5d91bd7",{"style":78,"_key":1039,"markDefs":1040,"children":1041,"_type":58},"a425b154c18a",[],[1042],{"_type":56,"marks":1043,"text":525,"_key":1044},[],"d0bc5b551958",{"style":650,"_key":1046,"markDefs":1047,"children":1048,"_type":58},"6a7c55dc1a61",[],[1049],{"_type":56,"marks":1050,"text":1051,"_key":1052},[],"How to check a midwife is registered and insured","4a693713b2c7",{"children":1054,"_type":58,"style":78,"_key":1077,"markDefs":1078},[1055,1059,1064,1068,1073],{"marks":1056,"text":1057,"_key":1058,"_type":56},[],"You’re able to check that a midwife is registered by ","ab007a878e88",{"text":1060,"_key":1061,"_type":56,"marks":1062},"searching the NMC register ","a13eacfc49f0",[1063],"bf7e7d78b8bb",{"marks":1065,"text":1066,"_key":1067,"_type":56},[],"- you can do this using their first and last name, or you can ask them for their unique PIN to search the register. If a midwife is providing only antenatal and postnatal care, they can access insurance via the Royal College of Nursing and will be registered with them. If they are providing labour and birth care they are legally required to have insurance and currently the only way to access insurance as an independent midwife is through being ","a697d1b57292",{"_key":1069,"_type":56,"marks":1070,"text":1072},"4cf1b92f1443",[1071],"8ea406ea38f0","Zest",{"_type":56,"marks":1074,"text":1075,"_key":1076},[]," registered.","2f5a0aff9524","71722a8ce99f",[1079,1081],{"type":65,"url":1080,"_type":67,"_key":1063},"https://www.nmc.org.uk/registration/search-the-register/",{"_key":1071,"type":65,"url":1082,"_type":67},"https://zest-midwives.co.uk/",{"style":650,"_key":1084,"markDefs":1085,"children":1086,"_type":58},"d4689f9071b1",[],[1087],{"text":1088,"_key":1089,"_type":56,"marks":1090},"Why location matters - and what areas we cover from Folkestone","376b9b2da91e",[],{"markDefs":1092,"children":1093,"_type":58,"style":78,"_key":1098},[],[1094],{"text":1095,"_key":1096,"_type":56,"marks":1097},"We are happy to travel up to an hour from Folkestone. We don’t generally travel further than this to ensure that we can make it to births that are happening quickly! Areas we cover include: Folkestone, Hythe, Dover, Deal, Margate, Broadstairs, Ramsgate, Whitstable, Canterbury, Ashford, Maidstone, Herne Bay, Faversham, Rye and all the little Kent villages in between!","871dd0dee0cc",[],"98ec02d284bd",{"style":59,"_key":1100,"markDefs":1101,"children":1102,"_type":58},"c3e2e6c3c3fe",[],[1103],{"text":1104,"_key":1105,"_type":56,"marks":1106},"What Should You Do Right Now If Your Home Birth Has Been Suspended?","1e03d1b8d463",[108],{"_type":58,"style":650,"_key":1108,"markDefs":1109,"children":1110},"413b6f87f8db",[],[1111],{"marks":1112,"text":1113,"_key":1114,"_type":56},[],"Step 1: Confirm the current situation with your NHS Trust","00c7fb3659f3",{"markDefs":1116,"children":1117,"_type":58,"style":78,"_key":1122},[],[1118],{"text":1119,"_key":1120,"_type":56,"marks":1121},"You need to find out if your NHS Trust has suspended their homebirth services and how long they’re anticipated to be suspended. It’s not uncommon that the first time you hear of a suspension of services is when you are actually in labour. This is what we hear is happening in our local area.","fc6a8bdbc96e",[],"72c635756ecf",{"_type":58,"style":650,"_key":1124,"markDefs":1125,"children":1126},"eb67c5b77043",[],[1127],{"_type":56,"marks":1128,"text":1129,"_key":1130},[],"Step 2: Know your rights and how to challenge restrictions","75f91eb34509",{"_type":58,"style":78,"_key":1132,"markDefs":1133,"children":1137},"6e519655666f",[1134],{"type":65,"url":1135,"_type":67,"_key":1136},"https://zest-midwives.co.uk/giving-birth-at-home/","982191113232",[1138,1142,1146],{"text":1139,"_key":1140,"_type":56,"marks":1141},"You have the right to choose a homebirth - even if services are suspended. You can ask to speak to the Head of Midwifery and find out if using independent midwives has been explored as an option to support homebirths in the area. Zest, the company that enables access to our insurance, have recently created a useful ","bfa0c6a2169c",[],{"_key":1143,"_type":56,"marks":1144,"text":1145},"0e04269334bf",[1136],"template letter",{"_key":1147,"_type":56,"marks":1148,"text":1149},"941f9547fc84",[]," that you can use to challenge homebirth service restrictions in your area.",{"markDefs":1151,"children":1152,"_type":58,"style":650,"_key":1157},[],[1153],{"_type":56,"marks":1154,"text":1155,"_key":1156},[],"Step 3: Explore your alternatives early - don't wait","b21e8f904225","46191a25d66a",{"_type":58,"style":78,"_key":1159,"markDefs":1160,"children":1165},"8ec6b837777f",[1161],{"_key":1162,"type":65,"url":1163,"internalLink":1164,"_type":67},"2f54d38cbd83","https://junomidwives.co.uk/care-packages",{"_type":197,"_ref":196},[1166,1170,1174,1178,1181],{"marks":1167,"text":1168,"_key":1169,"_type":56},[],"If you know early in your pregnancy that you want a homebirth you need to consider your options if the NHS homebirth services are suspended. Would you consider using a midwife-led unit (MLU) if there were no homebirth services? (With the understanding that MLU’s are also sometimes closed due to staffing issues). Have a chat with your local independent midwife - they’re the only way to ","b853a6a7aef0",{"_key":1171,"_type":56,"marks":1172,"text":1173},"ff6fa086c376",[281],"guarantee access",{"_type":56,"marks":1175,"text":1176,"_key":1177},[]," to home birth with midwife support. If you’re based in Kent, we offer free intro chats so you can find out more about what we offer - book yours ","d07b368a4e5d",{"_key":1179,"_type":56,"marks":1180,"text":249},"af301741456e",[1162],{"_type":56,"marks":1182,"text":1183,"_key":1184},[],".","152d72801bfe",{"style":59,"_key":1186,"markDefs":1187,"children":1188,"_type":58},"be9816adeb68",[],[1189],{"_key":1190,"_type":56,"marks":1191,"text":1192},"69029f9e9410",[108],"Frequently Asked Questions About Home Birth in Kent",{"_key":1194,"listItem":914,"markDefs":1195,"children":1196,"level":921,"_type":58,"style":78},"9f91e926479b",[],[1197],{"_key":1198,"_type":56,"marks":1199,"text":1200},"4899782ccf54",[108],"Is home birth currently available on the NHS in East Kent?",{"_key":1202,"markDefs":1203,"children":1204,"_type":58,"style":78},"b973641f826e",[],[1205],{"_key":1206,"_type":56,"marks":1207,"text":1208},"bd899e65bd0b",[],"According to their website, yes. In our experience the service is frequently disrupted due to staffing issues.",{"children":1210,"level":921,"_type":58,"style":78,"_key":1215,"listItem":914,"markDefs":1216},[1211],{"_type":56,"marks":1212,"text":1213,"_key":1214},[108],"Can I have a home birth with an independent midwife even if the NHS has suspended its service?","36791370862f","ad8817e6bc01",[],{"markDefs":1218,"children":1219,"_type":58,"style":78,"_key":1224},[],[1220],{"_key":1221,"_type":56,"marks":1222,"text":1223},"70dbbc14fe3c",[],"You can have a homebirth with an independent midwife, however the latest we generally book clients is 36 weeks. So if it’s looking likely that an NHS homebirth won’t be possible, it’s worth getting in touch with us sooner rather than later.","597ebe831d67",{"markDefs":1226,"children":1227,"level":921,"_type":58,"style":78,"_key":1232,"listItem":914},[],[1228],{"marks":1229,"text":1230,"_key":1231,"_type":56},[108],"What happens if I go into labour and the NHS can't send a midwife?","70e986290209","2813a24e3cce",{"markDefs":1234,"children":1235,"_type":58,"style":78,"_key":1240},[],[1236],{"_type":56,"marks":1237,"text":1238,"_key":1239},[],"You have the option to transfer to a midwife-led unit or a labour ward. Some women or birthing people in this scenario will choose to freebirth. You will generally be advised to call an ambulance - particularly if birth is imminent or the baby has just been born. Some people will do this and other people will choose not to. In an emergency, paramedics and ambulances are great, however childbirth is not usually an emergency. Some people find that inviting paramedics into their home can cause stress and anxiety and would prefer not to. Some people will request that a community midwife comes out to them after their baby is born to notify the birth and do postnatal checks.","f577447d4163","ea5d05863ca1",{"level":921,"_type":58,"style":78,"_key":1242,"listItem":914,"markDefs":1243,"children":1244},"3201e969ec91",[],[1245],{"_key":1246,"_type":56,"marks":1247,"text":1248},"95827377f98b",[108],"How much does an independent midwife cost in Kent?",{"markDefs":1250,"children":1253,"_type":58,"style":78,"_key":1265},[1251],{"_type":67,"_key":1252,"type":65,"url":1163},"fb5c849a4dbb",[1254,1258,1262],{"marks":1255,"text":1256,"_key":1257,"_type":56},[],"Full care throughout your whole pregnancy with us costs £8500 and we offer payment plans to help spread the cost. Find out more about our ","71ccffae8c1d",{"marks":1259,"text":1260,"_key":1261,"_type":56},[1252],"care packages","718a4079ef46",{"_type":56,"marks":1263,"text":1183,"_key":1264},[],"ec7e44537bc3","852d4c23a858",{"listItem":914,"markDefs":1267,"children":1268,"level":921,"_type":58,"style":78,"_key":1273},[],[1269],{"_key":1270,"_type":56,"marks":1271,"text":1272},"dd0d2c3c8f4e",[108],"Can I still use the NHS for antenatal scans if I hire a private midwife?","2008983e4303",{"_key":1275,"markDefs":1276,"children":1277,"_type":58,"style":78},"3a965dc69222",[],[1278],{"marks":1279,"text":1280,"_key":1281,"_type":56},[],"Yes - you’re still entitled to use NHS services even if you hire an independent/private midwife.","2977b3824e5b",{"link":1283,"_key":1286,"_type":190},{"internalLink":1284,"blank":192,"_type":67,"text":1285,"type":194},{"_ref":549,"_type":197},"Find Out More - Book a Call With Us","dc4ee764ef46",{"children":1288,"_type":58,"style":78,"_key":1293,"markDefs":1294},[1289],{"marks":1290,"text":1291,"_key":1292,"_type":56},[],"\n\n","d53d3454d8bf","d1fd35a8325a",[],"2026-04-02T08:12:13Z",{"content":1297,"slug":1902,"image":1904,"seo":1907,"_type":37,"_updatedAt":1910,"publishedAt":1911,"_createdAt":1912,"_rev":1913,"_id":1914,"title":1915,"_system":1916},{"_type":49,"body":1298},[1299,1307,1315,1323,1331,1355,1363,1378,1382,1390,1398,1415,1423,1431,1439,1447,1453,1461,1469,1477,1485,1493,1501,1509,1528,1535,1552,1558,1566,1574,1582,1590,1598,1606,1614,1629,1637,1645,1653,1661,1669,1677,1685,1701,1717,1723,1731,1739,1755,1763,1771,1779,1795,1803,1811,1819,1827,1833,1846,1865,1879,1887,1895],{"_type":58,"style":59,"_key":1300,"markDefs":1301,"children":1302},"0a40ed4397cf",[],[1303],{"_type":56,"marks":1304,"text":1305,"_key":1306},[],"What Is Vitamin K and Why Is it Recommended for Newborns?","a08a8579f7c5",{"style":650,"_key":1308,"markDefs":1309,"children":1310,"_type":58},"fdd2f81acbb5",[],[1311],{"_key":1312,"_type":56,"marks":1313,"text":1314},"4c6934e0f723",[],"What does vitamin K do in the body?",{"style":78,"_key":1316,"markDefs":1317,"children":1318,"_type":58},"15ebe82f7ea3",[],[1319],{"text":1320,"_key":1321,"_type":56,"marks":1322},"Vitamin K helps our liver produce essential clotting factors for our blood - we need it to prevent bleeding. It's recommended by the Department of Health for all babies as it virtually eliminates the risk of vitamin K deficiency bleeding (VKDB) - more on that below!","245871dc78db",[],{"children":1324,"_type":58,"style":650,"_key":1329,"markDefs":1330},[1325],{"marks":1326,"text":1327,"_key":1328,"_type":56},[],"Why are babies born with low vitamin K levels?","6bc4298e0e98","558ad6930324",[],{"_type":58,"style":78,"_key":1332,"markDefs":1333,"children":1334},"986b9735684f",[],[1335,1339,1343,1347,1351],{"marks":1336,"text":1337,"_key":1338,"_type":56},[],"We don’t actually know ","1da0fcba12ba",{"_type":56,"marks":1340,"text":1341,"_key":1342},[281],"why ","233e2c8b085b",{"marks":1344,"text":1345,"_key":1346,"_type":56},[],"babies are born with lower levels of Vitamin K or ","de222ab7e459",{"marks":1348,"text":1349,"_key":1350,"_type":56},[281],"if ","bef295b89ca9",{"marks":1352,"text":1353,"_key":1354,"_type":56},[],"there is some physiological advantage to this or not.","e7e2d01e644c",{"_type":58,"style":650,"_key":1356,"markDefs":1357,"children":1358},"ca0305f215a8",[],[1359],{"_type":56,"marks":1360,"text":1361,"_key":1362},[],"What is vitamin K deficiency bleeding (VKDB)?","2c9db0cac0d7",{"_type":58,"style":78,"_key":1364,"markDefs":1365,"children":1369},"e15ac0ebbf59",[1366],{"_key":1367,"type":65,"url":1368,"blank":192,"_type":67},"39d774117e99","https://leaflets.ekhuft.nhs.uk/vitamin-k-for-newborn-babies/html/",[1370,1374],{"marks":1371,"text":1372,"_key":1373,"_type":56},[1367],"Vitamin K deficiency bleeding (VKDB","8ae97b09917c",{"_type":56,"marks":1375,"text":1376,"_key":1377},[],") is a rare condition that causes a baby to have internal bleeding, which can in very rare cases, lead to brain damage or even be fatal. The good news is that if treated quickly, most babies will recover from VKDB. The treatment for VKDB is vitamin K.","c7c9594df2b4",{"_key":1379,"_type":190,"link":1380},"26ddc644e5f6",{"blank":192,"_type":67,"text":193,"type":194,"internalLink":1381},{"_ref":196,"_type":197},{"markDefs":1383,"children":1384,"_type":58,"style":59,"_key":1389},[],[1385],{"_type":56,"marks":1386,"text":1387,"_key":1388},[],"Is the Vitamin K Injection Safe for My Baby?","018c6ba5b7cb","0a422bb88457",{"_type":58,"style":650,"_key":1391,"markDefs":1392,"children":1393},"9f9ced66566b",[],[1394],{"_key":1395,"_type":56,"marks":1396,"text":1397},"562eee96a39c",[],"What ingredients are in the vitamin K injection?",{"_key":1399,"markDefs":1400,"children":1404,"_type":58,"style":78},"ff7466a2c21a",[1401],{"_key":1402,"type":65,"url":1403,"blank":192,"_type":67},"051aeb0538f3","https://www.medicines.org.uk/emc/files/pil.9754.pdf",[1405,1409,1412],{"_type":56,"marks":1406,"text":1407,"_key":1408},[],"The active ingredient is vitamin K1 (phytomenadione). Other ingredients are: glycocholic acid, sodium hydroxide, lecithin, hydrochloric acid and water for injection. Some ingredients can be derived from animal products and if this is important to you, you’ll need to weigh up the risks and benefits of your baby having or not having vitamin K. A full manufacturer's leaflet can be found ","ea403c7269b6",{"_key":1410,"_type":56,"marks":1411,"text":249},"05dbcd75802e",[1402],{"text":1183,"_key":1413,"_type":56,"marks":1414},"d0c079abc8eb",[],{"_key":1416,"markDefs":1417,"children":1418,"_type":58,"style":650},"966d60022b8e",[],[1419],{"_type":56,"marks":1420,"text":1421,"_key":1422},[],"Are there any side effects?","982a353797c6",{"style":78,"_key":1424,"markDefs":1425,"children":1426,"_type":58},"e2b434379916",[],[1427],{"text":1428,"_key":1429,"_type":56,"marks":1430},"As with all injections, there is a small chance of infection, bleeding and swelling at the injection site and some babies may have a bruise. Allergic reactions are very rare but possible.","59c5bf20ef30",[],{"_key":1432,"markDefs":1433,"children":1434,"_type":58,"style":650},"045cd1287a30",[],[1435],{"marks":1436,"text":1437,"_key":1438,"_type":56},[],"Does the injection cause pain or distress?","832cb1830ba4",{"style":78,"_key":1440,"markDefs":1441,"children":1442,"_type":58},"aad28157fd4f",[],[1443],{"text":1444,"_key":1445,"_type":56,"marks":1446},"Giving vitamin K via injection involves a needle. In our experience most babies will cry when they have the injection and we can assume it does cause them some pain, in the same way injections cause adults pain. It’s helpful to administer it when your baby is having a close cuddle with a parent, so that they can be soothed straight away. Feeding your baby whilst they have the injection may also help to soothe them.","9e6af5e263ae",[],{"_type":190,"link":1448,"_key":1452},{"internalLink":1449,"blank":192,"_type":67,"text":1451,"type":194},{"_ref":1450,"_type":197},"1e0bdee8-5f1c-4a23-8abb-bcb082d62b77","Why You Should Probably Ditch Your Baby's Hat","d810cd757a3f",{"style":59,"_key":1454,"markDefs":1455,"children":1456,"_type":58},"c624f610103e",[],[1457],{"marks":1458,"text":1459,"_key":1460,"_type":56},[],"Vitamin K Injection vs. Oral - What's the Difference?","ef9a4433f71d",{"style":650,"_key":1462,"markDefs":1463,"children":1464,"_type":58},"027a0bb00b6e",[],[1465],{"_key":1466,"_type":56,"marks":1467,"text":1468},"95d7183621ea",[],"How does the injection work?",{"style":78,"_key":1470,"markDefs":1471,"children":1472,"_type":58},"e64965aebf7c",[],[1473],{"_type":56,"marks":1474,"text":1475,"_key":1476},[],"The vitamin K injection is usually given soon after birth within the first few hours of life. It’s an intramuscular injection, meaning it is injected into the muscle and it goes into one of your baby’s thighs. The injection is a one-off dose of 1mg.","baeb63d94d5a",{"markDefs":1478,"children":1479,"_type":58,"style":650,"_key":1484},[],[1480],{"text":1481,"_key":1482,"_type":56,"marks":1483},"How do oral Vitamin K drops work?","57afcc242901",[],"d160948dc81e",{"children":1486,"_type":58,"style":78,"_key":1491,"markDefs":1492},[1487],{"_type":56,"marks":1488,"text":1489,"_key":1490},[],"Oral vitamin K is given via an oral syringe into your baby’s mouth. 3 doses are required: within the first few hours after birth, on day 7 and on day 28 after birth. Each dose is 2mg.","8ca179f8ccf0","91eee89692c2",[],{"_key":1494,"markDefs":1495,"children":1496,"_type":58,"style":650},"9dd597be1997",[],[1497],{"text":1498,"_key":1499,"_type":56,"marks":1500},"Which option is more effective?","fec4f42f323f",[],{"_key":1502,"markDefs":1503,"children":1504,"_type":58,"style":78},"06d863b21ace",[],[1505],{"text":1506,"_key":1507,"_type":56,"marks":1508},"The injection is more effective than the oral drops, which is why the injection is one-off and the oral dose is 3 doses. With oral vitamin K there are a few factors that can impact its effectiveness: absorption (vitamin K is fat soluble - so ideally should be given after a feed to boost its absorption), babies are prone to vomiting (so there is uncertainty about how much vitamin K the baby actually gets with the oral dose) and subsequent doses can be missed or forgotten. Oral vitamin K is however still effective, and certainly more effective than no vitamin K.","aec0bfbb0d49",[],{"_type":58,"style":78,"_key":1510,"markDefs":1511,"children":1515},"7ca44c41ee44",[1512],{"internalLink":1513,"blank":192,"_type":67,"_key":1514,"type":194},{"_ref":549,"_type":197},"2482296dbd22",[1516,1520,1524],{"marks":1517,"text":1518,"_key":1519,"_type":56},[],"When you ","63e7c4f844a8",{"marks":1521,"text":1522,"_key":1523,"_type":56},[1514],"book care","d6f1c53b24a2",{"marks":1525,"text":1526,"_key":1527,"_type":56},[]," with us, we go through all your options and can signpost you to extra resources so that you can make the decision that feels right for you and your baby. ","ea487f3a9b3a",{"style":650,"_key":1529,"markDefs":1530,"children":1531,"_type":58},"1a10ed28f254",[],[1532],{"text":1533,"_key":1507,"_type":56,"marks":1534},"Why do some parents choose oral vitamin K?",[],{"style":78,"_key":1536,"markDefs":1537,"children":1541,"_type":58},"ec8aafa0d054",[1538],{"_type":67,"_key":1539,"type":194,"internalLink":1540},"e50b92ea73ee",{"_ref":196,"_type":197},[1542,1546,1549],{"marks":1543,"text":1544,"_key":1545,"_type":56},[],"Some parents understandably don’t like the idea of putting their baby through any pain or distress if they don’t have to. You have the right to choose if and how your baby receives vitamin K. If you choose the oral vitamin K, depending on where you live, community midwives will give this to your baby at the right times or you may have to get a prescription and give the vitamin K yourself. If our clients choose to have oral vitamin K we will provide all the required doses - it’s all included as part of our ","cf6b93d251c7",{"_type":56,"marks":1547,"text":1260,"_key":1548},[1539],"e2b8ed16653e",{"_key":1550,"_type":56,"marks":1551,"text":1183},"ff0fc8649937",[],{"_type":190,"link":1553,"_key":1557},{"internalLink":1554,"blank":192,"_type":67,"text":1556,"type":194},{"_ref":1555,"_type":197},"2d3d6118-03f6-4240-bd9d-23a28163637f","The BRAINS Decision Making Tool ","f57e6f76e937",{"_type":58,"style":59,"_key":1559,"markDefs":1560,"children":1561},"9c03f3bb497a",[],[1562],{"text":1563,"_key":1564,"_type":56,"marks":1565},"\nWhat Happens If My Baby Doesn't Get Vitamin K?","a00ddfe5a2fc",[],{"style":650,"_key":1567,"markDefs":1568,"children":1569,"_type":58},"f59d133e5600",[],[1570],{"text":1571,"_key":1572,"_type":56,"marks":1573},"How common is Vitamin K deficiency bleeding?","5036a2079cd5",[],{"_type":58,"style":78,"_key":1575,"markDefs":1576,"children":1577},"33f8f12d51af",[],[1578],{"marks":1579,"text":1580,"_key":1581,"_type":56},[],"VKDB is rare. The chance is thought to be about 1:11000 babies - although this figure changes slightly depending on the source.","3feda511173c",{"markDefs":1583,"children":1584,"_type":58,"style":650,"_key":1589},[],[1585],{"_key":1586,"_type":56,"marks":1587,"text":1588},"c4a364d2c7d2",[],"What are the signs of VKDB in newborns?","3684024ac59c",{"listItem":914,"markDefs":1591,"children":1592,"level":921,"_type":58,"style":78,"_key":1597},[],[1593],{"marks":1594,"text":1595,"_key":1596,"_type":56},[],"Minor bleeding from the skin, nose or mouth or umbilical cord. 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Some are told that the ","878faa2cb496",{"_type":56,"marks":2167,"text":2168,"_key":2169},[108],"midwife-led unit","64df57297710",{"_type":56,"marks":2171,"text":2172,"_key":2173},[]," is open and they could birth there. But for some, the midwife-led unit isn’t open so their only option would be to give birth on a ","f0e761461f1e",{"marks":2175,"text":2176,"_key":2177,"_type":56},[108],"labour ward","12826ab9cbce",{"marks":2179,"text":2180,"_key":2181,"_type":56},[],". You’re exposed to more i","86699ec9d17e",{"_key":2183,"_type":56,"marks":2184,"text":2185},"ad885a9fe241",[108],"nterventions",{"text":2187,"_key":2188,"_type":56,"marks":2189}," if you’re on a labour ward to give birth. We have also heard of women who decline coming in, being told that they can ","6c00720a0ce5",[],{"_type":56,"marks":2191,"text":2192,"_key":2193},[108],"freebirth","07456a192a10",{"text":2195,"_key":2196,"_type":56,"marks":2197}," instead. Now, freebirth is a ","d5649acff2ff",[],{"text":2199,"_key":2200,"_type":56,"marks":2201},"valid and legal choice","ebf4bdbfc3b1",[108],{"marks":2203,"text":2204,"_key":2205,"_type":56},[]," for women and birthing people to make. However, if your plan was to give birth at home with the support of midwives – freebirth is not necessarily the choice you ","b321eb32cb65",{"_type":56,"marks":2207,"text":2208,"_key":2209},[108],"want to make or feel comfortable","dbbf6164f301",{"_type":56,"marks":2211,"text":2212,"_key":2213},[]," making. 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You also need midwives who can ",{"text":2294,"_key":2295,"_type":56,"marks":2296},"promptly recognise an emergency scenario","c80f92054f07",[108],{"_type":56,"marks":2298,"text":2299,"_key":2300},[]," and understand how to manage this at home and liaise with the local hospital for transfer if necessary. This is the ","9a78bf90f361",{"_key":2302,"_type":56,"marks":2303,"text":2304},"8d09f4193102",[108],"bread and butter",{"_type":56,"marks":2306,"text":2307,"_key":2308},[]," of independent midwives. 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Birthrights say, ","f86db467595f",{"_type":56,"marks":2427,"text":2428,"_key":2429},[281],"\"If you are told you cannot give birth at home because of staff shortages, remind the hospital that it must make sure there are enough staff to provide the services it has promised. They should have plans for situations such as staff shortages. This could include providing an independent midwife.\". 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","fa1a829db819","e8850ced20bc",[2456,2457],{"_type":67,"_key":2448,"type":65,"url":1135,"blank":2434},{"_key":2439,"type":65,"url":2458,"blank":2434,"_type":67},"https://zest-midwives.co.uk",{"style":59,"_key":2460,"markDefs":2461,"children":2462,"_type":58},"2f5c97ffd861",[],[2463],{"text":2464,"_key":2465,"_type":56,"marks":2466},"Ready to Plan Your Homebirth in Kent? Let's Talk.","5484426c52a1",[],{"_key":2468,"markDefs":2469,"children":2470,"_type":58,"style":78},"18db725f6c5f",[],[2471],{"marks":2472,"text":2473,"_key":2474,"_type":56},[],"Click the button below to book an intro chat to see how we can support your homebirth plans.","59a63e59fea4",{"_type":190,"link":2476,"_key":2479},{"blank":192,"_type":67,"text":2477,"type":194,"internalLink":2478},"Let's chat home birth!",{"_ref":549,"_type":197},"28ae2bf5140e",{"asset":2481,"_type":586},{"_ref":2482,"_type":197},"image-4ff548cec3e206d143e66aabd75e98055fd927b9-2048x1365-jpg","2026-03-10T13:59:59Z","2026-02-25T14:05:22Z",{"_type":37,"_system":2486,"_updatedAt":2490,"publishedAt":2491,"_createdAt":2492,"_id":2489,"image":2493,"title":2496,"content":2497,"slug":3008,"_rev":3010},{"base":2487},{"rev":2488,"id":2489},"s6xZ6JxVFPaoeMahCbTPps","9a18426b-60bb-49c4-9230-0ae4e62fbea4","2026-03-31T09:37:44Z","2025-07-01","2025-07-01T13:50:25Z",{"asset":2494,"_type":586},{"_ref":2495,"_type":197},"image-56d3b3c0658f6559dfd8aad7491d79b30ec6d332-5184x3456-jpg","Your First Midwife Appointment: Rights, Choices & What to Expect",{"_type":49,"body":2498},[2499,2507,2514,2521,2528,2536,2560,2576,2582,2589,2597,2613,2621,2629,2641,2653,2665,2677,2685,2693,2705,2713,2725,2737,2753,2759,2767,2775,2791,2805,2820,2843,2852,2860,2884,2891,2899,2907,2919,2926,2950,2955,2963,2971,2979],{"style":650,"_key":2500,"markDefs":2501,"children":2502,"_type":58},"02291ccf61a5",[],[2503],{"text":2504,"_key":2505,"_type":56,"marks":2506},"Your first midwife appointment is the start of your maternity care and it can be an exciting or nerve-wracking experience. This blog is here to remind you that you have rights, options and choices in pregnancy - no matter what your story is.","1269c1676507",[281],{"_key":2508,"markDefs":2509,"children":2510,"_type":58,"style":78},"1b71d2645b35",[],[2511],{"text":525,"_key":2512,"_type":56,"marks":2513},"0aa30e65e985",[],{"children":2515,"_type":58,"style":78,"_key":2519,"markDefs":2520},[2516],{"_key":2517,"_type":56,"marks":2518,"text":525},"fa0ea55bf650",[108],"fdbefd24390c",[],{"style":78,"_key":2522,"markDefs":2523,"children":2524,"_type":58},"b4758686ea35",[],[2525],{"text":525,"_key":2526,"_type":56,"marks":2527},"72d5e16360e3",[],{"markDefs":2529,"children":2530,"_type":58,"style":59,"_key":2535},[],[2531],{"_type":56,"marks":2532,"text":2533,"_key":2534},[],"What Happens at Your Booking Appointment?","cb5861a87718","3db96e234d17",{"markDefs":2537,"children":2538,"_type":58,"style":78,"_key":2559},[],[2539,2543,2547,2551,2555],{"_type":56,"marks":2540,"text":2541,"_key":2542},[],"This usually happens between ","3130fbd8d734",{"_type":56,"marks":2544,"text":2545,"_key":2546},[108],"8-10 weeks of pregnancy ","1c71e3ab575a",{"marks":2548,"text":2549,"_key":2550,"_type":56},[],"and if you choose NHS maternity care it will likely be your longest appointment. If you choose independent midwifery care, appointments last ","1f2b74da5ba6",{"_key":2552,"_type":56,"marks":2553,"text":2554},"b7a140222c15",[281],"at least an hour",{"_type":56,"marks":2556,"text":2557,"_key":2558},[]," as standard throughout your pregnancy. ","dd09b2e7347b","96b486069801",{"markDefs":2561,"children":2562,"_type":58,"style":78,"_key":2575},[],[2563,2567,2571],{"marks":2564,"text":2565,"_key":2566,"_type":56},[],"The booking appointment is mostly a","896ceebb436e",{"marks":2568,"text":2569,"_key":2570,"_type":56},[108]," history-taking session","dbb383aff583",{"_key":2572,"_type":56,"marks":2573,"text":2574},"6e3c6debaf22",[],". A midwife will ask you lots of questions about your pregnancy, medical and social history and your general health. You will be offered a heap of tests and screening assessments…which brings us on to our next point.","a0e1ded555a3",{"_type":190,"link":2577,"_key":2581},{"text":2578,"type":194,"internalLink":2579,"blank":192,"_type":67},"Book Your Free Initial Consultation",{"_ref":2580,"_type":197},"188b6754-b356-44b4-8178-a917def757d9","d109d0b49877",{"style":78,"_key":2583,"markDefs":2584,"children":2585,"_type":58},"b116beeac5c7",[],[2586],{"marks":2587,"text":525,"_key":2588,"_type":56},[108],"3c6316da36fb",{"style":59,"_key":2590,"markDefs":2591,"children":2592,"_type":58},"4f63455646b0",[],[2593],{"text":2594,"_key":2595,"_type":56,"marks":2596},"Everything Offered in Pregnancy is Optional. Yes, Really!","2212b9a75772",[],{"markDefs":2598,"children":2599,"_type":58,"style":78,"_key":2612},[],[2600,2604,2608],{"_key":2601,"_type":56,"marks":2602,"text":2603},"9a07f7cd264c",[],"Lots of the things you are offered during pregnancy are so ‘routine’ that they might not seem optional. However you have the right to accept or decline any test, intervention or screening that is offered to you. You might accept everything offered to you. You might want some things but not others. ",{"_type":56,"marks":2605,"text":2606,"_key":2607},[108],"You get to choose","5bc7ae5dcbda",{"text":2609,"_key":2610,"_type":56,"marks":2611},". You also can take your time to make decisions, so don’t feel pressured or rushed at your booking appointment if you feel unsure about something that is being offered to you.","224242a8dddf",[],"f60c35145125",{"style":59,"_key":2614,"markDefs":2615,"children":2616,"_type":58},"8e834d1a92b0",[],[2617],{"text":2618,"_key":2619,"_type":56,"marks":2620},"What Tests and Checks Are Offered at a Booking Appointment?","ff39e98c0104",[],{"children":2622,"_type":58,"style":78,"_key":2627,"markDefs":2628},[2623],{"_type":56,"marks":2624,"text":2625,"_key":2626},[],"Here is a list of what is typically offered at a midwifery booking appointment:","1fd552ffcaec","67a04a137ac4",[],{"style":78,"_key":2630,"listItem":914,"markDefs":2631,"children":2632,"level":921,"_type":58},"4c1651678fab",[],[2633,2637],{"marks":2634,"text":2635,"_key":2636,"_type":56},[108],"Blood tests for","70f7c562f7e4",{"_type":56,"marks":2638,"text":2639,"_key":2640},[],": HIV, syphilis hepatitis, full blood count, blood group, atypical antibodies, sickle cell & thalassaemia and some hospitals offer an HbA1c test, which screens for type 2 diabetes.","7883105553ae",{"listItem":914,"markDefs":2642,"children":2643,"level":921,"_type":58,"style":78,"_key":2652},[],[2644,2648],{"marks":2645,"text":2646,"_key":2647,"_type":56},[108],"Basic observations","3879175433d6",{"marks":2649,"text":2650,"_key":2651,"_type":56},[],": blood pressure and pulse check.","e05685e47c70","b348e8733029",{"level":921,"_type":58,"style":78,"_key":2654,"listItem":914,"markDefs":2655,"children":2656},"7309bd6b5528",[],[2657,2661],{"_key":2658,"_type":56,"marks":2659,"text":2660},"3fc216c21da0",[108],"Urine test: ",{"marks":2662,"text":2663,"_key":2664,"_type":56},[],"at least a urine dipstick, some hospitals routinely send a sample off but they should ask your consent to do so and explain what they’re testing for.","7b72cdc7e778",{"listItem":914,"markDefs":2666,"children":2667,"level":921,"_type":58,"style":78,"_key":2676},[],[2668,2672],{"_type":56,"marks":2669,"text":2670,"_key":2671},[108],"Ultrasound scans:","1890dae70e7b",{"text":2673,"_key":2674,"_type":56,"marks":2675}," at approximately 12 and 20 weeks. Some hospitals also offer a routine 36 week scan.","bce18069cf69",[],"34f2554502bf",{"level":921,"_type":58,"style":78,"_key":2678,"listItem":914,"markDefs":2679,"children":2680},"31e82776128b",[],[2681],{"marks":2682,"text":2683,"_key":2684,"_type":56},[108],"NHS fetal anomaly screening programme information.","6317c35f500f",{"style":78,"_key":2686,"listItem":914,"markDefs":2687,"children":2688,"level":921,"_type":58},"2b2bee614bf7",[],[2689],{"text":2690,"_key":2691,"_type":56,"marks":2692},"BMI calculation.","6dbe6df30596",[108],{"_type":58,"style":78,"_key":2694,"listItem":914,"markDefs":2695,"children":2696,"level":921},"751f6813e73e",[],[2697,2701],{"_key":2698,"_type":56,"marks":2699,"text":2700},"e498253a8537",[108],"Screening assessments ",{"_key":2702,"_type":56,"marks":2703,"text":2704},"3baba3282b00",[],"for your chance of having: IUGR/pre-eclampsia, gestational diabetes and venous thromboembolism (VTE).",{"style":78,"_key":2706,"listItem":914,"markDefs":2707,"children":2708,"level":921,"_type":58},"ef75498facf5",[],[2709],{"_type":56,"marks":2710,"text":2711,"_key":2712},[108],"Carbon monoxide testing.","c61c7ac3db66",{"listItem":914,"markDefs":2714,"children":2715,"level":921,"_type":58,"style":78,"_key":2724},[],[2716,2720],{"_key":2717,"_type":56,"marks":2718,"text":2719},"8678746f5e47",[108],"An obstetric or anaesthetic review",{"marks":2721,"text":2722,"_key":2723,"_type":56},[],": if something in your medical or pregnancy history suggests additional input is advise.","742ab5cdd280","ca19bcb9886e",{"_type":58,"style":78,"_key":2726,"listItem":914,"markDefs":2727,"children":2728,"level":921},"77055516f4ea",[],[2729,2733],{"_type":56,"marks":2730,"text":2731,"_key":2732},[108],"Midwife appointments:","b8b6d0249c43",{"_type":56,"marks":2734,"text":2735,"_key":2736},[]," at regular intervals throughout your pregnancy.","239d5cbe04b9",{"_key":2738,"markDefs":2739,"children":2740,"_type":58,"style":78},"27d01d428c0d",[],[2741,2745,2749],{"text":2742,"_key":2743,"_type":56,"marks":2744},"The results of some of the screening tests may indicate that you should be offered further tests or medication and can impact your ‘risk label’ (see point 4!). You should be given information about everything that is offered to you, so that you can make an","dc711fdd1f3f",[],{"_type":56,"marks":2746,"text":2747,"_key":2748},[108]," informed decision.","5eb2d0a1f047",{"_type":56,"marks":2750,"text":2751,"_key":2752},[]," Whilst we don’t mean to be cynical…a standard  NHS booking appointment might only be an hour long, which really isn’t that much time to be able to discuss everything.","36e6fc23f432",{"_type":190,"link":2754,"_key":2758},{"internalLink":2755,"blank":192,"_type":67,"text":2757,"type":194},{"_ref":2756,"_type":197},"a809687b-6b64-4a99-a7df-9358e54b3e4e","Read our 'Am I Allowed...' Blog ","09df8d40146c",{"markDefs":2760,"children":2761,"_type":58,"style":59,"_key":2766},[],[2762],{"marks":2763,"text":2764,"_key":2765,"_type":56},[],"Can You Change Your Mind About Pregnancy Care Decisions?","ef70897a276d","face9ba34af4",{"children":2768,"_type":58,"style":78,"_key":2773,"markDefs":2774},[2769],{"text":2770,"_key":2771,"_type":56,"marks":2772},"If you decide you do or don’t want something at the booking appointment, you can revisit that decision during your pregnancy. For example…","f0264cfba093",[],"e749c0182a95",[],{"markDefs":2776,"children":2777,"level":921,"_type":58,"style":78,"_key":2790,"listItem":914},[],[2778,2782,2786],{"marks":2779,"text":2780,"_key":2781,"_type":56},[108],"Been booked for a glucose tolerance test but not sure that’s what you want","ec41c4a0176b",{"marks":2783,"text":2784,"_key":2785,"_type":56},[],"? ","a5a23fbb35a9",{"_type":56,"marks":2787,"text":2788,"_key":2789},[281],"You can change your mind.","d96a438ea9cf","a3c18fd52ed0",{"style":78,"_key":2792,"listItem":914,"markDefs":2793,"children":2794,"level":921,"_type":58},"ebd36b1b8279",[],[2795,2799,2802],{"marks":2796,"text":2797,"_key":2798,"_type":56},[108],"Ticked the 'labour ward' box, but feel more drawn to home birth","c581965357d5",{"_type":56,"marks":2800,"text":2784,"_key":2801},[],"cb558a27e105",{"_type":56,"marks":2803,"text":2788,"_key":2804},[281],"0dac65299752",{"style":78,"_key":2806,"listItem":914,"markDefs":2807,"children":2808,"level":921,"_type":58},"f42ffe6e4112",[],[2809,2813,2817],{"marks":2810,"text":2811,"_key":2812,"_type":56},[108],"Recommended an obstetric doctor review at booking but declined?","437fc0f1b046",{"marks":2814,"text":2815,"_key":2816,"_type":56},[]," ","7c7387ac4750",{"marks":2818,"text":2788,"_key":2819,"_type":56},[281],"679d7b8b3927",{"style":78,"_key":2821,"markDefs":2822,"children":2826,"_type":58},"65723eef797c",[2823],{"internalLink":2824,"blank":192,"_type":67,"_key":2825,"type":194},{"_ref":1555,"_type":197},"f0fd76d2d301",[2827,2831,2835,2839],{"_type":56,"marks":2828,"text":2829,"_key":2830},[],"The ","0a49566b3069",{"_type":56,"marks":2832,"text":2833,"_key":2834},[108],"BRAIN decision making tool ","e4fb2a2a5068",{"marks":2836,"text":2837,"_key":2838,"_type":56},[],"is a great way to help you make the decisions that feel right for you. Find out how to use the BRAIN tool ","600f1d14b18d",{"_type":56,"marks":2840,"text":2841,"_key":2842},[2825],"here!","02e2361e9291",{"children":2844,"_type":58,"style":2849,"_key":2850,"markDefs":2851},[2845],{"marks":2846,"text":2847,"_key":2848,"_type":56},[],"You are allowed to change your mind.","d7647c2f12c2","blockquote","4df0fb27ffe8",[],{"markDefs":2853,"children":2854,"_type":58,"style":59,"_key":2859},[],[2855],{"text":2856,"_key":2857,"_type":56,"marks":2858},"Understanding Your Risk Label in Pregnancy","23d2698ed777",[],"527d4453f576",{"children":2861,"_type":58,"style":78,"_key":2882,"markDefs":2883},[2862,2866,2870,2874,2878],{"text":2863,"_key":2864,"_type":56,"marks":2865},"You will be given a ‘low’ or ‘high’ risk label depending on your medical, pregnancy and social history, but also on factors such as your age and BMI. This label ","0955217843bd",[],{"text":2867,"_key":2868,"_type":56,"marks":2869},"will influence what you are offered ","5af45e951841",[108],{"_type":56,"marks":2871,"text":2872,"_key":2873},[],"during pregnancy and may mean you are discouraged for making certain choices, particularly around place of birth. The main issue with risk labels is that they often ","6ee82e1804ca",{"_type":56,"marks":2875,"text":2876,"_key":2877},[108],"lack nuance ","9f3913cab3cf",{"_type":56,"marks":2879,"text":2880,"_key":2881},[],"and you may be viewed as a sum of your risk factors, rather than as an individual.","1757cbed1165","0bdf56546432",[],{"markDefs":2885,"children":2886,"_type":58,"style":59,"_key":2890},[],[2887],{"marks":2888,"text":2889,"_key":2881,"_type":56},[],"\nWhat Does \"High Risk\" in Pregnancy Actually Mean?","12896ec215e7",{"children":2892,"_type":58,"style":78,"_key":2897,"markDefs":2898},[2893],{"text":2894,"_key":2895,"_type":56,"marks":2896},"For example, if you have a BMI over 30 (but no health or pregnancy concerns) you are automatically classified as ‘high risk’ and you will be routinely offered testing for gestational diabetes at 28 weeks of pregnancy. The result of this testing may then influence and impact your options for birth. Why is this a problem I hear you thinking?! Well, just because things are routinely offered during pregnancy does not mean that they’re based on good evidence or that they’re improving outcomes for women and babies. In the case of gestational diabetes, if you are diagnosed with this during pregnancy you will face pressure to accept an induction of labour before 40 weeks. This is despite the fact that there isn't the evidence to suggest that induction of labour is beneficial to women with gestational diabetes.","14f73b8ae0f5",[],"3b8299fd263a",[],{"_type":58,"style":78,"_key":2900,"markDefs":2901,"children":2902},"3c0f72d4dfa3",[],[2903],{"marks":2904,"text":2905,"_key":2906,"_type":56},[],"There are many standardised care pathways within the maternity system and it’s useful to remember that these are based on guidelines (which are not always based on good evidence!) and that they are not the law.  ","7a7c4238ac30",{"markDefs":2908,"children":2909,"_type":58,"style":2849,"_key":2918},[],[2910,2914],{"_type":56,"marks":2911,"text":2912,"_key":2913},[],"Y","0d263d6cd930",{"text":2915,"_key":2916,"_type":56,"marks":2917},"ou have the right to question, accept or decline all or certain aspects of care and choose what feels right for you.","246b91047348",[281],"c068b4f10f9c",{"children":2920,"_type":58,"style":78,"_key":2924,"markDefs":2925},[2921],{"marks":2922,"text":525,"_key":2923,"_type":56},[],"167f743115a2","280b6f8fe45f",[],{"_type":58,"style":78,"_key":2927,"markDefs":2928,"children":2929},"d065c3ba2106",[],[2930,2934,2938,2942,2946],{"_type":56,"marks":2931,"text":2932,"_key":2933},[],"If you do opt for care that is ","f35eafbad7b9",{"text":2935,"_key":2936,"_type":56,"marks":2937},"‘out of guidance’ ","804eb9528bd4",[108],{"text":2939,"_key":2940,"_type":56,"marks":2941},"(this means care that is not recommended by national guidelines or the hospital’s own policy), it may be worth contacting the Consultant Midwife at the hospital to help you navigate your choices. You can always seek a ","d9872f591387",[],{"text":2943,"_key":2944,"_type":56,"marks":2945},"second opinion ","bdd61e544ace",[108],{"_key":2947,"_type":56,"marks":2948,"text":2949},"d2915f7fb49b",[],"from independent midwives, many of us offer birth planning sessions in addition to full midwifery continuity of care.",{"_type":190,"link":2951,"_key":2954},{"type":194,"internalLink":2952,"blank":192,"_type":67,"text":2953},{"_ref":2580,"_type":197},"Book a Birth Planning Session","41c7f856ab5f",{"style":59,"_key":2956,"markDefs":2957,"children":2958,"_type":58},"918e2e6f6721",[],[2959],{"_key":2960,"_type":56,"marks":2961,"text":2962},"9aee731f0c5c",[],"You Know Your Body Best: Advocating for Yourself in Pregnancy",{"markDefs":2964,"children":2965,"_type":58,"style":78,"_key":2970},[],[2966],{"_key":2967,"_type":56,"marks":2968,"text":2969},"3524ca141798",[],"You know your body. Pregnancy is the time to really try and tune in and connect with both the physical sensations and changes that are occurring and with your intuition. It can be easy to hand over responsibility to the ‘experts’ and ‘go with the flow’ from when you have your booking appointment, but the reality of doing this is that you will not receive care that is individualised to you. You are an autonomous human being, capable of making decisions during this huge life experience. It can absolutely be useful having the input of a healthcare professional, but ultimately you have to make the decisions that feel right for you and you should never be pressured into accepting something that doesn’t feel right, just because you tick a certain box.","f7bf94eeb2ff",{"style":59,"_key":2972,"markDefs":2973,"children":2974,"_type":58},"1ee3687bea27",[],[2975],{"_type":56,"marks":2976,"text":2977,"_key":2978},[],"Looking for Personalised Pregnancy Care in Kent?","8266def5299d",{"_key":2980,"markDefs":2981,"children":2988,"_type":58,"style":78},"b00affc218ef",[2982,2985],{"type":194,"internalLink":2983,"blank":192,"_type":67,"_key":2984},{"_ref":196,"_type":197},"5fd4b6ce39e4",{"type":194,"internalLink":2986,"blank":192,"_type":67,"_key":2987},{"_type":197,"_ref":549},"a5ef5c4a5a83",[2989,2993,2997,3001,3004],{"text":2990,"_key":2991,"_type":56,"marks":2992},"If you're looking for pregnancy care that sees you as an individual, that supports you to develop self-trust and have a positive pregnancy experience,","6acac83c3cc8",[],{"_type":56,"marks":2994,"text":2995,"_key":2996},[2987]," get in touch today","4a763ac89245",{"_key":2998,"_type":56,"marks":2999,"text":3000},"bd3b23d6c5d2",[]," to book your free initial consultation. We offer full continuity of midwifery care, home birth services, birth planning and birth reflections services - find all our care packages ",{"marks":3002,"text":249,"_key":3003,"_type":56},[2984],"bc41f381111a",{"_key":3005,"_type":56,"marks":3006,"text":3007},"974ba7ba8306",[],".\n",{"current":3009,"_type":8},"your-first-midwife-appointment-rights-choices-and-what-to-expect","4h8LC4LU7Q8wtV98M27Wnk",{"_createdAt":3012,"_rev":3013,"content":3014,"_system":3376,"image":3380,"title":3383,"_type":37,"_updatedAt":3384,"slug":3385,"_id":3379,"publishedAt":3387},"2025-04-25T15:09:36Z","TetcsaoOoWs97ZzdMkIjQw",{"_type":49,"body":3015},[3016,3032,3039,3047,3059,3067,3083,3091,3115,3123,3150,3158,3163,3170,3178,3205,3212,3220,3264,3271,3279,3294,3302,3310,3318,3338,3349,3357,3364,3369],{"_type":58,"style":650,"_key":3017,"markDefs":3018,"children":3019},"0a460dda46a9",[],[3020,3024,3028],{"_key":3021,"_type":56,"marks":3022,"text":3023},"027224b85788",[281],"Understanding the limitations of CTG monitoring (and ",{"_type":56,"marks":3025,"text":3026,"_key":3027},[],"indeed","347ef043d659",{"marks":3029,"text":3030,"_key":3031,"_type":56},[281]," all fetal heart rate monitoring!) can help you to reclaim informed decision-making during your birth.","ea8d9a9e7476",{"_type":58,"style":78,"_key":3033,"markDefs":3034,"children":3035},"129a1d12f171",[],[3036],{"_type":56,"marks":3037,"text":525,"_key":3038},[],"8e8ae064952b",{"markDefs":3040,"children":3041,"_type":58,"style":59,"_key":3046},[],[3042],{"_type":56,"marks":3043,"text":3044,"_key":3045},[],"What Is a CTG and How Does It Work?","10b123904629","b6d15497b654",{"children":3048,"_type":58,"style":78,"_key":3057,"markDefs":3058},[3049,3053],{"_type":56,"marks":3050,"text":3051,"_key":3052},[108],"Cardiotocography (CTG)","0d2c58f57d67",{"text":3054,"_key":3055,"_type":56,"marks":3056}," uses a machine to continuously monitor the fetal heart rate. It generally involves you lying on a bed and having two monitors on leads that are strapped to your abdomen with stretchy fabric bands. One monitor is picking up the fetal heart rate and the other is to monitor contractions based on the pressure of your uterus. A CTG can be used intermittently with the aim of assessing fetal wellbeing during the antenatal period, or it can be used continuously during labour to try and detect fetal hypoxia (lack of oxygen).","4d102f32b347",[],"9e29ed32a71c",[],{"markDefs":3060,"children":3061,"_type":58,"style":59,"_key":3066},[],[3062],{"_key":3063,"_type":56,"marks":3064,"text":3065},"f78ff7074ed2",[],"Wireless CTG Monitoring: What Is Telemetry?","6429c22740bf",{"children":3068,"_type":58,"style":78,"_key":3081,"markDefs":3082},[3069,3073,3077],{"_type":56,"marks":3070,"text":3071,"_key":3072},[],"Some hospitals have wireless CTG machines - known as ","634063370825",{"marks":3074,"text":3075,"_key":3076,"_type":56},[108],"telemetry","b72623ed4560",{"_key":3078,"_type":56,"marks":3079,"text":3080},"59152f8be094",[],", which means you aren’t as restricted in your movements but you do still need to stay in range of the main CTG machine. The monitors may also still lose contact (which can happed with wired monitoring too), so you may still need regular readjustment of the monitors to get a good reading. These constant readjustments can be disruptive to your labour flow and might mean you're asked to stay in a certain position or even hold the monitor to keep contact. A bonus of telemetry is that some are waterproof, so can also be used in birth pools.","c0b01b9d852c",[],{"children":3084,"_type":58,"style":59,"_key":3089,"markDefs":3090},[3085],{"text":3086,"_key":3087,"_type":56,"marks":3088},"What Is a Fetal Scalp Electrode (FSE)?","167496cf27e9",[],"7275d849f7ac",[],{"_key":3092,"markDefs":3093,"children":3094,"_type":58,"style":78},"013ef69f2a35",[],[3095,3099,3103,3107,3111],{"_key":3096,"_type":56,"marks":3097,"text":3098},"f33ca969ee33",[],"There is the option to have ",{"_type":56,"marks":3100,"text":3101,"_key":3102},[108],"fetal electrocardiogram ","85d6c02fbec9",{"_type":56,"marks":3104,"text":3105,"_key":3106},[],"(fECG) monitoring via a ","f345b8ffb606",{"_key":3108,"_type":56,"marks":3109,"text":3110},"aecc88d7ca91",[108],"fetal scalp electrode",{"marks":3112,"text":3113,"_key":3114,"_type":56},[]," (FSE). An FSE is a small metal spiral that sits just under the baby’s scalp and it requires a vaginal examination to apply. It will pierce the baby’s scalp in order to be attached and the lead will then come out of the vagina and connect to the CTG machine. An FSE is used instead of the abdominal heart rate monitor. An FSE might be recommended where contact is poor via abdominal monitoring or in hospitals that use ST Analysis (STAN) in conjunction with CTG monitoring.","55dadd26a819",{"style":59,"_key":3116,"markDefs":3117,"children":3118,"_type":58},"e95d39b1f7d3",[],[3119],{"_type":56,"marks":3120,"text":3121,"_key":3122},[],"Does CTG Monitoring Actually Improve Birth Outcomes?","95e6540fa241",{"children":3124,"_type":58,"style":78,"_key":3146,"markDefs":3147},[3125,3129,3134,3138,3142],{"_type":56,"marks":3126,"text":3127,"_key":3128},[],"The aim of CTG monitoring is to detect fetal distress so that intervention can happen at the right time to improve outcomes. However, despite its widespread use in maternity care, ","9de4fab734ac",{"marks":3130,"text":3132,"_key":3133,"_type":56},[3131],"c4f0dff18eb6","research","337c64714d30",{"_type":56,"marks":3135,"text":3136,"_key":3137},[]," repeatedly shows that it does not significantly improve neonatal outcomes, such as cerebral palsy and neonatal death. ","374a8edb7bec",{"_key":3139,"_type":56,"marks":3140,"text":3141},"82d96df44a45",[108],"The interpretation of CTGs is subjective",{"_type":56,"marks":3143,"text":3144,"_key":3145},[]," and there are high rates of false positives - whereby clinicians think there’s a problem based on the fetal heart trace, which leads to potentially unnecessary interventions during birth.","39d45a6d83a9","507a4b846ece",[3148],{"type":65,"url":3149,"blank":2434,"_type":67,"_key":3131},"https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006066.pub3/full?highlightAbstract=ctg",{"_key":3151,"markDefs":3152,"children":3153,"_type":58,"style":2849},"c141b0d0104c",[],[3154],{"text":3155,"_key":3156,"_type":56,"marks":3157}," CTGs have been shown to lead to higher rates of intervention, such as instrumental births and unplanned caesarean sections. ","abb34dcf6087",[],{"_key":3159,"_type":190,"link":3160},"f40fa4d4b178",{"_type":67,"text":3161,"type":194,"internalLink":3162,"blank":192},"Explore Our Care Packages ",{"_ref":196,"_type":197},{"markDefs":3164,"children":3165,"_type":58,"style":78,"_key":3169},[],[3166],{"marks":3167,"text":525,"_key":3168,"_type":56},[108],"18d760cc583b","eca8923bf1ce",{"_type":58,"style":59,"_key":3171,"markDefs":3172,"children":3173},"690ca2dfd01d",[],[3174],{"_type":56,"marks":3175,"text":3176,"_key":3177},[],"How CTG Monitoring Can Disrupt Your Labour","b1d2df6c7176",{"_key":3179,"markDefs":3180,"children":3181,"_type":58,"style":78},"22387404e130",[],[3182,3186,3190,3193,3197,3201],{"_type":56,"marks":3183,"text":3184,"_key":3185},[],"If you’ve ever had a CTG or are a midwife working on a labour ward, you’ll know that when a CTG is in use the ","c3b15321e32d",{"_type":56,"marks":3187,"text":3188,"_key":3189},[108],"focus switches from the woman to the machine","d768a5d6fb5e",{"_type":56,"marks":3191,"text":1183,"_key":3192},[108,281],"739218617e40",{"_type":56,"marks":3194,"text":3195,"_key":3196},[]," Every effort is made to ensure there is ‘good contact’ with the CTG so that a fetal heart rate trace can be interpreted. What this means is that the monitor may need to be adjusted throughout your labour if contact is lost, which can disrupt your labour flow. It will also restrict your movement or may mean that you are advised to stay in one position to get a ‘good trace’. This restriction doesn’t help your baby move through your pelvis or you manage the sensations of labour. ","e50c0b43149f",{"_type":56,"marks":3198,"text":3199,"_key":3200},[108],"Focusing on the CTG displaces a woman’s intuition and self-trust","8e47463f1358",{"_type":56,"marks":3202,"text":3203,"_key":3204},[],". CTG machines can also be very noisy, constantly beeping and many hospitals have policies recommending that a ‘Fresh Eyes’ assessment is carried out every hour with another healthcare professional. What this means is another person coming in to your birth space every hour to look at the monitor. Having these constant interruptions and distractions will not help oxytocin, that beautiful labour hormone, flow.","0ece9ae48075",{"_key":3206,"markDefs":3207,"children":3208,"_type":58,"style":78},"bc1c5a661e46",[],[3209],{"_type":56,"marks":3210,"text":525,"_key":3211},[],"fead5cd4090d",{"_key":3213,"markDefs":3214,"children":3215,"_type":58,"style":59},"cf25b0c1f88c",[],[3216],{"text":3217,"_key":3218,"_type":56,"marks":3219},"Who Is Advised to Have Continuous CTG Monitoring in Labour?","fa7a8978648a",[],{"markDefs":3221,"children":3228,"_type":58,"style":78,"_key":3263},[3222,3225],{"url":3223,"blank":2434,"_type":67,"_key":3224,"type":65},"https://www.nice.org.uk/guidance/ng229/chapter/Recommendations","80ad64781225",{"type":65,"url":3226,"blank":2434,"_type":67,"_key":3227},"https://birthsmalltalk.com/blog-feed/","5da914a039dc",[3229,3233,3236,3240,3243,3247,3251,3255,3259],{"text":3230,"_key":3231,"_type":56,"marks":3232},"Generally, anyone who is considered ‘high risk’ will be advised to have continuous CTG monitoring throughout their labour. For the full list of antenatal indications and in labour indications for continuous CTG, see the NICE guidelines ","73967b3d1c16",[],{"marks":3234,"text":803,"_key":3235,"_type":56},[3224],"cd734ef74061",{"marks":3237,"text":3238,"_key":3239,"_type":56},[]," Note also that your local hospital policy may have additional recommendations surrounding fetal monitoring. NICE also advise that clinicians use their clinical judgement, taking a multidisciplinary approach and looking at the whole clinical picture to recommend a CTG if there are any other concerns in the antenatal period or in labour that could lead to fetal compromise. It’s worth noting that maternity is a very litigious area of health care, and so a CTG might be recommended out of health provider fear rather than because there is actually any indication to do one. Dr Kirsten Small has a wealth of CTG resources on her ","fc704afa2e13",{"_type":56,"marks":3241,"text":636,"_key":3242},[3227],"d2f2cdfee8b6",{"_type":56,"marks":3244,"text":3245,"_key":3246},[],", many of which debunk the idea that a CTG is ","ba5225863d02",{"_key":3248,"_type":56,"marks":3249,"text":3250},"8ab6a8720827",[281],"needed ",{"_key":3252,"_type":56,"marks":3253,"text":3254},"b461d32b68ab",[],"in certain clinical scenarios, such as VBAC. There just isn’t good evidence that CTGs are improving outcomes or that they’re superior to intermittent auscultation (more on that below). The reality is that fetal heart rate monitoring (all types!) was introduced without any trials - it's a ",{"_type":56,"marks":3256,"text":3257,"_key":3258},[108],"non-evidenced based intervention","95b5595a1dbb",{"text":3260,"_key":3261,"_type":56,"marks":3262}," that is now ingrained in practice. ","fc5343776b81",[],"57e0d1de6ab5",{"markDefs":3265,"children":3266,"_type":58,"style":78,"_key":3270},[],[3267],{"marks":3268,"text":525,"_key":3269,"_type":56},[],"3c01a19f0b19","850d2a0bac26",{"markDefs":3272,"children":3273,"_type":58,"style":59,"_key":3278},[],[3274],{"text":3275,"_key":3276,"_type":56,"marks":3277},"Can You Decline a CTG in Labour?","4dabf595dbc6",[],"04530259b724",{"children":3280,"_type":58,"style":78,"_key":3292,"markDefs":3293},[3281,3285,3289],{"_type":56,"marks":3282,"text":3283,"_key":3284},[],"It is always your choice if you want to have a CTG or not during labour. CTGs are such a routine part of maternity care that it may just be assumed that you’ll accept one. Your doctor or midwife may advise one form of monitoring over another based on your history, but ultimately they should respect your choice. You can request to have CTG monitoring in the absence of any indications but it is worth knowing that this has been shown to lead to an ","cfeadbceb124",{"text":3286,"_key":3287,"_type":56,"marks":3288},"increase in potentially unnecessary interventions","4a6083f842eb",[108],{"marks":3290,"text":1183,"_key":3291,"_type":56},[],"702edea56967","41bc49015757",[],{"_type":58,"style":59,"_key":3295,"markDefs":3296,"children":3297},"543986277f84",[],[3298],{"text":3299,"_key":3300,"_type":56,"marks":3301},"What Is Intermittent Auscultation (IA)?","0eed488880f0",[],{"_key":3303,"markDefs":3304,"children":3305,"_type":58,"style":78},"1ce239a1099b",[],[3306],{"marks":3307,"text":3308,"_key":3309,"_type":56},[],"The other option for fetal monitoring is intermittent auscultation (IA), whereby a handheld doppler is used to listen intermittently to the fetal heart rate. Current NICE guidelines for IA advise to listen in every 15 minutes during the ‘first stage’ of labour and every 5 minutes in the ‘second stage’ of labour. It is worth noting that there is also not any good evidence to support this 15 or 5 minute protocol, but it is considered ‘best practice’. If you have managed to make it to the end of your pregnancy and retained a ‘low risk’ label, then IA is considered suitable and safe fetal monitoring for your labour. IA is the only form of fetal monitoring we offer our home birth clients. ","14d047354156",{"style":59,"_key":3311,"markDefs":3312,"children":3313,"_type":58},"cc703b3cad7b",[],[3314],{"text":3315,"_key":3316,"_type":56,"marks":3317},"Your Fetal Monitoring Options: Making the Right Choice for You","8f1cdb8ba865",[],{"style":78,"_key":3319,"markDefs":3320,"children":3321,"_type":58},"2dc6ef7117a8",[],[3322,3326,3330,3334],{"text":3323,"_key":3324,"_type":56,"marks":3325},"You can decline all fetal monitoring during labour if you wish","195ed2e9c11e",[108],{"_type":56,"marks":3327,"text":3328,"_key":3329},[],". We don't have research comparing no fetal heart rate monitoring with fetal heart rate monitoring  - it would never get passed an ethics committee. Fetal monitoring is a ","8b899484a965",{"_key":3331,"_type":56,"marks":3332,"text":3333},"17a4ddde7ee0",[108],"non-evidence based intervention",{"marks":3335,"text":3336,"_key":3337,"_type":56},[]," that was introduced over a hundred years ago.  ","71081f31021b",{"style":78,"_key":3339,"markDefs":3340,"children":3341,"_type":58},"4bf38f7baf9f",[],[3342,3345],{"_type":56,"marks":3343,"text":3344,"_key":3337},[],"You may be recommended to have a CTG but choose IA instead. If you’re birthing in hospital you may choose to opt for the occasional CTG in labour instead of a continuous one. It’s worth thinking about all your options during pregnancy to see ",{"_type":56,"marks":3346,"text":3347,"_key":3348},[108],"what feels right for you.","1532d96b82ba",{"markDefs":3350,"children":3351,"_type":58,"style":2849,"_key":3356},[],[3352],{"_type":56,"marks":3353,"text":3354,"_key":3355},[],"It’s your body, your birth.","554da25357f0","ae107b92f44f",{"style":78,"_key":3358,"markDefs":3359,"children":3360,"_type":58},"11164b183e46",[],[3361],{"text":525,"_key":3362,"_type":56,"marks":3363},"e94b6c7cfe0f",[],{"_type":190,"link":3365,"_key":3368},{"internalLink":3366,"blank":192,"_type":67,"text":3367,"type":194},{"_ref":502,"_type":197},"Book a Birth Planning Session ","91bca90f8175",{"_type":58,"style":78,"_key":3370,"markDefs":3371,"children":3372},"6562894d5f78",[],[3373],{"_key":3374,"_type":56,"marks":3375,"text":525},"c17a87680ec8",[],{"base":3377},{"rev":3378,"id":3379},"s6xZ6JxVFPaoeMahCbsnDY","4fb48e4e-fb75-43a2-96b5-ffe76971bbbc",{"_type":586,"asset":3381},{"_ref":3382,"_type":197},"image-9d2048ab885cf60dc9a0c797717949d121a9ec82-3024x4032-jpg","CTG Monitoring in Labour: What It Is, How It Works & Your Choices","2026-03-10T15:00:22Z",{"current":3386,"_type":8},"ctg-monitoring-in-labour-what-it-is-how-it-works-and-your-choices","2025-04-22",{"_updatedAt":3389,"_type":37,"image":3390,"_system":3393,"publishedAt":3397,"slug":3398,"_rev":3400,"_id":3396,"content":3401,"title":3700,"_createdAt":3701},"2026-03-31T09:36:35Z",{"asset":3391,"_type":586},{"_ref":3392,"_type":197},"image-2b51c5f02fab0dfedfb4d50aa24e4dfce2e3f366-3024x4032-jpg",{"base":3394},{"rev":3395,"id":3396},"5fd977pr5Ct4pKgLyc5hbw","0828f1a3-6611-4bab-9d3b-9e6c78b636bd","2024-12-18",{"current":3399,"_type":8},"home-birth-transfer-is-not-a-failure","4h8LC4LU7Q8wtV98M27Npk",{"_type":49,"body":3402},[3403,3411,3419,3446,3465,3473,3488,3520,3528,3546,3551,3559,3586,3594,3602,3610,3630,3635,3643,3659,3667],{"markDefs":3404,"children":3405,"_type":58,"style":59,"_key":3410},[],[3406],{"_key":3407,"_type":56,"marks":3408,"text":3409},"c584397d0564",[],"What Is a Home Birth Transfer?","1c892b827dd4",{"children":3412,"_type":58,"style":78,"_key":3417,"markDefs":3418},[3413],{"_type":56,"marks":3414,"text":3415,"_key":3416},[],"Home birth transfer means being transferred from home to hospital, either during labour or after birth, when a home birth was planned.","addda1203eeb","ac00c6d734b6",[],{"style":78,"_key":3420,"markDefs":3421,"children":3426,"_type":58},"5b6c6279246d",[3422],{"internalLink":3423,"_type":67,"href":3424,"_key":3425,"type":194},{"_type":197,"_ref":426},"https://junomidwives.co.uk/birth-stories/sophie-sams-twin-hospital-birth-story/","d28fcb0a1846",[3427,3431,3435,3439,3442],{"text":3428,"_key":3429,"_type":56,"marks":3430},"Recently on Instagram I saw a post that said, ","d1c1b73d38cf",[],{"_key":3432,"_type":56,"marks":3433,"text":3434},"dbb4408d62b2",[108],"‘home birth transfer is not a failure’",{"text":3436,"_key":3437,"_type":56,"marks":3438},". It resonated with me, as someone who had planned a home birth and ultimately ended up choosing to transfer in (read my birth story ","43a1e17032b6",[],{"_type":56,"marks":3440,"text":249,"_key":3441},[3425],"54bd555ffe04",{"_type":56,"marks":3443,"text":3444,"_key":3445},[],"). I never truly saw my home birth transfer as a failure – I made informed decisions at the time with the information I had and how I was feeling. Sure, I had the odd brain-gremlin afterwards, wondering if I could have ‘tried harder’ to have the home birth I wanted – but I never felt like a failure.","3f65cb752004",{"markDefs":3447,"children":3451,"_type":58,"style":78,"_key":3464},[3448],{"href":3449,"_key":3450,"type":65,"url":3449,"_type":67},"https://www.all4maternity.com/compassionate-and-safe-home-birth-transfer/","50f534f08962",[3452,3456,3460],{"_type":56,"marks":3453,"text":3454,"_key":3455},[],"I would like to acknowledge that for some women a home birth transfer will be distressing – this could be down to the reason for and management of the transfer or the treatment they receive during the transfer or on arrival at the hospital. ","d500ffb4d3e6",{"_type":56,"marks":3457,"text":3458,"_key":3459},[3450],"The Practicing Midwife","9dd23d33b0cb",{"text":3461,"_key":3462,"_type":56,"marks":3463}," have published an article recently about safe and compassionate home birth transfer highlighting the importance of communication and antenatal conversations around possible reasons for transfers, having a known midwife who is trusted by the woman or birthing person and ensuring that the transfer itself is done with privacy, dignity and emotional support – both during and after. ","a2f2d0af821a",[],"219346eb722b",{"markDefs":3466,"children":3467,"_type":58,"style":59,"_key":3472},[],[3468],{"text":3469,"_key":3470,"_type":56,"marks":3471},"Is Home Birth Safe? What the Research Actually Shows","ed5589bf1a42",[],"ea53784752c3",{"_key":3474,"markDefs":3475,"children":3476,"_type":58,"style":78},"0fc6bffce54b",[],[3477,3481,3484],{"text":3478,"_key":3479,"_type":56,"marks":3480},"We have heard of people being told they shouldn’t plan a home birth for their first baby ‘just in case’, or they’re ‘brave’ for planning a home birth, or to get ready for their ‘inevitable transfer’ – the last comment speaking to a belief that a home birth transfer ","e6ed77fa4112",[],{"marks":3482,"text":1977,"_key":3483,"_type":56},[281],"8acf3d925ce6",{"_key":3485,"_type":56,"marks":3486,"text":3487},"7bb3fe918dce",[]," a failure. But you know what? Women and birthing people don’t ‘fail’ at birth (the system can and does fail us, but that’s a blog for another time!).",{"_key":3489,"markDefs":3490,"children":3494,"_type":58,"style":78},"2cc3acc7bf68",[3491],{"_type":67,"href":3492,"_key":3493,"type":65,"url":3492},"https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30063-8/fulltext","8032b3359cec",[3495,3499,3502,3506,3509,3513,3516],{"marks":3496,"text":3497,"_key":3498,"_type":56},[],"We have current, good quality ","f4bbc726b1f1",{"marks":3500,"text":3132,"_key":3501,"_type":56},[3493],"134c96762738",{"_type":56,"marks":3503,"text":3504,"_key":3505},[]," from the Lancet to show that home birth is a safe option for women and babies. It leads to less intervention for women and birthing people and is as safe as hospital birth for babies. This is true for both those classed as ‘low’ and ‘high’ risk. Although the risk of adverse outcomes ","48df78a68bd9",{"text":1977,"_key":3507,"_type":56,"marks":3508},"9ed37b14f9d6",[281],{"marks":3510,"text":3511,"_key":3512,"_type":56},[]," slightly higher for those in the ‘high’ risk category, the chance of there ","ddfaa7a44d9a",{"text":1624,"_key":3514,"_type":56,"marks":3515},"57206593b736",[108],{"text":3517,"_key":3518,"_type":56,"marks":3519}," being a poor outcome is significantly more likely. ","ded158138cb9",[],{"style":59,"_key":3521,"markDefs":3522,"children":3523,"_type":58},"19cca4763fea",[],[3524],{"marks":3525,"text":3526,"_key":3527,"_type":56},[],"Home Birth vs Hospital Birth: Place of Birth Impacts Outcomes ","740e2f12d9ec",{"markDefs":3529,"children":3533,"_type":58,"style":78,"_key":3545},[3530],{"_type":67,"_key":3531,"type":65,"url":3532},"73568fff5cc6","https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.13283",[3534,3537,3541],{"text":3535,"_key":3518,"_type":56,"marks":3536},"We know that women and birthing people who plan to give birth in hospital are more likely to experience interventions (that may not be necessary) than those who plan to give birth at home. We know that even just planning to birth at home reduces the likelihood of several interventions, even if ultimately the birth does not occur at home. According to the research from the Lancet, women with uncomplicated pregnancies who plan to give birth at home reduce their chance of having a caesarean section by 40%. For women with more complicated pregnancies who planned a home birth, ",[],{"marks":3538,"text":3539,"_key":3540,"_type":56},[3531],"research from the UK","16ea5c7bcf8b",{"_key":3542,"_type":56,"marks":3543,"text":3544},"5fdacf639034",[]," showed that 74% had a straightforward vaginal birth compared to just 51% who planned a hospital birth. Where you choose to birth has a significant impact on how you ultimately end up giving birth.","9ef981d7b4fd",{"_key":3547,"_type":190,"link":3548},"03539566075f",{"_type":67,"text":3549,"type":194,"internalLink":3550},"Want guaranteed access to home birth?",{"_type":197,"_ref":196},{"markDefs":3552,"children":3553,"_type":58,"style":59,"_key":3558},[],[3554],{"_key":3555,"_type":56,"marks":3556,"text":3557},"fb98d68d3a1d",[],"Why Do So Many People Still Believe Home Birth Is Unsafe?","c6f5204a3683",{"_type":58,"style":78,"_key":3560,"markDefs":3561,"children":3565},"da7a86b576a9",[3562],{"type":65,"url":3563,"_type":67,"href":3563,"_key":3564},"https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2023-24","3b8c0db5af08",[3566,3570,3574,3578,3582],{"_type":56,"marks":3567,"text":3568,"_key":3569},[],"In general there is a big misconception that giving birth at home is unsafe and that giving birth in hospital is inherently safe. We live in a culture that says that birth ","798ff491aaf5",{"marks":3571,"text":3572,"_key":3573,"_type":56},[281],"should","2414e69ea8d2",{"text":3575,"_key":3576,"_type":56,"marks":3577}," happen in the hospital. Better to be close to the hospital ‘just in case’; a culture that sees home birth as a bit ‘out there’. So, whilst the research shows us home birth is indeed safe, society doesn’t quite believe it. And paradoxically we rarely question the safety of going into hospital to have our babies, despite knowing that our chance of interventions is increased just by being in the building. The NHS has just published the latest ","0d2564e95464",[],{"_type":56,"marks":3579,"text":3580,"_key":3581},[3564],"maternity statistics","ef69acde1e23",{"text":3583,"_key":3584,"_type":56,"marks":3585}," for 2023 -2024 showing a caesarean section rate (both planned and unplanned) of over 40%. This figure has been increasing year on year with no improvement in outcomes for women and babies and yet most people still choose to give birth in hospital because it is perceived to be safer. Something is evidently wrong and I’ll give you a clue: it’s not women and birthing people’s bodies, no matter what the media may have you believe. ","9f3047212771",[],{"markDefs":3587,"children":3588,"_type":58,"style":59,"_key":3593},[],[3589],{"_type":56,"marks":3590,"text":3591,"_key":3592},[],"Are Birth Interventions Always Necessary?","b5da2b969b84","14bfe65cad74",{"children":3595,"_type":58,"style":78,"_key":3600,"markDefs":3601},[3596],{"_key":3597,"_type":56,"marks":3598,"text":3599},"73bcab77f506",[],"This is the bit where I do a small disclaimer – sometimes interventions are necessary. Sometimes they save lives. This is not a blog about interventions (e.g. caesareans) or hospitals being bad. Some women and birthing people will absolutely need to give birth in hospital. I’m grateful that we have hospitals and doctors who can do caesarean sections and instrumental births. I’m grateful for anaesthetists who can provide women and birthing people with pain relief. We live in a country where we have access to all this medical expertise and we absolutely should not take that for granted. But, and it is a big but, we do overuse the interventions in childbirth. Our medical system doesn’t trust the bodies of women and birthing people. It doesn’t trust birth. If the physiology of birth was understood, respected and protected by all working in maternity services, then perhaps we would see interventions only being used when truly necessary.","d984326366c2",[],{"_key":3603,"markDefs":3604,"children":3605,"_type":58,"style":59},"b0a7c34a61b1",[],[3606],{"marks":3607,"text":3608,"_key":3609,"_type":56},[],"Why I Would Plan a Home Birth Again (Even After Transferring)","3a23af69c95b",{"style":78,"_key":3611,"markDefs":3612,"children":3617,"_type":58},"9a3f64c2c2ce",[3613],{"internalLink":3614,"blank":192,"_type":67,"_key":3616,"type":194},{"_type":197,"_ref":3615},"5bfdca5b-bb5b-4937-94d9-6352b358d763","d8a61ca76ace",[3618,3622,3626],{"marks":3619,"text":3620,"_key":3621,"_type":56},[],"I have a strong belief that had I agreed to an induction of labour at 37 weeks, as is recommended by NICE for a DCDA twin pregnancy, I would have ended up with a caesarean birth (of course I can never truly know – but I do know that the odds would not have been in my favour). My babies did not choose to come for another 4 weeks (deepest apologies to my pelvis for that), my labour started spontaneously and I didn’t choose to go to hospital until I was very much in established labour (thank you to Natasha for persuading me gently to get back in the pool for several more hours!). I still had almost all the interventions under the sun, but I didn’t have a caesarean which I personally was very keen to avoid. My choices were mine to make and someone else in a similar situation might make completely different ones. If I have another baby, I would plan a home birth again because I know that this is likely to result in me having a straightforward vaginal birth. I would be given another ‘","53912df3ad12",{"marks":3623,"text":3624,"_key":3625,"_type":56},[3616],"high risk","3435802bdf8c",{"_type":56,"marks":3627,"text":3628,"_key":3629},[],"’ label in future pregnancies because I had a postpartum haemorrhage, but that haemorrhage was from the episiotomy required for the forceps birth I had. Planning to birth at home automatically would reduce the likelihood of me having another instrumental birth and another episiotomy. Were I to choose mainstream maternity care, I would be encouraged to birth in the hospital because of this risk factor, even though I would be more likely to experience the interventions that could lead to a postpartum haemorrhage…is it making sense to you?! ","8a0b58a65bc9",{"link":3631,"_key":3634,"_type":190},{"_type":67,"text":3632,"type":194,"internalLink":3633,"blank":192},"Read all about birth plans",{"_ref":1722,"_type":197},"d70383062243",{"children":3636,"_type":58,"style":59,"_key":3641,"markDefs":3642},[3637],{"marks":3638,"text":3639,"_key":3640,"_type":56},[],"Home Birth Transfer Is Not a Failure","72084bb97a7d","a64afa43c672",[],{"style":78,"_key":3644,"markDefs":3645,"children":3646,"_type":58},"72c976b16f48",[],[3647,3651,3655],{"_key":3648,"_type":56,"marks":3649,"text":3650},"fad828c66da0",[],"Instead of seeing a home birth transfer as a failure, I believe we should acknowledge how great it is that someone made a choice to give birth at home and when they chose or needed to, there was a hospital and medical staff available to support them. How can it be a failure if women and birthing people are truly being supported to make decisions that feel right to them? How can it be a failure if the midwife recognised that an emergency was unfolding and more help was needed? What if we saw the availability of the hospital, if and when needed or chosen, as a gift? I’d hope that anyone who transfers to hospital during a planned home birth ",{"text":3652,"_key":3653,"_type":56,"marks":3654},"never","ff3a26e71895",[281],{"text":3656,"_key":3657,"_type":56,"marks":3658}," feels like a failure – whatever the reason for transfer.","d0284900ef4e",[],{"_type":58,"style":59,"_key":3660,"markDefs":3661,"children":3662},"158db3118892",[],[3663],{"_type":56,"marks":3664,"text":3665,"_key":3666},[],"Thinking About a Home Birth? Let's Chat","116e0cd9708a",{"_type":58,"style":78,"_key":3668,"markDefs":3669,"children":3679},"dd0d6751488a",[3670,3674],{"_key":3671,"type":194,"internalLink":3672,"_type":67,"href":3673},"d9cb64589da9",{"_ref":549,"_type":197},"https://junomidwives.co.uk/contact-us/",{"_type":67,"href":3675,"_key":3676,"type":194,"internalLink":3677},"https://junomidwives.co.uk/birth-stories/","83a77f4dc148",{"_type":197,"_ref":3678},"1a4b975f-bf33-4691-bcca-e6e21a769d08",[3680,3684,3688,3692,3696],{"marks":3681,"text":3682,"_key":3683,"_type":56},[],"Interested in home birth? Want to chat about your options? ","8a4c406829d9",{"text":3685,"_key":3686,"_type":56,"marks":3687},"Get in touch","80adeea5aeaf",[3671],{"_type":56,"marks":3689,"text":3690,"_key":3691},[]," to book a free, no-strings attached chat. Head over to our ","ffa377b134f7",{"marks":3693,"text":3694,"_key":3695,"_type":56},[3676],"birth stories","230d5a0f26c9",{"_key":3697,"_type":56,"marks":3698,"text":3699},"94225a6ba537",[]," page to read about some beautiful births.","Home Birth Transfer: Why It's Not a Failure & What the Research Says","2025-03-18T13:46:28Z",{"content":3703,"publishedAt":4004,"_rev":4005,"title":4006,"slug":4007,"image":4009,"_id":4012,"_createdAt":4013,"_type":37,"_updatedAt":4014,"_system":4015},{"_type":49,"body":3704},[3705,3713,3721,3737,3745,3753,3761,3769,3777,3785,3793,3801,3809,3817,3825,3844,3852,3879,3887,3895,3903,3911,3919,3933,3949,3957,3976,3984,3992],{"style":59,"_key":3706,"markDefs":3707,"children":3708,"_type":58},"944cc650cc59",[],[3709],{"_type":56,"marks":3710,"text":3711,"_key":3712},[],"What Is Freebirth (aka Unassisted Birth)?","549b53e88373",{"markDefs":3714,"children":3715,"_type":58,"style":78,"_key":3720},[],[3716],{"text":3717,"_key":3718,"_type":56,"marks":3719},"Freebirth is the term to describe intentionally giving birth without medical or midwifery assistance. It is also referred to as ‘unassisted birth’.","109e53c4f23c",[],"7671138e6854",{"_key":3722,"markDefs":3723,"children":3726,"_type":58,"style":78},"daf3d57b3ae6",[3724],{"_type":67,"href":989,"_key":3725,"type":65,"url":989},"475d9ba22412",[3727,3731,3734],{"text":3728,"_key":3729,"_type":56,"marks":3730},"It is entirely legal to freebirth in the UK. Birthrights have a useful fact sheet on the legalities of freebirth which you can find ","c61aa1df79e1",[],{"marks":3732,"text":249,"_key":3733,"_type":56},[3725],"beb4fdfad55d",{"_type":56,"marks":3735,"text":1183,"_key":3736},[],"497c6f172cf2",{"markDefs":3738,"children":3739,"_type":58,"style":59,"_key":3744},[],[3740],{"_type":56,"marks":3741,"text":3742,"_key":3743},[],"What Freebirth Is Not: The Difference Between Freebirth and Born Before Arrival (BBA)","658da708d765","a1f5c2132447",{"_type":58,"style":78,"_key":3746,"markDefs":3747,"children":3748},"6f499251289c",[],[3749],{"marks":3750,"text":3751,"_key":3752,"_type":56},[],"Sometimes babies are born very quickly (we’re looking at you second babies), not where they were intended to be born and without midwifery/medical care. This is referred to as ‘born before arrival’ (BBA). This is different to freebirth as the intention was to have midwifery or medical input, but the baby had other ideas!","9e3405cd0474",{"children":3754,"_type":58,"style":78,"_key":3759,"markDefs":3760},[3755],{"text":3756,"_key":3757,"_type":56,"marks":3758},"The term freebirth also cannot be applied to contexts where women and birthing people do not have access to medical facilities or skilled birth care and therefore have no choice in how or where they birth, or who if anyone they have to support them. ","857ed1fd0b62",[],"8f0ef1ddd0f5",[],{"markDefs":3762,"children":3763,"_type":58,"style":59,"_key":3768},[],[3764],{"marks":3765,"text":3766,"_key":3767,"_type":56},[],"Why Do Some Women Choose Freebirth?","2df447d3c185","ac6120df934e",{"_key":3770,"listItem":914,"markDefs":3771,"children":3772,"level":921,"_type":58,"style":78},"d7a2f0243624",[],[3773],{"_key":3774,"_type":56,"marks":3775,"text":3776},"4a010f904c6d",[],"Self-belief in their bodies, their ability to birth without assistance – ie consider birth a normal life event that does not require medical input",{"level":921,"_type":58,"style":78,"_key":3778,"listItem":914,"markDefs":3779,"children":3780},"2bc2cd641c96",[],[3781],{"_type":56,"marks":3782,"text":3783,"_key":3784},[],"Lack of confidence in or mistrust of the mainstream maternity system","ab3418f7b439",{"style":78,"_key":3786,"listItem":914,"markDefs":3787,"children":3788,"level":921,"_type":58},"ad93a7ef9d73",[],[3789],{"text":3790,"_key":3791,"_type":56,"marks":3792},"Previous traumatic experience with healthcare professionals","0af987c54963",[],{"_type":58,"style":78,"_key":3794,"listItem":914,"markDefs":3795,"children":3796,"level":921},"1a2061337ef8",[],[3797],{"_key":3798,"_type":56,"marks":3799,"text":3800},"432e84e87c2d",[],"Lack of access to home birth services",{"_key":3802,"listItem":914,"markDefs":3803,"children":3804,"level":921,"_type":58,"style":78},"38b2dfdeae64",[],[3805],{"_type":56,"marks":3806,"text":3807,"_key":3808},[],"Lack of support for birth plans (particularly if choosing to birth outside of normative care)","f5040bd68c24",{"style":2849,"_key":3810,"markDefs":3811,"children":3812,"_type":58},"29153f0594d6",[],[3813],{"_type":56,"marks":3814,"text":3815,"_key":3816},[],"We support those who choose freebirth, because women and birthing people have the right to make this choice","dc18e1f124ea",{"_type":58,"style":59,"_key":3818,"markDefs":3819,"children":3820},"99da0cfb804a",[],[3821],{"_type":56,"marks":3822,"text":3823,"_key":3824},[],"How Can an Independent Midwife Support a Freebirth?","e27256445b96",{"markDefs":3826,"children":3831,"_type":58,"style":78,"_key":3843},[3827],{"_type":67,"href":3828,"_key":3829,"type":194,"internalLink":3830},"https://junomidwives.co.uk/care-packages/","2e249c897fef",{"_ref":196,"_type":197},[3832,3836,3839],{"text":3833,"_key":3834,"_type":56,"marks":3835},"Women and birthing people who choose freebirth are not one dimensional – choosing to freebirth may or may not mean engaging with care during pregnancy or after birth. Some may choose to not engage with any maternity care during their pregnancy and some may dip in and out of accessing services as they wish. Some may wish to have antenatal check ups and/or postnatal care, but wish to birth undisturbed and without the presence of a midwife. It can look different for different people. We are able to provide both antenatal care and postnatal care as either one-off appointments or full ","e7a214145e28",[],{"_key":3837,"_type":56,"marks":3838,"text":1260},"9df7cb7a05a9",[3829],{"_key":3840,"_type":56,"marks":3841,"text":3842},"189001c80706",[]," and we offer the newborn examination. We are also able to notify births. ","23ac3c5b6236",{"markDefs":3845,"children":3846,"_type":58,"style":59,"_key":3851},[],[3847],{"_key":3848,"_type":56,"marks":3849,"text":3850},"abdb1240a8a7",[],"Birth Notification After a Freebirth: What You Need to Know","12291ae26184",{"_key":3853,"markDefs":3854,"children":3858,"_type":58,"style":78},"f3785d62753c",[3855],{"_type":67,"href":3856,"_key":3857,"type":65,"url":3856},"https://www.legislation.gov.uk/ukpga/2006/41/section/269","eee0c4640a8f",[3859,3863,3867,3871,3875],{"_key":3860,"_type":56,"marks":3861,"text":3862},"56106283118d",[],"By law, the birth of a baby must be ",{"_type":56,"marks":3864,"text":3865,"_key":3866},[281],"notified","8c8d9a56ceb5",{"_type":56,"marks":3868,"text":3869,"_key":3870},[]," within 36 hours of their birth. Once the baby is born, they have rights and the process of notifying is a means of ensuring their rights are upheld. ","65ebdd24b842",{"text":3872,"_key":3873,"_type":56,"marks":3874},"The law","be59acc9aee5",[3857],{"_type":56,"marks":3876,"text":3877,"_key":3878},[]," requires that all births are notified to a ‘relevant body’, which is defined as one of the following:","ac0deef351f3",{"listItem":914,"markDefs":3880,"children":3881,"level":921,"_type":58,"style":78,"_key":3886},[],[3882],{"text":3883,"_key":3884,"_type":56,"marks":3885},"NHS England","39804b5828c0",[],"fc2d9d304aa3",{"listItem":914,"markDefs":3888,"children":3889,"level":921,"_type":58,"style":78,"_key":3894},[],[3890],{"_key":3891,"_type":56,"marks":3892,"text":3893},"de98f84b25d6",[],"An integrated care board","f7881c34b8ce",{"children":3896,"level":921,"_type":58,"style":78,"_key":3901,"listItem":914,"markDefs":3902},[3897],{"text":3898,"_key":3899,"_type":56,"marks":3900},"Local authorities","75a1f3f6e0f7",[],"eefa4a4ee916",[],{"style":78,"_key":3904,"markDefs":3905,"children":3906,"_type":58},"19e8b7314c54",[],[3907],{"marks":3908,"text":3909,"_key":3910,"_type":56},[],"The notification process will generate an NHS number for the baby. If you give birth at home or in hospital with the NHS, the birth notification will be done by a midwife, via a computer system and an NHS number will be generated automatically. As independent midwives, we usually notify a birth via the local Child Health Information Services (CHIS), this involves us sending the birth details and usually waiting 1-2 days to receive confirmation and an NHS number. The law states that the birth can be notified by someone present at the time of birth or who attended the mother or birthing person within 6 hours of the birth.","ff337391cddd",{"style":59,"_key":3912,"markDefs":3913,"children":3914,"_type":58},"d4d22762e36c",[],[3915],{"text":3916,"_key":3917,"_type":56,"marks":3918},"How to Self-Notify the Birth of Your Baby","79a012881fae",[],{"style":78,"_key":3920,"markDefs":3921,"children":3925,"_type":58},"cebdda95b5b5",[3922],{"blank":2434,"_type":67,"_key":3923,"type":65,"url":3924},"71d908a178b8","https://www.england.nhs.uk/long-read/your-guide-to-birth-notification-after-an-unassisted-birth/",[3926,3930],{"_type":56,"marks":3927,"text":3928,"_key":3929},[],"Parents are able to self-notify the birth of their baby. This can look like phoning your local maternity unit after the birth to inform them – in this scenario they may send a midwife out to you. It could be informing the GP of the birth (although this will be an uncommon occurrence for GPs so some barriers may be faced). Parents are now able to self-notify via email and they'll be sent a 'digital postcard'. This doesn't automatically generate an NHS number, that can be obtained if and when your baby is seen by a medical professional. Details on self-notification after free birth can be found ","efe4c4b97357",{"marks":3931,"text":803,"_key":3932,"_type":56},[3923],"72360e80817e",{"style":78,"_key":3934,"markDefs":3935,"children":3936,"_type":58},"43d3bd57b864",[],[3937,3941,3945],{"marks":3938,"text":3939,"_key":3940,"_type":56},[],"Notifying the birth is different to ","5e1c3510f26c",{"text":3942,"_key":3943,"_type":56,"marks":3944},"registering","5099f9a5c39c",[281],{"_key":3946,"_type":56,"marks":3947,"text":3948},"5980d83d75c0",[]," the birth of a baby, which must be done with a registrar within 42 days of birth and is usually done by the parents. ",{"_key":3950,"markDefs":3951,"children":3952,"_type":58,"style":59},"944c8834e8f7",[],[3953],{"text":3954,"_key":3955,"_type":56,"marks":3956},"Why Healthcare Professionals Need Better Training on Birth Rights","448222244186",[],{"_type":58,"style":78,"_key":3958,"markDefs":3959,"children":3963},"6ea5fe5cd450",[3960],{"blank":192,"_type":67,"_key":3961,"type":194,"internalLink":3962},"1e36dc218e48",{"_ref":2756,"_type":197},[3964,3968,3972],{"_key":3965,"_type":56,"marks":3966,"text":3967},"71e61caab52e",[],"Despite the law being explicit about women and birthing people’s rights when it comes to birth, there is a lack of understanding about these rights amongst healthcare professionals. This lack of understanding leads to obstetric violence and disrespectful care. It leads to women and birthing people choosing to birth outside of the system to avoid having their autonomy during birth challenged or ignored. It leads to healthcare providers acting inappropriately when women do choose freebirth. We strongly believe that there needs to be regular training for all midwives, doctors, students, paramedics, neonatal doctors – anyone who comes into contact with pregnant people – about women and birthing people’s rights during pregnancy and childbirth. Because ultimately, when healthcare professionals understand that women and birthing people have the right to choose and that the law supports them if they choose to have no medical care during pregnancy or childbirth, they realise that they are not responsible for the choices women and birthing people make. Check out our",{"_type":56,"marks":3969,"text":3970,"_key":3971},[3961]," article ","4b874052246c",{"_key":3973,"_type":56,"marks":3974,"text":3975},"5653f38aae9a",[],"on what you’re ‘allowed’ to do during childbirth.",{"_type":58,"style":2849,"_key":3977,"markDefs":3978,"children":3979},"dd51421452e2",[],[3980],{"_key":3981,"_type":56,"marks":3982,"text":3983},"3de990639ac6",[],"Upholding women and birthing people’s rights during childbirth is at the core of the juno midwives philosophy",{"children":3985,"_type":58,"style":78,"_key":3990,"markDefs":3991},[3986],{"_type":56,"marks":3987,"text":3988,"_key":3989},[108],"Read…","25e22780b680","11c41a752fc4",[],{"markDefs":3993,"children":3994,"_type":58,"style":78,"_key":4003},[],[3995,3999],{"text":3996,"_key":3997,"_type":56,"marks":3998},"Freebirth Stories","f30b7da3145b",[281],{"text":4000,"_key":4001,"_type":56,"marks":4002}," by Mavis Kirkham and Nadine Edwards is a book that shares the stories of women and birthing people who have chosen freebirth and also the stories of doulas who support freebirth. It demonstrates there is a wide range of reasons why women choose freebirth. It highlights some episodes where maternity healthcare professionals react positively to a woman’s choice to freebirth, but also many scenarios where healthcare providers are disrespectful, rude and unkind about women’s choices. ","e31a66a05440",[],"937905ef59ca","2024-09-26","lTiZ7ejil6ZSBCJHGJ9tOC","Freebirth in the UK: What It Is, Your Rights & How We Can Support You",{"current":4008,"_type":8},"freebirth-in-the-uk-what-it-is-your-rights-and-how-we-can-support-you",{"_type":586,"asset":4010},{"_type":197,"_ref":4011},"image-c7c22ba7580982ed16d6f79b94520b53c1dd26f7-1080x1350-jpg","8d351a31-8c6c-41bb-b73f-e9c7e50ae21c","2025-04-07T15:20:49Z","2026-03-17T12:21:24Z",{"base":4016},{"id":4012,"rev":4017},"7l2KCMg711eQ9a3UN6ISx7",{"content":4019,"image":4752,"_createdAt":4755,"publishedAt":4756,"_rev":4757,"_type":37,"_system":4758,"_updatedAt":4761,"slug":4762,"_id":3615,"title":4764},{"_type":49,"body":4020},[4021,4029,4047,4076,4081,4089,4130,4138,4146,4151,4159,4167,4181,4189,4197,4205,4213,4221,4229,4237,4245,4253,4265,4288,4296,4304,4312,4333,4341,4349,4357,4365,4373,4381,4389,4397,4405,4413,4421,4429,4437,4445,4501,4509,4517,4525,4533,4541,4549,4557,4565,4573,4581,4589,4597,4605,4612,4628,4636,4644,4652,4658,4666,4674,4682,4690,4698,4704,4712,4731],{"_key":4022,"markDefs":4023,"children":4024,"_type":58,"style":59},"dd0c13597dc6",[],[4025],{"_type":56,"marks":4026,"text":4027,"_key":4028},[],"Do You Have the Right to Choose a Home Birth If You're High Risk?","c191a731b121",{"style":78,"_key":4030,"markDefs":4031,"children":4034,"_type":58},"f92f1b576165",[4032],{"href":3492,"_key":4033,"type":65,"url":3492,"_type":67},"da19bb1c34d2",[4035,4039,4043],{"marks":4036,"text":4037,"_key":4038,"_type":56},[],"There is good evidence to show that home birth is a safe option for women, birthing people and their babies if they fall into the ‘low risk’ category and have had healthy, uncomplicated pregnancies. The most recent research to support this is from the 2020 ","271c9ecb2558",{"_key":4040,"_type":56,"marks":4041,"text":4042},"d43b35d7cb7d",[4033],"Lancet series",{"_type":56,"marks":4044,"text":4045,"_key":4046},[]," on home birth outcomes. But what if your pregnancy is considered ‘high risk’? Is home birth still a safe option for you and can you still choose it?","90135675ba8f",{"_type":58,"style":78,"_key":4048,"markDefs":4049,"children":4056},"4a81389a9ef2",[4050,4053],{"type":65,"url":4051,"_type":67,"href":4051,"_key":4052},"https://birthrights.org.uk/wp-content/uploads/2019/03/Choice-of-place-of-birth-2019.pdf","f956cf7878b3",{"href":4054,"_key":4055,"type":65,"url":4054,"_type":67},"https://www.nice.org.uk/guidance/ng235/chapter/Recommendations#planning-place-of-birth","cadbd1cd9f22",[4057,4061,4064,4068,4072],{"_type":56,"marks":4058,"text":4059,"_key":4060},[],"To go back to basics, in the UK you have the legal right to choose where you give birth, regardless of your risk status during pregnancy and even if your decision seems incomprehensible to somebody else. As long as you have mental capacity, you have the right to choose. Birthrights explain this clearly ","5de40d10018a",{"_type":56,"marks":4062,"text":249,"_key":4063},[4052],"e77e941cb95a",{"_type":56,"marks":4065,"text":4066,"_key":4067},[],". Anecdotally, we know that home birth is usually discouraged if a pregnancy is considered high risk and ","e33d216b5297",{"marks":4069,"text":4070,"_key":4071,"_type":56},[4055],"NICE guidelines","5f49372421c6",{"_type":56,"marks":4073,"text":4074,"_key":4075},[]," do not recommend home birth unless the pregnancy is low risk and uncomplicated.","50a69515fb93",{"_type":190,"link":4077,"_key":4080},{"internalLink":4078,"blank":192,"_type":67,"text":4079,"type":194},{"_ref":196,"_type":197},"Our care packages","3dbd0226bf07",{"markDefs":4082,"children":4083,"_type":58,"style":59,"_key":4088},[],[4084],{"_type":56,"marks":4085,"text":4086,"_key":4087},[],"Why \"High Risk\" Isn't Black and White","6ea9cee5af4b","5d2ae833d397",{"children":4090,"_type":58,"style":78,"_key":4126,"markDefs":4127},[4091,4095,4098,4102,4106,4110,4114,4118,4122],{"_type":56,"marks":4092,"text":4093,"_key":4094},[],"Risk is a spectrum and it’s too binary to just put women and birthing people into a high or low risk category. Let’s use the example of gestational diabetes. Where someone has been diagnosed with gestational diabetes (GD), their pregnancy automatically becomes classed as high risk. However, if blood sugars have been controlled by diet throughout pregnancy, the baby has not been exposed to the risks of high blood sugars (hyperglycaemia) – in essence they are the same as someone who does ","26ed1caa072d",{"text":1624,"_key":4096,"_type":56,"marks":4097},"1957ef4cc288",[108],{"_type":56,"marks":4099,"text":4100,"_key":4101},[]," have GD. On the other hand, someone who has had uncontrolled blood sugars throughout their pregnancy and required multiple forms of medication has a very different risk profile in that their baby ","19d1b1be81c8",{"text":4103,"_key":4104,"_type":56,"marks":4105},"has","c936bd2aed49",[281],{"_type":56,"marks":4107,"text":4108,"_key":4109},[]," been exposed to hyperglycaemia and the associated risks of this (read more about those ","879ed471b1f0",{"marks":4111,"text":249,"_key":4113,"_type":56},[4112],"9e3ebf4df188","04f7cce9e63e",{"_type":56,"marks":4115,"text":4116,"_key":4117},[]," under ‘interventions’). So whilst both pregnancies are classed as high risk, we cannot compare someone with controlled gestational diabetes to someone with uncontrolled gestational diabetes. And just to clarify, someone who has controlled blood sugars during pregnancy is not ","63332c20863a",{"marks":4119,"text":4120,"_key":4121,"_type":56},[281],"better","950380e9ddad",{"_type":56,"marks":4123,"text":4124,"_key":4125},[]," than someone who has had more difficulty maintaining normal blood sugars and who may require medication to support them – we’re all built differently and for some, diet alone will not maintain normal blood sugars. Regardless of this, both those with controlled and uncontrolled gestational diabetes have the same right to plan a home birth.","d51b64dfad42","c9eeb4d9679a",[4128],{"_key":4112,"type":65,"url":4129,"_type":67,"href":4129},"https://www.nice.org.uk/guidance/ng3/chapter/recommendations#gestational-diabetes",{"markDefs":4131,"children":4132,"_type":58,"style":59,"_key":4137},[],[4133],{"_key":4134,"_type":56,"marks":4135,"text":4136},"4e901204267b",[],"What Counts as High Risk in Pregnancy?","d5c557079d8b",{"_key":4139,"markDefs":4140,"children":4141,"_type":58,"style":78},"7b02c80ed73e",[],[4142],{"text":4143,"_key":4144,"_type":56,"marks":4145},"Some women and birthing people may have a whole host of ‘red flags’ or risk factors – bunting in fact! Having a medical condition where the impact on pregnancy is perhaps uncertain will likely result in a high risk label. These people will likely benefit from multidisciplinary team input during their pregnancy for an individualised care plan to be made – but it could also be the case that their medical condition may be very unlikely to affect labour and birth at all. There is not enough research to assess the safety of place of birth for specific medical conditions – so recommendations are therefore based on professional opinion. In our experience, medical opinion will err on the side of caution – obstetricians are understandably more comfortable on a labour ward, where lots of monitoring of women and babies can happen. This doesn’t necessarily mean that the labour ward is the best option for place of birth for all women and birthing people with ‘high risk’ pregnancies – but what it does mean is more exposure to interventions that may not be necessary. Birthing in hospital carries its own set of risks.","63e363fa33aa",[],{"_type":190,"link":4147,"_key":4150},{"blank":192,"_type":67,"text":4148,"type":194,"internalLink":4149},"Book a birth planning session",{"_ref":2580,"_type":197},"bff96cb36426",{"markDefs":4152,"children":4153,"_type":58,"style":59,"_key":4158},[],[4154],{"marks":4155,"text":4156,"_key":4157,"_type":56},[],"What Does the Research Say About Home Birth for High Risk Women?","cc1e21083148","5c978cc9ea70",{"_type":58,"style":78,"_key":4160,"markDefs":4161,"children":4162},"662ec4ce9331",[],[4163],{"_key":4164,"_type":56,"marks":4165,"text":4166},"2fb8dc4ac105",[],"There is some research on home birth outcomes for women and babies where the pregnancy is considered to be high risk. We will be exploring the data from the 2011 Birthplace in England Study, which whilst was a very large study, is now over 10 years old and more research is needed.",{"_key":4168,"markDefs":4169,"children":4172,"_type":58,"style":78},"f6f305c1f259",[4170],{"_type":67,"href":3532,"_key":4171,"type":65,"url":3532},"2e8f54a733d7",[4173,4177],{"_key":4174,"_type":56,"marks":4175,"text":4176},"32c94083ab4c",[4171],"An analysis",{"text":4178,"_key":4179,"_type":56,"marks":4180}," of the Birthplace in England study looked at perinatal (baby related) and maternal outcomes for 8180 high risk women. 1489 of these women planned a home birth and they were compared to 6691 women who planned a labour ward birth. Women who had a multiple pregnancy (ie twins) were not included. The criteria for high risk is listed below. ","d0ec1ff7c1ef",[],{"markDefs":4182,"children":4183,"_type":58,"style":78,"_key":4188},[],[4184],{"_type":56,"marks":4185,"text":4186,"_key":4187},[108],"Medical conditions that defined a pregnancy as high risk in the Birthplace analysis were:","9ee1cf51c90e","d0330f356749",{"listItem":914,"markDefs":4190,"children":4191,"level":921,"_type":58,"style":78,"_key":4196},[],[4192],{"_type":56,"marks":4193,"text":4194,"_key":4195},[],"confirmed cardiac disease","124e5557d601","2a7949b6224f",{"listItem":914,"markDefs":4198,"children":4199,"level":921,"_type":58,"style":78,"_key":4204},[],[4200],{"text":4201,"_key":4202,"_type":56,"marks":4203},"hypertensive disorders (high blood 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The risk of perinatal adverse outcome was lower in high risk women planning a home birth compared to high risk women planning a hospital birth. For women and birthing people having their ","f94193af33a1",{"_type":56,"marks":4452,"text":4453,"_key":4454},[108],"first","16e02a87677f",{"_type":56,"marks":4456,"text":4457,"_key":4458},[]," baby, the chance of an adverse outcome related to the baby was ","7692edf9ec27",{"marks":4460,"text":4461,"_key":4462,"_type":56},[108],"27.7 per 1000 (2.7%)","93f54bd20111",{"text":4464,"_key":4465,"_type":56,"marks":4466}," planned home births vs. ","e1df3fc9662c",[],{"_type":56,"marks":4468,"text":4469,"_key":4470},[108],"46 per 1000 (4.6%)","5a983c12e346",{"_type":56,"marks":4472,"text":4473,"_key":4474},[]," planned labour ward births. 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When comparing high risk women with low risk women, the risk of adverse perinatal outcomes increased for those planning a home birth, however if there were no complicating factors at the start of labour – this increased risk was not seen. ","4e753a98afea","7214954bedfb",[],{"markDefs":4502,"children":4503,"_type":58,"style":59,"_key":4508},[],[4504],{"_type":56,"marks":4505,"text":4506,"_key":4507},[],"Maternal Outcomes: How Does Place of Birth Affect Your Birth Experience?","ebe969eeff95","b4e75a778f76",{"markDefs":4510,"children":4511,"_type":58,"style":78,"_key":4516},[],[4512],{"marks":4513,"text":4514,"_key":4515,"_type":56},[108],"The analysis also looked at adverse maternal outcomes requiring obstetric input, including:","65cd3d0ef585","d3135accd037",{"_type":58,"style":78,"_key":4518,"listItem":914,"markDefs":4519,"children":4520,"level":921},"2d18d0a2d399",[],[4521],{"_type":56,"marks":4522,"text":4523,"_key":4524},[],"augmentation (speeding labour up with the hormone drip)","32490912a15a",{"_key":4526,"listItem":914,"markDefs":4527,"children":4528,"level":921,"_type":58,"style":78},"2b0506ce6957",[],[4529],{"_type":56,"marks":4530,"text":4531,"_key":4532},[],"instrumental birth (forceps or ventouse)","0edeca298163",{"listItem":914,"markDefs":4534,"children":4535,"level":921,"_type":58,"style":78,"_key":4540},[],[4536],{"marks":4537,"text":4538,"_key":4539,"_type":56},[],"caesarean section in labour","fbe27f51bb76","6c5b3bd90e5d",{"style":78,"_key":4542,"listItem":914,"markDefs":4543,"children":4544,"level":921,"_type":58},"9f387d3763e1",[],[4545],{"marks":4546,"text":4547,"_key":4548,"_type":56},[],"general anaesthesia","3402f281d754",{"listItem":914,"markDefs":4550,"children":4551,"level":921,"_type":58,"style":78,"_key":4556},[],[4552],{"text":4553,"_key":4554,"_type":56,"marks":4555},"blood transfusion","583231b4d22e",[],"177c7d770ade",{"style":78,"_key":4558,"listItem":914,"markDefs":4559,"children":4560,"level":921,"_type":58},"40326b754f20",[],[4561],{"_type":56,"marks":4562,"text":4563,"_key":4564},[],"3rd/4th degree perineal tear","4122f2108b02",{"_key":4566,"listItem":914,"markDefs":4567,"children":4568,"level":921,"_type":58,"style":78},"9e6e44daed8c",[],[4569],{"marks":4570,"text":4571,"_key":4572,"_type":56},[],"admission for higher level care (eg high dependency unit or intensive care unit)","c986f7b5c05e",{"_key":4574,"markDefs":4575,"children":4576,"_type":58,"style":78},"eacff3baec40",[],[4577],{"_key":4578,"_type":56,"marks":4579,"text":4580},"c2edb663f366",[108],"The second outcome looked at was straightforward vaginal birth, which was defined as a vaginal birth that occurred without the following:",{"level":921,"_type":58,"style":78,"_key":4582,"listItem":914,"markDefs":4583,"children":4584},"0b5298876363",[],[4585],{"_type":56,"marks":4586,"text":4587,"_key":4588},[],"a caesarean section in labour","d00deee90f4d",{"level":921,"_type":58,"style":78,"_key":4590,"listItem":914,"markDefs":4591,"children":4592},"8167bc2c1860",[],[4593],{"_key":4594,"_type":56,"marks":4595,"text":4596},"bc1034f233cb",[],"an instrumental birth",{"_type":58,"style":78,"_key":4598,"listItem":914,"markDefs":4599,"children":4600,"level":921},"cd004ff07069",[],[4601],{"_type":56,"marks":4602,"text":4603,"_key":4604},[],"a blood transfusion","6e64176ba90e",{"_key":4606,"listItem":914,"markDefs":4607,"children":4608,"level":921,"_type":58,"style":78},"336c348ede36",[],[4609],{"text":4563,"_key":4610,"_type":56,"marks":4611},"534bca873663",[],{"children":4613,"_type":58,"style":78,"_key":4626,"markDefs":4627},[4614,4618,4622],{"_type":56,"marks":4615,"text":4616,"_key":4617},[],"Planned home birth was associated with ","8a53b163eb58",{"_key":4619,"_type":56,"marks":4620,"text":4621},"823a913388c9",[108],"significantly lower rates of interventions and adverse maternal outcomes",{"_type":56,"marks":4623,"text":4624,"_key":4625},[]," requiring obstetric input and significantly higher rates of straightforward vaginal births, than planned hospital births. ","322bd5798eba","848f5cae4b76",[],{"markDefs":4629,"children":4630,"_type":58,"style":2849,"_key":4635},[],[4631],{"_type":56,"marks":4632,"text":4633,"_key":4634},[],"For high risk women having their first baby, planning a home birth resulted in 73% having a straightforward vaginal birth, compared to 51% who planned a hospital birth.","1f70bebda8ec","e2b048a42e2f",{"_type":58,"style":78,"_key":4637,"markDefs":4638,"children":4639},"c89aa11e71ab",[],[4640],{"marks":4641,"text":4642,"_key":4643,"_type":56},[],"For those having a second or more baby, the percentage of vaginal birth if home birth was planned was 92% vs. 74% if planning a hospital birth. More women who planned a labour ward birth had multiple complicating risk factors compared to those planning a home birth, which may be a contributing factor to the difference in straightforward vaginal birth rates. Transfer rates for women and birthing people from home in the study population were 39% for those having their first baby and 14% of those having their second or more baby.","af9d2ea47f8f",{"_key":4645,"markDefs":4646,"children":4647,"_type":58,"style":78},"cce173a197f6",[],[4648],{"_type":56,"marks":4649,"text":4650,"_key":4651},[],"The Birthplace analysis gives us insight into outcomes for high risk women who plan a home birth, compared to those planning a hospital birth. It shows that on the whole, adverse outcomes are for women, birthing people and their babies are low – even when considered high risk. We definitely need more research on high risk women who are planning to home birth, both in terms of the physical outcomes for them and their babies, and in terms of their experiences of planning a home birth with a high risk label.","00b47cec5103",{"_type":190,"link":4653,"_key":4657},{"type":194,"internalLink":4654,"blank":192,"_type":67,"text":4656},{"_type":197,"_ref":4655},"a6378440-c555-4df1-8a9a-9e064f753f6a","Check out our other blogs","ad42f41a7d10",{"_key":4659,"markDefs":4660,"children":4661,"_type":58,"style":59},"5b5399a7ca77",[],[4662],{"marks":4663,"text":4664,"_key":4665,"_type":56},[],"A Risk Factor Is a Consideration, Not a Guarantee","039273e23bca",{"_type":58,"style":78,"_key":4667,"markDefs":4668,"children":4669},"fb9799788df7",[],[4670],{"_key":4671,"_type":56,"marks":4672,"text":4673},"51aaa90550c3",[],"Just because someone has been labelled high risk doesn’t mean that they should automatically be excluded or dissuaded from having a home birth if that is their plan or wish. Having access to a multidisciplinary team can be useful to draw in different expertise and help assess what things need to be considered for pregnancy, birth and the postnatal period. However, most obstetricians and midwives in the UK do not attend home birth or even see true physiological birth, so they are unlikely to be thrilled at the prospect of a home birth, particularly where someone is classed as high risk. But each woman or birthing person needs to be looked at as an individual and as healthcare professionals we need to figure out how we can best support them to have a positive birth experience – even if their choices seem incomprehensible to us and do not align with our beliefs about what is best. There are of course scenarios where a hospital based birth for someone with a high risk label is the safest option (eg. pregnancies complicated by placenta praevia or where there is a known fetal condition requiring surgery)",{"style":78,"_key":4675,"markDefs":4676,"children":4677,"_type":58},"581236f1ad67",[],[4678],{"marks":4679,"text":4680,"_key":4681,"_type":56},[],"Place of birth discussions need to primarily take into account what the woman or birthing person wishes to happen, what the risks of their choices may be but also, something which is often missed, what the benefits may be in planning a birth at home even with a high risk label. If first time, high risk birthers have a 73% chance of having a straightforward vaginal birth at home, compared to only 51% in hospital, and if their babies are less likely to experience an adverse perinatal outcome at home compared to their high risk counterparts in hospital – we need to be discussing that with women. Home birth is not for everyone, but a high risk label should not automatically exclude someone from considering it.","2ad0a98714ab",{"_key":4683,"markDefs":4684,"children":4685,"_type":58,"style":78},"879bddd3c666",[],[4686],{"_type":56,"marks":4687,"text":4688,"_key":4689},[],"We are fortunate (despite the numerous valid reports on our inadequate maternity services) that most of the UK is well connected to maternity units, we have skilled midwives and systems in place to transfer women and babies to hospital in the event that further care is needed. We need to support high risk women and birthing people if they wish to give birth at home because they have a legal right to make that choice. The law supports women. Working collaboratively with women and birthing who plan to birth at home is likely to result in better outcomes than declining them care or trying to coerce them to change their mind. Women and birthing people understand that birth is not without risk – we need to respect that.","2e6b8b13cfbf",{"children":4691,"_type":58,"style":78,"_key":4696,"markDefs":4697},[4692],{"_type":56,"marks":4693,"text":4694,"_key":4695},[],"If you choose to hire us as your independent midwives and fall into a higher risk category, we can liaise with the local NHS multidisciplinary team (only if you wish) as part of your pregnancy care. This can be useful when something is out of our scope of practice or area of expertise, but ultimately it is your choice if you wish to have this additional input or not.","777a3b0ad454","4fb5fb9b65f5",[],{"_type":190,"link":4699,"_key":4703},{"_type":67,"text":4700,"type":194,"internalLink":4701,"blank":192},"Sign up to our newsletter",{"_ref":4702,"_type":197},"a6455549-a293-4566-9a61-0dedee7dcbd3","d082d5af87b9",{"markDefs":4705,"children":4706,"_type":58,"style":59,"_key":4711},[],[4707],{"_type":56,"marks":4708,"text":4709,"_key":4710},[],"How We Support High Risk Women Planning a Home Birth","485b593f9353","1cbba093f4f6",{"markDefs":4713,"children":4717,"_type":58,"style":78,"_key":4730},[4714],{"type":194,"internalLink":4715,"_type":67,"href":3673,"_key":4716},{"_ref":2580,"_type":197},"c58d1e9899a6",[4718,4722,4726],{"_type":56,"marks":4719,"text":4720,"_key":4721},[],"If you’ve thought about home birth, but thought it might be out of the question due to a pre-existing medical condition or a previous pregnancy issue, ","cee33c5a7684",{"_type":56,"marks":4723,"text":4724,"_key":4725},[4716],"get in touch","13a2421a90b7",{"_key":4727,"_type":56,"marks":4728,"text":4729},"042d698c6277",[]," to see how we can support you to birth at home.","d15db77f8729",{"markDefs":4732,"children":4738,"_type":58,"style":78,"_key":4751},[4733],{"href":4734,"_key":4735,"type":194,"internalLink":4736,"anchor":4737,"_type":67},"https://junomidwives.co.uk/care-packages/#hospital-birth-package","06ec56a1fa85",{"_type":197,"_ref":196},"#hospital-birth-package",[4739,4743,4747],{"_key":4740,"_type":56,"marks":4741,"text":4742},"b027d0d533dd",[],"We also provide pregnancy and postnatal care to women and birthing people who plan to give birth in the ",{"text":4744,"_key":4745,"_type":56,"marks":4746},"hospital","9be2d6e9ad7f",[4735],{"text":4748,"_key":4749,"_type":56,"marks":4750},", so if home birth doesn’t feel quite right for you, we can support you non-clinically during your birth in other settings.","55edaaf8553a",[],"b39a74a28402",{"asset":4753,"_type":586},{"_ref":4754,"_type":197},"image-ca20469af5804a257d3f5d2a5a8f6879436513a8-1080x1350-jpg","2025-04-07T15:20:42Z","2024-07-27","V3aI2QowveaYP3Z79qYJUC",{"base":4759},{"id":3615,"rev":4760},"lFrvlEMldmWjsfq3cZhhD8","2026-03-11T13:22:01Z",{"_type":8,"current":4763},"can-you-have-a-home-birth-if-you-re-high-risk-what-the-evidence-says","Can You Have a Home Birth If You're High Risk? What the Evidence Says",{"_updatedAt":4766,"_rev":4767,"_id":4768,"content":4769,"_system":5237,"_createdAt":5240,"image":5241,"_type":37,"title":5244,"slug":5245,"publishedAt":5247},"2026-03-11T13:25:54Z","V3aI2QowveaYP3Z79qbwGq","3efbd5e7-b87e-460b-8a4c-3dad2bba9846",{"_type":49,"body":4770},[4771,4779,4787,4795,4810,4818,4826,4844,4849,4857,4885,4893,4917,4942,4950,4958,4966,4974,4982,4990,4998,5006,5014,5022,5030,5038,5046,5053,5071,5087,5095,5099,5107,5144,5152,5160,5168,5176,5200,5208,5223],{"markDefs":4772,"children":4773,"_type":58,"style":78,"_key":4778},[],[4774],{"text":4775,"_key":4776,"_type":56,"marks":4777},"July is Group B Strep. awareness month & we will be answering some common questions about GBS in this blog!","5677e4d349e2",[108],"e230969c79ea",{"_type":58,"style":78,"_key":4780,"markDefs":4781,"children":4782},"9982144c614f",[],[4783],{"text":4784,"_key":4785,"_type":56,"marks":4786},"Content warning: in this blog post we will outline some statistics which touch upon rates of infection and morbidity (illness) and neonatal (baby) death.","efce4a9e808b",[281],{"markDefs":4788,"children":4789,"_type":58,"style":59,"_key":4794},[],[4790],{"_type":56,"marks":4791,"text":4792,"_key":4793},[],"What Is Group B Strep (GBS)?","4908f68a06b2","f6c68f598e3a",{"style":78,"_key":4796,"markDefs":4797,"children":4798,"_type":58},"e408655f0089",[],[4799,4803,4806],{"_type":56,"marks":4800,"text":4801,"_key":4802},[],"GBS stands for Group B Streptococcus. GBS is part of the normal flora of the gastrointestinal tract. It is a common type of bacteria that lives in the vagina, rectum and intestines of about 20-40% of women. The presence of GBS is known as being a ‘carrier’ or being ‘colonised’ – it does not mean you are infected with it and colonisation can also be temporary. It is important to note that GBS is ","ff3be5e0bb05",{"_key":4804,"_type":56,"marks":4805,"text":1624},"23c9e45ec135",[108],{"_key":4807,"_type":56,"marks":4808,"text":4809},"7d9f147780ab",[]," a sexually transmitted disease.",{"_key":4811,"markDefs":4812,"children":4813,"_type":58,"style":59},"e68f500c5868",[],[4814],{"_key":4815,"_type":56,"marks":4816,"text":4817},"236fac506aea",[],"How Is GBS Detected During Pregnancy?",{"_type":58,"style":78,"_key":4819,"markDefs":4820,"children":4821},"32f77e7d9246",[],[4822],{"marks":4823,"text":4824,"_key":4825,"_type":56},[],"It may be detected on a vaginal swab or on a urine sample during pregnancy. In terms of having a swab, best practice to detect GBS is to take one or more swabs from the lower vagina and the rectum to be able to identify colonisation and avoid false negative test results. Many NHS trusts routinely send off a urine sample to be analysed at the initial booking appointment to screen for the presences of a urinary tract infection (UTI), which some people are more susceptible to in pregnancy. You should always be asked for your consent and be provided with an explanation of what the urine test will be looking for. We know from practice that women and birthing people are not being routinely informed that the urine sample may identify bacteria like Group B Strep and what the implications of testing for that are.","c0d21b713dbc",{"_key":4827,"markDefs":4828,"children":4832,"_type":58,"style":78},"cc548ad9944e",[4829],{"internalLink":4830,"_type":67,"href":3673,"_key":4831,"type":194},{"_ref":2580,"_type":197},"2b55d19216d8",[4833,4837,4840],{"_key":4834,"_type":56,"marks":4835,"text":4836},"7969679de3d6",[],"Some women and birthing people choose to have a GBS swab done privately, which is something we can facilitate – ",{"text":4724,"_key":4838,"_type":56,"marks":4839},"f90a68f288bf",[4831],{"_type":56,"marks":4841,"text":4842,"_key":4843},[]," if you’d like to know more. ","f305e612b3de",{"_key":4845,"_type":190,"link":4846},"331253f82dd0",{"blank":192,"_type":67,"text":4847,"type":194,"internalLink":4848},"Ask us about having a GBS swab",{"_type":197,"_ref":2580},{"_key":4850,"markDefs":4851,"children":4852,"_type":58,"style":59},"eeeea546ab15",[],[4853],{"marks":4854,"text":4855,"_key":4856,"_type":56},[],"\nWhat Does a GBS Positive Result Mean for You and Your Baby?","5af1b6258215",{"markDefs":4858,"children":4863,"_type":58,"style":78,"_key":4884},[4859],{"_type":67,"href":4860,"_key":4861,"type":194,"internalLink":4862},"https://junomidwives.co.uk/got-a-decision-to-make-use-ya-brain/","87360e9a2519",{"_type":197,"_ref":1555},[4864,4868,4872,4876,4880],{"marks":4865,"text":4866,"_key":4867,"_type":56},[],"If GBS is found in the urine, oral antibiotics are offered to clear the bacteria (even in the absence of any UTI symptoms) as this is considered to be a ‘heavy colonisation’ of the bacteria. If the GBS is picked up on a swab, oral antibiotics are not offered during pregnancy as they do not clear the GBS colonisation from the vagina or intestines. In either case, intravenous (IV) antibiotics are offered 4 hourly when you are in labour to minimise the chance of transmission of the GBS bacteria to your baby, which in rare cases can cause serious infection in newborn babies (more on that later!). If your waters break before you go into labour, you will be ","d11ad72671db",{"_type":56,"marks":4869,"text":4870,"_key":4871},[281],"offered","c052b5e09787",{"marks":4873,"text":4874,"_key":4875,"_type":56},[]," immediate antibiotics and an induction of labour – again, the aim is to minimise the chance of the baby picking up the GBS during labour or as they are being born. It is your choice if you want to have these antibiotics or not. Using the ","905c08cd6042",{"text":4877,"_key":4878,"_type":56,"marks":4879},"BRAIN decision making tool","46124c786391",[4861],{"marks":4881,"text":4882,"_key":4883,"_type":56},[]," may come in handy here to help you weigh up the pros and cons of antibiotics and/or induction of labour. ","9581834832a4","e94d38b57f5d",{"children":4886,"_type":58,"style":59,"_key":4891,"markDefs":4892},[4887],{"marks":4888,"text":4889,"_key":4890,"_type":56},[],"How Likely Is a GBS Infection in Newborn Babies?","7c26afb7fa53","e78ee3310194",[],{"markDefs":4894,"children":4895,"_type":58,"style":78,"_key":4916},[],[4896,4900,4904,4908,4912],{"_type":56,"marks":4897,"text":4898,"_key":4899},[],"Early-onset GBS infection occurs within 24 hours of birth and affects ","03c33a613b12",{"marks":4901,"text":4902,"_key":4903,"_type":56},[108],"1:1750","e78c91f74b40",{"marks":4905,"text":4906,"_key":4907,"_type":56},[]," newborns and late-onset GBS infection occurs from 7 days – 3 months following birth and affects ","18b5dac1342b",{"_key":4909,"_type":56,"marks":4910,"text":4911},"c29d49288125",[108],"1:2700 babies",{"text":4913,"_key":4914,"_type":56,"marks":4915},". The antibiotics offered in labour are only effective at reducing the incidence of early-onset infection, but make no difference to the incidence of late-onset GBS infection. The statistics demonstrate that most babies born to women or birthing people who carry GBS will be unaffected ie. they will be well and not develop a GBS infection. For a small proportion of babies GBS can cause serious infection and in very rare cases even death.","591ddf824790",[],"1c48ef9c2f92",{"markDefs":4918,"children":4922,"_type":58,"style":78,"_key":4941},[4919],{"href":4920,"_key":4921,"type":65,"url":4920,"_type":67},"https://gbss.org.uk/info-support/about-group-b-strep/what-is-group-b-strep/","af053a6d0d37",[4923,4927,4930,4934,4937],{"_type":56,"marks":4924,"text":4925,"_key":4926},[108],"The","f6aa603591a2",{"_type":56,"marks":4928,"text":4274,"_key":4929},[],"a89be3fe5c49",{"_type":56,"marks":4931,"text":4932,"_key":4933},[4921,108],"Group B Strep Support","8e68e28564a5",{"_key":4935,"_type":56,"marks":4936,"text":4274},"c04a8ebf84e4",[],{"marks":4938,"text":4939,"_key":4940,"_type":56},[108],"website has these figures on babies with a confirmed GBS infection in the UK and Ireland:","57912309fa53","9ef15d230746",{"markDefs":4943,"children":4944,"_type":58,"style":78,"_key":4949},[],[4945],{"_key":4946,"_type":56,"marks":4947,"text":4948},"dc075753ca21",[108,281],"Early-onset GBS infection","4381ce3cb7e5",{"_key":4951,"listItem":914,"markDefs":4952,"children":4953,"level":921,"_type":58,"style":78},"1e54dadc4e8c",[],[4954],{"_key":4955,"_type":56,"marks":4956,"text":4957},"fdf6b302a9de",[],"1:1750 or 0.06% babies will develop an early-onset GBS infection",{"listItem":914,"markDefs":4959,"children":4960,"level":921,"_type":58,"style":78,"_key":4965},[],[4961],{"_type":56,"marks":4962,"text":4963,"_key":4964},[],"1:19 or 5.2% of those infected will die","59b77ce57a12","627cf6863542",{"_key":4967,"listItem":914,"markDefs":4968,"children":4969,"level":921,"_type":58,"style":78},"575305da19aa",[],[4970],{"text":4971,"_key":4972,"_type":56,"marks":4973},"1:14 or 7.4% of those infected will live with a long-term physical or mental disability","b0621aa1f80e",[],{"_key":4975,"markDefs":4976,"children":4977,"_type":58,"style":78},"4a81f2d81d18",[],[4978],{"_key":4979,"_type":56,"marks":4980,"text":4981},"e5c6dee7e438",[108,281],"Late-onset GBS",{"listItem":914,"markDefs":4983,"children":4984,"level":921,"_type":58,"style":78,"_key":4989},[],[4985],{"_type":56,"marks":4986,"text":4987,"_key":4988},[],"1:2700 or 0.04% of babies will develop a late-onset GBS infection","0dceace8e474","aa6e794d2cf3",{"listItem":914,"markDefs":4991,"children":4992,"level":921,"_type":58,"style":78,"_key":4997},[],[4993],{"text":4994,"_key":4995,"_type":56,"marks":4996},"1:13 or 7.7% of those infected will die","a6f4f5b5df9e",[],"6902043123b7",{"_key":4999,"listItem":914,"markDefs":5000,"children":5001,"level":921,"_type":58,"style":78},"448f1072639d",[],[5002],{"_type":56,"marks":5003,"text":5004,"_key":5005},[],"1:18 or 12.4% of those infected will live with a long-term physical or mental disability","849fb9619842",{"children":5007,"_type":58,"style":59,"_key":5012,"markDefs":5013},[5008],{"_key":5009,"_type":56,"marks":5010,"text":5011},"e4632b1c8c9a",[],"Why Isn't GBS Screening Routine in the NHS?","3e3c580e48cf",[],{"style":78,"_key":5015,"markDefs":5016,"children":5017,"_type":58},"5c7da2fbb1aa",[],[5018],{"_key":5019,"_type":56,"marks":5020,"text":5021},"cf43eb7b53ea",[],"Screening for GBS is not routinely offered by the NHS because routine screening has so far not been proven by research to improve outcomes. Given that 20-40% of women are GBS carriers, screening would result in significantly more women and birthing people being offered antibiotics during labour, when they may not need them. Consideration has to be given to routine use of antibiotics when we live in an age of antibiotic resistance and what effect antibiotics have on the newborn baby’s microbiome. We need to make sure that when we use antibiotics they are truly needed.",{"style":59,"_key":5023,"markDefs":5024,"children":5025,"_type":58},"ac0095b1392f",[],[5026],{"_key":5027,"_type":56,"marks":5028,"text":5029},"6111d631f30e",[],"Does Having GBS Affect Your Choice of Birth Place?",{"children":5031,"_type":58,"style":78,"_key":5036,"markDefs":5037},[5032],{"text":5033,"_key":5034,"_type":56,"marks":5035},"The main issue that can arise with choice of place of birth if you have GBS, is that if you have chosen to have the IV antibiotics during labour, this may or may not be facilitated across all birth settings. There would be no issue receiving the antibiotics on a labour ward, but you would need to check if you would be able to have them if you chose to birth on an alongside midwifery-led unit (a birth centre attached to a hospital), a free-standing birth centre (not physically attached to a hospital) or at home. If your place of birth is restricted due to lack of access to the IV antibiotics, you may wish to weigh up whether the benefits of the IV antibiotics outweigh the risks of birthing on a labour ward if you are otherwise considered ‘low risk’ and have had an uncomplicated pregnancy.","25003b945e0c",[],"c6ce54a3d3e8",[],{"children":5039,"_type":58,"style":78,"_key":5044,"markDefs":5045},[5040],{"_type":56,"marks":5041,"text":5042,"_key":5043},[],"In our experience IV antibiotics are usually out of the question for home birth (that doesn’t mean you can’t choose home birth – but you choose to forgo the antibiotics). Freestanding birth centres may or may not have a policy that supports the use of IV antibiotics specifically for women and birthing people who have GBS. We would recommend finding this out as soon as you can in your pregnancy if you have GBS and wish to use one. Consult with the midwifery manager to see how your choice of using the freestanding birth centre and having antibiotics could be supported. This will help to ensure you can both birth where you wish and make an informed choice as to whether you have IV antibiotics or not. Unfortunately, there does not appear to be a national consensus on the use of IV antibiotics in free standing birth centres so you will find different policies and practices all over the country.","dc01e10bb87f","a91b8620caec",[],{"style":59,"_key":5047,"markDefs":5048,"children":5049,"_type":58},"dfba70d213aa",[],[5050],{"_type":56,"marks":5051,"text":5052,"_key":5043},[],"\nDoes GBS Affect How You Can Give Birth?",{"_type":58,"style":78,"_key":5054,"markDefs":5055,"children":5059},"2b937622dbbf",[5056],{"href":5057,"_key":5058,"type":65,"url":5057,"_type":67},"https://www.cochrane.org/CD006066/PREG_continuous-cardiotocography-ctg-form-electronic-fetal-monitoring-efm-fetal-assessment-during-labour#:~:text=CTG%20during%20labour%20is%20associated,sections%20and%20instrumental%20vaginal%20births.","d7fd3f74d549",[5060,5064,5067],{"text":5061,"_key":5062,"_type":56,"marks":5063},"Having GBS should not affect how you choose to give birth. If you are planning a vaginal birth, you will be advised to have IV antibiotics every 4 hours during labour. This involves having a cannula in your hand or wrist. If you have a caesarean section, antibiotics are not required – unless your waters have broken and / or you have an emergency caesarean during labour. If your pregnancy is otherwise uncomplicated, being a GBS carrier is not a reason to recommend continuous fetal monitoring (a CTG) during labour. ","e7a871e1a87d",[],{"_type":56,"marks":5065,"text":891,"_key":5066},[5058],"8ad7f26f623e",{"_type":56,"marks":5068,"text":5069,"_key":5070},[]," has shown that the routine use of CTGs in labour in ‘low risk’ women increases the chance of interventions, such as caesarean sections, in labour. ","9cee915e1cdc",{"_type":58,"style":59,"_key":5072,"markDefs":5073,"children":5074},"866878c501c0",[],[5075,5079,5083],{"_type":56,"marks":5076,"text":5077,"_key":5078},[],"Do You","e26577dcf26b",{"_key":5080,"_type":56,"marks":5081,"text":5082},"a7e3b23ad66f",[281]," Have ",{"_key":5084,"_type":56,"marks":5085,"text":5086},"3c94273e9527",[],"to Have Antibiotics for GBS in Labour?",{"_key":5088,"markDefs":5089,"children":5090,"_type":58,"style":78},"024f96afdcda",[],[5091],{"_type":56,"marks":5092,"text":5093,"_key":5094},[],"It is your choice if you want to have antibiotics during labour or not. We know that antibiotics are very effective at reducing the incidence of early-onset GBS infection in newborn babies, but have no impact on late-onset GBS infection. We also know that the incidence of early-onset GBS infection is rare with 1:1750 babies being affected. There is a small risk of allergic reaction to antibiotics, and it is important that your healthcare provider knows if you have an allergy to penicillin. A penicillin allergy is not compatible with the usual antibiotics given for GBS so health care providers will offer a suitable alternative to this.","0bd0b51844ee",{"_type":190,"link":5096,"_key":5098},{"internalLink":5097,"blank":192,"_type":67,"text":4148,"type":194},{"_ref":2580,"_type":197},"32eb42871249",{"children":5100,"_type":58,"style":59,"_key":5105,"markDefs":5106},[5101],{"_type":56,"marks":5102,"text":5103,"_key":5104},[],"What Happens After Birth If You Have GBS?","83d2d482c102","ab001cc41b51",[],{"style":78,"_key":5108,"markDefs":5109,"children":5116,"_type":58},"1b10ec0d93b2",[5110,5113],{"url":5111,"_type":67,"href":5111,"_key":5112,"type":65},"https://www.nice.org.uk/guidance/ng195/chapter/recommendations#management-for-babies-at-increased-risk-of-infection","69e3ba6ad4c7",{"_type":67,"href":5114,"_key":5115,"type":65,"url":5114},"https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.14821","0b1618f264b2",[5117,5121,5124,5128,5132,5136,5140],{"marks":5118,"text":5119,"_key":5120,"_type":56},[],"Different hospitals will have different policies, but generally speaking it will be recommended that your baby has some observations after birth. These observations are checking their temperature, heartbeat, breathing rate and general wellbeing. There is no need for them to be separated from you for these observations and having GBS does not affect breastfeeding. The ","e6a025e18cf7",{"_key":5122,"_type":56,"marks":5123,"text":4070},"4eb57189dac8",[5112],{"_key":5125,"_type":56,"marks":5126,"text":5127},"31ba2eba0cf7",[]," recommend using ",{"_key":5129,"_type":56,"marks":5130,"text":5131},"dac69e8e2272",[281],"clinical judgement",{"_key":5133,"_type":56,"marks":5134,"text":5135},"fb25f5ca6d52",[]," to assess if a baby requires observations for 12 hours following birth in the presence of a single risk factor – of which GBS colonisation is classed as one. The likelihood of GBS infection developing after 12 hours is very low. The Royal College of Obstetricians and Gynaecologists ",{"text":5137,"_key":5138,"_type":56,"marks":5139},"(RCOG)","6cc91b902b29",[5115],{"text":5141,"_key":5142,"_type":56,"marks":5143}," advise that babies do not require special observations if they are born at term (>37 weeks), are clinically well at birth and if their mother or birth parent received IV antibiotics more than 4 hours before they were born. Some hospitals may have a policy of routine observations for at least 12 hours for all babies born to mothers or birth parents who carry GBS, regardless of whether IV antibiotics were given or not. ","9040ef55ae8b",[],{"_type":58,"style":78,"_key":5145,"markDefs":5146,"children":5147},"907e7ea476a0",[],[5148],{"_type":56,"marks":5149,"text":5150,"_key":5151},[],"If you birth at home, your midwives can do some observations on your baby if you wish. If they have any concerns with your baby’s wellbeing, they can refer you to the hospital for a review by a neonatal doctor. Regardless of where your baby is born, if there are ongoing concerns about their wellbeing or any suspicions of infection, they will be reviewed by a neonatal doctor and it may be recommended that they have IV antibiotics. If the baby is otherwise stable, they can remain with you on the postnatal ward, but if it seems like the baby is unwell they may need to be admitted to the neonatal unit for more intense observation and care.","43b128af1160",{"_key":5153,"markDefs":5154,"children":5155,"_type":58,"style":78},"e58422f39357",[],[5156],{"_key":5157,"_type":56,"marks":5158,"text":5159},"c44d8ac003d7",[],"Signs of an unwell baby to look out for include: being unusually floppy, displaying abnormal behaviour (such as inconsolable crying or listlessness), a change in skin colour, rapid breathing, having a temperature above 38 degrees celsius or below 36 degrees celsius that cannot be attributed to environmental factors, lack of interest in feeding or continuous rapid breathing. If you ever have any concerns about your baby, even if you can’t put your finger on it, it is worth getting it checked out.",{"_type":58,"style":59,"_key":5161,"markDefs":5162,"children":5163},"f10d2f685698",[],[5164],{"marks":5165,"text":5166,"_key":5167,"_type":56},[],"Will GBS Affect Future Pregnancies?","bb606452e5f4",{"children":5169,"_type":58,"style":78,"_key":5174,"markDefs":5175},[5170],{"_type":56,"marks":5171,"text":5172,"_key":5173},[],"GBS is transient – meaning that a person may not always be a carrier. If you have been a GBS carrier in a previous pregnancy, you may wish to have a repeat swab in your next pregnancy to see if the GBS is still present. If the swab is negative for GBS between 35-37 weeks in a subsequent pregnancy, then IV antibiotics during labour are not recommended by the NICE guidelines. However, if you have had a previous baby diagnosed with a GBS infection, then NICE recommends IV antibiotics in labour – regardless of the result of a swab or urine test in the current pregnancy.","f926c972795c","537c163bfdb1",[],{"markDefs":5177,"children":5181,"_type":58,"style":78,"_key":5199},[5178],{"internalLink":5179,"_type":67,"href":3673,"_key":5180,"type":194},{"_ref":549,"_type":197},"6cbf2a786b39",[5182,5186,5189,5192,5195],{"_type":56,"marks":5183,"text":5184,"_key":5185},[108,281],"Got more questions? Interested in independent midwifery care? Want guaranteed access to home birth?","ec4111997c45",{"_key":5187,"_type":56,"marks":5188,"text":4274},"0e0628db7dea",[],{"_key":5190,"_type":56,"marks":5191,"text":3685},"4bd4d80e3a74",[108,281,5180],{"text":4274,"_key":5193,"_type":56,"marks":5194},"7bfe88433318",[],{"text":5196,"_key":5197,"_type":56,"marks":5198},"to arrange an informal chat about what we can offer you.","a87f9c92f7b9",[108,281],"13eb2f27678a",{"markDefs":5201,"children":5202,"_type":58,"style":78,"_key":5207},[],[5203],{"_key":5204,"_type":56,"marks":5205,"text":5206},"486ebc78623b",[108],"Further resources","3366a7558dca",{"children":5209,"_type":58,"style":78,"_key":5219,"markDefs":5220},[5210,5215],{"marks":5211,"text":5213,"_key":5214,"_type":56},[5212],"2ad3afe4b9ac","Group B Strep Explained","3154546afabc",{"_key":5216,"_type":56,"marks":5217,"text":5218},"c600de4400ba",[]," – another fantastic, accessible book from Sara Wickham","814c0de15c18",[5221],{"_key":5212,"type":65,"url":5222,"_type":67,"href":5222},"https://www.sarawickham.com/gbse/",{"children":5224,"_type":58,"style":78,"_key":5233,"markDefs":5234},[5225,5229],{"_type":56,"marks":5226,"text":4932,"_key":5228},[5227],"02c8c92ad4aa","24190757b5e4",{"marks":5230,"text":5231,"_key":5232,"_type":56},[]," – a charity providing information about GBS and support for those who have been affected by it","b7813785a063","820200d0a77c",[5235],{"_type":67,"href":5236,"_key":5227,"type":65,"url":5236},"https://gbss.org.uk/",{"base":5238},{"rev":5239,"id":4768},"c1HqLtX09dCBnnfIQetTXo","2025-04-07T15:20:36Z",{"asset":5242,"_type":586},{"_ref":5243,"_type":197},"image-7b98536c9bb664918c3245efc38502a73be2874d-1080x1350-jpg","Group B Strep in Pregnancy: 10 Things Every Pregnant Woman Should Know",{"current":5246,"_type":8},"group-b-strep-in-pregnancy-10-things-every-pregnant-woman-should-know","2024-07-22",{"_createdAt":5249,"image":5250,"_id":1555,"content":5253,"_system":5931,"_type":37,"_rev":5934,"_updatedAt":5935,"title":5936,"slug":5937,"publishedAt":5939},"2025-04-07T15:20:31Z",{"_type":586,"asset":5251},{"_ref":5252,"_type":197},"image-7792659e5e19f178ed1089631cade7d4e7162508-1080x1350-jpg",{"_type":49,"body":5254},[5255,5263,5275,5283,5291,5330,5338,5346,5354,5366,5378,5390,5402,5414,5426,5431,5439,5447,5458,5488,5504,5520,5536,5552,5568,5597,5608,5630,5641,5649,5653,5661,5669,5677,5709,5736,5747,5766,5777,5782,5790,5805,5813,5821,5829,5841,5849,5857,5865,5873,5881,5889,5911,5919,5927],{"_type":58,"style":59,"_key":5256,"markDefs":5257,"children":5258},"9cd54c520ce3",[],[5259],{"_type":56,"marks":5260,"text":5261,"_key":5262},[],"What Is the BRAINS Decision Making Tool?","912f72b9aeee",{"_type":58,"style":78,"_key":5264,"markDefs":5265,"children":5266},"ccee793e5186",[],[5267,5271],{"_type":56,"marks":5268,"text":5269,"_key":5270},[],"BRAINS is a decision making tool that stands for ","7fd260ae7526",{"_type":56,"marks":5272,"text":5273,"_key":5274},[108],"benefits, risks, alternatives, intuition, nothing, second opinion.","4d9b2222dd7b",{"children":5276,"_type":58,"style":59,"_key":5281,"markDefs":5282},[5277],{"_key":5278,"_type":56,"marks":5279,"text":5280},"d67b9a3fb65c",[],"Why Is Informed Decision Making in Pregnancy So Important?","77bb92cd2fc5",[],{"_key":5284,"markDefs":5285,"children":5286,"_type":58,"style":78},"26b1c8bfafff",[],[5287],{"_type":56,"marks":5288,"text":5289,"_key":5290},[],"There are so many decisions to be made during pregnancy and birth, it can all feel a bit overwhelming. Some people may find it so overwhelming that they default to ‘going with the flow’ of what their healthcare professional advises them to do. We believe that it is incredibly important for women and birthing people to make the decisions that are right for them – not just because they’ve been told ‘it’s policy’ or ‘it’s in the guidelines’. For some people, following policy and guidelines will feel like the right thing to do and for others it won’t – using BRAIN helps make decisions that are right for you.","6af01d7fd548",{"_type":58,"style":78,"_key":5292,"markDefs":5293,"children":5301},"a20bee58f647",[5294,5298],{"type":194,"internalLink":5295,"_type":67,"href":5296,"_key":5297},{"_ref":2756,"_type":197},"https://junomidwives.co.uk/am-i-allowed/","0c5a5083e018",{"href":5299,"_key":5300,"type":65,"url":5299,"_type":67},"https://birthrights.org.uk/advice-factsheets/","acad0f561d4b",[5302,5306,5310,5314,5318,5322,5326],{"text":5303,"_key":5304,"_type":56,"marks":5305},"You have the legal right to to accept or decline any test or intervention that is offered to you, yet we are still amazed by the amount of people we meet who question if they’re ‘allowed’ to do x, y or z. We wrote about this in our blog post, ","ce0059aa6520",[],{"_type":56,"marks":5307,"text":5308,"_key":5309},[5297],"‘Am I allowed?’","7b7f8787a86c",{"text":5311,"_key":5312,"_type":56,"marks":5313},", because you are absolutely allowed to ","5386cf6ce8ad",[],{"text":5315,"_key":5316,"_type":56,"marks":5317},"accept or decline","63bf4a8c268c",[108],{"_type":56,"marks":5319,"text":5320,"_key":5321},[]," any test or intervention that is offered or recommended to you during pregnancy. Power dynamics between healthcare professionals and women can be very unbalanced, so it’s not uncommon that we hear of people being pressured or coerced into accepting the status quo. ","3438cac35cac",{"_key":5323,"_type":56,"marks":5324,"text":5325},"1a87792ecb82",[5300],"Birthrights",{"_type":56,"marks":5327,"text":5328,"_key":5329},[]," have a wealth of information and fact sheets on their website about your rights during pregnancy and birth – and we will continue to signpost to them again and again. ","b7d2fe9199f1",{"markDefs":5331,"children":5332,"_type":58,"style":78,"_key":5337},[],[5333],{"_type":56,"marks":5334,"text":5335,"_key":5336},[],"The beautiful thing about the BRAIN decision making tool is that it can be applied to pretty much any decision you need to make during pregnancy, birth or in the postnatal period. It can be used for the ‘big’ decisions, the ‘small’ decisions – and everything in between. It can be really helpful to methodically go through to help you reach a decision from a thoughtful place rather than a fearful place. Except in the super rare cases of true ‘life or death’ emergencies, there will usually be time to go through BRAIN before making a decision.","638d3837ebd7","4fa88171d92b",{"_key":5339,"markDefs":5340,"children":5341,"_type":58,"style":59},"9b400ede93b6",[],[5342],{"_type":56,"marks":5343,"text":5344,"_key":5345},[],"How to Use the BRAIN Tool: A Step-by-Step Guide","dacd05982f82",{"_key":5347,"markDefs":5348,"children":5349,"_type":58,"style":78},"49a0695736ea",[],[5350],{"_key":5351,"_type":56,"marks":5352,"text":5353},"b40432628317",[281],"To use BRAIN, ask yourself the following questions when faced with a decision:",{"markDefs":5355,"children":5356,"_type":58,"style":78,"_key":5365},[],[5357,5361],{"_key":5358,"_type":56,"marks":5359,"text":5360},"a6ef0671a104",[108],"Benefits",{"_key":5362,"_type":56,"marks":5363,"text":5364},"bc58539c8c79",[]," – what are the benefits of the test / intervention / procedure?","0677552b0a88",{"style":78,"_key":5367,"markDefs":5368,"children":5369,"_type":58},"aaa2320c8432",[],[5370,5374],{"marks":5371,"text":5372,"_key":5373,"_type":56},[108],"Risks","ffa25fab585d",{"text":5375,"_key":5376,"_type":56,"marks":5377}," – what are the risks of the test / intervention / procedure?","b77e0b346a0d",[],{"markDefs":5379,"children":5380,"_type":58,"style":78,"_key":5389},[],[5381,5385],{"_type":56,"marks":5382,"text":5383,"_key":5384},[108],"Alternatives","7e24c91e9854",{"text":5386,"_key":5387,"_type":56,"marks":5388}," – are there any alternatives to the test / intervention / procedure?","1061fb5c7686",[],"6deb95017e46",{"_key":5391,"markDefs":5392,"children":5393,"_type":58,"style":78},"c6ffdf261fb1",[],[5394,5398],{"text":5395,"_key":5396,"_type":56,"marks":5397},"Intuition","4b6af0f22755",[108],{"marks":5399,"text":5400,"_key":5401,"_type":56},[]," – what is your intuition, or your gut saying? ","3fa2ef543835",{"_type":58,"style":78,"_key":5403,"markDefs":5404,"children":5405},"db4c4a81957f",[],[5406,5410],{"_type":56,"marks":5407,"text":5408,"_key":5409},[108],"Nothing","810f61d872d5",{"_key":5411,"_type":56,"marks":5412,"text":5413},"95ff3326b9e9",[]," – what happens if you do nothing for 1 hour, 1 day, 1 week etc? ",{"_type":58,"style":78,"_key":5415,"markDefs":5416,"children":5417},"1892f3a1bc3f",[],[5418,5422],{"_key":5419,"_type":56,"marks":5420,"text":5421},"f29cc6c72655",[108],"Second opinion",{"marks":5423,"text":5424,"_key":5425,"_type":56},[]," - would it help to ask for a second opinion from another person? (e.g. doctor / midwife)","400470b7f3d7",{"_key":5427,"_type":190,"link":5428},"901e7d2980e3",{"blank":192,"_type":67,"text":5429,"type":194,"internalLink":5430},"Need help with a birth plan? Get in touch!",{"_ref":2580,"_type":197},{"markDefs":5432,"children":5433,"_type":58,"style":59,"_key":5438},[],[5434],{"_key":5435,"_type":56,"marks":5436,"text":5437},"2e57acd29466",[],"Using BRAIN for a Big Decision: Should I Have an Induction of Labour?","ec04f8e93ef5",{"style":78,"_key":5440,"markDefs":5441,"children":5442,"_type":58},"374b46939b8e",[],[5443],{"_key":5444,"_type":56,"marks":5445,"text":5446},"f20ce04621df",[108],"Example decision to be made: having an induction of labour for post dates",{"_type":58,"style":78,"_key":5448,"markDefs":5449,"children":5450},"9524ff33d6ad",[],[5451,5454],{"_type":56,"marks":5452,"text":5360,"_key":5453},[108],"aec10f5e3141",{"_type":56,"marks":5455,"text":5456,"_key":5457},[]," – the NICE guidelines recommend induction of labour for ‘post dates’ between 41- 42 weeks to reduce the rate of stillbirth. It is helpful to know what the rates of stillbirth are for ‘low risk’ women & birthing people, to help you decide if this is a benefit for you.","13cbc0aaf4c0",{"style":78,"_key":5459,"markDefs":5460,"children":5463,"_type":58},"e6ab4612d0fb",[5461],{"href":408,"_key":5462,"type":65,"url":408,"_type":67},"fcf4e0660441",[5464,5468,5472,5476,5480,5484],{"_key":5465,"_type":56,"marks":5466,"text":5467},"11ac1a5d5071",[5462],"This research",{"_type":56,"marks":5469,"text":5470,"_key":5471},[]," from 2019 by ","f85dcf290f11",{"_type":56,"marks":5473,"text":5474,"_key":5475},[281],"Muglu et al.","f360dc0c62a2",{"_type":56,"marks":5477,"text":5478,"_key":5479},[]," gives us these figures on the risk of stillbirth at the following gestations for ","2a2a436d2301",{"_type":56,"marks":5481,"text":5482,"_key":5483},[108],"‘low risk’","0754a3b011db",{"_key":5485,"_type":56,"marks":5486,"text":5487},"c30ea079aa46",[]," women or birthing people who have had uncomplicated pregnancies : ",{"listItem":914,"markDefs":5489,"children":5490,"level":921,"_type":58,"style":78,"_key":5503},[],[5491,5495,5499],{"_type":56,"marks":5492,"text":5493,"_key":5494},[],"38 weeks ","ef8b4dde35e9",{"_type":56,"marks":5496,"text":5497,"_key":5498},[108],"0.12 per 1000","7d20a9c70a7a",{"_type":56,"marks":5500,"text":5501,"_key":5502},[],", or 1 in 8333","d5b74378fbfa","6f45e5ef0c92",{"markDefs":5505,"children":5506,"level":921,"_type":58,"style":78,"_key":5519,"listItem":914},[],[5507,5511,5515],{"_type":56,"marks":5508,"text":5509,"_key":5510},[],"39 weeks ","2885b4ca6638",{"_type":56,"marks":5512,"text":5513,"_key":5514},[108],"0.14 per 1000","6c1fa5d51452",{"_type":56,"marks":5516,"text":5517,"_key":5518},[],", or 1 in 7142","0353e0e4300d","c3d0e63b58c8",{"level":921,"_type":58,"style":78,"_key":5521,"listItem":914,"markDefs":5522,"children":5523},"28fbfcaf1680",[],[5524,5528,5532],{"_key":5525,"_type":56,"marks":5526,"text":5527},"22ece821bdc3",[],"40 weeks ",{"_key":5529,"_type":56,"marks":5530,"text":5531},"90752795a4d5",[108],"0.33 per 1000",{"_type":56,"marks":5533,"text":5534,"_key":5535},[],", or 1 in 3030","79a2dba1b49b",{"markDefs":5537,"children":5538,"level":921,"_type":58,"style":78,"_key":5551,"listItem":914},[],[5539,5543,5547],{"text":5540,"_key":5541,"_type":56,"marks":5542},"41 weeks ","a8027f867d1f",[],{"text":5544,"_key":5545,"_type":56,"marks":5546},"0.80 per 1000","562a72e186f8",[108],{"_type":56,"marks":5548,"text":5549,"_key":5550},[],", or 1 in 1250","515dc5bd7db8","a34afbb9cffd",{"_key":5553,"listItem":914,"markDefs":5554,"children":5555,"level":921,"_type":58,"style":78},"252061454548",[],[5556,5560,5564],{"marks":5557,"text":5558,"_key":5559,"_type":56},[],"42 weeks ","ddbd195bc0a2",{"_key":5561,"_type":56,"marks":5562,"text":5563},"2b2385c60e93",[108],"0.88 per 1000",{"marks":5565,"text":5566,"_key":5567,"_type":56},[],", or 1 in 1136","e4793abb9735",{"_key":5569,"markDefs":5570,"children":5574,"_type":58,"style":78},"b3eea90d5c1f",[5571],{"href":5572,"_key":5573,"type":65,"url":5572,"_type":67},"https://bmjopen.bmj.com/content/11/6/e047040.long","19ac9d2427a9",[5575,5578,5582,5586,5590,5593],{"marks":5576,"text":5372,"_key":5577,"_type":56},[108],"b7b98e47aa9e",{"_type":56,"marks":5579,"text":5580,"_key":5581},[]," – ","f3342762767f",{"marks":5583,"text":5584,"_key":5585,"_type":56},[5573],"induction of labour for non-medical reasons","2648a3a2e3d4",{"_type":56,"marks":5587,"text":5588,"_key":5589},[]," (postdates is ","5442e79f9ab2",{"marks":5591,"text":1624,"_key":5592,"_type":56},[281],"4886a1185f61",{"_type":56,"marks":5594,"text":5595,"_key":5596},[]," a medical reason) carries risks for both women and babies – including more likely to need an instrumental assisted birth, a caesarean section, an epidural, experience labour as more painful, babies are more likely to experience asphyxia (reduced oxygen supply) and birth trauma. ","adf1b94aa38c",{"style":78,"_key":5598,"markDefs":5599,"children":5600,"_type":58},"8b191174380b",[],[5601,5604],{"marks":5602,"text":5383,"_key":5603,"_type":56},[108],"41fda3115656",{"marks":5605,"text":5606,"_key":5607,"_type":56},[]," – the alternative would be to await spontaneous labour, or to have a caesarean section (although that should prompt another BRAIN analysis!).","ab5b675ba33f",{"_type":58,"style":78,"_key":5609,"markDefs":5610,"children":5614},"38bdddd4e116",[5611],{"_type":67,"href":5612,"_key":5613,"type":65,"url":5612},"https://www.sarawickham.com/time/","3679e9378fa2",[5615,5618,5622,5626],{"_type":56,"marks":5616,"text":5395,"_key":5617},[108],"3a95a650e59b",{"_type":56,"marks":5619,"text":5620,"_key":5621},[]," – how do you feel about having an induction of labour? Do you have concerns about your baby’s wellbeing or do you feel confident that they are well? Does it worry you going beyond 41 or 42 weeks of pregnancy? Does it feel, in your gut, like the right choice to make? Or does having the induction, or awaiting events, make you feel anxious? We cannot recommend Sara Wickham’s book, ","3ed9a31a8a4d",{"_key":5623,"_type":56,"marks":5624,"text":5625},"0537d4881fd7",[5613],"In Your Own Time",{"_key":5627,"_type":56,"marks":5628,"text":5629},"5b8bf4925ee6",[],", for balanced, sensible information about the timing of induction of labour.",{"style":78,"_key":5631,"markDefs":5632,"children":5633,"_type":58},"513f76973c17",[],[5634,5637],{"text":5408,"_key":5635,"_type":56,"marks":5636},"4aa375c8849d",[108],{"text":5638,"_key":5639,"_type":56,"marks":5640}," – what happens if you do nothing, but check in again at a later point in pregnancy? Would you reassess at 42 weeks? Would you accept some extra monitoring of the baby’s heartbeat? This would usually be in the form of attending a maternity unit a couple of times a week for a CTG monitoring, although it is important to know that this is not an evidence-based practice, nor has it been shown to improve outcomes.","7e2ff8046c76",[],{"_key":5642,"markDefs":5643,"children":5644,"_type":58,"style":78},"a2d8ac376434",[],[5645],{"_type":56,"marks":5646,"text":5647,"_key":5648},[],"Going through a decision methodically like this allows you to weigh up the pros and cons – and in this scenario to decide if the increased risk of stillbirth outweighs the risks associated with induction of labour. Only you can decide what level of risk is acceptable to you.","02c9fc7663a7",{"_type":190,"link":5650,"_key":5652},{"blank":192,"_type":67,"text":4079,"type":194,"internalLink":5651},{"_ref":196,"_type":197},"da595a978e2b",{"style":59,"_key":5654,"markDefs":5655,"children":5656,"_type":58},"b3898c160a43",[],[5657],{"_key":5658,"_type":56,"marks":5659,"text":5660},"904d98038fcd",[],"\nUsing BRAIN for a 'Smaller' Decision: Should I Have a Glucose Tolerance Test?",{"children":5662,"_type":58,"style":78,"_key":5667,"markDefs":5668},[5663],{"marks":5664,"text":5665,"_key":5666,"_type":56},[108],"Example decision to be made: having a glucose tolerance test because you have a risk factor for developing gestational diabetes eg a BMI >30","167d83e0ec55","2683cdef8f27",[],{"markDefs":5670,"children":5671,"_type":58,"style":78,"_key":5676},[],[5672],{"_type":56,"marks":5673,"text":5674,"_key":5675},[281],"This decision may feel big to some, in our experience most people accept the glucose tolerance test when at their first midwifery booking appointment if they’re told they have a risk factor. We do not feel that it is generally presented as a choice – something for women and birthing people to go away and have a think about. We also do not believe that in-depth discussions are happening about what it means to have the test and what the potential benefits AND risks are.","e0757a061a90","41c447ff2352",{"_key":5678,"markDefs":5679,"children":5683,"_type":58,"style":78},"44f3cfb799f4",[5680],{"_key":5681,"type":65,"url":5682,"_type":67,"href":5682},"d263f9b39d35","https://lilynicholsrdn.com/manage-gestational-diabetes-without-fear/",[5684,5687,5691,5695,5698,5702,5705],{"_type":56,"marks":5685,"text":5360,"_key":5686},[108],"5afa33db7689",{"marks":5688,"text":5689,"_key":5690,"_type":56},[]," – knowing if you have developed gestational diabetes or not may help you make changes to your diet and exercise habits that may be beneficial for your overall health and the health of your baby. ","c7f5c8715544",{"_key":5692,"_type":56,"marks":5693,"text":5694},"78a3595e27a5",[281],"If you have recently been diagnosed with gestational diabetes, check out",{"_type":56,"marks":5696,"text":4274,"_key":5697},[],"a9b3c3613f76",{"_key":5699,"_type":56,"marks":5700,"text":5701},"5271bf5499ef",[5681,281],"this blog",{"marks":5703,"text":4274,"_key":5704,"_type":56},[],"9ff495258a91",{"marks":5706,"text":5707,"_key":5708,"_type":56},[281],"from nutritionist Lily Nichols about managing your diagnosis without fear.","b292a187f7bc",{"_type":58,"style":78,"_key":5710,"markDefs":5711,"children":5715},"339f0cc32f46",[5712],{"_type":67,"href":5713,"_key":5714,"type":65,"url":5713},"https://midwifethinking.com/2018/03/20/gestational-diabetes-beyond-the-label/","9500713f71e1",[5716,5719,5723,5727,5730,5733],{"text":5372,"_key":5717,"_type":56,"marks":5718},"f8be089c2da2",[108],{"text":5720,"_key":5721,"_type":56,"marks":5722}," – if you have the test and are found to have gestational diabetes this impacts the care you are offered for the rest of your pregnancy. For example, you will be offered more regular growth scans and will be offered an induction of labour at 40+6 weeks at the latest as per the NICE guidelines (regardless of if your gestational diabetes has been ‘well controlled’ or not). ","34dd97e50dc1",[],{"_type":56,"marks":5724,"text":5725,"_key":5726},[281],"Rachel Reed offers a useful explainer of gestational diabetes and a critique of the screening process and label","58a33f190040",{"text":4274,"_key":5728,"_type":56,"marks":5729},"344e4d78dcb6",[],{"_type":56,"marks":5731,"text":249,"_key":5732},[5714,281],"a58e147fde87",{"text":1183,"_key":5734,"_type":56,"marks":5735},"fe6196bec98a",[281],{"children":5737,"_type":58,"style":78,"_key":5745,"markDefs":5746},[5738,5741],{"_key":5739,"_type":56,"marks":5740,"text":5383},"b7743871d14d",[108],{"_type":56,"marks":5742,"text":5743,"_key":5744},[]," – the alternative to having a glucose tolerance test could be to do home blood glucose monitoring to see how and if what you’re eating affects your blood sugars and then adjust your diet accordingly. It could be keeping an eye on any glucose in your urine at your midwife appointments when they offer to dip your urine and having your bump measured to assess the size of the baby (although this by no means can say how much your baby will weigh at birth, it may indicate if the baby is growing smaller or bigger than expected). It could also be doing nothing and simply declining the test. ","6406752c144f","a3ca66508111",[],{"style":78,"_key":5748,"markDefs":5749,"children":5750,"_type":58},"e356ff71e6b8",[],[5751,5755,5759,5762],{"_type":56,"marks":5752,"text":5753,"_key":5754},[108],"Intuition –","4e006678886d",{"_type":56,"marks":5756,"text":5757,"_key":5758},[]," what does your gut say about having a glucose tolerance test? Do you feel it would be beneficial and provide you with more knowledge? Will you feel stressed ","b85621a4366c",{"text":1624,"_key":5760,"_type":56,"marks":5761},"36e2c80a375b",[108],{"text":5763,"_key":5764,"_type":56,"marks":5765}," having one if it’s been recommended? Will you feel stressed if the results are positive for gestational diabetes? Or could this knowledge be empowering? ","9a9e2fb22d60",[],{"style":78,"_key":5767,"markDefs":5768,"children":5769,"_type":58},"2785e65e9c82",[],[5770,5773],{"text":5408,"_key":5771,"_type":56,"marks":5772},"957cfd7974e1",[108],{"marks":5774,"text":5775,"_key":5776,"_type":56},[]," – you may choose to decline the test completely. It is usually offered between 24 – 28+6 weeks of pregnancy, which is worth knowing if you do change your mind. It is also worth remembering that doing nothing at this point does not have to mean doing nothing for your entire pregnancy – you are allowed to change your mind! ","4de3798bde71",{"_type":190,"link":5778,"_key":5781},{"type":194,"internalLink":5779,"blank":192,"_type":67,"text":5780},{"_ref":3678,"_type":197},"Read dreamy birth stories","5d02302c8c85",{"_key":5783,"markDefs":5784,"children":5785,"_type":58,"style":59},"a030266a47a7",[],[5786],{"_type":56,"marks":5787,"text":5788,"_key":5789},[],"What Else Can You Use the BRAINS Tool For?","a3bc772397d3",{"children":5791,"_type":58,"style":78,"_key":5803,"markDefs":5804},[5792,5796,5799],{"_key":5793,"_type":56,"marks":5794,"text":5795},"a1ceec20fcda",[],"Hopefully these examples of using the BRAINS tool have been helpful and remember that this tool can be used for ",{"text":1709,"_key":5797,"_type":56,"marks":5798},"10b6026acef9",[281],{"_type":56,"marks":5800,"text":5801,"_key":5802},[]," decision you need to make during pregnancy, birth and the postnatal period. Making decisions that are right for you during your pregnancy can be empowering and contribute to a positive pregnancy, birth and postnatal experience. Your decisions may align entirely with what has been recommended by your healthcare provider or they may differ – either way, using BRAINS helps you figure out what is right for YOU.","acecb8c52c15","b4f03de6856c",[],{"markDefs":5806,"children":5807,"_type":58,"style":78,"_key":5812},[],[5808],{"_key":5809,"_type":56,"marks":5810,"text":5811},"845e89148440",[],"See some more examples below, some things you’ll know the answer to straight away and others you’ll need more time to think about:","5497de56ef81",{"style":78,"_key":5814,"markDefs":5815,"children":5816,"_type":58},"38b3ca8ee65f",[],[5817],{"_key":5818,"_type":56,"marks":5819,"text":5820},"b20f5e10ad2f",[108],"During pregnancy:",{"_type":58,"style":78,"_key":5822,"listItem":914,"markDefs":5823,"children":5824,"level":921},"022e4e9411bf",[],[5825],{"_type":56,"marks":5826,"text":5827,"_key":5828},[281],"Bump 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GBS","39a52ea319f8","1370b40db0c7",{"children":5866,"level":921,"_type":58,"style":78,"_key":5871,"listItem":914,"markDefs":5872},[5867],{"marks":5868,"text":5869,"_key":5870,"_type":56},[281],"Having your waters broken","3ded92bcb5a6","5b3a6e648c0d",[],{"level":921,"_type":58,"style":78,"_key":5874,"listItem":914,"markDefs":5875,"children":5876},"5ebaf7f20acc",[],[5877],{"_type":56,"marks":5878,"text":5879,"_key":5880},[281],"Having an epidural","ddc032ee661f",{"_key":5882,"markDefs":5883,"children":5884,"_type":58,"style":78},"7e14af6823bd",[],[5885],{"_key":5886,"_type":56,"marks":5887,"text":5888},"61d9f56adb1f",[108],"Postnatal",{"_type":58,"style":78,"_key":5890,"listItem":914,"markDefs":5891,"children":5892,"level":921},"cb9422d38148",[],[5893,5897,5900,5904,5907],{"_type":56,"marks":5894,"text":5895,"_key":5896},[281],"Having blood","4baebed75667",{"_type":56,"marks":5898,"text":4274,"_key":5899},[],"bc6591c30bc1",{"_type":56,"marks":5901,"text":5902,"_key":5903},[281],"thinning","7e14ec96fe8d",{"_key":5905,"_type":56,"marks":5906,"text":4274},"411e56a40951",[],{"text":5908,"_key":5909,"_type":56,"marks":5910},"injections","0769a4a9808c",[281],{"markDefs":5912,"children":5913,"level":921,"_type":58,"style":78,"_key":5918,"listItem":914},[],[5914],{"_key":5915,"_type":56,"marks":5916,"text":5917},"069e8ff3d553",[281],"Vitamin K for your baby","9718d1102a14",{"_key":5920,"listItem":914,"markDefs":5921,"children":5922,"level":921,"_type":58,"style":78},"c2cf012a0958",[],[5923],{"marks":5924,"text":5925,"_key":5926,"_type":56},[281],"How you birth your placenta","19b06fbf42be",{"_type":190,"link":5928,"_key":5930},{"text":13,"type":194,"internalLink":5929,"blank":192,"_type":67},{"_ref":549,"_type":197},"e85740566177",{"base":5932},{"rev":5933,"id":1555},"lFrvlEMldmWjsfq3cbSE5U","7l2KCMg711eQ9a3UN6K1sG","2026-03-11T13:30:25Z","The BRAIN Decision Making Tool: How to Make Informed Choices in Pregnancy & Birth",{"_type":8,"current":5938},"the-brain-decision-making-tool-how-to-make-informed-choices-in-pregnancy-and-birth","2024-07-15",{"_updatedAt":5941,"content":5942,"_createdAt":6867,"_rev":6868,"title":6869,"publishedAt":6870,"image":6871,"_type":37,"_id":6874,"slug":6875,"_system":6877},"2026-03-11T13:38:28Z",{"_type":49,"body":5943},[5944,5952,5960,5968,5976,6020,6028,6036,6044,6052,6060,6068,6076,6084,6088,6096,6112,6124,6136,6144,6151,6159,6171,6179,6187,6195,6203,6210,6218,6226,6234,6242,6250,6258,6266,6278,6290,6297,6305,6316,6334,6341,6349,6357,6368,6376,6387,6401,6405,6413,6421,6428,6436,6443,6451,6459,6467,6475,6483,6491,6499,6507,6523,6539,6547,6555,6562,6570,6578,6585,6593,6605,6613,6621,6629,6637,6645,6659,6664,6672,6687,6695,6703,6734,6742,6780,6840,6852],{"markDefs":5945,"children":5946,"_type":58,"style":59,"_key":5951},[],[5947],{"_type":56,"marks":5948,"text":5949,"_key":5950},[],"What Is Induction of Labour (IOL)?","ba982c6c9b4b","b68e6d10b94b",{"_key":5953,"markDefs":5954,"children":5955,"_type":58,"style":78},"976d1fe2d3af",[],[5956],{"_type":56,"marks":5957,"text":5958,"_key":5959},[],"IOL is when your labour is started artificially because it is considered safer for you and your baby for them to be born. The evidence however doesn't always support that IOL is improving outcomes - but that's another post. This post we'll be discussing the methods of IOL. There are several different methods of induction of labour (IOL), but they are broadly separated into two categories: mechanical methods and medicinal methods. Mechanical methods involve using hands or devices to physically stretch and open the cervix and medicinal methods rely on synthetic hormones to achieve the same goal. This blog will discuss the most common forms of IOL, including those used at our local East Kent NHS trust. Settle in, it’s a long one!","72b185fbb303",{"style":59,"_key":5961,"markDefs":5962,"children":5963,"_type":58},"0b83d31e0eef",[],[5964],{"marks":5965,"text":5966,"_key":5967,"_type":56},[],"What Is a Membrane Sweep and How Does It Work?","cb2fbb4734e9",{"style":78,"_key":5969,"markDefs":5970,"children":5971,"_type":58},"d96969fb281d",[],[5972],{"marks":5973,"text":5974,"_key":5975,"_type":56},[],"A membrane sweep involves a midwife or doctor inserting two gloved & lubricated fingers into the vagina to try and reach the cervix to both manually stretch it with their fingers and to try and separate the bag of waters surrounding the baby from the lower part of the uterus – the aim of this is to stimulate the release of the body’s natural prostaglandins to help start labour.","00cd336a19fd",{"_key":5977,"markDefs":5978,"children":5985,"_type":58,"style":78},"9b68ad18aa4b",[5979,5982],{"href":5980,"_key":5981,"type":65,"url":5980,"_type":67},"https://www.nice.org.uk/guidance/ng207/chapter/Recommendations#methods-for-induction-of-labour","234ae0fe76fd",{"_key":5983,"type":65,"url":5984,"_type":67,"href":5984},"58060b975eb5","https://www.cochrane.org/CD000451/PREG_membrane-sweeping-induction-labour",[5986,5990,5993,5997,6000,6004,6008,6012,6016],{"marks":5987,"text":5988,"_key":5989,"_type":56},[],"They are considered a form of IOL by the ","e317e567e40a",{"_type":56,"marks":5991,"text":4070,"_key":5992},[5981],"856ed63dfbb6",{"marks":5994,"text":5995,"_key":5996,"_type":56},[],", which advise that women be offered membrane sweeps from 39 weeks of pregnancy. ","774ed7dbe4c7",{"_type":56,"marks":5998,"text":891,"_key":5999},[5983],"998771df1c07",{"marks":6001,"text":6002,"_key":6003,"_type":56},[]," suggests that sweeps may increase the likelihood of ‘spontaneous’ labour – an oxymoron given that a sweep is considered a form of induction – but what they mean is avoiding further methods of induction, which could be seen as a benefit. It could be argued that a ‘successful’ membrane sweep (i.e. one that starts labour off) could just be down to the baby and the woman or birthing person’s body being ready for labour to begin anyway. If a membrane sweep is ‘unsuccessful’, further sweeps may be offered. It is also worth noting that anecdotally, membrane sweeps are not often presented as a form of induction, but as a means to ","37dbfa871a23",{"marks":6005,"text":6006,"_key":6007,"_type":56},[281],"avoid the hospital-based methods","b3b16acc5a9e",{"text":6009,"_key":6010,"_type":56,"marks":6011},". It is ","7e1307c959a2",[],{"_key":6013,"_type":56,"marks":6014,"text":6015},"c62240a2110b",[108],"always",{"text":6017,"_key":6018,"_type":56,"marks":6019}," your choice to have a membrane sweep or not – even if it is presented as something that is routine and hospital policy. ","15ed22f2d974",[],{"children":6021,"_type":58,"style":78,"_key":6026,"markDefs":6027},[6022],{"_type":56,"marks":6023,"text":6024,"_key":6025},[108],"Potential benefits:","4b0b2db1e385","ca5a5c40221a",[],{"_key":6029,"listItem":914,"markDefs":6030,"children":6031,"level":921,"_type":58,"style":78},"860e02065ef9",[],[6032],{"text":6033,"_key":6034,"_type":56,"marks":6035},"may start labour off, avoiding the need for further methods of induction","936b53bf8977",[],{"_key":6037,"listItem":914,"markDefs":6038,"children":6039,"level":921,"_type":58,"style":78},"0a006672cee9",[],[6040],{"text":6041,"_key":6042,"_type":56,"marks":6043},"this may mean there is more choice of place of birth – there is no recommendation for continuous fetal monitoring, or closer observation, in an otherwise uncomplicated pregnancy & labour where a membrane sweep has been done","0c24956a8607",[],{"markDefs":6045,"children":6046,"_type":58,"style":78,"_key":6051},[],[6047],{"text":6048,"_key":6049,"_type":56,"marks":6050},"Potential risks / considerations:","0aa6f93b3f9b",[108],"e486f1489f3b",{"markDefs":6053,"children":6054,"level":921,"_type":58,"style":78,"_key":6059,"listItem":914},[],[6055],{"_key":6056,"_type":56,"marks":6057,"text":6058},"f0b3b0a19e65",[],"waters may be accidentally broken (you will then need to make further decisions about how you wish to proceed)","cebdb42e5762",{"markDefs":6061,"children":6062,"level":921,"_type":58,"style":78,"_key":6067,"listItem":914},[],[6063],{"marks":6064,"text":6065,"_key":6066,"_type":56},[],"may experience bleeding, pain or discomfort during and after the procedure","80c6c6435aed","a27b686d4151",{"level":921,"_type":58,"style":78,"_key":6069,"listItem":914,"markDefs":6070,"children":6071},"24574841e526",[],[6072],{"_type":56,"marks":6073,"text":6074,"_key":6075},[],"may cause irregular contractions that aren’t doing much to the cervix, but that can prevent resting in the last few days / weeks of pregnancy","995436d75509",{"style":78,"_key":6077,"listItem":914,"markDefs":6078,"children":6079,"level":921,"_type":58},"b3cb27fc9427",[],[6080],{"_type":56,"marks":6081,"text":6082,"_key":6083},[],"requires a vaginal examination","0d11d19019ec",{"_type":190,"link":6085,"_key":6087},{"text":4148,"type":194,"internalLink":6086,"blank":192,"_type":67},{"_ref":2580,"_type":197},"2073ac50e835",{"_key":6089,"markDefs":6090,"children":6091,"_type":58,"style":59},"acb4d8317bdc",[],[6092],{"_type":56,"marks":6093,"text":6094,"_key":6095},[],"Mechanical Methods of Induction: Balloon Catheters and Dilapan Rods","ec42a17ea830",{"markDefs":6097,"children":6098,"_type":58,"style":78,"_key":6111},[],[6099,6103,6107],{"_type":56,"marks":6100,"text":6101,"_key":6102},[],"Next we will look at two devices that are used for IOL: Dilapan rods & balloon catheters. These aim to open the cervix enough for the waters to be broken. These methods are recommended in certain situations, eg when babies are suspected to be small or if you have had a previous caesarean section. This is because the mechanical methods of induction involve no synthetic hormones, and therefore there is minimal risk of them causing your uterus to hyperstimulate. ","2cc4fe19f179",{"_type":56,"marks":6104,"text":6105,"_key":6106},[108],"Hyperstimulation","e1671210c81c",{"marks":6108,"text":6109,"_key":6110,"_type":56},[]," of the uterus is when there are more than 5 contractions in a 10 minute period for a sustained period of time, this can affect the amount of oxygen the baby gets and cause fetal distress (typically identified by changes to the baby’s heart rate observed on a CTG machine). In the case of hyperstimulation, an injection called terbutaline is given to relax the uterus. More than one dose of terbutaline can be given and if it is effective, the uterus will relax and the baby’s heart rate will improve accordingly. If the terbutaline injection does not appear to be working, an emergency caesarean section will be recommended.","3bfa74f88b1d","02ca7d1f9a07",{"markDefs":6113,"children":6114,"_type":58,"style":78,"_key":6123},[],[6115,6119],{"marks":6116,"text":6117,"_key":6118,"_type":56},[108],"Balloon catheters","461cc6895120",{"_key":6120,"_type":56,"marks":6121,"text":6122},"a726e34c942d",[]," involve a tube being inserted into the cervix and a balloon is then inflated with sterile water to put pressure on the cervix to dilate (single balloon catheter). Another form is where a second balloon is inflated at the lower end of the cervix too (double balloon catheter).","eeb004664ee5",{"_type":58,"style":78,"_key":6125,"markDefs":6126,"children":6127},"b07135b2c9c2",[],[6128,6132],{"_key":6129,"_type":56,"marks":6130,"text":6131},"03ad090bd407",[108],"Dilapan",{"_type":56,"marks":6133,"text":6134,"_key":6135},[]," are small rods that are inserted into the cervix, which absorb cervical fluid causing them to swell and stretch the cervix.","4155770fae77",{"_type":58,"style":78,"_key":6137,"markDefs":6138,"children":6139},"2a2bca100306",[],[6140],{"_key":6141,"_type":56,"marks":6142,"text":6143},"c067ec30a3f7",[],"Both Dilapan and balloon catheters require lying on a bed, with legs in stirrups (lithotomy position), having a speculum inserted into the vagina and then a doctor or a midwife using instruments to place the devices correctly into the cervix. Some women and birthing people find this procedure very uncomfortable or painful and pain relief (such as gas and air) should be offered for the procedure. The length of time the devices stay in the cervix seems to differ across NHS trusts but may be anything from 12 – 24 hours. After this point, a vaginal examination will be recommended to remove them and assess how open the cervix is and if it is possible to break the waters. Mechanical methods of IOL can be requested over medicinal methods.",{"_key":6145,"markDefs":6146,"children":6147,"_type":58,"style":78},"7033d9dc0c01",[],[6148],{"_key":6149,"_type":56,"marks":6150,"text":6024},"fb1fde31a97d",[108],{"style":78,"_key":6152,"listItem":914,"markDefs":6153,"children":6154,"level":921,"_type":58},"86e434f89e48",[],[6155],{"_key":6156,"_type":56,"marks":6157,"text":6158},"a0bc0a60fbc9",[],"very low risk of causing uterine hyperstimulation due to there being no synthetic hormones in use",{"_key":6160,"listItem":914,"markDefs":6161,"children":6162,"level":921,"_type":58,"style":78},"3d27212941f7",[],[6163,6167],{"_type":56,"marks":6164,"text":6165,"_key":6166},[281],"some","1f2551d38163",{"marks":6168,"text":6169,"_key":6170,"_type":56},[]," NHS trusts may support outpatient use of mechanical methods of IOL – where you go home and return to hospital when the devices are ready to be removed","7790798d07fa",{"children":6172,"level":921,"_type":58,"style":78,"_key":6177,"listItem":914,"markDefs":6178},[6173],{"_type":56,"marks":6174,"text":6175,"_key":6176},[],"considered to be a safer form of cervical ripening (softening & opening the cervix) for those who have had a previous caesarean","8144cf240a11","e5b9c5fda61e",[],{"style":78,"_key":6180,"listItem":914,"markDefs":6181,"children":6182,"level":921,"_type":58},"8cb82d766be2",[],[6183],{"marks":6184,"text":6185,"_key":6186,"_type":56},[],"can be easily removed if wanted","519c20b4e8fb",{"children":6188,"_type":58,"style":78,"_key":6193,"markDefs":6194},[6189],{"_key":6190,"_type":56,"marks":6191,"text":6192},"da37246eed37",[108],"Potential risks / downsides:","9041c653a853",[],{"style":78,"_key":6196,"listItem":914,"markDefs":6197,"children":6198,"level":921,"_type":58},"d27d81a40a56",[],[6199],{"_type":56,"marks":6200,"text":6201,"_key":6202},[],"pain, bleeding & discomfort during the procedure","eb0fab9ce0df",{"listItem":914,"markDefs":6204,"children":6205,"level":921,"_type":58,"style":78,"_key":6209},[],[6206],{"_type":56,"marks":6207,"text":6082,"_key":6208},[],"25bc3d79a589","13b5e56193a7",{"markDefs":6211,"children":6212,"level":921,"_type":58,"style":78,"_key":6217,"listItem":914},[],[6213],{"_key":6214,"_type":56,"marks":6215,"text":6216},"a1bbb7e56b9b",[],"some monitoring will be required in hospital before and after the procedure","b25ddf80e01b",{"style":78,"_key":6219,"listItem":914,"markDefs":6220,"children":6221,"level":921,"_type":58},"8214001d056e",[],[6222],{"_key":6223,"_type":56,"marks":6224,"text":6225},"be8ee8e7eac2",[],"accidentally breaking the waters",{"listItem":914,"markDefs":6227,"children":6228,"level":921,"_type":58,"style":78,"_key":6233},[],[6229],{"text":6230,"_key":6231,"_type":56,"marks":6232},"devices not being places correctly (therefore not doing their job!)","e040b0ba4016",[],"74348c6697e4",{"level":921,"_type":58,"style":78,"_key":6235,"listItem":914,"markDefs":6236,"children":6237},"6b786d411eb1",[],[6238],{"_key":6239,"_type":56,"marks":6240,"text":6241},"3f28b592342a",[],"can only be inserted if the cervix is already slightly open, otherwise medicinal methods will be recommended",{"level":921,"_type":58,"style":78,"_key":6243,"listItem":914,"markDefs":6244,"children":6245},"65376bed9b09",[],[6246],{"marks":6247,"text":6248,"_key":6249,"_type":56},[],"often further methods of induction are required to stimulate contractions","fd07457a95f3",{"markDefs":6251,"children":6252,"_type":58,"style":59,"_key":6257},[],[6253],{"_type":56,"marks":6254,"text":6255,"_key":6256},[],"Medicinal Methods of Induction: Propess and Prostin","a6c36b1f5e41","87f328f893d6",{"style":78,"_key":6259,"markDefs":6260,"children":6261,"_type":58},"fd1d228d4659",[],[6262],{"_key":6263,"_type":56,"marks":6264,"text":6265},"86f07ce099b9",[],"Medicinal methods of IOL contain synthetic versions of the body’s natural hormones to ‘ripen’ the cervix (Process and Prostin) or stimulate contractions (syntocinon – the hormone drip).",{"_type":58,"style":78,"_key":6267,"markDefs":6268,"children":6269},"7e3a71b19505",[],[6270,6274],{"_type":56,"marks":6271,"text":6272,"_key":6273},[108],"Propess","9e214421aae9",{"text":6275,"_key":6276,"_type":56,"marks":6277}," looks like a small, flat tampon and contains synthetic prostaglandins. It is inserted into the vagina and pushed up to sit behind the cervix, where it will swell slightly and release synthetic prostaglandins over a 24-hour period. An advantage of Propess is that it can be removed if necessary (ie. you have too many contractions) and this is why it is generally offered before Prostin. Some NHS Trusts offer two 24-hour cycles of Propess, locally in East Kent one cycle is offered. ","c859136f8024",[],{"style":78,"_key":6279,"markDefs":6280,"children":6281,"_type":58},"22e414182f63",[],[6282,6286],{"_type":56,"marks":6283,"text":6284,"_key":6285},[108],"Prostin","658fea801e19",{"_key":6287,"_type":56,"marks":6288,"text":6289},"86dc7c93612e",[]," – this comes in gel or tablet form and contains synthetic prostaglandins. It is inserted into the vagina with a plastic introducer and generally left for 6 hours. Sometimes more than one dose is needed.",{"_type":58,"style":78,"_key":6291,"markDefs":6292,"children":6293},"fb14549f0173",[],[6294],{"marks":6295,"text":6024,"_key":6296,"_type":56},[108],"8964f53cd86f",{"style":78,"_key":6298,"listItem":914,"markDefs":6299,"children":6300,"level":921,"_type":58},"de4212c31276",[],[6301],{"_key":6302,"_type":56,"marks":6303,"text":6304},"07d80bdfda7a",[],"may stimulate labour enough that no further methods of IOL are needed",{"style":78,"_key":6306,"listItem":914,"markDefs":6307,"children":6308,"level":921,"_type":58},"5677761f7079",[],[6309,6312],{"_type":56,"marks":6310,"text":6272,"_key":6311},[108],"3f4682412410",{"_type":56,"marks":6313,"text":6314,"_key":6315},[]," can be removed if needed and generally involves less frequent vaginal examinations","a06137a65b93",{"_key":6317,"listItem":914,"markDefs":6318,"children":6319,"level":921,"_type":58,"style":78},"92481c993f8f",[],[6320,6323,6327,6330],{"_type":56,"marks":6321,"text":6165,"_key":6322},[281],"cdc09341b363",{"text":6324,"_key":6325,"_type":56,"marks":6326}," NHS trusts offer outpatient IOL with ","e2e2fc996259",[],{"_type":56,"marks":6328,"text":6272,"_key":6329},[108],"8576be5d4e5b",{"_key":6331,"_type":56,"marks":6332,"text":6333},"80ec220291ef",[],", and only for IOLs that are considered ‘low risk’ such as those for ‘post-dates’",{"_key":6335,"markDefs":6336,"children":6337,"_type":58,"style":78},"a862429c8bce",[],[6338],{"_type":56,"marks":6339,"text":6192,"_key":6340},[108],"9a822c9919ff",{"listItem":914,"markDefs":6342,"children":6343,"level":921,"_type":58,"style":78,"_key":6348},[],[6344],{"_type":56,"marks":6345,"text":6346,"_key":6347},[],"may cause hyperstimulation","7ed9e8241a3d","be0c53c9da88",{"_key":6350,"listItem":914,"markDefs":6351,"children":6352,"level":921,"_type":58,"style":78},"2b9b71753341",[],[6353],{"_key":6354,"_type":56,"marks":6355,"text":6356},"0e0245419921",[],"regular monitoring in hospital of baby before, during and after the procedure is recommended (the length and frequency varies across NHS trusts)",{"listItem":914,"markDefs":6358,"children":6359,"level":921,"_type":58,"style":78,"_key":6367},[],[6360,6363],{"marks":6361,"text":6284,"_key":6362,"_type":56},[108],"3e556bedd373",{"_key":6364,"_type":56,"marks":6365,"text":6366},"d6a3e3b1be8b",[]," cannot be removed once it has been inserted","6181cc87a268",{"markDefs":6369,"children":6370,"level":921,"_type":58,"style":78,"_key":6375,"listItem":914},[],[6371],{"_key":6372,"_type":56,"marks":6373,"text":6374},"94e1995b238e",[],"both can cause vaginal discomfort and dryness","15e1eb59f995",{"listItem":914,"markDefs":6377,"children":6378,"level":921,"_type":58,"style":78,"_key":6386},[],[6379,6382],{"text":6284,"_key":6380,"_type":56,"marks":6381},"89ad36aaed23",[108],{"marks":6383,"text":6384,"_key":6385,"_type":56},[]," involves more frequent vaginal examinations","13a5a32facd9","e5721ecae585",{"children":6388,"level":921,"_type":58,"style":78,"_key":6397,"listItem":914,"markDefs":6398},[6389,6393],{"marks":6390,"text":6391,"_key":6392,"_type":56},[],"nausea, vomiting & diarrhoea are common side effects of prostaglandins – the full list of potential side effects can be found ","7dfc45775c16",{"_type":56,"marks":6394,"text":249,"_key":6396},[6395],"356ab5deea23","b3f14e25b464","8d5e42d8ea40",[6399],{"type":65,"url":6400,"_type":67,"href":6400,"_key":6395},"https://bnf.nice.org.uk/drugs/dinoprostone/#indications-and-dose",{"_key":6402,"_type":190,"link":6403},"28032bcd7730",{"blank":192,"_type":67,"text":4079,"type":194,"internalLink":6404},{"_type":197,"_ref":196},{"_type":58,"style":59,"_key":6406,"markDefs":6407,"children":6408},"d9409267999e",[],[6409],{"text":6410,"_key":6411,"_type":56,"marks":6412},"\nArtificially Breaking Your Waters: What You Need to Know","8921f9deff7e",[],{"children":6414,"_type":58,"style":78,"_key":6419,"markDefs":6420},[6415],{"_type":56,"marks":6416,"text":6417,"_key":6418},[],"Artificially breaking the waters (another mechanical method of IOL) is not usually the first method of inducing labour, unless your cervix is open enough upon arrival at the hospital. Breaking the waters is the step following Dilapan / balloon catheters and / or Propess / Prostin – that’s if your waters haven’t broken spontaneously. The aim of breaking the waters is to stimulate contractions. The midwife or doctor will do a vaginal examination and use a long plastic hook that has a small, sharpened tip (they look a little like long flattened crochet hooks) to puncture the membrane sac around the baby and release the waters. Generally, 2-4 hours after the waters have been broken a vaginal examination would be offered to assess the cervix – the timing of this may depend on the hospital’s local policy, if you’ve had a baby before, if you’re having any contractions, the activity of the ward and what your preferences are…","3506d39577dc","eabf5f311f7b",[],{"_type":58,"style":78,"_key":6422,"markDefs":6423,"children":6424},"ca07396d45ee",[],[6425],{"marks":6426,"text":6024,"_key":6427,"_type":56},[108],"7e09acbddd0a",{"_type":58,"style":78,"_key":6429,"listItem":914,"markDefs":6430,"children":6431,"level":921},"1dc2e0ad3f93",[],[6432],{"text":6433,"_key":6434,"_type":56,"marks":6435},"may be enough to start contractions / labour without needing further intervention","69e7a26b7c53",[],{"_type":58,"style":78,"_key":6437,"markDefs":6438,"children":6439},"4a6bd0e8d75d",[],[6440],{"_key":6441,"_type":56,"marks":6442,"text":6192},"3786eb5775b2",[108],{"markDefs":6444,"children":6445,"level":921,"_type":58,"style":78,"_key":6450,"listItem":914},[],[6446],{"_type":56,"marks":6447,"text":6448,"_key":6449},[],"the protective sac of waters around baby is no longer intact, potentially increasing the risk of infection (especially if there are also frequent vaginal examinations)","14590c5d03b8","c6b5b66c7f36",{"children":6452,"level":921,"_type":58,"style":78,"_key":6457,"listItem":914,"markDefs":6458},[6453],{"marks":6454,"text":6455,"_key":6456,"_type":56},[],"procedure can be difficult, uncomfortable and painful","97a0b49fcd05","2ba7e75023ca",[],{"listItem":914,"markDefs":6460,"children":6461,"level":921,"_type":58,"style":78,"_key":6466},[],[6462],{"_type":56,"marks":6463,"text":6464,"_key":6465},[],"may cause sudden intense onset of contractions","1875aba22e21","a732eac99e00",{"listItem":914,"markDefs":6468,"children":6469,"level":921,"_type":58,"style":78,"_key":6474},[],[6470],{"_type":56,"marks":6471,"text":6472,"_key":6473},[],"may cause some bleeding","bc10f803ba7d","1d6364527eb5",{"_key":6476,"listItem":914,"markDefs":6477,"children":6478,"level":921,"_type":58,"style":78},"3c69a98f9921",[],[6479],{"_key":6480,"_type":56,"marks":6481,"text":6482},"4657f9a3b819",[],"cord prolapse (very rare!) – this is where a loop of the baby’s cord slips down into the and sometimes out of the vagina and is an obstetric emergency, which usually requires an immediate caesarean unless a vaginal birth is imminent",{"level":921,"_type":58,"style":78,"_key":6484,"listItem":914,"markDefs":6485,"children":6486},"7e2202feca5c",[],[6487],{"marks":6488,"text":6489,"_key":6490,"_type":56},[],"choice of place of birth likely to be limited","961ea3669b26",{"style":59,"_key":6492,"markDefs":6493,"children":6494,"_type":58},"d18130758b99",[],[6495],{"marks":6496,"text":6497,"_key":6498,"_type":56},[],"\nA Note on Vaginal Examinations During Induction","66273b344ade",{"_key":6500,"markDefs":6501,"children":6502,"_type":58,"style":78},"2570b530dc6e",[],[6503],{"marks":6504,"text":6505,"_key":6506,"_type":56},[],"Membrane sweeps, Dilapan, balloon catheters, Propess, Prostin and breaking the waters all require vaginal examinations. For a vaginal examination, you will need to be lying pretty flat on your back on the hospital bed, underwear removed, knees drawn up to your chest, feet together and knees apart to open your legs. Generally, a pre-labour cervix is ‘posterior’ which means pointed towards your back and this can make it difficult for the midwife or doctor to locate it during a vaginal examination, which in turn can make the procedure more uncomfortable or painful for you. It can be helpful to place a rolled-up towel underneath your bottom to tilt your pelvis forward, which will bring your cervix forward. Using gas and air can also help during the procedure. If at any stage a vaginal examination feels too uncomfortable and you want a break or for it to stop completely, you can absolutely say so. ","7c10703c5488",{"_key":6508,"markDefs":6509,"children":6510,"_type":58,"style":78},"fab80d3a686a",[],[6511,6515,6519],{"_key":6512,"_type":56,"marks":6513,"text":6514},"c6cdb102d3d6",[],"A vaginal examination should only be done if you have given your ",{"text":6516,"_key":6517,"_type":56,"marks":6518},"informed consent ","fd95745863dd",[108],{"marks":6520,"text":6521,"_key":6522,"_type":56},[],"and in a way that maintains your privacy and dignity. Maintaining your privacy and dignity involves offering a chaperone, checking that you’re happy with who is the room when you have the vaginal examination (you may not want that medical student or your mother-in-law present!), ensuring that you are not exposed (i.e. by using a sheet to cover you) and ensuring that either curtains are pulled or that there’s no chance of a member of staff or a random visitor walking in mid-procedure. No-one wants to be offered a sandwich and an apple juice mid vaginal examination, trust us on that.","e39b54885dce",{"children":6524,"_type":58,"style":78,"_key":6533,"markDefs":6534},[6525,6529],{"text":6526,"_key":6527,"_type":56,"marks":6528},"The purpose of these vaginal examinations, in addition to inserting the devices, medications or breaking the waters, is to assess the cervix. We wrote about vaginal examinations in an earlier blog – check it out ","0879c02f3992",[],{"_type":56,"marks":6530,"text":803,"_key":6532},[6531],"b16fccdb0a15","517530def80b","f4a88d3b3361",[6535],{"type":194,"internalLink":6536,"_type":67,"href":6538,"_key":6531},{"_ref":6537,"_type":197},"389cfb92-a2bf-4b27-92fe-a3d516e73418","https://junomidwives.co.uk/vaginal-examinations/",{"markDefs":6540,"children":6541,"_type":58,"style":59,"_key":6546},[],[6542],{"text":6543,"_key":6544,"_type":56,"marks":6545},"The Hormone Drip (Syntocinon): The Final Step of Induction","9b015137e8bc",[],"c67555842d41",{"style":78,"_key":6548,"markDefs":6549,"children":6550,"_type":58},"47079bd53b61",[],[6551],{"marks":6552,"text":6553,"_key":6554,"_type":56},[],"Syntocinon is the last method of induction on the ladder of IOL methods – although some of the other rungs may have been skipped depending on individual circumstances. It is the synthetic version of the hormone oxytocin, and it acts on the uterus in the same way to cause contractions. It does not cross the blood-brain barrier as natural oxytocin does, therefore you do not get any of the other benefits such as the corresponding release of your body’s natural painkillers, beta-endorphins. Syntocinon is delivered via an IV line via a cannula and is only given after your waters have broken (whether that is on their own or artificially). The dose is increased incrementally, usually until there are 4 contractions in a 10 minute period.","71a0e193acdb",{"markDefs":6556,"children":6557,"_type":58,"style":78,"_key":6561},[],[6558],{"marks":6559,"text":6024,"_key":6560,"_type":56},[108],"e7e3fdab1b1d","813ddcc6e72e",{"level":921,"_type":58,"style":78,"_key":6563,"listItem":914,"markDefs":6564,"children":6565},"fed47ad02a19",[],[6566],{"_key":6567,"_type":56,"marks":6568,"text":6569},"935014271c24",[],"may stimulate contractions and help labour to progress, avoiding a caesarean birth",{"_key":6571,"listItem":914,"markDefs":6572,"children":6573,"level":921,"_type":58,"style":78},"8ebf96f9519b",[],[6574],{"_type":56,"marks":6575,"text":6576,"_key":6577},[],"can be stopped, paused or turned down if needed","79747b3d3a54",{"_key":6579,"markDefs":6580,"children":6581,"_type":58,"style":78},"c0941da86ecc",[],[6582],{"marks":6583,"text":6192,"_key":6584,"_type":56},[108],"ac4a6d87de86",{"level":921,"_type":58,"style":78,"_key":6586,"listItem":914,"markDefs":6587,"children":6588},"54150a0432be",[],[6589],{"_key":6590,"_type":56,"marks":6591,"text":6592},"d0a403e6c458",[],"can cause hyperstimulation",{"style":78,"_key":6594,"listItem":914,"markDefs":6595,"children":6596,"level":921,"_type":58},"81e06f270794",[],[6597,6601],{"_type":56,"marks":6598,"text":6599,"_key":6600},[108],"very rarely,","51091055da53",{"_type":56,"marks":6602,"text":6603,"_key":6604},[]," hyperstimulation may cause a uterine rupture (which is where a hole develops in the lining of the womb) or placental abruption (where the placenta comes away from the wall of the uterus before the baby is born), both of which are an obstetric emergencies that require an immediate caesarean section","384d8b7aeaa2",{"_key":6606,"listItem":914,"markDefs":6607,"children":6608,"level":921,"_type":58,"style":78},"45a5663dc40f",[],[6609],{"_type":56,"marks":6610,"text":6611,"_key":6612},[],"continuous monitoring (a CTG) of the baby’s heart rate is required because of the risk of hyperstimulation","f1cbd087265a",{"children":6614,"level":921,"_type":58,"style":78,"_key":6619,"listItem":914,"markDefs":6620},[6615],{"text":6616,"_key":6617,"_type":56,"marks":6618},"place of birth limited to a labour ward (because of the required increased monitoring)","17a860223851",[],"32e7865ffce9",[],{"_key":6622,"listItem":914,"markDefs":6623,"children":6624,"level":921,"_type":58,"style":78},"db90846d3ff3",[],[6625],{"_type":56,"marks":6626,"text":6627,"_key":6628},[],"can make contractions feel more intense and painful (compared to spontaneous labour), requiring an epidural","31346053206e",{"listItem":914,"markDefs":6630,"children":6631,"level":921,"_type":58,"style":78,"_key":6636},[],[6632],{"text":6633,"_key":6634,"_type":56,"marks":6635},"an IV line is needed to administer the medication","f71f2e8b18f8",[],"809aa07dbce6",{"_type":58,"style":78,"_key":6638,"listItem":914,"markDefs":6639,"children":6640,"level":921},"10e2b8ae2db1",[],[6641],{"_type":56,"marks":6642,"text":6643,"_key":6644},[],"increased chance of having a postpartum haemorrhage","7e8290553565",{"markDefs":6646,"children":6650,"level":921,"_type":58,"style":78,"_key":6658,"listItem":914},[6647],{"href":6648,"_key":6649,"type":65,"url":6648,"_type":67},"https://bnf.nice.org.uk/drugs/oxytocin/#directions-for-administration","bf09cfdbf251",[6651,6655],{"marks":6652,"text":6653,"_key":6654,"_type":56},[],"other common and rare side effects can be found ","bedcadcfe0e9",{"_type":56,"marks":6656,"text":249,"_key":6657},[6649],"2415da27f23c","5a9855310929",{"description":4877,"_key":6660,"asset":6661,"_type":6663},"533e8d95ef77",{"_ref":6662,"_type":197},"file-8d8cc485f3dba8cc14acaef52d2511cae68a5c5f-pdf","pdf",{"_type":58,"style":59,"_key":6665,"markDefs":6666,"children":6667},"abb04fa0b31c",[],[6668],{"_key":6669,"_type":56,"marks":6670,"text":6671},"93bb8407b387",[],"Induction of Labour Is a Package Deal, Not a Single Decision",{"markDefs":6673,"children":6677,"_type":58,"style":78,"_key":6686},[6674],{"_key":6675,"type":65,"url":6676,"_type":67,"href":6676},"42300ddc0a17","https://www.sarawickham.com/",[6678,6682],{"_type":56,"marks":6679,"text":6680,"_key":6681},[6675],"Sara Wickham","9b7edd8f61c4",{"text":6683,"_key":6684,"_type":56,"marks":6685}," writes about IOL as a ‘package deal’ in her books. Some women and birthing people who choose induction labour may go through several of the possible methods of induction e.g. a membrane sweep, then dilapan, then propess, then artificially breaking the waters and finally syntocinon. Some people will skip several steps, e.g. if the waters have broken before labour and you have agreed to an IOL, the syntocinon drip may be the next recommended step. It can be a lengthy process (we’re talking multiple days) to get your body into labour if it wasn’t quite ready for it. Choosing induction of labour also means choosing increased monitoring of the woman or birthing person and the baby in the form of regular or continuous CTG monitoring, regular vaginal examinations to check the dilation of the cervix and therefore the progress of the induction, and choosing an actively managed placental birth (with an injection) – because the process of induction is very different to the process of spontaneous labour and the hormonal interplay is disrupted, affecting the body’s natural physiology.","633a2853c61c",[],"2e9223f97fab",{"children":6688,"_type":58,"style":78,"_key":6693,"markDefs":6694},[6689],{"_type":56,"marks":6690,"text":6691,"_key":6692},[],"It is really important to know that choosing to have an IOL is not just a simple case of agreeing to whatever method is advised to start labour of. There will be several other decisions to make along the way. IOL is not like spontaneous labour, so lots of the interventions offered are to mitigate the risks of the IOL. For example, having an actively managed 3rd stage with the injection makes sense if you’ve had an IOL because there is an increased chance of bleeding after the birth. Having regular vaginal examinations (for which there is no evidence to support an improvement of outcomes for in labour) make more sense when considering an IOL because if someone has an epidural and syntocinon, they will not behave in the same way as someone experiencing a spontaneous labour – so external signs of labour progress cannot be used. CTG monitoring, whilst not shown to improve outcomes in uncomplicated labours, makes sense for a labour that is being induced with a syntocinon drip, because of the risk of hyperstimulation.","c1c8446f7021","5ab8890946d2",[],{"children":6696,"_type":58,"style":59,"_key":6701,"markDefs":6702},[6697],{"_type":56,"marks":6698,"text":6699,"_key":6700},[],"\nHow Common Is Induction of Labour and Should You Be Concerned?","63a898f98a91","a1a306937b85",[],{"_type":58,"style":78,"_key":6704,"markDefs":6705,"children":6714},"3c588b1491c6",[6706,6711],{"_type":67,"href":6707,"_key":6708,"type":194,"internalLink":6709},"https://junomidwives.co.uk/should-you-have-an-induction-of-labour/","18e294844b47",{"_ref":6710,"_type":197},"114d42d0-d579-4424-84c3-fe5842aea82e",{"href":6712,"_key":6713,"type":65,"url":6712,"_type":67},"https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2021-22","2d317d42331b",[6715,6719,6722,6726,6730],{"_key":6716,"_type":56,"marks":6717,"text":6718},"8ecf75e236dc",[],"IOL is not bad per se – there are some valid reasons why are offered, which we touched upon in the previous ",{"marks":6720,"text":37,"_key":6721,"_type":56},[6708],"28c284019e6e",{"text":6723,"_key":6724,"_type":56,"marks":6725},". There is also no doubt that for some women and birthing people IOL is the right choice and does make a difference to their labour and birth outcomes. We are however concerned that many of the reasons that IOL are offered are not based on robust evidence and that the rate of IOL has increased significantly in the past 10 years, with the ","acfb81d2d2d5",[],{"marks":6727,"text":6728,"_key":6729,"_type":56},[6713],"latest stats","a0ed6d79bcab",{"_type":56,"marks":6731,"text":6732,"_key":6733},[]," showing 33% of women in England having their labour started off artificially. Anecdotally, we hear of the risks for the rationale for IOL being heavily overstated e.g. telling someone about the risk of shoulder dystocia, without giving them the actual statistics. The risks of the IOL do not seem to be discussed with the same level of urgency. ","75d6d28e9dbb",{"style":59,"_key":6735,"markDefs":6736,"children":6737,"_type":58},"f5f51a69624a",[],[6738],{"text":6739,"_key":6740,"_type":56,"marks":6741},"\nMaking an Informed Decision About Induction of Labour","3e617ff41d7b",[],{"_key":6743,"markDefs":6744,"children":6751,"_type":58,"style":78},"06ded02b6872",[6745,6748],{"_type":67,"_key":6746,"type":65,"url":6747},"c3b1cebf676d","https://birthrights.org.uk/factsheets/consenting-to-treatment/",{"_type":67,"_key":6749,"type":65,"url":6750},"6e84ffbc81e0","https://bmjopen.bmj.com/content/13/5/e071703",[6752,6756,6760,6764,6768,6772,6776],{"marks":6753,"text":6754,"_key":6755,"_type":56},[],"Maternity is an incredibly litigious profession and a ","f431085b25ad",{"_key":6757,"_type":56,"marks":6758,"text":6759},"cea10ab68c60",[281],"‘healthy baby is all that matters’",{"_type":56,"marks":6761,"text":6762,"_key":6763},[]," is still very much a prevalent ideology – so it is not difficult to see why IOL would be pushed in an attempt to avoid the risk of stillbirth or shoulder dystocia. This attitude however completely fails to see that IOL can and does come with risks for women, birthing people and their babies and that those risks may outweigh the benefits of awaiting spontaneous labour. It’s worth reading up on your rights, Birthrights have several factsheets – check out this one about ","7cfbe282ffcd",{"_key":6765,"_type":56,"marks":6766,"text":6767},"bf58bd86ff7e",[6746],"consent",{"_type":56,"marks":6769,"text":6770,"_key":6771},[],". 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It is recommended when it is considered safer for you or your baby for them to be born. It's important to know the research doesn't always support this. ","7abef1703ef9","4c7d09432a7a",[],{"_key":6903,"markDefs":6904,"children":6905,"_type":58,"style":59},"26dd2022bb1a",[],[6906],{"_type":56,"marks":6907,"text":6908,"_key":6909},[],"Why Is the Induction of Labour Rate Rising in England?","ac96a044f3bd",{"_key":6911,"markDefs":6912,"children":6922,"_type":58,"style":78},"5b14c76fac17",[6913,6915,6917,6919],{"type":65,"url":6712,"_type":67,"_key":6914},"20fea88e6963",{"_type":67,"_key":6916,"type":65,"url":6712},"4e44113bf62f",{"_type":67,"_key":6918,"type":65,"url":6712},"f7151540b0aa",{"url":6920,"_type":67,"_key":6921,"type":65},"https://www.facebook.com/EKHUFTMaternity/posts/pfbid02RwS9xtCDVavr1L5T2aKPt8KcugUhYjGMvbus3r3suAp9jYNj6nTnQo859hN1GfBjl","51ad2725af50",[6923,6926,6930,6933,6936,6939,6943,6947,6951],{"_type":56,"marks":6924,"text":6925,"_key":6899},[]," In England, rates of induction have increased significantly over the past decade or so, the ",{"marks":6927,"text":6928,"_key":6929,"_type":56},[6914],"most","8f74ed0730dc",{"_key":6931,"_type":56,"marks":6932,"text":4274},"623fad78ac60",[],{"marks":6934,"text":4325,"_key":6935,"_type":56},[6916],"d6c314c3c0a7",{"marks":6937,"text":4274,"_key":6938,"_type":56},[],"3edea70abd98",{"_type":56,"marks":6940,"text":6941,"_key":6942},[6918],"statistics","f4f30ae4b4c3",{"_type":56,"marks":6944,"text":6945,"_key":6946},[]," show that 33% of women in England had an induction in 2021/22, compared to 22% in 2011/12. The most recent statistics shared by our local trust on their Facebook page, ","74c6b3321d95",{"_type":56,"marks":6948,"text":6949,"_key":6950},[6921],"East Kent Hospitals Maternity","ced2005d70db",{"marks":6952,"text":6953,"_key":6954,"_type":56},[],", are from March 2024 and show an IOL rate of 32% of that 61% had a vaginal birth, 30% had an emergency caesarean section and 9% had an instrumental assisted birth (forceps or ventouse).","1b6ccffe38e7",{"style":78,"_key":6956,"markDefs":6957,"children":6961,"_type":58},"2831709c7578",[6958],{"_type":67,"_key":6959,"type":194,"internalLink":6960,"blank":192},"3c6c2026b0d9",{"_type":197,"_ref":2756},[6962,6966,6969,6973,6977],{"marks":6963,"text":6964,"_key":6965,"_type":56},[],"Having an IOL should ","032c7a54329f",{"_type":56,"marks":6967,"text":6015,"_key":6968},[108],"cfe5bfa1defe",{"_type":56,"marks":6970,"text":6971,"_key":6972},[]," be your choice – you are '","e7967af642a5",{"text":6974,"_key":6975,"_type":56,"marks":6976},"allowed","5387ff6120d7",[6959],{"_type":56,"marks":6978,"text":6979,"_key":6980},[],"' to accept or decline. Unfortunately (but unsurprisingly) what we hear from women and birthing people is that they often feel a lot of pressure to agree to an IOL. Coercion is rife in the NHS maternity care, and it is not uncommon to hear of the ‘dead baby’ card being played, which is when women and birthing people are told their baby may die if they don’t have an IOL. Blanket recommendations for IOL based on population level risk factors fail to see women as individuals. Conversations about IOL lack nuance and often fail to acknowledge that there are risks involved to both women and babies when labour is started artificially. ","28e6f3c44c67",{"_key":6982,"_type":190,"link":6983},"a6fe08644d97",{"text":4148,"type":194,"internalLink":6984,"blank":192,"_type":67},{"_type":197,"_ref":2580},{"style":59,"_key":6986,"markDefs":6987,"children":6988,"_type":58},"2c46c079661a",[],[6989],{"marks":6990,"text":6991,"_key":6992,"_type":56},[],"What Are the Reasons Induction of Labour Is Recommended?","9d88f3017dad",{"listItem":914,"markDefs":6994,"children":6995,"level":921,"_type":58,"style":78,"_key":7004},[],[6996,7000],{"text":6997,"_key":6998,"_type":56,"marks":6999},"pre-eclampsia","d615b0ee0cc1",[108],{"_key":7001,"_type":56,"marks":7002,"text":7003},"81cc149849eb",[]," – high blood pressure, protein in the urine and/or abnormal blood test 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They looked at a 16-year period of data from 2000 – 2016. 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We don’t share the results of the Dahlen et al. study to freak people out. We share them because we know that too often this information ","b6cd0280e097",[],{"_key":7251,"_type":56,"marks":7252,"text":2024},"8c19def3a51f",[281],{"_type":56,"marks":7254,"text":7255,"_key":7256},[]," being shared. We also know that we need more research the outcomes for women, birthing people and their babies who have an IOL for medical indicated reasons.","a05dd7b7ffcd","a78b1ac443ed",{"markDefs":7259,"children":7260,"_type":58,"style":78,"_key":7265},[],[7261],{"_type":56,"marks":7262,"text":7263,"_key":7264},[],"In the same way that having a risk factor for something doesn’t guarantee that that thing will happen, not everyone who has an IOL will experience the things mentioned above. In order to make an informed decision, you need to have as much information as possible. You have to be able to decide if the benefits of IOL outweigh the risks in your specific circumstance and no-one else can make that decision for you.","03ccbecf1cb4","7e0a52c37dc8",{"_type":58,"style":78,"_key":7267,"markDefs":7268,"children":7269},"8d2d74d0466f",[],[7270],{"_type":56,"marks":7271,"text":7272,"_key":7273},[],"It is also vital that women and birthing people are aware that IOL is very different to spontaneous labour and takes you on a very different path, usually involving more interventions. Again, this doesn’t mean that no-one should ever have an IOL – but knowing that when you agree to an IOL you are agreeing to heading out on this path.","e7e5141c375a",{"_type":58,"style":78,"_key":7275,"markDefs":7276,"children":7277},"b62aa0352699",[],[7278],{"marks":7279,"text":7280,"_key":7281,"_type":56},[],"Stay tuned for the next blog, we will be looking at the different methods of IOL, including those that are used at our local East Kent NHS trust.","d9ec61117592",{"_key":7283,"_type":190,"link":7284},"79837c426fba",{"blank":192,"_type":67,"text":7285,"type":194,"internalLink":7286},"Book your free intro chat",{"_ref":549,"_type":197},"2026-03-11T13:44:05Z","Should You Have an Induction of Labour? 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Individuals face challenges in nurturing and honouring this period and valuing it for what it truly is…a time of change, rest and recovery. The initial postnatal period solidifies the life changing events that have just taken place…the birth of a new human being! There is as much a need to plan for this as for the birth itself. So where to begin?","d9008dcdd0b8",{"markDefs":7329,"children":7330,"_type":58,"style":59,"_key":7335},[],[7331],{"marks":7332,"text":7333,"_key":7334,"_type":56},[],"How to Start Making Your Postnatal Plan","0d44ab42a1a8","ed0971ac1759",{"_key":7337,"markDefs":7338,"children":7339,"_type":58,"style":78},"1fffcac6047c",[],[7340],{"text":7341,"_key":7342,"_type":56,"marks":7343},"If we give the same level of attention to the postnatal period as we do labour and birth, we can experience the joy and take on the challenges of motherhood and parenthood better equipped. Making a postnatal plan is a logical way to explore what you want, what your support will be and what your priorities are for the postnatal period.","cee1709caf78",[],{"_type":58,"style":78,"_key":7345,"markDefs":7346,"children":7347},"70b82ff67537",[],[7348],{"_type":56,"marks":7349,"text":7350,"_key":7351},[108],"Ask yourself:","2174d8936536",{"_type":58,"style":78,"_key":7353,"listItem":914,"markDefs":7354,"children":7355,"level":921},"9a1b92f6c86e",[],[7356],{"_type":56,"marks":7357,"text":7358,"_key":7359},[],"What do you want your start in parenthood to look like for you and your partner?","af9c03dab4e8",{"_type":58,"style":78,"_key":7361,"listItem":914,"markDefs":7362,"children":7363,"level":921},"38917a32dcd3",[],[7364],{"_type":56,"marks":7365,"text":7366,"_key":7367},[],"Is it in your own home?","5b527ce319bd",{"_key":7369,"listItem":914,"markDefs":7370,"children":7371,"level":921,"_type":58,"style":78},"61e55ca84e3c",[],[7372],{"text":7373,"_key":7374,"_type":56,"marks":7375},"How can you make that space the best possible environment for you and your baby?","92aa67702c3a",[],{"_key":7377,"listItem":914,"markDefs":7378,"children":7379,"level":921,"_type":58,"style":78},"de33b50ea0a7",[],[7380,7384,7387],{"_type":56,"marks":7381,"text":7382,"_key":7383},[],"Who do you want around and also, who do you ","b83ac9eed2a6",{"_key":7385,"_type":56,"marks":7386,"text":1624},"445a66c50e69",[281],{"_type":56,"marks":7388,"text":7389,"_key":7390},[]," want around?","43adbf714715",{"level":921,"_type":58,"style":78,"_key":7392,"listItem":914,"markDefs":7393,"children":7394},"2175f53d91de",[],[7395],{"_type":56,"marks":7396,"text":7397,"_key":7398},[],"What will you need to keep yourself comfortable at home and to not have to worry about leaving the house?","3a7290988d3f",{"style":78,"_key":7400,"listItem":914,"markDefs":7401,"children":7402,"level":921,"_type":58},"848083533fb2",[],[7403],{"_key":7404,"_type":56,"marks":7405,"text":7406},"f6d6afe5629d",[],"Can you outsource help? Either paid (ie. a postnatal doula or a cleaner) or unpaid from family and/or friends?",{"description":7408,"_key":7409,"asset":7410,"_type":6663},"Download your free postnatal plan template","16cdb3574a4b",{"_ref":7411,"_type":197},"file-a57a5a12d4285aa8636d2d0eb935ee3365250432-pdf",{"_key":7413,"markDefs":7414,"children":7418,"_type":58,"style":78},"ff2e3b8bcf55",[7415],{"internalLink":7416,"_type":67,"_key":7417,"type":194},{"_type":197,"_ref":7314},"8871c9244758",[7419,7423,7426],{"_type":56,"marks":7420,"text":7421,"_key":7422},[],"As discussed in the previous ","7c132f6fac4e",{"_type":56,"marks":7424,"text":37,"_key":7425},[7417],"cc793f6b2456",{"_type":56,"marks":7427,"text":7428,"_key":7429},[],", using the five elements of the postnatal period as described by Heng Ou, you can explore the issues that matter to you most and the ones that can offer you the nourishment and recovery space needed for you and your family.","debb8831ff7f",{"children":7431,"_type":58,"style":78,"_key":7436,"markDefs":7437},[7432],{"text":7433,"_key":7434,"_type":56,"marks":7435},"The five elements","b10902a80526",[108],"b6f10ad548ae",[],{"_type":58,"style":78,"_key":7439,"listItem":7440,"markDefs":7441,"children":7442,"level":921},"51bf8a4cbb39","number",[],[7443],{"_type":56,"marks":7444,"text":7445,"_key":7446},[],"A quiet safe retreat","a20077376081",{"_type":58,"style":78,"_key":7448,"listItem":7440,"markDefs":7449,"children":7450,"level":921},"08c3205bfac2",[],[7451],{"_key":7452,"_type":56,"marks":7453,"text":7454},"a635bb39304c",[],"Healing warmth and nourishing food",{"markDefs":7456,"children":7457,"level":921,"_type":58,"style":78,"_key":7462,"listItem":7440},[],[7458],{"text":7459,"_key":7460,"_type":56,"marks":7461},"Help and support","aece1a3cf4a8",[],"ee9e51fb31f6",{"_key":7464,"listItem":7440,"markDefs":7465,"children":7466,"level":921,"_type":58,"style":78},"6b836ca3776c",[],[7467],{"_key":7468,"_type":56,"marks":7469,"text":7470},"890d7a8449c0",[],"Plenty of rest",{"_type":58,"style":78,"_key":7472,"listItem":7440,"markDefs":7473,"children":7474,"level":921},"7804d5df07e5",[],[7475],{"marks":7476,"text":7477,"_key":7478,"_type":56},[],"Moments of ritual","b6b04faca1c0",{"style":59,"_key":7480,"markDefs":7481,"children":7482,"_type":58},"500efd062216",[],[7483],{"_key":7484,"_type":56,"marks":7485,"text":7486},"e44586eb6f0a",[],"Creating a Quiet and Safe Space to Recover After Birth",{"_key":7488,"markDefs":7489,"children":7490,"_type":58,"style":78},"ff3e91cfc0db",[],[7491],{"text":7492,"_key":7493,"_type":56,"marks":7494},"Whether you’ve had a home birth or hospital birth you will have just experienced a momentous, life changing experience, and the first time when you slide into your own cosy bed should feel magical. At a home birth your midwives can set up your bedroom space to be a little haven to return to once you have birthed. If you have birthed in hospital you may want to have someone at home getting this ready for you. Little things like clean bedsheets and some absorbent bed pads can go a long way. It’s possible that you may have left in the middle of the night in labour and making the bed was the last thing on your mind. This is where trusted friends and family come in. Or you can send your partner home ahead of your discharge from hospital/birth centre, so they can get this ready for you. Preparing a list of things to ensure your comfort will help guide your partner and/or family to best support you after giving birth.","f197c14dc6bb",[],{"_type":58,"style":59,"_key":7496,"markDefs":7497,"children":7498},"e48c7e381e0c",[],[7499],{"_type":56,"marks":7500,"text":7501,"_key":7502},[],"Nourishing Food and Healing Warmth in the Postnatal Period","95bf43ecba8d",{"markDefs":7504,"children":7505,"_type":58,"style":78,"_key":7510},[],[7506],{"_type":56,"marks":7507,"text":7508,"_key":7509},[],"Birthing and feeding a baby are thirsty work. Having nutritious dinners on standby is so helpful. It’s easy for us to turn to junk food when we are overtired and have little to no time to shop and cook. You could start by batch cooking your favourite meals and freezing portions in the last few weeks of your pregnancy. Fill the cupboard with healthy snacks (and treats!) and perhaps order in a supply of fresh fruits to compliment those snacks. If family and friends are offering their services or are coming to visit, make sure they don’t come empty handed – people generally want to support new parents, but don’t always know how.\n","43de9ada67c5","18fbaf384216",{"_type":58,"style":59,"_key":7512,"markDefs":7513,"children":7514},"6e64c809b412",[],[7515],{"_type":56,"marks":7516,"text":7517,"_key":7518},[],"What Should You Eat After Giving Birth?","bc0cc77a2e12",{"_key":7520,"markDefs":7521,"children":7525,"_type":58,"style":78},"dc8b37148ec2",[7522],{"url":7523,"_type":67,"_key":7524,"type":65},"https://lilynicholsrdn.com/real-food-postpartum-recovery-meals/","c9910d31f54e",[7526,7530,7534],{"_type":56,"marks":7527,"text":7528,"_key":7529},[],"Nourishing foods for rest and recuperation involve a well balanced diet and you will reap the benefits if you are able to achieve this in your postnatal period, but it will require some pre-planning. As dietician, ","55b744d72d3a",{"marks":7531,"text":7532,"_key":7533,"_type":56},[7524,108],"Lily Nichols","432833f52665",{"_type":56,"marks":7535,"text":7536,"_key":7537},[]," tells us:","9e4d4bc471e9",{"_key":7539,"markDefs":7540,"children":7541,"_type":58,"style":2849},"4c6d6f101ef4",[],[7542],{"text":7543,"_key":7544,"_type":56,"marks":7545},"“You might be surprised to learn that nutrient needs in the early postpartum phase — and especially while breastfeeding— are higher than while you were pregnant”","572e56cbbfed",[],{"style":78,"_key":7547,"markDefs":7548,"children":7551,"_type":58},"5cdb69d255c9",[7549],{"type":65,"url":7523,"_type":67,"_key":7550},"2a89a7c9f149",[7552,7556,7560],{"_type":56,"marks":7553,"text":7554,"_key":7555},[],"Protein sources that include omega 3, good fats and are high in iodine all contribute to healing tissues, milk production and baby’s brain development. So fatty fish, nuts/seeds, beef, and eggs can help both you and your baby thrive in this postnatal period. Soft cooked veg (easier to digest than raw veg and salads) and well-cooked grains that stabilise blood sugars and replenish your energy, will balance out meals giving you everything your body needs to feel good and nutured. As I prepare for the birth of some of my friends’ babies I am starting to note what culinary skills I will utilise to help them in their postnatal covery. Lily Nichols has a selection of recipes available on her website exactly for this purpose. Perhaps directing some of your friends and family to ","9f61185a5447",{"marks":7557,"text":7558,"_key":7559,"_type":56},[7550],"this page","fe0ef3ff3ff0",{"text":7561,"_key":7562,"_type":56,"marks":7563}," will help! 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There are so many different companies offering healthy meal subscriptions to aid you on this part of recovery.","63a31ccb6fa0",{"_key":7573,"markDefs":7574,"children":7575,"_type":58,"style":2849},"a7c2376dfe4d",[],[7576],{"marks":7577,"text":7578,"_key":7579,"_type":56},[],"‘Hold the mother…not the baby’","12a4b6a816dd",{"style":59,"_key":7581,"markDefs":7582,"children":7583,"_type":58},"67908d8e2d5f",[],[7584],{"text":7585,"_key":7586,"_type":56,"marks":7587},"Managing Visitors After Having a Baby","82eb5ddaaf9c",[],{"children":7589,"_type":58,"style":78,"_key":7602,"markDefs":7603},[7590,7594,7598],{"_key":7591,"_type":56,"marks":7592,"text":7593},"f12e086e0866",[],"Visitors can either enrich your experience or create tension in your postnatal bubble. So inviting visitors at a time when ",{"text":7595,"_key":7596,"_type":56,"marks":7597},"you","5d6b80aeedf5",[108,281],{"_key":7599,"_type":56,"marks":7600,"text":7601},"80deb5018f9b",[]," want them is important, but again this may be easier said than done. The postnatal period can be unpredictable in the sense that both you and your baby and partner are going through a period of adjustment that has a physical and emotional impact. In short, it is a bit tricky to do any kind of planning to accommodate visitors. So perhaps setting a rule where the first 7- 10 days you don’t have visitors or restrict visitors to one person whose role is to support you and your partner to be able to care for your own baby yourselves. This may come in the form of cooking, cleaning, holding the baby when you need to shower and returning said baby after!","f919aeb59e3e",[],{"children":7605,"_type":58,"style":78,"_key":7610,"markDefs":7611},[7606],{"_type":56,"marks":7607,"text":7608,"_key":7609},[],"Restricting visitors initially can offer major benefits to your baby’s well being and regulation as being passed around visitors has been shown to influence and disrupt their sleep patterns, feeding and their microbiome.","727dcfe1f03d","5885dff35e35",[],{"_key":7613,"markDefs":7614,"children":7615,"_type":58,"style":78},"8e9b9698b712",[],[7616],{"marks":7617,"text":7618,"_key":7619,"_type":56},[],"The reason for addressing this issue before birth is because new parents often express their upset and frustration at visitors turning up unannounced. There can also be an expectation from visitors that they will get to meet the new baby very soon after birth. So questioning what might happen if your boundaries aren’t respected and recognising that other people’s feelings are not your responsibility is really challenging. This may be where your partner comes in. Having this discussion during the antenatal period is the perfect time for this, and setting those boundaries with family and friends may be useful. It may be that you send a text to all friends and family with a clear message about what you need from them at this time, for example:","be1285cb9002",{"style":78,"_key":7621,"markDefs":7622,"children":7623,"_type":58},"45b446bd5b23",[],[7624],{"_key":7625,"_type":56,"marks":7626,"text":7627},"a25c9658f848",[281],"‘We know you are all very excited to meet the baby, we are keeping visitors to a minimum for the first week / 10 days, whilst we start to figure out feeding and life with our new one and whilst I recover from the birth. We can’t wait for you to meet the baby and we’ll let you know when we are ready!’",{"style":2849,"_key":7629,"markDefs":7630,"children":7631,"_type":58},"894d26ef0c07",[],[7632],{"text":7633,"_key":7634,"_type":56,"marks":7635},"‘Listen to hear, not to fix’","826f5f0379c7",[],{"markDefs":7637,"children":7638,"_type":58,"style":59,"_key":7643},[],[7639],{"marks":7640,"text":7641,"_key":7642,"_type":56},[],"How to Support Your Relationship in the Postnatal Period","6bc00283d339","70b1ccd7aa9c",{"children":7645,"_type":58,"style":78,"_key":7650,"markDefs":7651},[7646],{"marks":7647,"text":7648,"_key":7649,"_type":56},[],"Partners are relied upon for birth support and are likely to have experienced quite a few sleepless nights too, especially if you have birthed in a hospital. They are often advocating for their loved ones without the full knowledge and depth of the situation at hand and this comes with a lot of emotional stress. So the postnatal period needs to be a time where you can both revel in the joy of your new baby, reconnect and mentally and physically adjust to your new roles. Clear communication is the goal, but accept that you’ll both be sleep deprived and there may be some tensions. You could create lists for the postnatal period for your partner offering useful guidance on areas of home life that are not their usual domain. A second time mum recently shared with us that one of her postnatal requests is every few days bed linen is changed – without her having to ask. Who doesn’t love the feeling of getting into a freshly made bed! It is all about recognising your own abilities and managing expectations we have of ourselves, of each other in a relationship and working out what our families and friends can offer. If you like things done in a certain way then communicating this before you give birth will help manage expectations and frustrations that emerge within relationships. Bear in mind that it may also be a time where you will need to adjust your own expectations if your partner doesn’t do something exactly as you would but still gets the job done.","fd85564946c4","63f0e2b28956",[],{"_type":58,"style":78,"_key":7653,"markDefs":7654,"children":7655},"2f78c7e37a03",[],[7656],{"_type":56,"marks":7657,"text":7658,"_key":7659},[],"The UK has some of the worst parental leave and your partner may only actually have two weeks off following the birth. So consider who could come and support you after this time period. Even if your partner works from home the needs of you and your baby continue past this two week period and your partner will be unable to give you the support you need and meet the demands of their job simultaneously.","dd50afe97a83",{"markDefs":7661,"children":7662,"_type":58,"style":78,"_key":7667},[],[7663],{"marks":7664,"text":7665,"_key":7666,"_type":56},[],"It is a really challenging time for relationships as where you were once a duo now you are a trio (or more!). Biologically you are designed to focus very much on your baby in order for them to thrive and your relationship with your partner takes a back seat. But if you have taken the time to talk about expectations and have identified likely challenges and emotions that may come of this, then you can both find connection in the ups and downs of it all. This is important for your relationship in the long term.","2a966bfe0f2e","5e77a2f60453",{"_type":58,"style":59,"_key":7669,"markDefs":7670,"children":7671},"1f50013e57f6",[],[7672],{"marks":7673,"text":7674,"_key":7675,"_type":56},[],"Rest and Sleep With a Newborn: What to Expect","64e4b734d009",{"_key":7677,"markDefs":7678,"children":7679,"_type":58,"style":78},"2646fb052271",[],[7680],{"_key":7681,"_type":56,"marks":7682,"text":7683},"f8e8715a5ec8",[],"You may have also heard the phrase ‘sleep when the baby is sleeping’. Achieving this is a big challenge for parents, whether it’s your first or you have toddlers running around or older children seeking your attention. You might not realise it now but there is definitely a difference between resting and sleeping. Quality time with your thoughts, with your healing body and with your partner can also be of huge value to your postnatal recovery.",{"style":78,"_key":7685,"markDefs":7686,"children":7687,"_type":58},"4d771aeab2de",[],[7688],{"_type":56,"marks":7689,"text":7690,"_key":7691},[],"There is an unrealistic expectation in society that a newborn baby can be placed into a routine that seamlessly fits in with our lives; eating and sleeping in line with what we already do. What might be more helpful is to try and understand how babies function and that this is a 24/7 situation! Babies have very different sleeping patterns compared with us adults. Newborn babies will sleep for approximately 2- 4 hours at a time. They are much lighter sleepers and, due to their smaller stomachs, they require feeding often. This is a normal pattern of feeding and sleeping that most newborns will display in the postpartum period. In addition babies will want to feed overnight and this is due to the milk production hormone peaking in the early hours of the morning. Therefore between 1am and 5am you might expect to see your baby awake and keen to feed. So mentally preparing with this knowledge in mind may help you to understand how and when to get the sleep and rest that you need.","4bc8ca60e736",{"_type":58,"style":59,"_key":7693,"markDefs":7694,"children":7695},"0bd6611980d9",[],[7696],{"marks":7697,"text":7698,"_key":7699,"_type":56},[],"Breastfeeding Support: Planning Ahead","db4baa03f92e",{"markDefs":7701,"children":7708,"_type":58,"style":78,"_key":7729},[7702,7705],{"type":65,"url":7703,"_type":67,"_key":7704},"https://www.besideyoukent.co.uk/local-breastfeeding-support/","f3c864a2d812",{"_key":7706,"type":65,"url":7707,"_type":67},"1a4c20890d4c","https://lcgb.org/find-an-ibclc/",[7709,7713,7717,7721,7725],{"text":7710,"_key":7711,"_type":56,"marks":7712},"Thinking about your intentions to breastfeed and knowing how to seek additional support can be part of your postpartum plan too. In East Kent there are a number of ","a41eaf9da840",[],{"_key":7714,"_type":56,"marks":7715,"text":7716},"8579714a069a",[7704],"local feeding support groups",{"text":7718,"_key":7719,"_type":56,"marks":7720}," available, it is just knowing where to look. In addition you might want to seek out specialist support in the form of a session with a certified lactation consultant (","c48e34b9ab25",[],{"_key":7722,"_type":56,"marks":7723,"text":7724},"f80ceabeb33a",[7706],"IBCLC",{"_key":7726,"_type":56,"marks":7727,"text":7728},"111658ceb243",[],"), pre and/or post birth. You’ll find these specialists across the country. Friends and family are always looking for gifts so maybe add this to your list. It makes for a really useful alternative to clothes that they grow out of before the next feed!","672479a04106",{"markDefs":7731,"children":7732,"_type":58,"style":59,"_key":7737},[],[7733],{"text":7734,"_key":7735,"_type":56,"marks":7736},"Postnatal Rituals to Support Your Recovery","fd13633fa7a2",[],"7c0248e51ef5",{"style":78,"_key":7739,"markDefs":7740,"children":7741,"_type":58},"86748985cea9",[],[7742],{"_type":56,"marks":7743,"text":7744,"_key":7745},[],"In our busy lives, learning to slow down can be a big challenge and often our society faces burn out. We forget the things that matter most and offer grounding to ourselves. As a result we have lost sight of these ritualistic practices that bring us moments of peace and reflection. And now a baby really does just throw it all up in the air! The postnatal period could be the time to bring that back in. Perhaps continuing with affirmations that you used as a labour tool, keeping the playlist you had for birth. Taking comfort in the quiet when you are alone with your baby.","4c7a36b94185",{"children":7747,"_type":58,"style":78,"_key":7752,"markDefs":7753},[7748],{"marks":7749,"text":7750,"_key":7751,"_type":56},[],"Ask yourself what new rituals can you find in your postpartum experience. These need not be big things, small and things carried out with good intentions count too! Here are some examples to help you along the way.","6d4b590c73ad","6b04db518b47",[],{"markDefs":7755,"children":7756,"_type":58,"style":78,"_key":7761},[],[7757],{"text":7758,"_key":7759,"_type":56,"marks":7760},"Energising rituals","02a092d1a75c",[108,281],"ca480cb7f065",{"level":921,"_type":58,"style":78,"_key":7763,"listItem":914,"markDefs":7764,"children":7765},"35d640c398e1",[],[7766],{"_key":7767,"_type":56,"marks":7768,"text":7769},"4c61390f8ae8",[],"Spending time outdoors – even if that’s just five minutes in your garden, on a balcony, or outside your front door",{"listItem":914,"markDefs":7771,"children":7772,"level":921,"_type":58,"style":78,"_key":7777},[],[7773],{"text":7774,"_key":7775,"_type":56,"marks":7776},"A short walk around the block","1764768e327c",[],"5d0913aac535",{"level":921,"_type":58,"style":78,"_key":7779,"listItem":914,"markDefs":7780,"children":7781},"7ca2694a871c",[],[7782],{"_type":56,"marks":7783,"text":7784,"_key":7785},[],"Short stretching sequence – find one online, or just stretch your body in a way that feels good","56daa6d33811",{"children":7787,"_type":58,"style":78,"_key":7792,"markDefs":7793},[7788],{"text":7789,"_key":7790,"_type":56,"marks":7791},"Reflective rituals","688a13e0e08d",[108,281],"fbb635c21afa",[],{"markDefs":7795,"children":7796,"level":921,"_type":58,"style":78,"_key":7801,"listItem":914},[],[7797],{"_key":7798,"_type":56,"marks":7799,"text":7800},"f9e740323d8b",[],"5 minutes of journaling your thoughts and feelings","4418bad5322d",{"level":921,"_type":58,"style":78,"_key":7803,"listItem":914,"markDefs":7804,"children":7805},"22f1d480b6f4",[],[7806],{"_key":7807,"_type":56,"marks":7808,"text":7809},"b4041bff381d",[],"5 minute meditation – you could use an app to guide you",{"children":7811,"level":921,"_type":58,"style":78,"_key":7820,"listItem":914,"markDefs":7821},[7812,7816],{"_type":56,"marks":7813,"text":7814,"_key":7815},[],"Affirmations – e.g. ","aded325221a2",{"text":7817,"_key":7818,"_type":56,"marks":7819},"‘My baby and I are learning together’","ebcfd462d94c",[281],"ce9250a85028",[],{"markDefs":7823,"children":7824,"_type":58,"style":78,"_key":7829},[],[7825],{"text":7826,"_key":7827,"_type":56,"marks":7828},"Calming rituals","acac5bcda670",[108,281],"cc6da880340d",{"_type":58,"style":78,"_key":7831,"listItem":914,"markDefs":7832,"children":7833,"level":921},"6b4e43f4df9e",[],[7834],{"_type":56,"marks":7835,"text":7836,"_key":7837},[],"A warm bath or shower to unwind before bed","daf1fd57b1c0",{"style":78,"_key":7839,"listItem":914,"markDefs":7840,"children":7841,"level":921,"_type":58},"1ae7d8df1ce9",[],[7842],{"_type":56,"marks":7843,"text":7844,"_key":7845},[],"Placing a few drops of essential oils on your pillow before settling down","78ba8a721cf0",{"style":78,"_key":7847,"listItem":914,"markDefs":7848,"children":7849,"level":921,"_type":58},"5986244b400d",[],[7850],{"_type":56,"marks":7851,"text":7852,"_key":7853},[],"Having a comforting cup of tea or coffee in your favourite mug","48ab586f8291",{"style":78,"_key":7855,"markDefs":7856,"children":7857,"_type":58},"33d645437665",[],[7858],{"_key":7859,"_type":56,"marks":7860,"text":7861},"290beaa08046",[108,281],"Making a postnatal plan can really bring in the nourishing and nurturing care and support you might need to enjoy your postpartum period. There is no right or wrong way of doing this but we hope these pointers help you put pen to paper. Click the button below to download our free, printable postnatal plan template.",{"_key":7863,"asset":7864,"_type":6663,"description":7408},"0ffe8ea97583",{"_ref":7411,"_type":197},{"style":78,"_key":7866,"markDefs":7867,"children":7871,"_type":58},"64a795508270",[7868],{"_key":7869,"type":65,"url":7870,"_type":67},"960f64b18b71","https://motherbees.com/pages/the-first-forty-days",[7872,7876,7879,7883],{"marks":7873,"text":7874,"_key":7875,"_type":56},[108],"Read","3382daa07eed",{"marks":7877,"text":5580,"_key":7878,"_type":56},[],"29acc81be461",{"_key":7880,"_type":56,"marks":7881,"text":7882},"e1ccccb4b5ee",[7869,281],"The First Forty Days",{"_type":56,"marks":7884,"text":7885,"_key":7886},[]," by Heng Ou ","7cb7b0cb82e2",{"children":7888,"_type":58,"style":78,"_key":7924,"markDefs":7925},[7889,7892,7895,7899,7902,7907,7910,7913,7916,7921],{"marks":7890,"text":6845,"_key":7891,"_type":56},[108],"f96bc27d5a58",{"text":5580,"_key":7893,"_type":56,"marks":7894},"4190bed9e725",[],{"_type":56,"marks":7896,"text":7897,"_key":7898},[281],"The Great Birth Rebellion podcast,","ceb5c2a47d43",{"text":4274,"_key":7900,"_type":56,"marks":7901},"e5d7a29ddc06",[],{"_type":56,"marks":7903,"text":7905,"_key":7906},[7904,281],"0ab2795b17fd","ep. 40 Planning a powerful postpartum with Lael Stone","719e8dfa6ddc",{"text":4274,"_key":7908,"_type":56,"marks":7909},"4afd5e1f8204",[],{"marks":7911,"text":6823,"_key":7912,"_type":56},[281],"b8ff6af01f3b",{"text":4274,"_key":7914,"_type":56,"marks":7915},"14024e592cb2",[],{"_type":56,"marks":7917,"text":7919,"_key":7920},[7918,281],"514306713c88","ep. 63 How to give great postnatal support","c5a8050d0194",{"_type":56,"marks":7922,"text":1183,"_key":7923},[281],"ae2211d561c7","94a95bbeeb60",[7926,7928],{"type":65,"url":7927,"_type":67,"_key":7904},"https://www.melaniethemidwife.com/podcasts/the-great-birth-rebellion?search=planning+a+powerful+postpartum",{"url":7929,"_type":67,"_key":7918,"type":65},"https://www.melaniethemidwife.com/podcasts/the-great-birth-rebellion?search=63",{"_type":58,"style":78,"_key":7931,"markDefs":7932,"children":7936},"700e8f29af4d",[7933],{"_type":67,"_key":7934,"type":65,"url":7935},"c2d79e6c646a","https://www.instagram.com/birth_ed/",[7937,7941,7945],{"_type":56,"marks":7938,"text":7939,"_key":7940},[108],"Follow","d8a1c881ee1c",{"text":7942,"_key":7943,"_type":56,"marks":7944}," – Megan Rossiter","108c6d228160",[],{"_type":56,"marks":7946,"text":7947,"_key":7948},[7934]," @birth_ed","950e0f6b99da",{"_type":586,"asset":7950},{"_type":197,"_ref":7951},"image-a418dc9e1683fbb6ddeca08ce35425d8b636793c-1080x1350-jpg","2024-06-25","Why You Need a Postnatal Plan (And How to Make One)","2026-03-11T13:48:50Z","2025-04-07T15:20:07Z",{"base":7957},{"id":7958,"rev":7959},"ab0aabb0-571f-4ddf-8f31-f041c3e4e20a","c1HqLtX09dCBnnfIQeuFwI","V3aI2QowveaYP3Z79qnXx6",{"current":7962,"_type":8},"why-you-need-a-postnatal-plan-and-how-to-make-one",{"_id":7314,"_updatedAt":7964,"content":7965,"slug":8244,"_type":37,"_createdAt":8246,"_rev":8247,"publishedAt":8248,"image":8249,"title":8252,"_system":8253},"2026-03-17T12:23:25Z",{"_type":49,"body":7966},[7967,7975,7983,7991,7999,8018,8026,8030,8038,8057,8065,8073,8078,8086,8102,8110,8117,8125,8142,8150,8157,8164,8171,8178,8185,8193,8201,8240],{"markDefs":7968,"children":7969,"_type":58,"style":59,"_key":7974},[],[7970],{"_key":7971,"_type":56,"marks":7972,"text":7973},"9191948b27f0",[],"What Is the Postnatal Period and Why Does It Matter?","e22921307525",{"markDefs":7976,"children":7977,"_type":58,"style":78,"_key":7982},[],[7978],{"text":7979,"_key":7980,"_type":56,"marks":7981},"The postnatal period may just be one of the biggest emotional rollercoasters you will ever go on! You may feel both pride and happiness at what you’ve achieved and perhaps also guilt and sadness when it is not all going super smoothly. It is important to acknowledge these feelings, whether positive or negative, and find a way in which to cope and move with them on your journey as a mother or parent.","758507767121",[],"3fc645cbb70e",{"style":78,"_key":7984,"markDefs":7985,"children":7986,"_type":58},"622d1afb666d",[],[7987],{"marks":7988,"text":7989,"_key":7990,"_type":56},[],"Postpartum is often not awarded the respect it deserves. This is certainly true of Western society where the overwhelming pressure mothers face is to ‘bounce back’ and get on with it, ignoring the significant life-changing events that have led to this period in the first place. ‘Bouncing back’ undermines the need for protection during this time and focuses on speeding through this precious time of adjustment. This lack of protection does not allow for the recovery, bonding and growth that is so necessary after giving birth for the woman or birthing person, their partner and their newborn baby.","4e438dbbb810",{"markDefs":7992,"children":7993,"_type":58,"style":59,"_key":7998},[],[7994],{"marks":7995,"text":7996,"_key":7997,"_type":56},[],"Why Is Postnatal Care So Inadequate in the UK?","010cec5a5937","869b63e42903",{"_type":58,"style":78,"_key":8000,"markDefs":8001,"children":8005},"94476e9852a5",[8002],{"_key":8003,"type":65,"url":8004,"_type":67},"2869023e407f","https://www.nice.org.uk/guidance/ng194/chapter/Context#:~:text=Postnatal%20care%20has%20for%20long,now%20and%20in%20the%20future",[8006,8010,8014],{"marks":8007,"text":8008,"_key":8009,"_type":56},[],"In mainstream maternity care, the postpartum period has been described as the ","3c1c77aad341",{"_type":56,"marks":8011,"text":8012,"_key":8013},[8003],"‘Cinderella’ of maternity services","f5becf3544cf",{"_key":8015,"_type":56,"marks":8016,"text":8017},"8d08def13650",[],". In the UK postnatal NHS community midwifery care services are considered inadequate, having dwindled to provide the bare minimum. It is routine for women and babies to be discharged from midwifery care between day 10 – 14 after giving birth, having only been seen by a midwife approximately three times, often with only one of those being a home visit. Often, regardless of how you have birthed, the current state of your mental health, or the challenges faced on your feeding journey, you are expected to leave the sanctuary of your own home for postnatal care with your newborn baby as early as five days following birth.",{"children":8019,"_type":58,"style":78,"_key":8024,"markDefs":8025},[8020],{"text":8021,"_key":8022,"_type":56,"marks":8023},"Being discharged from care after 14 days leaves a lot of women and new families feeling quite isolated and at a loss for whom to turn to when support is needed, particularly as GP services are overstretched and many people don’t have a pre-existing relationship with a named GP. The impersonal nature of primary care has minimised a holistic approach and time constraints mean that healthcare workers are unable to explore people’s needs properly. As a result, care becomes more of a tick box exercise to rule out worse case scenarios instead of bringing to focus all the ways in which we can optimise the health of new mothers, parents and their babies.","cfdd264f8654",[],"08743f555142",[],{"_type":190,"link":8027,"_key":8029},{"type":194,"internalLink":8028,"blank":192,"_type":67,"text":193},{"_type":197,"_ref":196},"5296142e0868",{"markDefs":8031,"children":8032,"_type":58,"style":59,"_key":8037},[],[8033],{"marks":8034,"text":8035,"_key":8036,"_type":56},[],"How Did Postnatal Care in the UK Become So Neglected?","f18e341ac17e","51278677fa0e",{"markDefs":8039,"children":8043,"_type":58,"style":78,"_key":8056},[8040],{"url":8041,"_type":67,"_key":8042,"type":65},"https://www.theo-clarke.org.uk/sites/www.theo-clarke.org.uk/files/2024-05/Birth%20Trauma%20Inquiry%20Report%20for%20Publication_May13_2024.pdf","2b12fcd37663",[8044,8048,8052],{"text":8045,"_key":8046,"_type":56,"marks":8047},"This erosion of postnatal care didn’t happen overnight but over generations. In the UK we can pinpoint this change in recent history. In the middle of the 20th century, as maternity care shifted from the home to the hospital, women were removed from their families and their community to give birth in hospitals. This change brought women and their midwives into tertiary centres that fragmented care and focussed significantly on ‘managing’ labour and birth, conforming to the medicalisation of childbirth. As increasing pressures on the NHS grew the adoption of the ‘conveyor belt’ system was firmly embedded in maternity services. The end of the production line was birth and the main goal was a healthy baby, with little regard to a woman’s experience. As a result, postnatal wards have become neglected over the years and women and their babies receive substandard care that does not offer the support and nurturing new parents need. It’s no secret that postnatal care is substandard, and this has been highlighted again in the recent ","2a3a4c990304",[],{"_type":56,"marks":8049,"text":8050,"_key":8051},[8042],"APPG Report on Birth Trauma","9a2c4364f752",{"marks":8053,"text":8054,"_key":8055,"_type":56},[]," where postnatal mental health services and pelvic physiotherapy services, to name a few, are underfunded and poorly staffed. ","ddaf9fe13e6d","094b17870e8a",{"_key":8058,"markDefs":8059,"children":8060,"_type":58,"style":59},"19b792ea314f",[],[8061],{"_type":56,"marks":8062,"text":8063,"_key":8064},[],"When Does the Postnatal Period End?","009fe9e7e3e4",{"markDefs":8066,"children":8067,"_type":58,"style":78,"_key":8072},[],[8068],{"marks":8069,"text":8070,"_key":8071,"_type":56},[],"In the UK the postnatal period often refers to the first month following birth. NHS midwifery care puts the cut off at 28 days – which is arguably an arbitrary number. Some people may see the routinely recommended 6-week check up with the GP as the ‘end’ of this chapter. Some may consider the postnatal period to be between 4-6 weeks as this is the expected time it takes for postnatal bleeding to stop, although this does not take into account the other aspects of physical recovery that may continue past this point. This 4-6 week endpoint does however fit in with Western culture, which expects women and birthing people to be able to return to everyday life within this timeframe. We know from many women, birthing people and their families, that there is no real defined endpoint and more a merging of stages of life that will find you to-ing and fro-ing between this life as a mother or parent and your former self.","f1d84a2c2e82","ff7c10313e20",{"_type":190,"link":8074,"_key":8077},{"blank":192,"_type":67,"text":8075,"type":194,"internalLink":8076},"Birth Reflections with Juno",{"_ref":502,"_type":197},"217b0fe94d54",{"children":8079,"_type":58,"style":59,"_key":8084,"markDefs":8085},[8080],{"_type":56,"marks":8081,"text":8082,"_key":8083},[],"How Other Cultures Honour the Postnatal Period","869395a2ddb1","6d2d17d90c5f",[],{"style":78,"_key":8087,"markDefs":8088,"children":8089,"_type":58},"a5344d88490c",[],[8090,8094,8098],{"_type":56,"marks":8091,"text":8092,"_key":8093},[],"Across the globe the postnatal period is defined in various ways by different countries and cultures. In China a period of “sitting the month” is referred to where the first 40 days is a respected period of time where women and their babies remain home and support is provided by family. A similar cultural tradition exists in Latin America, called ","e4fba6a5f75a",{"text":8095,"_key":8096,"_type":56,"marks":8097},"la cuarentena","c8a86a0ad9bf",[281],{"_type":56,"marks":8099,"text":8100,"_key":8101},[]," – which literally translates to “quarantine.” It is seen as a time for mothers to bond with their babies. And many societies within the Middle East also observe a period of 40 days which focuses on rest, seclusion and ritual. What these cultures and traditions all appear to have in common is the idea of rest, support, recovery for the new mother and new parents in a safe and contained space that allows for a healthy transition in life. Looking after the mother ensures long term health for her and her family and creates a culture of respect and high regard for motherhood.","b5d9b0ae8f9a",{"_key":8103,"markDefs":8104,"children":8105,"_type":58,"style":59},"86f7877487c4",[],[8106],{"_key":8107,"_type":56,"marks":8108,"text":8109},"6776e447f3b5",[],"What Is the Fourth Trimester?",{"children":8111,"_type":58,"style":78,"_key":8115,"markDefs":8116},[8112],{"_type":56,"marks":8113,"text":8114,"_key":8101},[]," ‘The fourth trimester’ is a term now being used across Western society. Coined in 2002 by Harvey Karp, an American Paediatrician, this term initially referred to the baby and their first three months of life following birth. However we see ‘the fourth trimester’ is being used far more widely to refer to both the mother and the baby together as parts of society try to reclaim this period of recovery and provide the care needed to ensure mothers and families thrive. ","cf07be2a1d8f",[],{"markDefs":8118,"children":8119,"_type":58,"style":59,"_key":8124},[],[8120],{"marks":8121,"text":8122,"_key":8123,"_type":56},[],"The Five Elements of a Nourishing Postnatal Period","4e77bb946c97","906231c5a521",{"_type":58,"style":78,"_key":8126,"markDefs":8127,"children":8130},"18521ba11def",[8128],{"type":65,"url":7870,"_type":67,"_key":8129},"e5dd3d37bb12",[8131,8135,8138],{"_type":56,"marks":8132,"text":8133,"_key":8134},[],"Receiving help after you have given birth should not be seen as a treat but a “natural order of things”. This is what the author Heng Ou discusses in her carefully researched book, ","14d0c86ac070",{"text":7882,"_key":8136,"_type":56,"marks":8137},"739beb3c1ee6",[8129],{"marks":8139,"text":8140,"_key":8141,"_type":56},[]," and she gently directs questions back to mothers and parents.","4f3f5a68ef0f",{"_key":8143,"markDefs":8144,"children":8145,"_type":58,"style":78},"f953ac66c938",[],[8146],{"_type":56,"marks":8147,"text":8148,"_key":8149},[],"She argues it is a mothers birth right to have these five elements make up the postnatal period;","4a8499b78805",{"_type":58,"style":78,"_key":8151,"listItem":7440,"markDefs":8152,"children":8153,"level":921},"efb7f3306fde",[],[8154],{"_key":8155,"_type":56,"marks":8156,"text":7445},"91ebb28e50b2",[108],{"_key":8158,"listItem":7440,"markDefs":8159,"children":8160,"level":921,"_type":58,"style":78},"f41154c90a68",[],[8161],{"marks":8162,"text":7454,"_key":8163,"_type":56},[108],"0d5875768221",{"_key":8165,"listItem":7440,"markDefs":8166,"children":8167,"level":921,"_type":58,"style":78},"85e3fa56d957",[],[8168],{"_key":8169,"_type":56,"marks":8170,"text":7459},"d37775222722",[108],{"markDefs":8172,"children":8173,"level":921,"_type":58,"style":78,"_key":8177,"listItem":7440},[],[8174],{"_type":56,"marks":8175,"text":7470,"_key":8176},[108],"7e59b31a0d56","fc2c3d997227",{"markDefs":8179,"children":8180,"level":921,"_type":58,"style":78,"_key":8184,"listItem":7440},[],[8181],{"text":7477,"_key":8182,"_type":56,"marks":8183},"0e22219326bc",[108],"fbb5f2e8fdee",{"_type":58,"style":78,"_key":8186,"markDefs":8187,"children":8188},"b92b34fd813c",[],[8189],{"_type":56,"marks":8190,"text":8191,"_key":8192},[],"It is worth asking yourself what these five elements might mean to you during your postnatal period and how you might go about achieving them. If you are only just beginning to think about your postnatal journey, don’t worry, part two of this blog (exploring postnatal plans!) will be coming out soon. Keep your eyes peeled for tips and tricks on planning for your postnatal period!","3af0350ad3dc",{"style":59,"_key":8194,"markDefs":8195,"children":8196,"_type":58},"68bfc6d40e88",[],[8197],{"text":8198,"_key":8199,"_type":56,"marks":8200},"How to Start Planning for Your Postnatal Recovery","d6565b787a3c",[],{"_key":8202,"markDefs":8203,"children":8213,"_type":58,"style":78},"44f0bdf97eb5",[8204,8207,8210],{"internalLink":8205,"blank":192,"_type":67,"_key":8206,"type":194},{"_type":197,"_ref":502},"fe860509ea22",{"_type":67,"_key":8208,"type":194,"internalLink":8209,"blank":192},"fac9b62bfb5d",{"_ref":196,"_type":197},{"type":194,"internalLink":8211,"blank":192,"_type":67,"_key":8212},{"_ref":549,"_type":197},"8f868f1f2ce7",[8214,8218,8221,8225,8228,8232,8236],{"_key":8215,"_type":56,"marks":8216,"text":8217},"8e13819b7b6e",[],"We offer at least 2 -4 weeks of postnatal care, depending on your wants and needs. We also can offer one-off postnatal appointments and birth debriefs at your home. You can book our one-off appointments ",{"_type":56,"marks":8219,"text":803,"_key":8220},[8206],"ef54d492020a",{"_type":56,"marks":8222,"text":8223,"_key":8224},[]," If you're planning ahead and interested in our care packages - read about them ","ee89afecb9b3",{"text":249,"_key":8226,"_type":56,"marks":8227},"340e9ffb4510",[8208],{"_key":8229,"_type":56,"marks":8230,"text":8231},"1e49b512e296",[]," or ",{"marks":8233,"text":8234,"_key":8235,"_type":56},[8212],"book an intro chat ","f71a6cb95d23",{"_type":56,"marks":8237,"text":8238,"_key":8239},[],"to find out how we can work together. Our postnatal care is unhurried, flexible and individualised – you deserve to be supported and nurtured during this time.","76e68b325332",{"_type":190,"link":8241,"_key":8243},{"text":9,"type":194,"internalLink":8242,"blank":192,"_type":67},{"_type":197,"_ref":1831},"a3e0dbda4fac",{"current":8245,"_type":8},"why-postnatal-care-in-the-uk-isn-t-good-enough-and-what-you-deserve","2025-04-07T15:20:02Z","A1BL058D1L1LG4bFNGDJhg","2024-06-17",{"_type":586,"asset":8250},{"_type":197,"_ref":8251},"image-2c3c0c6695b556b9561440f8e701d65e2d220fc0-1080x1350-jpg","Why Postnatal Care in the UK Isn't Good Enough — And What You Deserve",{"base":8254},{"rev":8255,"id":7314},"7l2KCMg711eQ9a3UN6MKED",{"slug":8257,"_system":8259,"title":8263,"publishedAt":8264,"_type":37,"_createdAt":8265,"_id":8262,"image":8266,"_rev":8269,"_updatedAt":8270,"content":8271},{"current":8258,"_type":8},"is-hypnobirthing-just-for-hippies-busting-the-most-common-myths",{"base":8260},{"rev":8261,"id":8262},"c1HqLtX09dCBnnfIQetROS","2a2d6b1b-bffe-44b8-bf8d-fe7ed76c7bb2"," Is Hypnobirthing Just for Hippies? Busting the Most Common Myths","2024-06-11","2025-04-07T15:19:57Z",{"_type":586,"asset":8267},{"_ref":8268,"_type":197},"image-077076655c74676b14c9d83c11fe0d6d87065223-1080x1350-jpg","5fd977pr5Ct4pKgLycmHa6","2026-03-11T13:58:31Z",{"_type":49,"body":8272},[8273,8298,8306,8314,8322,8330,8338,8346,8354,8362,8370,8378,8386,8394,8402,8418],{"children":8274,"_type":58,"style":78,"_key":8294,"markDefs":8295},[8275,8279,8282,8287,8290],{"text":8276,"_key":8277,"_type":56,"marks":8278},"For this guest blog we asked local hypnobirthing instructor Kelly Geddes of","76ac6da8cb66",[281],{"marks":8280,"text":4274,"_key":8281,"_type":56},[],"15847e90f468",{"_key":8283,"_type":56,"marks":8284,"text":8286},"64b52f8af423",[281,8285],"7f738257a6f7","Birth Positively",{"text":4274,"_key":8288,"_type":56,"marks":8289},"f4611874b98b",[],{"text":8291,"_key":8292,"_type":56,"marks":8293},"to bust some hypnobirthing myths! Read on to find out why hypnobirthing is for everyone.","d646bdd6f21b",[281],"384280a632e0",[8296],{"_key":8285,"type":65,"url":8297,"_type":67},"https://www.birth-positively.co.uk/",{"children":8299,"_type":58,"style":59,"_key":8304,"markDefs":8305},[8300],{"text":8301,"_key":8302,"_type":56,"marks":8303},"What Is Hypnobirthing Really?","dec37d9e0ce8",[],"062dd597ca25",[],{"style":78,"_key":8307,"markDefs":8308,"children":8309,"_type":58},"528c90bd4984",[],[8310],{"text":8311,"_key":8312,"_type":56,"marks":8313},"Unfortunately, the name ‘hypnobirthing’ can make it sound like something it isn’t – a bit hippy, only for a certain type of person, birth etc. But did you know hypnobirthing is based on science and the fascinating way our bodies are actually designed to give birth?","3bc8fa59ab2c",[],{"children":8315,"_type":58,"style":78,"_key":8320,"markDefs":8321},[8316],{"text":8317,"_key":8318,"_type":56,"marks":8319},"I qualified as a hypnobirthing teacher 7 years ago after my own experiences with hypnobirthing. I was transformed from a someone who was terrified about the prospect of giving birth, to being genuinely excited about everything that was to come in just a few short weeks! How is that possible? Hypnobirthing!","5ada669ebdd9",[],"4a4980cfc592",[],{"markDefs":8323,"children":8324,"_type":58,"style":78,"_key":8329},[],[8325],{"_type":56,"marks":8326,"text":8327,"_key":8328},[],"Not convinced? Read on to hear some common hypnobirthing myths , and I might just change your mind!","71a20d25c40a","5f4cf7ce4914",{"children":8331,"_type":58,"style":59,"_key":8336,"markDefs":8337},[8332],{"_key":8333,"_type":56,"marks":8334,"text":8335},"0867f549e70f",[],"Myth 1: Hypnobirthing Is Only for Home Water Births","640e65f4dce7",[],{"markDefs":8339,"children":8340,"_type":58,"style":78,"_key":8345},[],[8341],{"text":8342,"_key":8343,"_type":56,"marks":8344},"If you search hypnobirthing videos on YouTube, you will no doubt find loads of births filmed at home, often in the water. The most likely reason for this is because people at home are more comfortable filming their births and uploading them onto YouTube, not because hypnobirthing doesn’t work for anyone else. The techniques you learn in a hypnobirthing course can be used for hospital births, inductions and even caesareans. It could even be argued that they are even more beneficial for these births as you won’t be utilising your lovely birth hormones in the same way.","0c5fb83245a6",[],"abdefbbf73aa",{"style":59,"_key":8347,"markDefs":8348,"children":8349,"_type":58},"1cea230ce3b4",[],[8350],{"marks":8351,"text":8352,"_key":8353,"_type":56},[],"Myth 2: Staying Relaxed During Labour Isn't Realistic","62bc1bf0c7eb",{"_key":8355,"markDefs":8356,"children":8357,"_type":58,"style":78},"ecd799df249b",[],[8358],{"_type":56,"marks":8359,"text":8360,"_key":8361},[],"I agree, being relaxed during labour is a nice idea. But it is more than that. It is essential for labour to be efficient and effective. Your uterus is a muscle. If you are holding tension in your body, your uterus will also be tense which means when you are having surges (contractions) your body will essentially be fighting with itself. When you are able to relax fully and deeply, you will be able to work with your body, not against it, leaving you to crack on with birthing your baby!","21c1d594887b",{"markDefs":8363,"children":8364,"_type":58,"style":59,"_key":8369},[],[8365],{"_key":8366,"_type":56,"marks":8367,"text":8368},"064b8c19f48e",[],"Myth 3: Hypnobirthing Is Only for People Who Want a Drug-Free Birth","fd131f2d790e",{"_key":8371,"markDefs":8372,"children":8373,"_type":58,"style":78},"c06d858c0f64",[],[8374],{"marks":8375,"text":8376,"_key":8377,"_type":56},[],"I’ll say it again for the people at the back – Hypnobirthing is for everyone! I’ll never tell you giving birth is pain free, but how you experience the sensations of birth is down to the individual. If you use hypnobirthing techniques during labour, you are actually less likely to reach for the drug-based pain relief options available to you, as you will have other techniques up your sleeve to support you. But if you do choose to have gas and air or an epidural, that in no way means you have somehow failed hypnobirthing! Hypnobirthing is all about choice and if you choose the drugs, that is of course absolutely fine (just make sure you know the benefits and risks of each one to help you choose which is best for you!).","f5f809123181",{"markDefs":8379,"children":8380,"_type":58,"style":59,"_key":8385},[],[8381],{"_key":8382,"_type":56,"marks":8383,"text":8384},"09e5a04530bd",[],"Is Hypnobirthing Right for You?","e4b637567966",{"markDefs":8387,"children":8388,"_type":58,"style":78,"_key":8393},[],[8389],{"text":8390,"_key":8391,"_type":56,"marks":8392},"Hopefully I have busted some of the common hypnobirthing myths that often stop people considering using hypnobirthing for birth. As well as using hypnobirthing for all 3 of my births, I have also worked with over a hundred couples and pregnant women and witnessed firsthand the impact it has. If you want to find out more or have any questions at all please do get in touch as I’d love to hear from you.","1e5054689663",[],"6be31dae95bb",{"_key":8395,"markDefs":8396,"children":8397,"_type":58,"style":78},"9ec8f70dbbba",[],[8398],{"marks":8399,"text":8400,"_key":8401,"_type":56},[281],"If you’re interested in hypnobirthing, get in touch with Kelly to find out more:","fc0e15815b7e",{"_type":58,"style":78,"_key":8403,"markDefs":8404,"children":8409},"1a2595e5c37d",[8405],{"type":8406,"email":8407,"_type":67,"_key":8408},"email","kelly@birht-positively.co.uk","d464b16464af",[8410,8414],{"_type":56,"marks":8411,"text":8412,"_key":8413},[],"Email: ","88824647f27f",{"_type":56,"marks":8415,"text":8416,"_key":8417},[8408],"kelly@birth-positively.co.uk","14f8f2d5c778",{"markDefs":8419,"children":8420,"_type":58,"style":78,"_key":8425},[],[8421],{"_type":56,"marks":8422,"text":8423,"_key":8424},[],"Instagram: @birthpositively","9449cdf7ae28","0245ab77c511",{"_id":8427,"image":8428,"_type":37,"_system":8431,"slug":8434,"publishedAt":8436,"_updatedAt":8437,"_rev":8438,"title":8439,"content":8440,"_createdAt":8844},"2f01623f-8984-48f8-a37b-fff6507f7243",{"asset":8429,"_type":586},{"_type":197,"_ref":8430},"image-afc883fe9310b34e893668ea1e44d8887da3cd05-1080x1350-jpg",{"base":8432},{"id":8427,"rev":8433},"lFrvlEMldmWjsfq3cbSDNM",{"current":8435,"_type":8},"can-you-reduce-your-risk-of-tearing-during-birth-what-the-evidence-says","2024-05-20","2026-03-11T14:04:37Z","5fd977pr5Ct4pKgLycrDgC"," Can You Reduce Your Risk of Tearing During Birth? What the Evidence Says",{"_type":49,"body":8441},[8442,8450,8458,8477,8485,8493,8501,8509,8517,8525,8533,8541,8560,8568,8608,8623,8628,8636,8644,8652,8660,8668,8676,8692,8708,8712,8720,8746,8764,8772,8780,8815,8820],{"markDefs":8443,"children":8444,"_type":58,"style":78,"_key":8449},[],[8445],{"text":8446,"_key":8447,"_type":56,"marks":8448},"This blog discusses two Cochrane reviews which looked at means of reducing perineal trauma during birth. A Cochrane review is a review of the available evidence – so they look at and combine the results of multiple studies to get a clearer picture of the effects (if any) of an intervention.","b168fb39d659",[281],"988022e72f13",{"_key":8451,"markDefs":8452,"children":8453,"_type":58,"style":59},"ce4b47259ca5",[],[8454],{"_key":8455,"_type":56,"marks":8456,"text":8457},"5c1eed12837d",[],"How Common Is Perineal Tearing During Childbirth?",{"_type":58,"style":78,"_key":8459,"markDefs":8460,"children":8465},"961a02307422",[8461],{"type":194,"internalLink":8462,"blank":192,"_type":67,"_key":8464},{"_ref":8463,"_type":197},"61da27b9-4180-4e64-b96c-e0aab2081215","f0f220b78d8c",[8466,8470,8473],{"_type":56,"marks":8467,"text":8468,"_key":8469},[],"Firstly, as noted in our previous ","7eade64dc16c",{"marks":8471,"text":37,"_key":8472,"_type":56},[8464],"acfdcedd239e",{"text":8474,"_key":8475,"_type":56,"marks":8476},", about 90% of women and birthing people giving birth for the first time will experience some form of perineal trauma and for the majority that trauma will be considered minor (first- or second-degree tear, or grazes) and will heal well with no long-lasting complications. Not all of these minor tears will require suturing. About 25% of women in England and Wales will experience an episiotomy during childbirth. Less than 4% of women and birthing people will experience a third- or fourth-degree tear (also called a severe perineal tear), which can result in both short- and long-term complications and requires specialist input.","dab08272ee79",[],{"_type":58,"style":59,"_key":8478,"markDefs":8479,"children":8480},"b18978784498",[],[8481],{"text":8482,"_key":8483,"_type":56,"marks":8484},"What Are the Risk Factors for Tearing During Birth?","bf8da7901fce",[],{"style":78,"_key":8486,"markDefs":8487,"children":8488,"_type":58},"96f76006e9c8",[],[8489],{"_key":8490,"_type":56,"marks":8491,"text":8492},"e5d91890dbbd",[],"Some of the risk factors include:",{"_key":8494,"listItem":914,"markDefs":8495,"children":8496,"level":921,"_type":58,"style":78},"731963edbc51",[],[8497],{"_key":8498,"_type":56,"marks":8499,"text":8500},"bfb78f3f5d89",[],"Having your first baby",{"_type":58,"style":78,"_key":8502,"listItem":914,"markDefs":8503,"children":8504,"level":921},"279252df012f",[],[8505],{"_type":56,"marks":8506,"text":8507,"_key":8508},[],"Having an instrumental assisted birth (forceps or ventouse)","98f2478eca7e",{"children":8510,"level":921,"_type":58,"style":78,"_key":8515,"listItem":914,"markDefs":8516},[8511],{"_type":56,"marks":8512,"text":8513,"_key":8514},[],"Having a baby over 4000g (you can’t accurately know a baby’s weight until they’ve been born)","310d31f1e004","2a84a5a9a557",[],{"_type":58,"style":78,"_key":8518,"listItem":914,"markDefs":8519,"children":8520,"level":921},"42df52905abe",[],[8521],{"_type":56,"marks":8522,"text":8523,"_key":8524},[],"Having an induction of labour","b7eb7431507e",{"style":78,"_key":8526,"listItem":914,"markDefs":8527,"children":8528,"level":921,"_type":58},"c297ffb7c508",[],[8529],{"_type":56,"marks":8530,"text":8531,"_key":8532},[],"Having a connective tissue disorder","45f1d706086d",{"_key":8534,"markDefs":8535,"children":8536,"_type":58,"style":59},"61d1401a0080",[],[8537],{"marks":8538,"text":8539,"_key":8540,"_type":56},[],"The Research on Perineal Trauma","83daf639dcd6",{"style":78,"_key":8542,"markDefs":8543,"children":8547,"_type":58},"b500803356a3",[8544],{"_type":67,"_key":8545,"type":65,"url":8546},"d9c0bcf19e24","https://www.cochrane.org/CD006672/PREG_perineal-techniques-during-second-stage-labour-reducing-perineal-trauma",[8548,8552,8556],{"_type":56,"marks":8549,"text":8550,"_key":8551},[],"A 2017 ","f2d0d9fda63e",{"_type":56,"marks":8553,"text":8554,"_key":8555},[8545],"Cochrane review","246ed303e430",{"_key":8557,"_type":56,"marks":8558,"text":8559},"9f86548c1824",[]," looked at the literature on methods of reducing perineal trauma in the second stage of labour (this is defined as the time when the cervix is fully dilated to when the baby is born). 20 studies, comprising of 15,181 women, contributed to this review. Below are the conclusions of the researched techniques:",{"_type":58,"style":59,"_key":8561,"markDefs":8562,"children":8563},"c9083d4365f7",[],[8564],{"text":8565,"_key":8566,"_type":56,"marks":8567},"Hands-On vs. Hands-Off: Which Technique Reduces Tearing?","46ae729a71cf",[],{"markDefs":8569,"children":8578,"_type":58,"style":78,"_key":8607},[8570,8573,8575],{"_type":67,"_key":8571,"type":65,"url":8572},"4f2842177a74","https://www.rcog.org.uk/for-the-public/perineal-tears-and-episiotomies-in-childbirth/perineal-tears-during-childbirth/#:~:text=Up%20to%209%20in%20every,the%20types%20of%20perineal%20tear%3F",{"url":8041,"_type":67,"_key":8574,"type":65},"2f27b00a4d76",{"_key":8576,"type":65,"url":8577,"_type":67},"87f9979941a1","https://www.all4maternity.com/the-uk-oasi-care-bundle-the-results-are-out-but-so-is-the-jury/",[8579,8583,8587,8591,8595,8599,8603],{"_key":8580,"_type":56,"marks":8581,"text":8582},"3141d952ae55",[],"This is when the midwife or doctor either has one hand ‘supporting’ the perineum and the other ‘controlling’ the birth of the baby’s head (hands-on) or where they keep their hands away from the perineum during the birth of a baby (hands-off). The Cochrane review found there was no difference in perineal trauma outcomes between using a hands-on or a hands-off technique. Which is interesting as there is a drive to introduce ‘perineal care bundles’ – such as the PEACHES and the OASI care bundles – both of which promote a ‘hands on’ approach with the aim of reducing ",{"marks":8584,"text":8585,"_key":8586,"_type":56},[8571],"third- and fourth-degree tears","4f0d9819bf21",{"_type":56,"marks":8588,"text":8589,"_key":8590},[],". Furthermore, the very recent All Party Parliamentary Group (APPG) ","ae88335b7e8b",{"_type":56,"marks":8592,"text":8593,"_key":8594},[8574],"report","52119b7d567f",{"text":8596,"_key":8597,"_type":56,"marks":8598}," on birth trauma has recommended that the OASI care bundle be rolled out across all NHS trusts. ","9fdd5ae60b90",[],{"_key":8600,"_type":56,"marks":8601,"text":8602},"06b26a8cb0a7",[8576],"Here",{"marks":8604,"text":8605,"_key":8606,"_type":56},[]," is a great critique of the OASI care bundle and the lack of robust evidence to support it.","282d211a0922","1b78670c2a5c",{"markDefs":8609,"children":8610,"_type":58,"style":78,"_key":8622},[],[8611,8615,8619],{"text":8612,"_key":8613,"_type":56,"marks":8614},"I have a funny memory of a being called in to a waterbirth that was going swimmingly (pun absolutely intended) and watching the lead midwife attempt to do a hands-on technique with the woman in the pool! Mind. Blown. For starters, that midwife’s back – ouch. Secondly, what is a hands-on technique going to achieve in a pool, when a woman is birthing physiologically and not being directed to push her baby out? Why disrupt the flow in that moment? Anyway, that’s a chat for another time. The final thing that the Cochrane review noted was that in a couple of studies, ","f605c157f9d6",[],{"_key":8616,"_type":56,"marks":8617,"text":8618},"eceb53de14e4",[108],"episiotomy rates were actually higher in the hands-on group",{"_type":56,"marks":8620,"text":1183,"_key":8621},[],"fbe8f2148612","cdf4e3aead01",{"link":8624,"_key":8627,"_type":190},{"text":8625,"type":194,"internalLink":8626,"blank":192,"_type":67},"Find out more about us!",{"_ref":1831,"_type":197},"55f90f166d9b",{"children":8629,"_type":58,"style":59,"_key":8634,"markDefs":8635},[8630],{"text":8631,"_key":8632,"_type":56,"marks":8633},"\nDo Warm Compresses During Labour Reduce Tearing?","eeda1566b217",[],"27763eae6c35",[],{"children":8637,"_type":58,"style":78,"_key":8642,"markDefs":8643},[8638],{"marks":8639,"text":8640,"_key":8641,"_type":56},[],"This is when a warm compress or flannel is gently applied to the perineum during the pushing phase. The Cochrane review found that they made no difference to the incidence of first- or second-degree tears or episiotomy rates, but they did appear to reduce the incidence of third- and fourth-degree tears. In our experience, some women and birthing people find a warm compress extremely soothing, and others would rather not have anyone near their perineum whilst they’re pushing a baby out. The choice, as always is yours. If you think a warm compress may be beneficial to you, include it in your birth plan. You can always ask for it if it has not been offered, and you can change your mind if actually having a warm compress on your perineum feels too invasive in the moment.","87d4ace446b3","73eabcf581d4",[],{"_key":8645,"markDefs":8646,"children":8647,"_type":58,"style":59},"f3f56677f32e",[],[8648],{"_type":56,"marks":8649,"text":8650,"_key":8651},[],"Does Perineal Massage During Labour Help?","0d584a40c45e",{"_key":8653,"markDefs":8654,"children":8655,"_type":58,"style":78},"1834df625052",[],[8656],{"_type":56,"marks":8657,"text":8658,"_key":8659},[],"In this context, the Cochrane review looked at the perineum being massaged by a midwife or doctor to try and stretch it as the baby’s head is coming, this is different to antenatal perineal massage which will be discussed later on. The Cochrane review concluded that there was poor quality data to suggest that it may reduce the incidence of episiotomy but made no difference to first- or second-degree tears. There was some evidence to suggest that women who received ‘warm’ perineal massage were less likely to experience third- or fourth-degree tears – athough, it is unclear what constitutes ‘warm’ perineal massage.","917ba8c16034",{"markDefs":8661,"children":8662,"_type":58,"style":78,"_key":8667},[],[8663],{"text":8664,"_key":8665,"_type":56,"marks":8666},"The perineal massage I have witnessed during my years of hospital-based midwifery has felt incredibly invasive – because it is. Notably if someone had an epidural, it was seen as a free pass to go overboard with the stretching, because hey – they can’t feel it right? And at that point in labour – how likely are we to be truly providing any stretch to the perineum? I think that perineal massage/stretching during the pushing phase is a way for healthcare professionals to feel like they’re ‘doing something’ or a bizarre attempt to speed the process up. Not a fan.","fa47e7b02f3f",[],"46bee36097c6",{"_type":58,"style":59,"_key":8669,"markDefs":8670,"children":8671},"1d5a85f75d89",[],[8672],{"marks":8673,"text":8674,"_key":8675,"_type":56},[],"What Is Ritgen's Manoeuvre and Does It Work?","976b9134b237",{"children":8677,"_type":58,"style":78,"_key":8690,"markDefs":8691},[8678,8682,8686],{"_type":56,"marks":8679,"text":8680,"_key":8681},[],"This is when the healthcare provider uses one hand to externally extract the baby’s chin from between the maternal anus and the coccyx and the other hand is placed directly on the baby’s head to control the speed of the birth and keep the baby’s head and neck flexed. The Cochrane review did not find much high-quality evidence regarding Ritgen’s manoeuvre, but what they did note from the research reviewed was that it made no difference to the likelihood of an intact perineum and actually ","6e91d863ee63",{"text":8683,"_key":8684,"_type":56,"marks":8685},"increased the chance of a second-degree tear","32fbbef3eab0",[108],{"marks":8687,"text":8688,"_key":8689,"_type":56},[],". There was no difference in rates of third- and fourth-degree tears or episiotomies.","b21d43d51f58","f702d686e44c",[],{"style":78,"_key":8693,"markDefs":8694,"children":8695,"_type":58},"ef9831ed59e5",[],[8696,8700,8704],{"_key":8697,"_type":56,"marks":8698,"text":8699},"0fa34715547f",[],"This Cochrane review concluded that warm compresses and perineal massage in the second stage of labour, ",{"_key":8701,"_type":56,"marks":8702,"text":8703},"ea678bbbbe12",[281],"may",{"_key":8705,"_type":56,"marks":8706,"text":8707},"bfc047343e7f",[]," reduce the incidence of third- and fourth-degree tears but that overall more research needs to be done to look at other outcomes. For example, are these techniques acceptable to women and birthing people? And if a labour is progressing physiologically and spontaneously, why mess with that process?",{"_type":190,"link":8709,"_key":8711},{"type":194,"internalLink":8710,"blank":192,"_type":67,"text":4079},{"_ref":196,"_type":197},"903f5ff2ef4d",{"children":8713,"_type":58,"style":59,"_key":8718,"markDefs":8719},[8714],{"_key":8715,"_type":56,"marks":8716,"text":8717},"746c8d21cf01",[],"Does Antenatal Perineal Massage Reduce the Risk of Tearing?","86901d61101e",[],{"_type":58,"style":78,"_key":8721,"markDefs":8722,"children":8726},"c5752e72b21b",[8723],{"_type":67,"_key":8724,"type":65,"url":8725},"9e50dfade074","https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005123.pub3/full",[8727,8731,8734,8738,8742],{"_key":8728,"_type":56,"marks":8729,"text":8730},"a65d4dd10119",[],"A 2013 ",{"_type":56,"marks":8732,"text":8554,"_key":8733},[8724],"5706755a02a9",{"_type":56,"marks":8735,"text":8736,"_key":8737},[]," looked at studies on antenatal perineal massage for at least four weeks prior to giving birth, to reduce the incidence of perineal trauma. They included four trials and a total of 2497 women. This review found that antenatal perineal massage was ","d2e9ee114294",{"marks":8739,"text":8740,"_key":8741,"_type":56},[281],"‘associated with an overall reduction in the incidence of perineal trauma requiring suturing…and women practicing perineal massage were less likely to experience episiotomy’.","2202c8170b12",{"text":8743,"_key":8744,"_type":56,"marks":8745}," The findings of this review were however only statistically significant for women giving birth for the first time.","42e6ab14a6ac",[],{"_type":58,"style":78,"_key":8747,"markDefs":8748,"children":8752},"efae14be95b9",[8749],{"internalLink":8750,"_type":67,"_key":8751,"type":194},{"_ref":8463,"_type":197},"747926749330",[8753,8757,8760],{"_type":56,"marks":8754,"text":8755,"_key":8756},[],"The overall reduction in perineal trauma was found to be 9% for women giving birth for the first time, and there was an overall reduction of 16% for episiotomies. The review found no difference in the incidence of first-, second-, third- or fourth-degree tears between women who used perineal massage and those who did not. So, the Cochrane review noted that the overall reduction in perineal trauma requiring suturing was likely to be due to less women giving birth for the first time experiencing an episiotomy. The review found that for every 15 women who practiced antenatal perineal massage, one fewer would require perineal suturing. In terms of the actual perineal massage, the review found that women who practised perineal massage more than 3.5 times a week did not experience an increased reduction in perineal trauma requiring suturing or episiotomy – which is good to know as some websites suggest massaging daily! Again, as per the last ","6f8fc4fafce1",{"_type":56,"marks":8758,"text":37,"_key":8759},[8751],"1b62e051f7aa",{"marks":8761,"text":8762,"_key":8763,"_type":56},[]," – it is worth remembering that an episiotomy is not a natural outcome of childbirth – a midwife or obstetrician has made the subjective decision (which should always be with consent) that one is necessary to help a baby be born – and this decision will be based on their experience and the culture of the maternity unit they practise in. ","bf53ae0eea6a",{"markDefs":8765,"children":8766,"_type":58,"style":78,"_key":8771},[],[8767],{"_type":56,"marks":8768,"text":8769,"_key":8770},[],"If you’re giving birth for the first time, there may be some benefit to practising perineal massage in the weeks leading up to giving birth. Some women and birthing people may find this empowering and useful to ‘get to know’ their perineum, others may find it uncomfortable and tricky to do. If perineal massage is something you want to try, you can find plenty of online guides on how to do it and if the idea of it doesn’t float your boat, don’t stress about it!","dd51ea335244","c3230c858a3f",{"children":8773,"_type":58,"style":59,"_key":8778,"markDefs":8779},[8774],{"_type":56,"marks":8775,"text":8776,"_key":8777},[],"The Surprising Factor That Reduces Your Risk of Episiotomy","33f392e89191","f56bb51914a3",[],{"children":8781,"_type":58,"style":78,"_key":8811,"markDefs":8812},[8782,8786,8791,8795,8799,8803,8807],{"_type":56,"marks":8783,"text":8784,"_key":8785},[],"An even more recent ","fcf004533f9d",{"_type":56,"marks":8787,"text":8789,"_key":8790},[8788],"7f940d3b43ee","Lancet review","c9464e16b454",{"marks":8792,"text":8793,"_key":8794,"_type":56},[]," of over ~500’000 women intending to give birth at home, found that for women giving birth for the first time there was ","361268ebed04",{"marks":8796,"text":8797,"_key":8798,"_type":56},[108],"25% reduction in episiotomy","e3805d31c32c",{"_type":56,"marks":8800,"text":8801,"_key":8802},[]," (much higher than antenatal perineal massage…) and for women having a second or more baby, there was a ","156769f8e28a",{"text":8804,"_key":8805,"_type":56,"marks":8806},"50% reduction in the chance of episiotomy!","38c80ad43edf",[108],{"_type":56,"marks":8808,"text":8809,"_key":8810},[]," This doesn’t mean that all the women did give birth at home, but that planning to birth at home reduced this risk, regardless of the actual place of birth. This study also found that overall women who intended to birth at home were less likely to experience a third- or fourth-degree tear, although no difference was found between home and hospital when looking only at women giving birth for the first time.","da30188cb8a9","4a707b34f849",[8813],{"_key":8788,"type":65,"url":8814,"_type":67},"https://www.thelancet.com/action/showPdf?pii=S2589-5370%2820%2930063-8",{"link":8816,"_key":8819,"_type":190},{"type":194,"internalLink":8817,"blank":192,"_type":67,"text":8818},{"_ref":2580,"_type":197},"Chat to us about home birth","87f6c3831b1d",{"markDefs":8821,"children":8825,"_type":58,"style":78,"_key":8843},[8822],{"internalLink":8823,"_type":67,"_key":8824,"type":194},{"_ref":549,"_type":197},"984da8ac7949",[8826,8830,8833,8836,8839],{"_key":8827,"_type":56,"marks":8828,"text":8829},"4af8123f10c7",[281],"We provide individualised, person-centred midwifery care from the antenatal period, through to labour & birth and the postnatal period. Continuity of care is associated with great outcomes for women, birthing people and their babies. You and your birth experience matter. If you would like to invest in a positive maternity experience,",{"_key":8831,"_type":56,"marks":8832,"text":4274},"7f0ae372bb68",[],{"text":4724,"_key":8834,"_type":56,"marks":8835},"b7f3456a4612",[281,8824],{"marks":8837,"text":4274,"_key":8838,"_type":56},[],"cd65b368eccf",{"marks":8840,"text":8841,"_key":8842,"_type":56},[281],"to arrange a free, no-strings attached consultation with us.","bbfefa4ba483","f700f8a0d444","2025-04-07T15:19:52Z",{"_createdAt":8846,"_updatedAt":8847,"_type":37,"slug":8848,"image":8850,"title":8853,"_system":8854,"_rev":8857,"_id":8463,"publishedAt":8858,"content":8859},"2025-04-07T15:19:46Z","2026-03-11T19:37:25Z",{"_type":8,"current":8849},"do-perineal-massage-devices-actually-work-the-evidence-behind-the-claims",{"asset":8851,"_type":586},{"_ref":8852,"_type":197},"image-eac3997e83d81370a41717450de3cd1532f408ca-1080x1350-jpg","Do Perineal Massage Devices Actually Work? The Evidence Behind the Claims",{"base":8855},{"id":8463,"rev":8856},"c1HqLtX09dCBnnfIQfAxq2","7l2KCMg711eQ9a3UN6phMF","2024-05-13",{"body":8860,"_type":49},[8861,8868,8886,8894,8902,8910,8934,8942,8950,8958,8966,8971,8979,9001,9009,9021,9029,9037,9045,9053,9061,9069,9077,9085,9089,9097,9118,9126,9134,9142,9150,9157,9165,9184,9192,9200,9205,9213,9235,9243,9251,9259,9267,9275,9283,9291,9308,9324,9332,9350,9358,9377,9406,9414,9432,9450,9458,9466],{"style":59,"_key":8862,"markDefs":8863,"children":8864,"_type":58},"89ebb881f152",[],[8865],{"marks":8866,"text":8457,"_key":8867,"_type":56},[],"958e9e7fee11",{"style":78,"_key":8869,"markDefs":8870,"children":8873,"_type":58},"112ef5be4514",[8871],{"type":65,"url":8572,"_type":67,"_key":8872},"0ab25b704155",[8874,8878,8882],{"text":8875,"_key":8876,"_type":56,"marks":8877},"I know nobody wants to hear this, but perineal tearing is a normal part of childbirth, but rest assured that most tears will heal well. The Royal College of Obstetricians and Gynaecologists (RCOG) state that up to 9 out of 10 women giving birth for the first time will experience some form of perineal tearing, with most being minor. Perineal tears are classified in the following way: first, second, third and fourth. The RCOG have a ","0b5e2e097e9e",[],{"marks":8879,"text":8880,"_key":8881,"_type":56},[8872],"guide","d2e6cb38d3a9",{"_key":8883,"_type":56,"marks":8884,"text":8885},"a68c78da8231",[]," on the different types of tear and what they anatomically involve, should you wish to learn more. ",{"markDefs":8887,"children":8888,"_type":58,"style":78,"_key":8893},[],[8889],{"marks":8890,"text":8891,"_key":8892,"_type":56},[],"There is understandably anxiety amongst some women and birthing people about this, because I mean, who would be thrilled at the prospect of a perineal or a vaginal tear? So, whilst yes, tearing is a very common and normal part of childbirth, I don’t intend to minimise the impact it can have – whether that’s antenatal anxiety and/or postnatal physical discomfort.","30352c27dddd","b85c51bfd07a",{"style":59,"_key":8895,"markDefs":8896,"children":8897,"_type":58},"b0bd248197f3",[],[8898],{"_type":56,"marks":8899,"text":8900,"_key":8901},[],"What Are Perineal Massage Devices and What Do They Claim?","95764340e4a8",{"style":78,"_key":8903,"markDefs":8904,"children":8905,"_type":58},"23b317d2639a",[],[8906],{"marks":8907,"text":8908,"_key":8909,"_type":56},[],"If your social media algorithm is anything like mine, you may have seen adverts for devices that claim to reduce the chance of tearing and/or episiotomy (an intentional cut to the vagina during childbirth) during childbirth. Which sounds pretty good right?","612b4d546ebc",{"_type":58,"style":78,"_key":8911,"markDefs":8912,"children":8913},"5586a04bf6fd",[],[8914,8918,8922,8926,8930],{"text":8915,"_key":8916,"_type":56,"marks":8917},"These vaginal dilators and perineal massagers claim to prepare the perineum (and sometimes the pelvic floor) to stretch for childbirth, reduce the chance of tearing, increase ","ce2a07970b9e",[],{"marks":8919,"text":8920,"_key":8921,"_type":56},[108],"‘control during delivery’","181de9b8c959",{"_key":8923,"_type":56,"marks":8924,"text":8925},"f628c7710496",[]," and cause ",{"_type":56,"marks":8927,"text":8928,"_key":8929},[108],"‘less stress for mother and baby during the second stage’","37d28785964e",{"text":8931,"_key":8932,"_type":56,"marks":8933},", to name a few. I, for one, would love to know what evidence there is that a vaginal dilator reduces the stress for a mother and baby…","50e5a25eb34a",[],{"markDefs":8935,"children":8936,"_type":58,"style":78,"_key":8941},[],[8937],{"_type":56,"marks":8938,"text":8939,"_key":8940},[],"So, are these bold claims based on any solid evidence? Despite some incredibly effective marketing, the actual evidence to back up the claims is limited. The three delightfully named devices I will be looking at in this blog are:","ed401adbfbbf","03d1b9f0ceb3",{"_key":8943,"markDefs":8944,"children":8945,"_type":58,"style":78},"57d77a856f97",[],[8946],{"_type":56,"marks":8947,"text":8948,"_key":8949},[],"– The Aniball","426aad37f7d3",{"markDefs":8951,"children":8952,"_type":58,"style":78,"_key":8957},[],[8953],{"marks":8954,"text":8955,"_key":8956,"_type":56},[],"– The EPI-NO","905d5e0422c9","255fc0ff91bc",{"style":78,"_key":8959,"markDefs":8960,"children":8961,"_type":58},"dd3e8fdaaa39",[],[8962],{"_key":8963,"_type":56,"marks":8964,"text":8965},"d597423752d6",[],"– The Perimom",{"link":8967,"_key":8970,"_type":190},{"text":8968,"type":194,"internalLink":8969,"blank":192,"_type":67},"Discover our care packages",{"_type":197,"_ref":196},"bfb12975cf4c",{"style":59,"_key":8972,"markDefs":8973,"children":8974,"_type":58},"734c4d5f5b6a",[],[8975],{"text":8976,"_key":8977,"_type":56,"marks":8978},"\nDoes the Aniball Reduce Tearing? What the Data Shows","1b1e2f4c14c0",[],{"children":8980,"_type":58,"style":78,"_key":8999,"markDefs":9000},[8981,8985,8988,8992,8995],{"text":8982,"_key":8983,"_type":56,"marks":8984},"Aniball","d40b95f0b3ba",[108],{"marks":8986,"text":5580,"_key":8987,"_type":56},[],"220c702bdf13",{"marks":8989,"text":8990,"_key":8991,"_type":56},[108],"Cost: £59.95","88d0c3ae6b70",{"marks":8993,"text":5580,"_key":8994,"_type":56},[],"55d4f10ff777",{"marks":8996,"text":8997,"_key":8998,"_type":56},[108],"Method: Vaginal dilator","3012fdba19a0","fac3b7d0ea2f",[],{"_type":58,"style":78,"_key":9002,"markDefs":9003,"children":9004},"1db4cb4458c3",[],[9005],{"marks":9006,"text":9007,"_key":9008,"_type":56},[],"Here are some direct quotes from the Aniball website:","5ad566c72ee6",{"style":78,"_key":9010,"markDefs":9011,"children":9012,"_type":58},"9bc596d92ad3",[],[9013,9017],{"marks":9014,"text":9015,"_key":9016,"_type":56},[],"‘","0f2ecc1f28ca",{"_key":9018,"_type":56,"marks":9019,"text":9020},"62e8a7841546",[281],"Experience natural birth without tearing or interventions’.",{"_type":58,"style":78,"_key":9022,"markDefs":9023,"children":9024},"9f0cb1826d77",[],[9025],{"text":9026,"_key":9027,"_type":56,"marks":9028},"‘Aniball is a proven pelvic floor trainer, it greatly reduces the risk of tearing or episiotomy and speeds up your postpartum pelvic floor recovery’.","6304493ef70f",[281],{"_key":9030,"markDefs":9031,"children":9032,"_type":58,"style":78},"e467a49d0142",[],[9033],{"_type":56,"marks":9034,"text":9035,"_key":9036},[281],"‘With Aniball, you greatly increase the chance of a positive birth experience without tearing.’","af41b8a5a617",{"children":9038,"_type":58,"style":78,"_key":9043,"markDefs":9044},[9039],{"text":9040,"_key":9041,"_type":56,"marks":9042},"Aniball cites one 2016 study from the Czech Republic as evidence for its effectiveness. Unfortunately, the full text article is not freely available online (although I did email the journal asking for a copy…). Below is what I gained from the article abstract:","0f83ea658e63",[],"9e3d34189dee",[],{"_key":9046,"markDefs":9047,"children":9048,"_type":58,"style":78},"21c83b2408f3",[],[9049],{"text":9050,"_key":9051,"_type":56,"marks":9052},"A retrospective study, looking at 315 primiparous (first time birthing) women, who were questioned following their birth about methods they used to try and prevent perineal tearing. Methods quoted were: Vaginal dilators such as the Aniball and the EPI-NO, perineal massage and so called ‘natural methods’ which included linseed and raspberry leaf tea.","89c663acc0f6",[281],{"markDefs":9054,"children":9055,"_type":58,"style":78,"_key":9060},[],[9056],{"_key":9057,"_type":56,"marks":9058,"text":9059},"325e10356e46",[281],"Women who used methods to prevent perineal trauma during pregnancy were compared with a control group of women who did not use any methods during their pregnancy. Women who experienced spontaneous vaginal birth and instrumental assisted (forceps or ventouse) birth were included in the study.","4cb94f3bb7bb",{"_type":58,"style":78,"_key":9062,"markDefs":9063,"children":9064},"54c676185e59",[],[9065],{"text":9066,"_key":9067,"_type":56,"marks":9068},"The authors report a significantly higher rate of an intact perineum amongst women who used vaginal dilators in pregnancy: 43.1% vs. 14.1% in the control group, they also found less episiotomies at 29.3% vs. 57.7%. They also reported a lower rate of instrumental assisted birth following the use of vaginal dilators. They found no difference in perineal outcomes for women using linseed or raspberry leaf tea.","2c7e6a9a4487",[281],{"style":78,"_key":9070,"markDefs":9071,"children":9072,"_type":58},"707df39bb5ea",[],[9073],{"_type":56,"marks":9074,"text":9075,"_key":9076},[],"So, we have a small study population, unassisted vaginal births being grouped with instrumental assisted births and an episiotomy rate that is far higher than the average rate in the UK. Furthermore, the abstract doesn’t go into detail about when in pregnancy the women started using the vaginal dilators and how often they did the exercises. All of which doesn’t scream ‘robust data’.","5adad3250c72",{"markDefs":9078,"children":9079,"_type":58,"style":78,"_key":9084},[],[9080],{"_key":9081,"_type":56,"marks":9082,"text":9083},"32bd9b5062d5",[],"The claims of the Aniball (see quotes above…or go and check out their website for fun!) cannot be said to be based on good evidence.","b292c85b03c8",{"_type":190,"link":9086,"_key":9088},{"type":194,"internalLink":9087,"blank":192,"_type":67,"text":4700},{"_ref":4702,"_type":197},"f24c26b43cf0",{"children":9090,"_type":58,"style":59,"_key":9095,"markDefs":9096},[9091],{"text":9092,"_key":9093,"_type":56,"marks":9094},"Does the EPI-NO Reduce Tearing? What the Data Shows","a7e255b77ec6",[],"4a34666b1c83",[],{"children":9098,"_type":58,"style":78,"_key":9116,"markDefs":9117},[9099,9103,9106,9110,9113],{"_type":56,"marks":9100,"text":9101,"_key":9102},[108],"EPI-NO","4a34099f66e1",{"marks":9104,"text":5580,"_key":9105,"_type":56},[],"0d4ce1f1fddf",{"_type":56,"marks":9107,"text":9108,"_key":9109},[108],"Cost: £99.99","2d4bb5f16843",{"_type":56,"marks":9111,"text":5580,"_key":9112},[],"70c3bd53a725",{"_key":9114,"_type":56,"marks":9115,"text":8997},"93a78fa086ad",[108],"124c563e40a8",[],{"markDefs":9119,"children":9120,"_type":58,"style":78,"_key":9125},[],[9121],{"_key":9122,"_type":56,"marks":9123,"text":9124},"6dd6baa51a94",[],"Quotes from the EPI-NO website says:","7cff1adc5fb7",{"markDefs":9127,"children":9128,"_type":58,"style":78,"_key":9133},[],[9129],{"_type":56,"marks":9130,"text":9131,"_key":9132},[281],"‘The best birth preparation training device’","8a34416253e7","10745867c9cc",{"_key":9135,"markDefs":9136,"children":9137,"_type":58,"style":78},"f1b5a1081bbb",[],[9138],{"text":9139,"_key":9140,"_type":56,"marks":9141},"‘…clinically proven to significantly increase the chance of an intact perineum, control during delivery and is more effective than perineal massage’.","4a5ac0f0640d",[281],{"_key":9143,"markDefs":9144,"children":9145,"_type":58,"style":78},"616b4bfbf6e1",[],[9146],{"_type":56,"marks":9147,"text":9148,"_key":9149},[281],"‘Using EPI-NO from 37 weeks has been proven to reduce tearing by up to 42%’","80020356dd5d",{"_key":9151,"markDefs":9152,"children":9153,"_type":58,"style":78},"e0c71e25bd7c",[],[9154],{"_key":9155,"_type":56,"marks":9156,"text":9092},"1f1b403d98fd",[],{"markDefs":9158,"children":9159,"_type":58,"style":78,"_key":9164},[],[9160],{"text":9161,"_key":9162,"_type":56,"marks":9163},"EPI-NO has a page on its website for data and cites several studies (an Australian pilot study from 2004, a 2004 Israeli study by a midwife who distributed the EPI-NO, a 2009 German prospective RCT involving 276 women, a German study of 80 women from 2000, a German study in 2001 involving 50 women) that support the use of the EPI-NO as a method for reducing episiotomies and perineal tears. They have also included the experiences of several midwives in this page called ‘Data and Clinical Trials’.","f176b71f5463",[],"eee29a9cffcd",{"markDefs":9166,"children":9170,"_type":58,"style":78,"_key":9183},[9167],{"type":65,"url":9168,"_type":67,"_key":9169},"https://epi-no.co.uk/wp-content/uploads/2020/11/2-Efficacy_Tollerability_Study_Jan_2016.pdf","dea254846ba0",[9171,9175,9179],{"_type":56,"marks":9172,"text":9173,"_key":9174},[],"Most of the studies cited are over 20 years old and involved a small number of participants. The most recent article is a ","eb3e30e04200",{"text":9176,"_key":9177,"_type":56,"marks":9178},"2016 literature review","3e738122c0f7",[9169],{"_key":9180,"_type":56,"marks":9181,"text":9182},"ceb2d00f4c6d",[]," of the existing research on the use of the EPI-NO, which found 5 studies and concluded that whilst the EPI-NO has the potential to be a promising device, there is no good evidence available to support the claims of reduced episiotomy and perineal tear rates. ","99a7c68c8aa3",{"markDefs":9185,"children":9186,"_type":58,"style":78,"_key":9191},[],[9187],{"_type":56,"marks":9188,"text":9189,"_key":9190},[],"Where EPI-NO has got the figure of a 42% reduction in tears is not clear…possibly from their survey of 1323 women between 2021-2023…? What’s interesting about that survey is that 35% of the women reported they had an episiotomy and 13.3% had a third- or fourth-degree tear – both of these figures are higher than the UK national average of approximately 25% and 3.1%, respectively.","35be73e1dab8","36c05b09e020",{"style":78,"_key":9193,"markDefs":9194,"children":9195,"_type":58},"970857b497d2",[],[9196],{"_type":56,"marks":9197,"text":9198,"_key":9199},[],"On another page of the website EPI-NO claims that by using their device, the chance of episiotomy is reduced by 65%, with a link to survey results that doesn’t work…I don’t know about you, but I am seeing holes in these claims.","2ffe4cf45d65",{"_type":190,"link":9201,"_key":9204},{"type":194,"internalLink":9202,"blank":192,"_type":67,"text":9203},{"_ref":2580,"_type":197},"Need help birth planning? get in touch.","db2e6e326b3a",{"_key":9206,"markDefs":9207,"children":9208,"_type":58,"style":59},"39c570d52426",[],[9209],{"text":9210,"_key":9211,"_type":56,"marks":9212},"Does the Perimom Work? What the Research Says","cb12d496543d",[],{"markDefs":9214,"children":9215,"_type":58,"style":78,"_key":9234},[],[9216,9220,9223,9227,9230],{"_type":56,"marks":9217,"text":9218,"_key":9219},[108],"Perimom","246bf09c744b",{"_type":56,"marks":9221,"text":5580,"_key":9222},[],"4d65417eb135",{"text":9224,"_key":9225,"_type":56,"marks":9226},"Cost: £32","0860c1193a0d",[108],{"_type":56,"marks":9228,"text":5580,"_key":9229},[],"034e923e5132",{"_type":56,"marks":9231,"text":9232,"_key":9233},[108],"Method: Perineal massage tool","f6ede6d2407c","6d9665a2c76b",{"children":9236,"_type":58,"style":78,"_key":9241,"markDefs":9242},[9237],{"_type":56,"marks":9238,"text":9239,"_key":9240},[],"Quotes from the Perimom website:","2d5a6d8830fd","e4f7ae09782d",[],{"_type":58,"style":78,"_key":9244,"markDefs":9245,"children":9246},"742aa093018d",[],[9247],{"marks":9248,"text":9249,"_key":9250,"_type":56},[281],"‘The ultimate tool for perineal massage’","c72ae0e45d9d",{"markDefs":9252,"children":9253,"_type":58,"style":78,"_key":9258},[],[9254],{"marks":9255,"text":9256,"_key":9257,"_type":56},[281],"‘…a thumb shaped tip allows you to perform the massage at the right angle…like it’s been done for generations.’","079493ae91ea","dc8f89fe87c7",{"_key":9260,"markDefs":9261,"children":9262,"_type":58,"style":78},"48f81f07734f",[],[9263],{"_type":56,"marks":9264,"text":9265,"_key":9266},[281],"‘You’re doing everything you can to prepare yourself for a positive birthing experience.’","0867184344ba",{"children":9268,"_type":58,"style":78,"_key":9273,"markDefs":9274},[9269],{"_key":9270,"_type":56,"marks":9271,"text":9272},"421c67c1ee47",[],"Presumably, with the last quote, they mean, by doing perineal massage.","0f3f2c0664e7",[],{"_type":58,"style":78,"_key":9276,"markDefs":9277,"children":9278},"b5328b148a4c",[],[9279],{"marks":9280,"text":9281,"_key":9282,"_type":56},[108],"What’s the data?","b4c484019508",{"_type":58,"style":78,"_key":9284,"markDefs":9285,"children":9286},"7e98366ec4c1",[],[9287],{"_key":9288,"_type":56,"marks":9289,"text":9290},"674c0d1bc587",[],"So, there’s no specific data on the use of the Perimom, but there are several research papers on perineal massage.",{"style":78,"_key":9292,"markDefs":9293,"children":9297,"_type":58},"7bb24cc30d20",[9294],{"_key":9295,"type":65,"url":9296,"_type":67},"cf3acbd01acc","https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005123.pub3/full#CD005123-sec-0067",[9298,9301,9304],{"_key":9299,"_type":56,"marks":9300,"text":2829},"ec8b983a6065",[],{"_key":9302,"_type":56,"marks":9303,"text":8554},"7ef8613d4d17",[9295],{"_type":56,"marks":9305,"text":9306,"_key":9307},[],", which looked at 4 studies, found that doing antenatal perineal massage did not alter the likelihood of women having first, second, third or fourth degree tears; but it did appear to reduce the incidence of episiotomy by 16%. They also concluded there was no difference in the chance of assisted vaginal birth.","52de4d2a824d",{"markDefs":9309,"children":9310,"_type":58,"style":78,"_key":9323},[],[9311,9315,9319],{"_key":9312,"_type":56,"marks":9313,"text":9314},"edad458af4cf",[],"I’m not convinced women have been doing perineal massage ‘for generations’ – but it ",{"_type":56,"marks":9316,"text":9317,"_key":9318},[281],"sounds","39ba8c3cc938",{"_type":56,"marks":9320,"text":9321,"_key":9322},[]," good right? I also can’t ignore that the Perimom resembles a shoe horn.","ae7b16a4ce08","2c35023463c4",{"_type":58,"style":59,"_key":9325,"markDefs":9326,"children":9327},"87d8732ccd81",[],[9328],{"text":9329,"_key":9330,"_type":56,"marks":9331},"Does Your Perineum Actually Need to Be 'Prepared' for Birth?","628c53802d9f",[],{"_type":58,"style":78,"_key":9333,"markDefs":9334,"children":9338},"ec29b4bda57b",[9335],{"url":9336,"_type":67,"_key":9337,"type":65},"https://midwifethinking.com/2016/01/13/perineal-protectors/","451652423807",[9339,9343,9346],{"_type":56,"marks":9340,"text":9341,"_key":9342},[],"All these devices claim to reduce the incidence of perineal trauma. They also feed into the idea that the perineum needs to be prepared for childbirth, that women and birthing people’s bodies are so inherently flawed that they must be prepared for birth. Rachel Reed writes wonderfully (as per) about this ","2a2d7fc9dc1d",{"_type":56,"marks":9344,"text":249,"_key":9345},[9337],"217b655576ba",{"_type":56,"marks":9347,"text":9348,"_key":9349},[]," and notes that whether a woman ‘prepares’ her perineum during pregnancy or not – it will indeed stretch during childbirth. Perineal trauma as mentioned earlier is a very common and normal part of childbirth. It is also however influenced by childbirth practices – for example, research shows that giving birth on your back increases the chance of perineal trauma. Yet, giving birth on your back is very much the norm.","be4e4d17777e",{"markDefs":9351,"children":9352,"_type":58,"style":59,"_key":9357},[],[9353],{"_key":9354,"_type":56,"marks":9355,"text":9356},"5471b27d84fb",[],"What You Need to Know About Severe Perineal Tears","f2eda2b4d6ba",{"children":9359,"_type":58,"style":78,"_key":9373,"markDefs":9374},[9360,9364,9369],{"_type":56,"marks":9361,"text":9362,"_key":9363},[],"Third- and fourth-degree tears are considered severe, but the incidence is low at 3.1% (or less than 4 per 100) in England and Wales, according to the 2022 ","01afdf19b3e6",{"marks":9365,"text":9367,"_key":9368,"_type":56},[9366],"7433f3245095","National Maternity and Perinatal Audit (NMPA)","84de5e1bc1dd",{"marks":9370,"text":9371,"_key":9372,"_type":56},[],". Interestingly, in the aforementioned EPI-NO survey, 13.3% of women experienced a third- or fourth-degree tear – which is way higher than what the NMPA found. Women giving birth for the first time were found to have an incidence of 4.5% with an unassisted vaginal birth and 6.9% with an instrumental assisted birth. Women and birthing people having their second (or more) baby were noted to have an incidence of 1.3% with an unassisted vaginal birth and 4% with an instrumental assisted birth. Severe tears can be life-altering for women and birthing people and it is very much a postcode lottery in the UK when it comes to support and care following this type of trauma.","a2d63792d585","3f7e014f8213",[9375],{"_key":9366,"type":65,"url":9376,"_type":67},"https://maternityaudit.org.uk/FilesUploaded/Ref%20336%20NMPA%20Clinical%20Report_2022.pdf",{"children":9378,"_type":58,"style":78,"_key":9404,"markDefs":9405},[9379,9383,9387,9390,9393,9396,9400],{"text":9380,"_key":9381,"_type":56,"marks":9382},"The data shows that regardless of if you have an unassisted or an assisted vaginal birth, if you’re giving birth for the first time you have a higher chance of sustaining a third- or fourth-degree tear compared to those giving birth to a second or more baby. And overall, instrumental assisted births increase the chance of sustaining a third- or fourth-degree tear, whether it’s your first or second or more baby. But it is important to remember, there’s still a ","939d4ea8cb1d",[],{"_type":56,"marks":9384,"text":9385,"_key":9386},[108],"significantly higher chance of","e1822ec324c3",{"text":4274,"_key":9388,"_type":56,"marks":9389},"8ce862b332fc",[],{"_key":9391,"_type":56,"marks":9392,"text":1624},"bdb47d9f2e6d",[108,281],{"text":4274,"_key":9394,"_type":56,"marks":9395},"946f4cc87768",[],{"_type":56,"marks":9397,"text":9398,"_key":9399},[108],"having a severe tear","9885515da5fd",{"_type":56,"marks":9401,"text":9402,"_key":9403},[]," during childbirth. ","19dba4b931ea","1aa90605c8ab",[],{"markDefs":9407,"children":9408,"_type":58,"style":59,"_key":9413},[],[9409],{"marks":9410,"text":9411,"_key":9412,"_type":56},[],"The Truth About Episiotomies: How Common Are They Really?","b6b6c0b01451","a8f1778e210a",{"style":78,"_key":9415,"markDefs":9416,"children":9419,"_type":58},"2c46369fcbfd",[9417],{"type":65,"url":9376,"_type":67,"_key":9418},"d0d01315d0e8",[9420,9424,9428],{"marks":9421,"text":9422,"_key":9423,"_type":56},[],"According to data from the ","91de6633aef9",{"text":9425,"_key":9426,"_type":56,"marks":9427},"NMPA","3867d860e442",[9418],{"_type":56,"marks":9429,"text":9430,"_key":9431},[]," in England and Wales, 24.6% of women had an episiotomy. This is separated into 9.7% of women and birthing people having an unassisted vaginal birth and 88.7% of women having an instrumental assisted birth (94.7% for forceps and 79.8% with a ventouse). There was a 35% episiotomy incidence amongst the women who responded to the EPI-NO survey…again, higher than the average in England and Wales.","bc31c1e0417a",{"markDefs":9433,"children":9437,"_type":58,"style":78,"_key":9449},[9434],{"url":9435,"_type":67,"_key":9436,"type":65},"https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000081.pub3/full?highlightAbstract=trauma%7Ctraum%7C*perineal","08b18b2713b3",[9438,9442,9445],{"marks":9439,"text":9440,"_key":9441,"_type":56},[],"Practices around episiotomy vary significantly around the world. In the study that Aniball quotes, the episiotomy rate (29.3%) in women who use a vaginal dilator is also higher than the overall episiotomy rate in England and Wales. Routine episiotomies were introduced as a means of ‘protecting’ the perineum of first-time mothers. At an exhibition we went to in Glasgow recently, it was reported that the rates of episiotomy increased from 5% in 1900 to 80% in 1950. Luckily routine episiotomies are no longer recommended as (surprise, surprise) ","8dfc0bc1c5a9",{"marks":9443,"text":3132,"_key":9444,"_type":56},[9436],"a3ce0345ffe3",{"marks":9446,"text":9447,"_key":9448,"_type":56},[]," does not support this practice. An episiotomy is not a ‘natural’ outcome of childbirth, it is the result of a healthcare professional making the decision that more space is needed in the birth canal. In the same way that any intervention used in childbirth can be be useful and necessary, episiotomies have their place, but I would question if almost a quarter of women and birthing people giving birth vaginally in England and Wales truly need an episiotomy?","c4d2fe3ab875","fe5cf3a85eea",{"_type":58,"style":59,"_key":9451,"markDefs":9452,"children":9453},"42bc113c07da",[],[9454],{"_key":9455,"_type":56,"marks":9456,"text":9457},"9ee5abfaa5cd",[],"Should You Buy a Perineal Massage Device? Our Verdict",{"markDefs":9459,"children":9460,"_type":58,"style":78,"_key":9465},[],[9461],{"_type":56,"marks":9462,"text":9463,"_key":9464},[],"What is perhaps slightly misleading about all of the devices mentioned, is the sense of a promise that using them will make a significant difference to the chances of a perineal tearing – and the data just doesn’t support that. Furthermore, it reinforces the idea that women and birthing people need to prepare the perineum for birth because our bodies are faulty. These companies all use excellent marketing tactics, making it seem as though without them the chance of tearing or having an episiotomy during childbirth is much higher. Oh, and they all encourage the spending of more money on their specialist lubrication too. These companies ignore the different practices of both individual midwives and obstetricians, and the modern day cultural practices around childbirth that contribute to perineal trauma (cascade of interventions anyone…). Educate yourself on physiological birth, learn about the cascade of interventions and don’t waste your money on these products.","8f54d2b5af99","2bce83e18d99",{"markDefs":9467,"children":9468,"_type":58,"style":78,"_key":9473},[],[9469],{"text":9470,"_key":9471,"_type":56,"marks":9472},"In our next blog we will be looking at the Cochrane reviews on methods for reducing perineal trauma in more depth – watch this space!","5fcfc058c49e",[281],"03463fd52af5",{"image":9475,"_system":9478,"_type":37,"_rev":9482,"title":9483,"_updatedAt":9484,"content":9485,"publishedAt":9804,"_createdAt":9805,"_id":9481,"slug":9806},{"_type":586,"asset":9476},{"_type":197,"_ref":9477},"image-b92f34d620a01b2d164f1e65ac273f94ee2311e5-1080x1350-jpg",{"base":9479},{"rev":9480,"id":9481},"c1HqLtX09dCBnnfIQf9hrv","4de7b6f9-f05a-4a39-8761-ee5a1bbb890a","7l2KCMg711eQ9a3UN6q1p0","What Is a VBAC? Everything You Need to Know About Vaginal Birth After Caesarean","2026-03-11T19:41:57Z",{"body":9486,"_type":49},[9487,9494,9502,9514,9538,9546,9554,9562,9570,9578,9608,9616,9621,9629,9647,9655,9663,9671,9679,9697,9716,9721,9729,9741,9756,9764,9782],{"_type":58,"style":59,"_key":9488,"markDefs":9489,"children":9490},"4007df95e97e",[],[9491],{"_key":9492,"_type":56,"marks":9493,"text":525},"b7376f576b24",[281],{"markDefs":9495,"children":9496,"_type":58,"style":59,"_key":9501},[],[9497],{"marks":9498,"text":9499,"_key":9500,"_type":56},[],"What Does VBAC Mean? (And HBAC, VBA2C?)","310da46e9c52","e53d9d66acf6",{"style":78,"_key":9503,"markDefs":9504,"children":9505,"_type":58},"e369c98f2aa4",[],[9506,9510],{"text":9507,"_key":9508,"_type":56,"marks":9509},"VBAC","e145b0e4f412",[108],{"text":9511,"_key":9512,"_type":56,"marks":9513}," refers to ‘vaginal birth after caesarean’ – and it is exactly what it says on the tin!","1a7dcd1951a5",[],{"markDefs":9515,"children":9516,"_type":58,"style":78,"_key":9537},[],[9517,9521,9525,9529,9533],{"marks":9518,"text":9519,"_key":9520,"_type":56},[],"Other variations of the acronym you may see include, ","ee6f2f6fed53",{"_key":9522,"_type":56,"marks":9523,"text":9524},"0f3138edce14",[108],"HBAC",{"marks":9526,"text":9527,"_key":9528,"_type":56},[]," ‘home birth after caesarean’ and ","1b9b0fd69821",{"marks":9530,"text":9531,"_key":9532,"_type":56},[108],"VBA2C","211df9101302",{"text":9534,"_key":9535,"_type":56,"marks":9536}," ‘vaginal birth after two caesareans’ (the number will be different depending on the number of previous caesarean births).","6f5923cb9095",[],"f7dd7936a536",{"markDefs":9539,"children":9540,"_type":58,"style":59,"_key":9545},[],[9541],{"_type":56,"marks":9542,"text":9543,"_key":9544},[],"Why Do Some Women And Birthing People Choose a VBAC?","e6ed73b5c367","85eaa85c8459",{"style":78,"_key":9547,"markDefs":9548,"children":9549,"_type":58},"23422cd7ec5f",[],[9550],{"text":9551,"_key":9552,"_type":56,"marks":9553},"Some women may choose a VBAC because there are less risks associated with vaginal birth compared to caesarean birth (more on this below!). Others may want to experience vaginal birth. Or perhaps they have plans for a large family and want to avoid a repeat caesarean and the associated risks of multiple caesareans. The choice of VBAC is likely to be very individual to each woman or birthing person, in the same way that choosing a repeat elective caesarean section is a very individual choice.","5f6f2177d366",[],{"children":9555,"_type":58,"style":59,"_key":9560,"markDefs":9561},[9556],{"_key":9557,"_type":56,"marks":9558,"text":9559},"94ab56670e33",[],"What Are the Benefits of a VBAC?","a602b534df98",[],{"_type":58,"style":78,"_key":9563,"markDefs":9564,"children":9565},"f950d3f0fb33",[],[9566],{"text":9567,"_key":9568,"_type":56,"marks":9569},"Women and birthing people who plan and have a VBAC avoid the risks associated with the surgery of a caesarean birth. For example, the chance of having a postpartum haemorrhage, a blood clot or an infection is reduced. Physical recovery from a vaginal birth is generally quicker than a caesarean birth too. Immediate skin-to-skin is more achievable following a vaginal birth and babies born vaginally tend to have fewer breathing issues as they transition to life outside the womb. In addition, if having a vaginal birth experience was a priority for someone, there may be a real sense of achievement and a confidence boost following a VBAC.","0be3b5dcf477",[],{"_type":58,"style":59,"_key":9571,"markDefs":9572,"children":9573},"98bd5f04255d",[],[9574],{"text":9575,"_key":9576,"_type":56,"marks":9577},"What Are the Risks of a VBAC?","68d8a33be4e3",[],{"children":9579,"_type":58,"style":78,"_key":9602,"markDefs":9603},[9580,9584,9589,9593,9598],{"_type":56,"marks":9581,"text":9582,"_key":9583},[],"It is important to remember that no birth is without risk. When we’re looking at VBAC, the most feared and perhaps talked about risk is uterine rupture. Uterine rupture is a rare, but serious complication of pregnancy and childbirth. It is an obstetric emergency, where an opening develops in the wall of the womb and it can happen during pregnancy or in labour. The Royal College of Obstetricians and Gynaecologists (RCOG) in the UK state that the risk of uterine rupture is 0.5% (or 1:200) for women who have had a previous caesarean birth. Women who have not had a previous caesarean can also experience uterine rupture, although it is even more rare at ","b560d0b1f5e7",{"marks":9585,"text":9587,"_key":9588,"_type":56},[9586],"f576ca01115f","0.05%","f906afcaca2a",{"_type":56,"marks":9590,"text":9591,"_key":9592},[]," (1:2000). The increased chance of uterine rupture for women with a previous caesarean is due to there being a scar on the uterus. The chance of uterine rupture is increased ","0646de1ee8e3",{"marks":9594,"text":9596,"_key":9597,"_type":56},[9595],"6e0a8c5134fd","2-3-fold","074b348f5072",{"marks":9599,"text":9600,"_key":9601,"_type":56},[]," (this equates to a chance of 1 -1.5%) for women with a previous caesarean when labour is induced or augmented, compared to labours that start spontaneously – which is worth thinking about when planning your VBAC. ","e5b135090c88","5429cc314f71",[9604,9606],{"type":65,"url":9605,"_type":67,"_key":9586},"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259955/#:~:text=Fig%203%20presents%20the%20prevalence,100.000%20according%20to%20retrospective%20cohort",{"type":65,"url":9607,"_type":67,"_key":9595},"https://www.rcog.org.uk/media/kpkjwd5h/gtg_45.pdf",{"style":78,"_key":9609,"markDefs":9610,"children":9611,"_type":58},"c238b7112f3f",[],[9612],{"_type":56,"marks":9613,"text":9614,"_key":9615},[],"There are differences in risk depending on the planned and actual mode of birth, Hazel Keedle has a great table of these in her book, ‘Birth After Caesarean’. Some women will plan a repeat caesarean, some will plan a VBAC but have an emergency caesarean and some will plan and have a VBAC. Research compared risks including uterine rupture, sepsis, postpartum haemorrhage and adverse outcomes for babies – overall the risk of these complications occurring was low across all modes of birth. There are higher rates of most of the risks for women who plan a VBAC but who have an emergency caesarean. But as Keedle notes, statistics only tell part of the story. Women’s personal experiences of their birth, whatever the mode, may tell a very different story.","80bc0c6de7f5",{"link":9617,"_key":9620,"_type":190},{"_type":67,"text":9618,"type":194,"internalLink":9619,"blank":192},"Find out about our birth planning sessions",{"_ref":2580,"_type":197},"396a7aaa2274",{"_type":58,"style":59,"_key":9622,"markDefs":9623,"children":9624},"e628c0faf938",[],[9625],{"_type":56,"marks":9626,"text":9627,"_key":9628},[],"What Does UK Guidance Say About VBAC?","1c63eef1ab3f",{"_type":58,"style":78,"_key":9630,"markDefs":9631,"children":9634},"4afd56e98efc",[9632],{"_type":67,"_key":9633,"type":65,"url":9607},"bed7d418946c",[9635,9639,9643],{"_type":56,"marks":9636,"text":9637,"_key":9638},[],"The 2015 Royal College of Obstetricians & Gynaecologists (RCOG) green-top guideline ","82d7f86b69bc",{"_type":56,"marks":9640,"text":9641,"_key":9642},[9633],"‘Birth after previous Caesarean birth’","a06117ad4201",{"text":9644,"_key":9645,"_type":56,"marks":9646}," notes that the success rate of VBAC is 72-75%. If you’ve also had a previous vaginal birth, the chance of success is even higher at 85-90%. In addition, a previous vaginal birth is also independently associated with a reduced chance of uterine rupture. ","f1faa14672c3",[],{"style":78,"_key":9648,"markDefs":9649,"children":9650,"_type":58},"62b51b04b3f6",[],[9651],{"marks":9652,"text":9653,"_key":9654,"_type":56},[],"The RCOG say that women planning a VBAC should be advised to birth in a hospital with access to immediate caesarean birth and advanced neonatal resuscitation facilities if needed. They also advise that continuous fetal (CTG) monitoring should be recommended as soon as there are regular contractions. Research has shown that one of the most common signs of uterine rupture is a fetal heart rate abnormality (usually a bradycardia, which is a persistent low heart rate), hence the recommendation for CTG monitoring to be able to immediately identify this occurring. However, we also know that CTG monitoring is associated with an increased likelihood of intervention. Other signs of uterine rupture include abdominal pain (continuous, not coming and going like contractions) and vaginal bleeding. Some women will be completely asymptomatic.","8d6f383f810c",{"markDefs":9656,"children":9657,"_type":58,"style":78,"_key":9662},[],[9658],{"text":9659,"_key":9660,"_type":56,"marks":9661},"There has not been enough research into the safety or efficacy of VBAC for women who have a history of the following: twin pregnancy, post-dates, antepartum stillbirth, are aged 40 or over or fetal macrosomia (a suspected large baby) – therefore the RCOG advise a ‘cautious approach’ when considering VBAC for women with these circumstances.","3d6df1ba8c07",[],"f038b9669d0f",{"markDefs":9664,"children":9665,"_type":58,"style":78,"_key":9670},[],[9666],{"_key":9667,"_type":56,"marks":9668,"text":9669},"085fede77ab3",[],"The contraindications that exist for vaginal birth are the same for VBAC – so if conditions like placenta praevia (where the placenta has developed in front of the cervix, essentially blocking it) exist, a repeat caesarean birth would be necessary.","90171d5c333f",{"_key":9672,"markDefs":9673,"children":9674,"_type":58,"style":59},"21f8f9c4281c",[],[9675],{"text":9676,"_key":9677,"_type":56,"marks":9678},"Can You Have a VBAC at Home or on a Midwife-Led Unit?","df01e3e795fe",[],{"markDefs":9680,"children":9683,"_type":58,"style":78,"_key":9696},[9681],{"_type":67,"_key":9682,"type":65,"url":787},"d3b794bc106e",[9684,9688,9692],{"marks":9685,"text":9686,"_key":9687,"_type":56},[],"You can absolutely plan to birth at home or on a MLU if you’re planning a VBAC – in the UK we are lucky that you have the ","e1f31718c885",{"_type":56,"marks":9689,"text":9690,"_key":9691},[9682],"right to choose","f4ef880f15d5",{"marks":9693,"text":9694,"_key":9695,"_type":56},[]," where you birth. It is worth noting that choosing to birth at home or on an MLU is considered ‘out of guidelines’ because as mentioned above, CTG monitoring and birthing on a labour ward are recommended. In the NHS you may be offered an appointment with an obstetrician or a consultant midwife to discuss your options and plans for VBAC if you’re choosing to birth ‘out of guidelines’. ","e233861c64f4","6863f3a236e0",{"_type":58,"style":78,"_key":9698,"markDefs":9699,"children":9703},"a73f74c9d221",[9700],{"_type":67,"_key":9701,"type":65,"url":9702},"8492ff9f8fd5","https://www.instagram.com/p/CyOhmifNBQb/?igsh=MXdtcXdyaDh6NTl4aQ%3D%3D",[9704,9708,9712],{"_type":56,"marks":9705,"text":9706,"_key":9707},[],"If you birth at home, there is no access to CTG monitoring – we use intermittent auscultation (that’s if you wish to have any fetal monitoring at all), where we listen to the baby’s heartbeat with a handheld doppler at regular intervals. There is also no immediate access to theatres for surgery or a neonatal unit, access to these is via ambulance transfer from home. If you choose to birth on an MLU it may be on the same site as the labour ward – therefore access to the emergency facilities is closer. There are many benefits however to planning to birth at home or on an MLU – so it is worth weighing up the risks and benefits to help you make your decision. The ","27fec46fb6a1",{"_type":56,"marks":9709,"text":9710,"_key":9711},[9701],"BRAIN tool","d2b3f5c6c04c",{"_type":56,"marks":9713,"text":9714,"_key":9715},[]," can be particularly useful to get your thoughts down on paper. ","c8425aad1bd0",{"_type":190,"link":9717,"_key":9720},{"type":194,"internalLink":9718,"blank":192,"_type":67,"text":9719},{"_type":197,"_ref":196},"Check out our care packages","77288d517dff",{"children":9722,"_type":58,"style":59,"_key":9727,"markDefs":9728},[9723],{"text":9724,"_key":9725,"_type":56,"marks":9726},"How to Decide What Is Right for You","deb3b5b78315",[],"5e5afdd1298b",[],{"_type":58,"style":78,"_key":9730,"markDefs":9731,"children":9732},"e8903f68694f",[],[9733,9737],{"_type":56,"marks":9734,"text":9735,"_key":9736},[],"Ultimately, you have to make the choice that feels right and safe to you. If you do plan a VBAC – know that the odds are in your favour! We know that birth is not and will never be without risk. The task is deciding what level of risk is acceptable to ","1ab32016935f",{"text":9738,"_key":9739,"_type":56,"marks":9740},"you. ","3954f7f51361",[108],{"_key":9742,"markDefs":9743,"children":9744,"_type":58,"style":78},"710a5b984717",[],[9745,9749,9752],{"_type":56,"marks":9746,"text":9747,"_key":9748},[],"The 0.5% chance of uterine rupture may feel too high for some women to plan a home or MLU birth. For others, the 99.5% chance of ","cf390880e991",{"_type":56,"marks":9750,"text":1624,"_key":9751},[281],"ab306a23f9b9",{"_key":9753,"_type":56,"marks":9754,"text":9755},"1ad7c1dc19e6",[]," having a uterine rupture, may boost their confidence in planning a home or MLU birth. We know that labouring at home supports the unrestricted, physiological process of birth, but we also know that this won’t feel like the right choice for every woman or birthing person planning a VBAC. ",{"markDefs":9757,"children":9758,"_type":58,"style":78,"_key":9763},[],[9759],{"_key":9760,"_type":56,"marks":9761,"text":9762},"c65b4a7ca60f",[],"We would highly recommend reading Hazel Keedle’s book, ‘Birth after Caesarean’ – it has heaps of information in it, useful statistics and personal stories of women who planned a VBAC.","8d18cd712b48",{"children":9765,"_type":58,"style":78,"_key":9778,"markDefs":9779},[9766,9770,9774],{"_type":56,"marks":9767,"text":9768,"_key":9769},[],"We are very happy to support women & birthing people planning a VBAC at home, so if this is something you’re looking for – ","76c31f1be191",{"marks":9771,"text":4724,"_key":9773,"_type":56},[9772],"f8a84aa72e0a","e8c09270391a",{"marks":9775,"text":9776,"_key":9777,"_type":56},[]," to find out more.","03801af003c3","f7eb985c65e8",[9780],{"internalLink":9781,"_type":67,"_key":9772,"type":194},{"_ref":549,"_type":197},{"style":78,"_key":9783,"markDefs":9784,"children":9788,"_type":58},"507398236cdd",[9785],{"type":65,"url":9786,"_type":67,"_key":9787},"https://open.spotify.com/episode/0RZzyTfNpwR7hLTt64Gfrx?si=17d60d7513d74fb7","3a6ead114728",[9789,9792,9796,9800],{"_type":56,"marks":9790,"text":6845,"_key":9791},[108],"ee7288dd6c08",{"text":9793,"_key":9794,"_type":56,"marks":9795},": ","7771ed9648d5",[],{"_type":56,"marks":9797,"text":9798,"_key":9799},[9787],"VBAC – an interview with Dr Hazel Keedle","b12f96257ad2",{"_key":9801,"_type":56,"marks":9802,"text":9803},"0ad50591a128",[]," on the Midwives Cauldron Podcast","2024-04-24","2025-04-07T15:19:34Z",{"current":9807,"_type":8},"what-is-a-vbac-everything-you-need-to-know-about-vaginal-birth-after-caesarean",{"_updatedAt":9809,"_system":9810,"publishedAt":9814,"_createdAt":9815,"image":9816,"content":9819,"_type":37,"title":10121,"_rev":10122,"slug":10123,"_id":9812},"2026-03-11T19:46:25Z",{"base":9811},{"id":9812,"rev":9813},"4fb26000-7459-404d-bb95-bb235e0b3e62","lFrvlEMldmWjsfq3cbR9gc","2024-04-15","2025-04-07T15:19:29Z",{"_type":586,"asset":9817},{"_ref":9818,"_type":197},"image-fcc4745bfbde02a02f42d27983daa0516d28073c-1080x1350-jpg",{"_type":49,"body":9820},[9821,9829,9848,9856,9884,9892,9911,9919,9927,9935,9943,9947,9955,9963,9982,9990,10006,10014,10022,10060,10068,10076,10084,10092,10097,10109],{"style":59,"_key":9822,"markDefs":9823,"children":9824,"_type":58},"a65a001c149a",[],[9825],{"text":9826,"_key":9827,"_type":56,"marks":9828},"What Is Caesarean Awareness Month and Why Does It Matter?","99add054e98f",[],{"_type":58,"style":78,"_key":9830,"markDefs":9831,"children":9835},"4614a5c4b528",[9832],{"_key":9833,"type":65,"url":9834,"_type":67},"96337a74e9ad","https://www.ican-online.org/mission/",[9836,9840,9844],{"_key":9837,"_type":56,"marks":9838,"text":9839},"2b9547615a22",[],"April is caesarean awareness month. It was first started by the ",{"_type":56,"marks":9841,"text":9842,"_key":9843},[9833],"International Cesarean Awareness Network","cb8becb3b43e",{"_type":56,"marks":9845,"text":9846,"_key":9847},[]," (ICAN), a non-profit organisation founded in the US in 1982 by a group of mothers who had experienced caesarean births and wanted to provide support and education to other families. They wanted to challenge the status quo at the time where in the US the ‘rule’ was no vaginal birth after caesarean. One of their aims became about prevention as they were witnessing a sharp increase in the rates of caesarean section. Their mission to date is to “improve maternal-child health by reducing preventable caesareans through education, supporting caesarean recovery, and advocating for vaginal birth after caesarean (VBAC)”. Caesarean awareness month was set up by them over 20 years ago to highlight this work. Not much has changed in their ethos, and they firmly believe in the respect of human rights in childbirth regardless of how someone chooses to give birth. ","30b872f6ced6",{"children":9849,"_type":58,"style":59,"_key":9854,"markDefs":9855},[9850],{"_type":56,"marks":9851,"text":9852,"_key":9853},[],"Do You Have the Right to Request a Caesarean Section?","bff2321757f3","4029aaead185",[],{"children":9857,"_type":58,"style":78,"_key":9878,"markDefs":9879},[9858,9862,9866,9870,9875],{"text":9859,"_key":9860,"_type":56,"marks":9861},"Human rights mean that you have a right to request or decline a caesarean section. This is no different from any other intervention offered to you along your pregnancy and childbirth journey, but we know this can be much harder to achieve in reality. To help you understand how this relates to you and your choices in birth take a look at ","96015bb71dcd",[],{"_key":9863,"_type":56,"marks":9864,"text":5325},"080cc27a0570",[9865],"e0c192980746",{"_key":9867,"_type":56,"marks":9868,"text":9869},"7b1afc875c94",[],", a UK registered charity determined to protect your human rights during pregnancy and childbirth. On their website you can find some useful, yet simple, factsheets all about your rights in relation to a number of different issues. For example, ",{"marks":9871,"text":9873,"_key":9874,"_type":56},[9872,281],"6a9969a28dd5","Your right to choose your midwife and doctor","8602f1bb99fd",{"_type":56,"marks":9876,"text":1183,"_key":9877},[],"35a95265792a","87a0143c046e",[9880,9882],{"_type":67,"_key":9865,"type":65,"url":9881},"https://birthrights.org.uk/factsheets/",{"_type":67,"_key":9872,"type":65,"url":9883},"https://birthrights.org.uk/factsheets/your-right-to-choose-midwife-and-doctor/",{"style":59,"_key":9885,"markDefs":9886,"children":9887,"_type":58},"8b084ddc67f9",[],[9888],{"marks":9889,"text":9890,"_key":9891,"_type":56},[],"What Is a Maternal Choice Caesarean Section?","f9c6696ca26f",{"style":78,"_key":9893,"markDefs":9894,"children":9898,"_type":58},"4d2b34226d63",[9895],{"type":65,"url":9896,"_type":67,"_key":9897},"https://birthrights.org.uk/factsheets/right-to-a-c-section/","5c5a5e726663",[9899,9903,9907],{"_type":56,"marks":9900,"text":9901,"_key":9902},[],"This is the term given to women and birthing people in the UK, who make the choice to have an elective caesarean section. At first glance the national guidance around requesting a caesarean all seems a bit convoluted so you’re definitely going to want to read the ","31937f870bb1",{"text":9904,"_key":9905,"_type":56,"marks":9906},"Your right to a caesarean birth","f326d5edad8e",[9897,281],{"_type":56,"marks":9908,"text":9909,"_key":9910},[]," factsheet, courtesy of Birthrights.","dce81de8b9a3",{"_type":58,"style":59,"_key":9912,"markDefs":9913,"children":9914},"a0093d08a52a",[],[9915],{"marks":9916,"text":9917,"_key":9918,"_type":56},[],"How Do You Request an Elective Caesarean on the NHS?","51a0c08d6343",{"_type":58,"style":78,"_key":9920,"markDefs":9921,"children":9922},"2580bd5b2fdd",[],[9923],{"marks":9924,"text":9925,"_key":9926,"_type":56},[],"Simply put, if you request a caesarean then you will be advised to have a thorough discussion with your healthcare provider, an obstetrician or a senior midwife, to go through the benefits and risks of both birth by caesarean section and vaginal birth. The depth of this conversation will depend on the individual health care worker and my understanding is that this is widely varied.","fafeccdde319",{"_type":58,"style":78,"_key":9928,"markDefs":9929,"children":9930},"631b310c281f",[],[9931],{"marks":9932,"text":9933,"_key":9934,"_type":56},[],"This is the slightly convoluted bit…if your healthcare provider feels that you are making an informed decision then they should accept your request to birth via caesarean section. But it is possible they may not support this if they believe you are not making an informed choice, or perhaps the ‘right’ choice. UK national guidelines advise that if the obstetrician declines your request, the hospital must provide access to an obstetrician who is willing to do the caesarean for you.","2eac4d46d8b8",{"_key":9936,"markDefs":9937,"children":9938,"_type":58,"style":78},"1bd22bb362a9",[],[9939],{"text":9940,"_key":9941,"_type":56,"marks":9942},"It may feel like jumping through hoops to prove yourself and there is a lot of paternalistic language being thrown about in the guidelines. But the key here is ‘informed choice’ – hard to fully achieve in the NHS when you only have a rushed 20 minute antenatal appointment in which to discuss this. In our experience it is uncommon that women are declined a maternal request caesarean but this is anecdotal evidence and based on our own experiences as midwives working in a handful of London maternity units. Should you find yourself in a position where your request is being declined, know that there are a lot of resources out there. The first step would be to seek out the Consultant Midwife based at the trust you have booked with. Your community midwife will be best placed to put you in touch with them.","d58d18bc50db",[],{"link":9944,"_key":9946,"_type":190},{"_type":67,"text":4148,"type":194,"internalLink":9945,"blank":192},{"_ref":2580,"_type":197},"9a79dc673dc4",{"markDefs":9948,"children":9949,"_type":58,"style":59,"_key":9954},[],[9950],{"_type":56,"marks":9951,"text":9952,"_key":9953},[],"Why Do Women Choose an Elective Caesarean Section?","b2caf94e8c49","29e00fe9e175",{"_type":58,"style":78,"_key":9956,"markDefs":9957,"children":9958},"9e4b590b977a",[],[9959],{"_key":9960,"_type":56,"marks":9961,"text":9962},"83073987ad45",[],"You do not have to explain your wishes for a caesarean birth to anyone and there are many reasons women have shared as to why they wish to have an elective caesarean section. These include but are not limited to: fear of childbirth and the pain of childbirth, safety concerns they hold around their own pre-existing health conditions, previous traumatic birth, a history of sexual abuse and a fear of having to undergo vaginal examinations during labour and childbirth. In addition some people find an elective caesarean birth offers convenience and a sense of control as they feel they can pick a date and time and feel reassured by this. There is of course always the possibility of going into labour before this date! Another reason, women and birthing people may choose an elective caesarean is that they have a positive attitude towards caesarean, for instance their family members may have had positive experiences giving birth via caesarean section. Whatever your reason, your choice should be respected and supported. You do not need to prove yourself to us, or indeed anyone!",{"_type":58,"style":78,"_key":9964,"markDefs":9965,"children":9969},"1b7e3786b70a",[9966],{"type":194,"internalLink":9967,"blank":192,"_type":67,"_key":9968},{"_type":197,"_ref":196},"bdd89f325fd8",[9970,9974,9978],{"marks":9971,"text":9972,"_key":9973,"_type":56},[],"We offer ","edec62b28aff",{"_key":9975,"_type":56,"marks":9976,"text":9977},"90c2d84b6cdd",[9968],"elective caesarean care packages",{"_type":56,"marks":9979,"text":9980,"_key":9981},[],", whereby you receive all the benefits of continuity of care throughout your pregnancy, we can provide non-clinical support and advocacy during your birth and then provide in-depth postnatal care at home when you are discharged from hospital.","3a9373b3bc19",{"markDefs":9983,"children":9984,"_type":58,"style":59,"_key":9989},[],[9985],{"_type":56,"marks":9986,"text":9987,"_key":9988},[],"Can You Decline a Caesarean Section?","5908c0b99b3d","a2843d4ad924",{"children":9991,"_type":58,"style":78,"_key":10004,"markDefs":10005},[9992,9996,10000],{"marks":9993,"text":9994,"_key":9995,"_type":56},[],"We often hear women talk about requesting a caesarean section as an alternative to an induction of labour (IOL) and this is because they feel they have no other option. For many women and birthing people, knowing you can ","7b6393c1c5b0",{"_type":56,"marks":9997,"text":9998,"_key":9999},[108],"decline","f3f7477eaa3d",{"_type":56,"marks":10001,"text":10002,"_key":10003},[]," interventions being offered could make a world of difference and open up birth options you never knew were possible. ","2cb656802618","9042871c90f3",[],{"_key":10007,"markDefs":10008,"children":10009,"_type":58,"style":78},"5ebf496d86fd",[],[10010],{"_type":56,"marks":10011,"text":10012,"_key":10013},[],"As I write this I am reflecting on all the conversations I’ve had with women and birthing people and the revelation that they can decline is both a positive one for me and also quite upsetting. The fact that they didn’t know this is deeply concerning and illustrates the challenges people face when accessing mainstream maternity services.","0ce9aba5e9e7",{"style":59,"_key":10015,"markDefs":10016,"children":10017,"_type":58},"ef40b02ad47d",[],[10018],{"text":10019,"_key":10020,"_type":56,"marks":10021},"How to Avoid an Unnecessary Caesarean: Understanding the Cascade of Interventions","ab19c0c6bf6d",[],{"children":10023,"_type":58,"style":78,"_key":10056,"markDefs":10057},[10024,10028,10033,10036,10040,10044,10048,10052],{"_type":56,"marks":10025,"text":10026,"_key":10027},[],"If you are very much planning to avoid a caesarean section then understanding your options about place of birth and other interventions is key. Choosing to birth in a hospital setting does increase your risk of medical interventions including caesarean section. The Great Birth Rebellion have released an episode on their podcast called the","52f8160b188c",{"_type":56,"marks":10029,"text":10031,"_key":10032},[10030],"fe05e58a161d"," Cascade of Interventions","5b99311c193f",{"marks":10034,"text":1183,"_key":10035,"_type":56},[281],"14cc2098f660",{"marks":10037,"text":10038,"_key":10039,"_type":56},[]," Understanding this so called ‘cascade of interventions’ is key to ","281b01e62128",{"text":10041,"_key":10042,"_type":56,"marks":10043},"Caesarean Awareness Month","08bc4d415658",[281],{"_type":56,"marks":10045,"text":10046,"_key":10047},[]," and the ","ec6703f7ec01",{"_key":10049,"_type":56,"marks":10050,"text":10051},"7e0f4bbdd687",[281],"ICAN’s",{"_type":56,"marks":10053,"text":10054,"_key":10055},[]," mission to provide education and prevention for unnecessary caesareans. ","db3b5a640ae2","c36f4d115b17",[10058],{"type":65,"url":10059,"_type":67,"_key":10030},"https://www.melaniethemidwife.com/podcasts/the-great-birth-rebellion/episodes/2148575903",{"_key":10061,"markDefs":10062,"children":10063,"_type":58,"style":78},"e304bb73d910",[],[10064],{"text":10065,"_key":10066,"_type":56,"marks":10067},"If you are planning a hospital birth and wish to avoid a caesarean section then you might want to find out the statistics on the rates of caesarean sections where you have booked for your care.","b550759ee2ca",[],{"style":78,"_key":10069,"markDefs":10070,"children":10071,"_type":58},"6609c9ba22bb",[],[10072],{"marks":10073,"text":10074,"_key":10075,"_type":56},[],"It is important to note that an elective caesarean section can be an entirely different experience to an emergency caesarean section. In addition, not all emergency caesareans are performed for life threatening situations – much as the term ‘emergency’ might lead you to believe. But if you have never had an operation, or stepped foot into an operating theatre, any kind of caesarean section may feel daunting to you.","db1488f7cbc8",{"_type":58,"style":59,"_key":10077,"markDefs":10078,"children":10079},"260ed211f722",[],[10080],{"text":10081,"_key":10082,"_type":56,"marks":10083},"Why Your Birth Experience and Choices Matter","d744fff70c46",[],{"_type":58,"style":78,"_key":10085,"markDefs":10086,"children":10087},"afb0f398793f",[],[10088],{"_type":56,"marks":10089,"text":10090,"_key":10091},[],"How you give birth and the respect for your choices throughout this experience is key in your journey to motherhood and the wellbeing and development of your newborn baby. Preparing for your birth and understanding your choices is the first step on this journey to a birth that leaves you feeling empowered; a birth where you felt listened to and your choices respected. This is why your wish to request a caesarean or to decline one, really matters.","e601ebb20379",{"_type":190,"link":10093,"_key":10096},{"type":194,"internalLink":10094,"blank":192,"_type":67,"text":10095},{"_type":197,"_ref":196},"Our Care Packages ","a02788507838",{"markDefs":10098,"children":10099,"_type":58,"style":78,"_key":10108},[],[10100,10104],{"marks":10101,"text":10102,"_key":10103,"_type":56},[108],"Read:","75eec20bcb7c",{"_key":10105,"_type":56,"marks":10106,"text":10107},"f181072437a0",[]," What’s Right For Me? by Sara Wickham","fcf822d6a818",{"style":78,"_key":10110,"markDefs":10111,"children":10112,"_type":58},"b641493be8fe",[],[10113,10117],{"text":10114,"_key":10115,"_type":56,"marks":10116},"Follow:","490d10af46c1",[108],{"marks":10118,"text":10119,"_key":10120,"_type":56},[]," @birthrightsorg on Instagram","c9b655b10d27","Caesarean Section Awareness Month: Your Rights, Your Choices, Your Birth","7l2KCMg711eQ9a3UN6qOM5",{"current":10124,"_type":8},"caesarean-section-awareness-month-your-rights-your-choices-your-birth",{"content":10126,"image":10299,"_rev":10302,"_id":10303,"title":10304,"_system":10305,"publishedAt":10308,"_updatedAt":10309,"slug":10310,"_type":37,"_createdAt":10312},{"body":10127,"_type":49},[10128,10136,10152,10160,10168,10176,10184,10192,10203,10211,10219,10227,10235,10243,10251,10259,10267,10275,10283,10291],{"_type":58,"style":59,"_key":10129,"markDefs":10130,"children":10131},"a8398ca8e674",[],[10132],{"_type":56,"marks":10133,"text":10134,"_key":10135},[],"How Juno Midwives Started: From Postnatal Care to Full Midwifery Services","f4c12ee08e5e",{"_type":58,"style":78,"_key":10137,"markDefs":10138,"children":10139},"aa83db6e639c",[],[10140,10144,10148],{"marks":10141,"text":10142,"_key":10143,"_type":56},[],"We can’t quite believe it but it has been one year since we officially launched as independent midwives. Some of you may remember we initially launched as ","24bf064004ab",{"_key":10145,"_type":56,"marks":10146,"text":10147},"dbf866b69d86",[281],"The Fourth Trimester",{"marks":10149,"text":10150,"_key":10151,"_type":56},[],", as we had planned to offer postnatal care only whilst we found our feet as independent midwives. This plan very quickly changed after meeting one of our local doulas, Betty, who quickly persuaded us that we needed to offer the full shebang – including labour and birth care. There was, and still is, a real need in East Kent for independent midwives as women’s options for place of birth have been limited by staffing shortages, unit closures and patchy homebirth cover.","034eca7237bc",{"_type":58,"style":78,"_key":10153,"markDefs":10154,"children":10155},"f26b05187e9d",[],[10156],{"marks":10157,"text":10158,"_key":10159,"_type":56},[],"We met our first client in May and supported her at the wonderful birth of her baby in June 2023. The high we experienced after that birth was something neither of us had felt when working in the NHS for a long time. The joy of being able to provide care that aligned with our values and that truly respected women’s rights and choices in childbirth was second to none. Our most recent client had a glorious home birth, which still gives us all the feels when we think back to it. Women and birthing people are powerful – any invitation into their birthing space is a privilege.","07ba80347980",{"style":59,"_key":10161,"markDefs":10162,"children":10163,"_type":58},"fec35a08a2a4",[],[10164],{"marks":10165,"text":10166,"_key":10167,"_type":56},[],"What Services Have We Provided in Our First Year?","86c248002239",{"style":78,"_key":10169,"markDefs":10170,"children":10171,"_type":58},"cff1873dd2b2",[],[10172],{"_type":56,"marks":10173,"text":10174,"_key":10175},[],"Since that first birth and over the course of our first year of business, we have provided:","75035a0eef3c",{"style":78,"_key":10177,"listItem":914,"markDefs":10178,"children":10179,"level":921,"_type":58},"990fd6c4ef59",[],[10180],{"text":10181,"_key":10182,"_type":56,"marks":10183},"antenatal care (including one-off appointments)","d34326081660",[],{"listItem":914,"markDefs":10185,"children":10186,"level":921,"_type":58,"style":78,"_key":10191},[],[10187],{"_type":56,"marks":10188,"text":10189,"_key":10190},[],"labour care","6500abdc587c","ebec8773439b",{"level":921,"_type":58,"style":78,"_key":10193,"listItem":914,"markDefs":10194,"children":10198},"3e56c8079c7f",[10195],{"blank":192,"_type":67,"_key":10196,"type":194,"internalLink":10197},"4f678fcb054a",{"_ref":196,"_type":197},[10199],{"_type":56,"marks":10200,"text":10201,"_key":10202},[10196],"home birth care","1ac62e5ba74d",{"children":10204,"level":921,"_type":58,"style":78,"_key":10209,"listItem":914,"markDefs":10210},[10205],{"marks":10206,"text":10207,"_key":10208,"_type":56},[],"postnatal care","42bc84786fc8","b0d9718ce0ae",[],{"listItem":914,"markDefs":10212,"children":10213,"level":921,"_type":58,"style":78,"_key":10218},[],[10214],{"_type":56,"marks":10215,"text":10216,"_key":10217},[],"newborn examinations (one offs and as part of our care packages)","eeec7be64e03","adcb711584e9",{"listItem":914,"markDefs":10220,"children":10221,"level":921,"_type":58,"style":78,"_key":10226},[],[10222],{"_key":10223,"_type":56,"marks":10224,"text":10225},"2ceed47937e5",[],"birth notifications (for those who have chosen to freebirth)","b4ebb579fbf6",{"children":10228,"level":921,"_type":58,"style":78,"_key":10233,"listItem":914,"markDefs":10234},[10229],{"marks":10230,"text":10231,"_key":10232,"_type":56},[],"pregnancy circles","78a945a251c1","90ea1c70282c",[],{"children":10236,"level":921,"_type":58,"style":78,"_key":10241,"listItem":914,"markDefs":10242},[10237],{"_key":10238,"_type":56,"marks":10239,"text":10240},"4bd78193eef0",[],"support for other independent midwives as a second birth attendant","eac00d75ba5e",[],{"markDefs":10244,"children":10245,"_type":58,"style":78,"_key":10250},[],[10246],{"_key":10247,"_type":56,"marks":10248,"text":10249},"7d6b5c75994a",[],"\nWe have connected with an amazing bunch of independent midwives, who always strive to support each other and who have helped us navigate the new world that is independent midwifery. We are grateful to know so many midwives whose philosophy of care aligns with our own and whose experience we can call upon. Shout out to Frances (Our Village Midwife), who has recently set up her independent midwifery business – East Kent is now lucky to have three independent midwives! This means we can support more women and birthing people. We have also had the pleasure of being welcomed into the Folkestone birth world by our local power duo, doulas Lucy and Betty of Folkey Birth Club. Their passion for birth and women’s rights are a force to be reckoned with.","272234b253fb",{"_type":58,"style":59,"_key":10252,"markDefs":10253,"children":10254},"475cef05a22f",[],[10255],{"marks":10256,"text":10257,"_key":10258,"_type":56},[],"Why We Left the NHS to Become Independent Midwives","65c09a829d46",{"style":78,"_key":10260,"markDefs":10261,"children":10262,"_type":58},"1efb2eb40035",[],[10263],{"marks":10264,"text":10265,"_key":10266,"_type":56},[],"Our passion for midwifery has been reignited by leaving the mainstream maternity system. We leave appointments with our clients feeling fulfilled and happy in the knowledge that we have had the time and space to really get to know them and have in-depth conversations about what’s going on for them. The support we are able to provide to our clients as independent midwives is unfortunately almost unheard of in the NHS. We get to meet the whole family (pets included) and there is something incredibly special about being part of that transformative journey.","63fa3423e73f",{"markDefs":10268,"children":10269,"_type":58,"style":78,"_key":10274},[],[10270],{"marks":10271,"text":10272,"_key":10273,"_type":56},[],"We are pleased to maintain a good working relationship with our local NHS Trust, so that if and when our clients do need to access their services, it is seamless. We have gone from high levels of imposter syndrome and quietly saying, ‘I’m an independent midwife’ to proudly telling people and usually answering an array of questions about how being an independent midwife works. Questions which we are very happy to answer – the UK needs more independent midwives, so if chatting to us sparks even one midwife’s interest, that’s a win!","6868362f849a","ea2889ad70e9",{"_key":10276,"markDefs":10277,"children":10278,"_type":58,"style":59},"1b6bcfc08079",[],[10279],{"_key":10280,"_type":56,"marks":10281,"text":10282},"3fb078d9455a",[],"What We've Learned From Our First Year in Business",{"_type":58,"style":78,"_key":10284,"markDefs":10285,"children":10286},"21e5f6958907",[],[10287],{"_key":10288,"_type":56,"marks":10289,"text":10290},"02093ced90cb",[],"One of the huge learning curves of setting up as independent midwives has been getting to grips with starting a business. We know how to do the midwife bit, but business is a whole new world to us. We’re proud of how far we’ve come and we know there is still a lot of learning to be done! It is undeniably bold to leave a salaried job in the NHS to set up an independent midwifery business, but we can both honestly say that we are significantly happier, and arguably better midwives for having done so. We can’t wait to see where our business takes us!",{"markDefs":10292,"children":10293,"_type":58,"style":78,"_key":10298},[],[10294],{"marks":10295,"text":10296,"_key":10297,"_type":56},[],"Finally, a special thank you to all of our clients, the women and their families, who have trusted us to care for them during the rite of passage that is pregnancy, birth and new parenthood – we wouldn’t exist without you.","85ca0f01a1bb","6bbf84a0fd89",{"_type":586,"asset":10300},{"_ref":10301,"_type":197},"image-845202651ff877286aeddd40b78f147158f9e725-1536x2048-jpg","lTiZ7ejil6ZSBCJHGJ8mYS","02e19d6d-9c46-4241-9e40-4ee1164f7cd8","One Year of Juno Midwives: Independent Midwifery in Kent",{"base":10306},{"id":10303,"rev":10307},"A1BL058D1L1LG4bFNGA3EC","2024-04-01","2026-03-17T12:17:18Z",{"_type":8,"current":10311},"one-year-of-juno-midwives-independent-midwifery-in-kent","2025-04-07T15:19:22Z",{"title":10314,"_updatedAt":10315,"_type":37,"image":10316,"publishedAt":10319,"_createdAt":10320,"_rev":10321,"slug":10322,"_system":10324,"_id":10327,"content":10328},"Physiological Birth of the Placenta: What It Is and How to Support It","2026-03-11T20:32:40Z",{"asset":10317,"_type":586},{"_ref":10318,"_type":197},"image-e44a61c414f0663d7218e010fac302d57fb01664-1080x1350-jpg","2024-03-25","2025-04-07T15:19:16Z","5fd977pr5Ct4pKgLygV9Co",{"current":10323,"_type":8},"physiological-birth-of-the-placenta-what-it-is-and-how-to-support-it",{"base":10325},{"rev":10326,"id":10327},"c1HqLtX09dCBnnfIQf3svx","99e7f815-9bdf-4551-961a-78013eb32274",{"_type":49,"body":10329},[10330,10338,10357,10365,10373,10381,10389,10397,10416,10421,10429,10459,10467,10475,10487,10508,10516,10524,10532,10540,10548,10556,10564,10569,10580,10600,10617,10642,10650],{"_type":58,"style":59,"_key":10331,"markDefs":10332,"children":10333},"9c45da79b13c",[],[10334],{"text":10335,"_key":10336,"_type":56,"marks":10337},"Birthing Your Placenta (or The Third Stage of Labour)","16135a19feac",[],{"markDefs":10339,"children":10343,"_type":58,"style":78,"_key":10356},[10340],{"_key":10341,"type":65,"url":10342,"_type":67},"5342c82b62eb","https://www.all4maternity.com/",[10344,10348,10352],{"_key":10345,"_type":56,"marks":10346,"text":10347},"5fd26a5e6103",[],"Natasha recently wrote an article for ",{"_type":56,"marks":10349,"text":10350,"_key":10351},[10341],"The Practising Midwife","49c1452e2f5c",{"_type":56,"marks":10353,"text":10354,"_key":10355},[]," about physiological birth of the placenta. The Practising Midwife is a really informative journal, which challenges and expands our knowledge and understanding of physiology in labour and birth. Here, she writes about the different ways of birthing the placenta and the key role that continuity of care can play in supporting a physiological placental birth.","c6a8d5a43c46","cfecd76a28f7",{"style":59,"_key":10358,"markDefs":10359,"children":10360,"_type":58},"afba6c1f2fd5",[],[10361],{"text":10362,"_key":10363,"_type":56,"marks":10364},"What Is a Physiological Placental Birth?","7d01bf0555ca",[],{"style":78,"_key":10366,"markDefs":10367,"children":10368,"_type":58},"a8509e8fcf66",[],[10369],{"_type":56,"marks":10370,"text":10371,"_key":10372},[],"One topic that is neglected in mainstream midwifery education and practice is the physiological birth of the placenta. This is where the placenta is birthed spontaneously, without any medical intervention after you have birthed your baby. Birth is not complete until the placenta is born and it does require some physical effort. Your midwives and birth partner(s) need to maintain that oxytocin-rich environment in order to assist you in the physiological birth of the placenta.","df14e9519e61",{"markDefs":10374,"children":10375,"_type":58,"style":59,"_key":10380},[],[10376],{"_key":10377,"_type":56,"marks":10378,"text":10379},"68cb1d56ac65",[],"What Is Active Management of the Third Stage?","a3fbcf92137e",{"style":78,"_key":10382,"markDefs":10383,"children":10384,"_type":58},"e06f6b49dede",[],[10385],{"_type":56,"marks":10386,"text":10387,"_key":10388},[],"The most common way women and birthing people birth their placenta in high-income countries is via something known as ‘active management of the third stage’. The term ‘third stage’ being the medicalised terminology for the part of your labour where the placenta is expelled from your body. The ‘active’ element refers to the administration of an oxytocic drug (syntocinon or syntometrine) via an intramuscular injection, usually in your thigh, very shortly after your baby is born. After the cord is clamped and cut, the placenta is then removed by your healthcare provider by gently applying traction to the umbilical cord. Active management is also used prophylatically to prevent a postpartum haemorrhage.","82d79f277238",{"markDefs":10390,"children":10391,"_type":58,"style":59,"_key":10396},[],[10392],{"_type":56,"marks":10393,"text":10394,"_key":10395},[],"When Is Active Management Recommended Over a Physiological Third Stage?","72289e51403b","e3e42b816e63",{"children":10398,"_type":58,"style":78,"_key":10412,"markDefs":10413},[10399,10403,10408],{"text":10400,"_key":10401,"_type":56,"marks":10402},"In a physiological labour and birth, your body is pretty good at doing this but where there has been medical intervention and use of synthetic hormones such as syntocinon/pitocin during labour, an active third stage is clinically recommended to help reduce the risk of a haemorrhage. This is because if you have had medical interventions throughout your labour, there is a higher chance of having a postpartum haemorrhage – so an actively managed placenta may be the safer option for you. The practice of active management has become routine in hospital settings regardless of what type of birth you have and is recommended by ","f146d33fd3dd",[],{"_key":10404,"_type":56,"marks":10405,"text":10407},"137319d56ba7",[10406],"3b41a516e310","NICE",{"_type":56,"marks":10409,"text":10410,"_key":10411},[],". What was once being used to manage a haemorrhage is routinely recommended to prevent a potential one even if you have an undisturbed physiological birth. It is important to note that whether you use the drugs or not, it is still possible (though not common) to have excessive bleeding.","10c342e4f3d2","aaaddedf50d5",[10414],{"_type":67,"_key":10406,"type":65,"url":10415},"https://www.nice.org.uk/guidance/ng235/chapter/Recommendations#third-stage-of-labour",{"_type":190,"link":10417,"_key":10420},{"_type":67,"text":10418,"type":194,"internalLink":10419,"blank":192},"Explore our care packages",{"_ref":196,"_type":197},"48f596888c0e",{"markDefs":10422,"children":10423,"_type":58,"style":59,"_key":10428},[],[10424],{"_key":10425,"_type":56,"marks":10426,"text":10427},"05b6765f1ad2",[],"Why Informed Choice About Placental Birth Is So Often Overlooked","788a4cd263fd",{"_type":58,"style":78,"_key":10430,"markDefs":10431,"children":10438},"e0c901fb787d",[10432,10435],{"_type":67,"_key":10433,"type":194,"internalLink":10434},"835815dcfc64",{"_ref":1722,"_type":197},{"type":65,"url":10436,"_type":67,"_key":10437},"https://www.sarawickham.com/byp/","fc82098ca4ba",[10439,10443,10447,10451,10455],{"_type":56,"marks":10440,"text":10441,"_key":10442},[],"For the majority of women and birthing people the birth of the placenta is often an afterthought. Some women have set feelings or cultural beliefs about the placenta but unless expressed, this part of childbirth is often neglected. Options are not discussed in depth and the routine practice takes precedence over informed choice. We encourage our clients to include their plans for placental birth in their ","cdb8525d537a",{"_type":56,"marks":10444,"text":10445,"_key":10446},[10433],"birth plan","65d96f15be38",{"_type":56,"marks":10448,"text":10449,"_key":10450},[]," and spend the time discussing the options well before they give birth. Sara Wickham and Nadine Edwards have written a really comprehensive but accessible guide to ","6a7dbf99423e",{"_key":10452,"_type":56,"marks":10453,"text":10454},"53d09116175f",[10437],"birthing your placenta",{"_key":10456,"_type":56,"marks":10457,"text":10458},"aa308adedd7f",[],", which we would highly recommend reading during pregnancy. Getting informed will prevent you from having to make last minute decisions about how you wish to birth your placenta with a midwife or obstetrician you have never met before, just at the moment when you should be basking in the glory of having birthed your baby!",{"children":10460,"_type":58,"style":59,"_key":10465,"markDefs":10466},[10461],{"text":10462,"_key":10463,"_type":56,"marks":10464},"How Continuity of Care Supports a Physiological Placental Birth","f749ec3a9f87",[],"b13556a2ec0f",[],{"markDefs":10468,"children":10469,"_type":58,"style":78,"_key":10474},[],[10470],{"marks":10471,"text":10472,"_key":10473,"_type":56},[],"This brings me onto how continuity of care with an independent midwife could enable you to have a truly physiological birth of the placenta. When you have an independent midwife who provides continuity throughout your pregnancy, labour and birth they are able to support you in your choices, without being bound by hospital policies. This can go a long way to preventing the overuse of non evidence based medical interventions and enable true physiology to run its course. In addition, as independent midwives, we have time – time to spend with you and go through all your options in depth. We get to learn what makes you tick so that when you tell us something is changing, be it through your facial expressions or body language, we’re able to interpret what may be going on for you and anticipate ways we can support that. This is key in supporting physiological birth of your placenta and preventing adverse outcomes like excessive bleeding. This means that if you wish to have a physiological birth of the placenta it is a good idea to have the same midwife for this part as for all the other parts that have gone before (antental, early labour, labour and birth!). True continuity of carer is highly unlikely to achieve if birthing in a hospital setting, and this is worth thinking about when considering your options for placental birth.","a06411e17645","b4b1e27d0ab7",{"_type":58,"style":2849,"_key":10476,"markDefs":10477,"children":10478},"7aed8b0bde70",[],[10479,10483],{"_type":56,"marks":10480,"text":10481,"_key":10482},[281,108],"“There are a few key elements to facilitating the physiological birth of a placenta. There are not set tasks attached to providing care, unlike in active management. Instead we take our cue from the woman or birthing person”","215973ecfffb",{"_type":56,"marks":10484,"text":10485,"_key":10486},[],"\nSoliman, 2024","490b3dc37377",{"_key":10488,"markDefs":10489,"children":10495,"_type":58,"style":78},"66ee8b11b1e1",[10490],{"_key":10491,"type":194,"url":10492,"internalLink":10493,"_type":67},"364ee1aaad22","https://junomidwives.co.uk/10-home-birth-myths-busted/",{"_ref":10494,"_type":197},"53a8562d-8016-4d0e-8d5b-92c47c4d4ce2",[10496,10500,10504],{"_type":56,"marks":10497,"text":10498,"_key":10499},[],"The earlier you book an independent midwife the more time you have with them. Having a ","298f14e60c3d",{"_type":56,"marks":10501,"text":10502,"_key":10503},[10491],"homebirth","446c8a86502f",{"marks":10505,"text":10506,"_key":10507,"_type":56},[]," with an independent midwife who you know and trust has been shown to support physiology and prevent adverse outcomes, so is a key way of preparing for a physiological birth of the placenta. As independent midwives, we see birth as a continuum whereby this experience is not disturbed by a changeover of staff in a hospital, or transferring rooms for different ‘stages’ of labour and care is provided by someone you’ve never met. These routine aspects interfere with the establishment of a safe, warm and protective birth space – all things needed to support physiology in labour and birth.","bb21cd611a8c",{"markDefs":10509,"children":10510,"_type":58,"style":59,"_key":10515},[],[10511],{"_type":56,"marks":10512,"text":10513,"_key":10514},[],"Top Tips for Supporting a Physiological Placental Birth","e4c3212c86d0","065da4c396c1",{"_type":58,"style":78,"_key":10517,"listItem":914,"markDefs":10518,"children":10519,"level":921},"24bebee6e942",[],[10520],{"_type":56,"marks":10521,"text":10522,"_key":10523},[],"Keep lighting low","882efb187ef6",{"listItem":914,"markDefs":10525,"children":10526,"level":921,"_type":58,"style":78,"_key":10531},[],[10527],{"_type":56,"marks":10528,"text":10529,"_key":10530},[],"Stay warm with extra towels and blankets","e872631f5389","0be3be62bf31",{"markDefs":10533,"children":10534,"level":921,"_type":58,"style":78,"_key":10539,"listItem":914},[],[10535],{"text":10536,"_key":10537,"_type":56,"marks":10538},"Have skin to skin with your baby +/- breastfeeding","a272bc42a4ea",[],"4200382b7e78",{"level":921,"_type":58,"style":78,"_key":10541,"listItem":914,"markDefs":10542,"children":10543},"5489541b4135",[],[10544],{"marks":10545,"text":10546,"_key":10547,"_type":56},[],"Healthcare providers and birth partners should keep voices low","623bbe1e627b",{"_key":10549,"listItem":914,"markDefs":10550,"children":10551,"level":921,"_type":58,"style":78},"39525e1b7810",[],[10552],{"_key":10553,"_type":56,"marks":10554,"text":10555},"e5c5b2d5e708",[],"Leave the cord to pulsate – there is often no immediate need to keep checking the cord, especially if you are doing optimal cord clamping",{"listItem":914,"markDefs":10557,"children":10558,"level":921,"_type":58,"style":78,"_key":10563},[],[10559],{"_type":56,"marks":10560,"text":10561,"_key":10562},[],"Let your midwife know what you’re feeling, if you feel the need to!","5c591945e0d4","28d7bc2d7220",{"_key":10565,"_type":190,"link":10566},"0fdad299a10d",{"blank":192,"_type":67,"text":10567,"type":194,"internalLink":10568},"Planning a home birth? Get in touch!",{"_ref":2580,"_type":197},{"_type":58,"style":78,"_key":10570,"markDefs":10571,"children":10572},"9308507d70dc",[],[10573,10577],{"_type":56,"marks":10574,"text":10575,"_key":10576},[108],"Learn more","409ba13f64d5",{"_type":56,"marks":10578,"text":6850,"_key":10579},[],"e5ce7897bc25",{"children":10581,"_type":58,"style":78,"_key":10597,"markDefs":10598},[10582,10585,10588,10593],{"_type":56,"marks":10583,"text":10102,"_key":10584},[108],"f6d160fd3b66",{"_key":10586,"_type":56,"marks":10587,"text":4274},"f1880aa2bd96",[],{"marks":10589,"text":10591,"_key":10592,"_type":56},[281,10590],"264191775c2e","Birthing your placenta: the third stage of labour","95337864578d",{"_key":10594,"_type":56,"marks":10595,"text":10596},"62426ab15378",[]," by Dr Nadine Edwards and Dr Sarah Wickham","d8e8a33355aa",[10599],{"type":65,"url":10436,"_type":67,"_key":10590},{"_type":58,"style":78,"_key":10601,"markDefs":10602,"children":10606},"96d5f2d3c4b8",[10603],{"_type":67,"_key":10604,"type":65,"url":10605},"9add93df58af","https://open.spotify.com/episode/7JdBUHN3fJoriag9JQKpZe?si=515370b30c204be1",[10607,10610,10613],{"_key":10608,"_type":56,"marks":10609,"text":6845},"a1dbbde9fa17",[108],{"_key":10611,"_type":56,"marks":10612,"text":9793},"461fce474e21",[],{"marks":10614,"text":10615,"_key":10616,"_type":56},[281,10604],"Episode 24 of the Great Birth Rebellion – Placental Birth","6dad2c92cb25",{"markDefs":10618,"children":10622,"_type":58,"style":78,"_key":10641},[10619],{"_key":10620,"type":65,"url":10621,"_type":67},"0813cb1cfe49","https://uk.demand.film/born-at-home/",[10623,10627,10630,10634,10638],{"_key":10624,"_type":56,"marks":10625,"text":10626},"9a93445e87e9",[108],"Watch:",{"_type":56,"marks":10628,"text":4274,"_key":10629},[],"8328dc9036de",{"_type":56,"marks":10631,"text":10632,"_key":10633},[281],"Born at Home","96042ef5736e",{"_type":56,"marks":10635,"text":10636,"_key":10637},[]," – find your local showing ","c0caf116b8ad",{"_type":56,"marks":10639,"text":249,"_key":10640},[10620],"447955d12592","608b7810eb7b",{"style":78,"_key":10643,"markDefs":10644,"children":10645,"_type":58},"7003bdcd70bb",[],[10646],{"marks":10647,"text":10648,"_key":10649,"_type":56},[281,108],"References","929483881063",{"markDefs":10651,"children":10652,"_type":58,"style":78,"_key":10664},[],[10653,10657,10660],{"text":10654,"_key":10655,"_type":56,"marks":10656},"Soliman, N. (2024) Physiological Birth of the Placenta. ","8487ce6e8f15",[],{"text":10350,"_key":10658,"_type":56,"marks":10659},"298fe3bcfa33",[281],{"marks":10661,"text":10662,"_key":10663,"_type":56},[]," 27(2), pages 12 – 15","6f2eef5c4e99","bd21a0aae211",{"_type":37,"_id":6537,"_createdAt":10666,"_system":10667,"publishedAt":10670,"_updatedAt":10671,"image":10672,"title":10675,"content":10676,"slug":11118,"_rev":11120},"2025-04-07T15:19:11Z",{"base":10668},{"rev":10669,"id":6537},"lFrvlEMldmWjsfq3cbazqE","2024-03-13","2026-03-11T20:38:20Z",{"_type":586,"asset":10673},{"_ref":10674,"_type":197},"image-283a24561e3c63a14e6b039912ee8a9bef527a22-1080x1350-jpg","Vaginal Examinations in Labour: What They Are and What You Need to Know",{"_type":49,"body":10677},[10678,10686,10724,10732,10740,10752,10764,10776,10788,10804,10812,10829,10833,10841,10860,10868,10876,10884,10892,10906,10925,10943,10947,10955,10959,10967,10994,11002,11010,11029,11037,11045,11053,11061,11069,11077,11085,11093,11101],{"_type":58,"style":59,"_key":10679,"markDefs":10680,"children":10681},"c6ce9465965c",[],[10682],{"_key":10683,"_type":56,"marks":10684,"text":10685},"cad9815aa8da",[],"What Is a Vaginal Examination in Labour?",{"_type":58,"style":78,"_key":10687,"markDefs":10688,"children":10695},"edd274dc8127",[10689,10692],{"_key":10690,"type":65,"url":10691,"_type":67},"8d2838dd99dc","https://www.britishjournalofmidwifery.com/content/comment/offering-vaginal-examinations/",{"_key":10693,"type":65,"url":10694,"_type":67},"828f35d60af7","https://birthrights.org.uk/wp-content/uploads/2013/10/Birthrights-Dignity-Survey-1.pdf",[10696,10700,10704,10708,10712,10716,10720],{"text":10697,"_key":10698,"_type":56,"marks":10699},"A vaginal examination is a procedure used during labour to assess the dilation, effacement, position, and consistency of the cervix in addition to feeling where the baby’s head (or bottom!) is in the pelvis and what position they are in. It involves a midwife or a doctor wearing gloves and inserting two, lubricated fingers into the vagina. It is an incredibly intimate procedure and should ","50637028c661",[],{"text":10701,"_key":10702,"_type":56,"marks":10703},"never ","193ad68c12c3",[281],{"_type":56,"marks":10705,"text":10706,"_key":10707},[],"be performed without consent, however there is both ","6f6b880f31d3",{"marks":10709,"text":10710,"_key":10711,"_type":56},[10690],"anecdotal","8d45e96536c4",{"_type":56,"marks":10713,"text":10714,"_key":10715},[]," and published evidence showing that women around the world (including the ","4870d022dcf2",{"marks":10717,"text":10718,"_key":10719,"_type":56},[10693],"UK","45898fd8b5e6",{"text":10721,"_key":10722,"_type":56,"marks":10723},") do experience vaginal examinations without their consent.","8d4d813e16dd",[],{"_type":58,"style":59,"_key":10725,"markDefs":10726,"children":10727},"3639482f868e",[],[10728],{"_key":10729,"_type":56,"marks":10730,"text":10731},"659ad7de8bf0",[],"What Does a Vaginal Examination Actually Assess?",{"markDefs":10733,"children":10734,"_type":58,"style":78,"_key":10739},[],[10735],{"_type":56,"marks":10736,"text":10737,"_key":10738},[],"A quick overview on the language used when assessing the cervix:","e11fa9a6585e","da77b3ee10cd",{"style":78,"_key":10741,"listItem":914,"markDefs":10742,"children":10743,"level":921,"_type":58},"dff68b2fb2c0",[],[10744,10748],{"marks":10745,"text":10746,"_key":10747,"_type":56},[108],"Dilation","51519c8bd05e",{"_type":56,"marks":10749,"text":10750,"_key":10751},[]," – how open the cervix is, usually recorded in centimetres","4cc52e06aae6",{"level":921,"_type":58,"style":78,"_key":10753,"listItem":914,"markDefs":10754,"children":10755},"11d1efa2cf9e",[],[10756,10760],{"_type":56,"marks":10757,"text":10758,"_key":10759},[108],"Effacement","791a1da4e0e2",{"text":10761,"_key":10762,"_type":56,"marks":10763}," – how thin/short the cervix is; during pregnancy the cervix is a long, closed and tube shaped","14a932e43d12",[],{"_key":10765,"listItem":914,"markDefs":10766,"children":10767,"level":921,"_type":58,"style":78},"437a10e5b9a0",[],[10768,10772],{"_key":10769,"_type":56,"marks":10770,"text":10771},"eaa2c642e026",[108],"Position",{"text":10773,"_key":10774,"_type":56,"marks":10775}," – the cervix can be posterior (pointing towards your back), central (in the middle) or anterior (facing towards your front)","3f138e991f72",[],{"children":10777,"level":921,"_type":58,"style":78,"_key":10786,"listItem":914,"markDefs":10787},[10778,10782],{"text":10779,"_key":10780,"_type":56,"marks":10781},"Consistency","49e3b20e9af2",[108],{"_type":56,"marks":10783,"text":10784,"_key":10785},[]," – the cervix can feel firm or soft, or somewhere in between ","4b8fdaffc128","7bb425b1458a",[],{"markDefs":10789,"children":10790,"_type":58,"style":78,"_key":10803},[],[10791,10795,10799],{"_type":56,"marks":10792,"text":10793,"_key":10794},[],"During an uncomplicated pregnancy, the cervix remains firm, long, closed and usually posterior. During labour it undergoes several changes to become soft, short and more anterior facing. Usually, it has to do these things before it starts to dilate and this is what is generally happening in early labour. Vaginal examinations ","bb8ae16fbc15",{"_type":56,"marks":10796,"text":10797,"_key":10798},[281],"can","28790f1984bd",{"marks":10800,"text":10801,"_key":10802,"_type":56},[]," be a useful clinical tool in certain situations, however they cannot predict when a baby will be born. ","79f20ff65050","d94161f3e7f3",{"markDefs":10805,"children":10806,"_type":58,"style":59,"_key":10811},[],[10807],{"_type":56,"marks":10808,"text":10809,"_key":10810},[],"How Often Are Vaginal Examinations Recommended in Labour?","97f20dd0ff15","0d5b995805b2",{"_key":10813,"markDefs":10814,"children":10818,"_type":58,"style":78},"a301f6ca571c",[10815],{"type":65,"url":10816,"_type":67,"_key":10817},"https://www.nice.org.uk/guidance/ng235/chapter/Recommendations#first-stage-of-labour","67d44249d446",[10819,10822,10825],{"text":10820,"_key":10802,"_type":56,"marks":10821},"Current ",[],{"_key":10823,"_type":56,"marks":10824,"text":10407},"d7983ab1572f",[10817],{"marks":10826,"text":10827,"_key":10828,"_type":56},[]," guidelines advise that a vaginal examination should be offered to ‘diagnose’ labour and then every four hours when labour is considered ‘established’ (when the cervix is 4cm dilated and there are regular contractions). ","2dce02c4eaba",{"_type":190,"link":10830,"_key":10832},{"type":194,"internalLink":10831,"blank":192,"_type":67,"text":2953},{"_ref":502,"_type":197},"4734d70998d2",{"style":59,"_key":10834,"markDefs":10835,"children":10836,"_type":58},"63f354ca28f5",[],[10837],{"marks":10838,"text":10839,"_key":10840,"_type":56},[],"Is the Four-Hourly Vaginal Examination Guideline Based on Good Evidence?","e1b66aba9d2b",{"_key":10842,"markDefs":10843,"children":10847,"_type":58,"style":78},"8b5a8855ee44",[10844],{"_type":67,"_key":10845,"type":65,"url":10846},"e9b63218d6bf","https://doi.org/10.1016/0002-9378(54)90311-7",[10848,10852,10856],{"marks":10849,"text":10850,"_key":10851,"_type":56},[],"The evidence to support the four hourly recommendation for vaginal examinations is based on ","c85e210879a4",{"marks":10853,"text":10854,"_key":10855,"_type":56},[10845],"out-of-date evidence","940efcba553d",{"marks":10857,"text":10858,"_key":10859,"_type":56},[]," from the 1950s and serves to ensure that women and birthing people meet the time frames for labour that have been agreed by the medical profession. In a fragmented maternity system (the norm in the UK), where women are cared for by midwives they don’t know and who work shifts, it is not surprising that vaginal examinations are heavily relied on to assess labour progress. If you don’t know someone before labour, it can be really hard to assess behaviour changes and other ways of knowing labour is advancing. Additionally, in the context of medical interventions such as inductions of labour and epidural analgesia – regular vaginal examinations are often needed to assess that labour is progressing because these interventions alter the physiology of birth. For example, the lack of sensation that the epidural provides means that women don’t move instinctively or display the behavioural changes seen in women birthing without an epidural and labour can slow down – so vaginal examinations in this scenario may be helpful to ensure labour is progressing. ","1adf541be6f4",{"children":10861,"_type":58,"style":59,"_key":10866,"markDefs":10867},[10862],{"marks":10863,"text":10864,"_key":10865,"_type":56},[],"Are There Other Ways to Assess Labour Progress Without a Vaginal Examination?","2f23973094da","afd862f576b3",[],{"_key":10869,"markDefs":10870,"children":10871,"_type":58,"style":78},"3d99f0135f0b",[],[10872],{"_key":10873,"_type":56,"marks":10874,"text":10875},"e1d47b0833a0",[],"There are other ways of knowing if someone is progressing in labour including:",{"style":78,"_key":10877,"listItem":914,"markDefs":10878,"children":10879,"level":921,"_type":58},"b1c6e214eb21",[],[10880],{"_key":10881,"_type":56,"marks":10882,"text":10883},"2aafc8c1e347",[],"behavioural changes",{"style":78,"_key":10885,"listItem":914,"markDefs":10886,"children":10887,"level":921,"_type":58},"9e12f28c3b65",[],[10888],{"_type":56,"marks":10889,"text":10890,"_key":10891},[],"becoming more vocal","e9403a6715d4",{"listItem":914,"markDefs":10893,"children":10896,"level":921,"_type":58,"style":78,"_key":10905},[10894],{"_key":10895,"type":65,"url":10846,"_type":67},"ce649a6657ab",[10897,10901],{"text":10898,"_key":10899,"_type":56,"marks":10900},"noting the ","2ee21d5a14f8",[],{"marks":10902,"text":10903,"_key":10904,"_type":56},[10895],"Rhombus of Michaelis ","1674895a2d92","8d107f53fa39",{"_key":10907,"listItem":914,"markDefs":10908,"children":10912,"level":921,"_type":58,"style":78},"ed23dff0830c",[10909],{"type":65,"url":10910,"_type":67,"_key":10911},"https://www.sarawickham.com/questions-and-answers/evidence-for-the-purple-line/","d7207b626708",[10913,10917,10921],{"_type":56,"marks":10914,"text":10915,"_key":10916},[],"the presence of a ","12cc32e1816c",{"marks":10918,"text":10919,"_key":10920,"_type":56},[10911],"purple line","d64957a34198",{"_type":56,"marks":10922,"text":10923,"_key":10924},[]," between the buttocks (observed in lighter skinned women)","53556dc65885",{"markDefs":10926,"children":10930,"_type":58,"style":78,"_key":10942},[10927],{"url":10928,"_type":67,"_key":10929,"type":65},"https://doi.org/10.1111/1471-0528.14930","f96335593725",[10931,10935,10938],{"_type":56,"marks":10932,"text":10933,"_key":10934},[],"These other ways of knowing can be used by midwives working within mainstream maternity services of course, but the culture of maternity services is such that vaginal examinations are heavily relied on. Frequently women are not ‘allowed’ to access maternity services in labour unless they have had a vaginal examination to ‘ensure’ they are in active labour. The thing is that anyone who works in birth will tell you that women and birthing people do not always dilate in at a linear rate – that is to say they don’t follow what the text books say (2cm dilation every 4 hours is the accepted rate of dilation in obstetrics). We have countless stories of who dilate significantly faster than the textbooks would suggest, surprising everyone! And in the same breath, there are also many women who dilate significantly slower than the textbooks suggest and whilst this is often seen as a problem in mainstream maternity care, ","a995b391d383",{"_type":56,"marks":10936,"text":3132,"_key":10937},[10929],"8d30ff0afe0b",{"marks":10939,"text":10940,"_key":10941,"_type":56},[]," has shown that (surprise, surprise) some women have much longer labours than others with no adverse outcomes. ","2aacabb64113","55769c0e13b4",{"link":10944,"_key":10946,"_type":190},{"_type":67,"text":193,"type":194,"internalLink":10945,"blank":192},{"_ref":196,"_type":197},"dee0c225b7af",{"markDefs":10948,"children":10949,"_type":58,"style":78,"_key":10954},[],[10950],{"marks":10951,"text":10952,"_key":10953,"_type":56},[],"The importance of completing a holistic assessment cannot be understated – and this applies to both women who are progressing faster than expected and slower than expected. A slower labour is not automatically abnormal in the absence of any other concerning signs – so if the woman’s observations are normal and she feels well in herself, if there are no concerns with the baby’s wellbeing and there are no signs of obstructed labour (e.g. minimal urine output despite drinking to thirst) – then it is reasonable to await events and observe. Anecdotally, we have cared for women in the hospital who are progressing slower than expected and who have been offered (but declined) a caesarean section who then go on to have a straightforward vaginal birth after having more time for their labour to progress. Speaking to faster labours, it is so important to listen to women and birthing people when things are progressing faster than expected. We hear stories of first time women and birthing people being told that they can’t possibly be ready to push or that it is going to take hours for them to have a baby, when in fact they intuitively know their baby is coming. This dismissal of women’s experiences by healthcare professionals can be incredibly damaging.","aae8972ec5ad","ac7b79357cb5",{"_type":190,"link":10956,"_key":10958},{"blank":192,"_type":67,"text":9,"type":194,"internalLink":10957},{"_ref":1831,"_type":197},"e1b123827ea8",{"_type":58,"style":59,"_key":10960,"markDefs":10961,"children":10962},"09040386c1d7",[],[10963],{"marks":10964,"text":10965,"_key":10966,"_type":56},[],"How Continuity of Care Reduces the Need for Vaginal Examinations","921ac45f8bcb",{"_type":58,"style":78,"_key":10968,"markDefs":10969,"children":10973},"3e0ee53a803c",[10970],{"type":194,"url":5296,"internalLink":10971,"_type":67,"_key":10972},{"_ref":2756,"_type":197},"757ab837a1e8",[10974,10978,10982,10986,10990],{"_type":56,"marks":10975,"text":10976,"_key":10977},[],"Continuity of care – having the same midwife throughout the pregnancy, labour & birth and postnatal period – means that a relationship exists before labour. This means that a midwife really knows the woman or birthing person and therefore can more easily assess the alternative signs of labour. Additionally, in the antenatal period, there is time to discuss vaginal examinations and alternative methods of assessing labour progress. There is time to understand how a woman or birthing person may feel about having vaginal examinations and decide if they want to be offered four hourly vaginal examinations in labour or have these offered based on the clinical picture or their preferences, or indeed not at all. Midwives who are experienced in supporting physiological birth don’t need to rely on vaginal examinations to know if labour is progressing or not, instead they’re a tool to be used if the clinical picture changes or perhaps when the findings would support decision making. Ultimately, it should ","7c032c06ad05",{"_key":10979,"_type":56,"marks":10980,"text":10981},"dd398855dc72",[281],"always ",{"_key":10983,"_type":56,"marks":10984,"text":10985},"61cf0495829c",[],"be the ",{"_type":56,"marks":10987,"text":10988,"_key":10989},[10972],"choice","d2001277ea81",{"_key":10991,"_type":56,"marks":10992,"text":10993},"2611ac601544",[]," of women and birthing people to choose if they want to have a vaginal examination or not. ",{"style":59,"_key":10995,"markDefs":10996,"children":10997,"_type":58},"372b84aa770c",[],[10998],{"marks":10999,"text":11000,"_key":11001,"_type":56},[],"What Should Always Happen Before a Vaginal Examination?","dd0cb14083ec",{"style":78,"_key":11003,"markDefs":11004,"children":11005,"_type":58},"318dd6db5ac6",[],[11006],{"_type":56,"marks":11007,"text":11008,"_key":11009},[],"There are some general principles that should be applied when offering and doing a vaginal examination:","b645d8129003",{"level":921,"_type":58,"style":78,"_key":11011,"listItem":914,"markDefs":11012,"children":11016},"c2abea368f73",[11013],{"_key":11014,"type":65,"url":11015,"_type":67},"9a3b9d5a9bb6","https://www.aims.org.uk/information/item/vaginal-examinations#:~:text=Other%20reasons%20why%20a%20vaginal,is%20pressing%20on%20the%20cervix.",[11017,11021,11025],{"text":11018,"_key":11019,"_type":56,"marks":11020},"an explanation of the ","9f88182e31f7",[],{"_type":56,"marks":11022,"text":11023,"_key":11024},[11014],"potential risks and benefits","f412af904332",{"text":11026,"_key":11027,"_type":56,"marks":11028}," of the procedure ","3a4906f9dcfb",[],{"markDefs":11030,"children":11031,"level":921,"_type":58,"style":78,"_key":11036,"listItem":914},[],[11032],{"_key":11033,"_type":56,"marks":11034,"text":11035},"6cfa84020223",[],"an explanation of the purpose of the examination","23235a8a0c23",{"children":11038,"level":921,"_type":58,"style":78,"_key":11043,"listItem":914,"markDefs":11044},[11039],{"text":11040,"_key":11041,"_type":56,"marks":11042},"a discussion of alternative options","1313ea29b439",[],"831aa7ef0870",[],{"_key":11046,"listItem":914,"markDefs":11047,"children":11048,"level":921,"_type":58,"style":78},"2832095c8364",[],[11049],{"_type":56,"marks":11050,"text":11051,"_key":11052},[],"ensuring the woman is aware she can change her mind and/or ask the examination to stop at any point","2327fa35aa5d",{"_key":11054,"listItem":914,"markDefs":11055,"children":11056,"level":921,"_type":58,"style":78},"de31461fb450",[],[11057],{"text":11058,"_key":11059,"_type":56,"marks":11060},"ensuring consent has been freely given prior to any examination (sometimes someone can verbally say yes, but their body language is saying no – pay attention to that)","c79972f3cb8f",[],{"style":78,"_key":11062,"listItem":914,"markDefs":11063,"children":11064,"level":921,"_type":58},"1075d728b356",[],[11065],{"_type":56,"marks":11066,"text":11067,"_key":11068},[],"respecting someone’s decision if they decline an examination","da5f3be769fa",{"markDefs":11070,"children":11071,"level":921,"_type":58,"style":78,"_key":11076,"listItem":914},[],[11072],{"text":11073,"_key":11074,"_type":56,"marks":11075},"never coercing someone into having one","fd8f3404d468",[],"68b886bcd788",{"level":921,"_type":58,"style":78,"_key":11078,"listItem":914,"markDefs":11079,"children":11080},"687e16b32c29",[],[11081],{"_type":56,"marks":11082,"text":11083,"_key":11084},[],"ensuring that dignity is maintained throughout the examination (for example by not exposing someone more than is necessary, ensuring curtains are pulled / doors are closed)","c023c0388923",{"style":78,"_key":11086,"listItem":914,"markDefs":11087,"children":11088,"level":921,"_type":58},"f3a79d5d5928",[],[11089],{"marks":11090,"text":11091,"_key":11092,"_type":56},[],"offering a chaperone","d2bf0e34291e",{"style":78,"_key":11094,"markDefs":11095,"children":11096,"_type":58},"8e2ce51c7f70",[],[11097],{"marks":11098,"text":11099,"_key":11100,"_type":56},[],"Vaginal examinations provide information about what a cervix is doing and where a baby is in the pelvis at that point in time. They do not predict when a baby will be born – no such tool exists. Having a known midwife, who both understands and respects physiological birth and knows when a vaginal examination is truly clinically indicated, will likely result in a woman or birthing person experiencing minimal, if any, vaginal examinations during labour.","cd1da9136388",{"children":11102,"_type":58,"style":78,"_key":11114,"markDefs":11115},[11103,11107,11111],{"_type":56,"marks":11104,"text":11105,"_key":11106},[],"We can support you to have a great birth experience, wherever you’re planning to birth, ","2b2f91aeb028",{"text":4724,"_key":11108,"_type":56,"marks":11109},"46680564232c",[11110],"04070190bd6c",{"_type":56,"marks":11112,"text":9776,"_key":11113},[],"7da0123e2c0c","65593eae88eb",[11116],{"_type":67,"_key":11110,"type":194,"internalLink":11117},{"_type":197,"_ref":2580},{"current":11119,"_type":8},"vaginal-examinations-in-labour-what-they-are-and-what-you-need-to-know","5fd977pr5Ct4pKgLygXqSw",{"content":11122,"_system":11412,"image":11415,"_id":10494,"publishedAt":11418,"_rev":11419,"slug":11420,"_createdAt":11422,"_type":37,"title":11423,"_updatedAt":11424},{"_type":49,"body":11123},[11124,11132,11171,11179,11203,11211,11219,11223,11231,11265,11273,11292,11300,11308,11313,11321,11329,11337,11345,11353,11361,11369,11399,11404],{"_key":11125,"markDefs":11126,"children":11127,"_type":58,"style":59},"18975761aac6",[],[11128],{"text":11129,"_key":11130,"_type":56,"marks":11131},"Myth 1: You Can't Have a Home Birth With Your First Baby","e7b6cf843093",[],{"style":78,"_key":11133,"markDefs":11134,"children":11144,"_type":58},"c9fd832c1bbc",[11135,11138,11141],{"_type":67,"_key":11136,"type":65,"url":11137},"6bc1f4d996ff","https://www.nice.org.uk/guidance/ng235/chapter/Recommendations",{"_key":11139,"type":65,"url":11140,"_type":67},"459cd398bb4a","https://www.npeu.ox.ac.uk/birthplace",{"_key":11142,"type":65,"url":11143,"_type":67},"70a741f46bdf","https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(19)30119-1/fulltext",[11145,11149,11152,11156,11160,11164,11167],{"marks":11146,"text":11147,"_key":11148,"_type":56},[],"It’s entirely YOUR choice where you plan to have your baby – whether its your first or seventh. The current ","2f6625ca3bb2",{"text":4070,"_key":11150,"_type":56,"marks":11151},"aef80d0f7599",[11136],{"_type":56,"marks":11153,"text":11154,"_key":11155},[]," advise that if you’re having your first baby, home birth is slightly more risky for your baby than birthing on a midwife-led unit or in a hospital. Despite these guidelines being updated in 2023, the ","4535df38fe5b",{"marks":11157,"text":11158,"_key":11159,"_type":56},[11139],"evidence","e223bc9956f8",{"marks":11161,"text":11162,"_key":11163,"_type":56},[]," used for that guidelines is from 2011 and more recent ","e8151739a6cd",{"_key":11165,"_type":56,"marks":11166,"text":11158},"1fdcd1041013",[11142],{"marks":11168,"text":11169,"_key":11170,"_type":56},[]," published in the Lancet in 2019, shows that even for first timers – home birth is a safe option. Even just planning a home birth (regardless of where you actually end up giving birth) is associated with reduced chances of c-sections, instrumental births and epidural analgesia. ","853f6a274a45",{"style":59,"_key":11172,"markDefs":11173,"children":11174,"_type":58},"5e718d8cb047",[],[11175],{"marks":11176,"text":11177,"_key":11178,"_type":56},[],"Myth 2: Home Birth Is More Dangerous Than Hospital Birth","9df1dd04f817",{"markDefs":11180,"children":11186,"_type":58,"style":78,"_key":11202},[11181,11183],{"_key":11182,"type":65,"url":3492,"_type":67},"a8be61d3aa60",{"_key":11184,"type":65,"url":11185,"_type":67},"a94dcddbd4f6","https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/livebirths/bulletins/birthcharacteristicsinenglandandwales/2020#:~:text=6.,increase%20from%202.1%25%20in%202019.",[11187,11190,11194,11198],{"_key":11188,"_type":56,"marks":11189,"text":891},"ba3a5e59b72a",[11182],{"_key":11191,"_type":56,"marks":11192,"text":11193},"71edc0a64eb9",[]," shows that, particularly for ‘low risk’ women, home birth is a safe option for women, birthing people & their babies. Home birth has been shown to have many benefits to women and birthing people, notably significantly less interventions. Home birth is however not common, with only ",{"marks":11195,"text":11196,"_key":11197,"_type":56},[11184],"2.4% of births","f22d9e8cf554",{"_key":11199,"_type":56,"marks":11200,"text":11201},"680532434d24",[]," occurring at home in 2020 in the UK and it is a common perception that it is not the ‘safe’ option. Some people are concerned about being far away from the hospital just in case something goes wrong at home. Skilled intuitive midwives, who you know and trust, will be quietly observing and monitoring for signs that everything is on track or if there things to be concerned about. In our experience, most transfers to hospital are not ‘blue light’ or drastic emergency transfers. You may have chosen to be transferred or we may have picked up on some concerning signs and recommended transfer to hospital for further monitoring or obstetric input. ","7b547c941327",{"children":11204,"_type":58,"style":59,"_key":11209,"markDefs":11210},[11205],{"_key":11206,"_type":56,"marks":11207,"text":11208},"abac0fbdfc43",[],"Myth 3: There Isn't Enough Space in My Home to Give Birth","2995689e4f20",[],{"markDefs":11212,"children":11213,"_type":58,"style":78,"_key":11218},[],[11214],{"_type":56,"marks":11215,"text":11216,"_key":11217},[],"Babies don’t need much space to be born and you can absolutely get creative with your space. You may also be surprised if you’ve ever given birth in a hospital at how small hospital rooms can be – with little space to roam around during labour. Birthing in your own space, no matter how big or small, allows you to move freely during your labour – intuitively going where feels right at the time. Being somewhere where you feel comfortable and safe during labour and birth will help your oxytocin to flow!","283988fab7c1","985dd6471fbf",{"link":11220,"_key":11222,"_type":190},{"internalLink":11221,"blank":192,"_type":67,"text":193,"type":194},{"_ref":196,"_type":197},"f1aaa871a4ef",{"style":59,"_key":11224,"markDefs":11225,"children":11226,"_type":58},"2ad163801a89",[],[11227],{"_type":56,"marks":11228,"text":11229,"_key":11230},[],"Myth 4: I Can't Birth at Home Because I'm High Risk","146534310f63",{"_type":58,"style":78,"_key":11232,"markDefs":11233,"children":11239},"4cf063830e0b",[11234,11236],{"_key":11235,"type":65,"url":787,"_type":67},"d613a54aaae2",{"url":11237,"_type":67,"_key":11238,"type":65},"https://www.sarawickham.com/research-updates/home-birth-also-safer-for-higher-risk-women/","75e5c476ce85",[11240,11244,11247,11251,11254,11258,11261],{"_type":56,"marks":11241,"text":11242,"_key":11243},[],"In the UK, you have the ","1a55408923c3",{"text":9690,"_key":11245,"_type":56,"marks":11246},"abecd099837d",[11235],{"marks":11248,"text":11249,"_key":11250,"_type":56},[]," where you give birth – regardless of what has been recommended to you. You may have been advised that it would be safer for you to give birth in hospital with close monitoring and the reasons for this may be valid and evidence based. Sometimes, risks can be blown out of proportion and ultimately you have to decide what feels right and safe to ","2eb41b8dfe73",{"_key":11252,"_type":56,"marks":11253,"text":7595},"dda19c8cb4bb",[108],{"_type":56,"marks":11255,"text":11256,"_key":11257},[],". There is less ","ebf962272be6",{"text":3132,"_key":11259,"_type":56,"marks":11260},"c93f4365f6d3",[11238],{"text":11262,"_key":11263,"_type":56,"marks":11264}," on home birth for high risk women, and generally in the research all high risk women get lumped together regardless of what their risk factors are, however choosing to birth at home still results in fewer interventions. If you are considered ‘high risk’ but would like to plan a home birth, we can support you with your choice. ","e88a81f73b73",[],{"_key":11266,"markDefs":11267,"children":11268,"_type":58,"style":59},"c8158c6b5c77",[],[11269],{"marks":11270,"text":11271,"_key":11272,"_type":56},[],"Myth 5: Birth Is Too Noisy, I'll Disturb the Neighbours","5ad95ea22847",{"children":11274,"_type":58,"style":78,"_key":11288,"markDefs":11289},[11275,11279,11284],{"_type":56,"marks":11276,"text":11277,"_key":11278},[],"This is a common concern we hear amongst women and birthing people who are considering birthing at home. During labour most people do make sounds (these changing sounds usually get your midwives quietly excited!) – but women and birthing people are never as loud as they think they are. In our experience, your neighbours will be none the wiser that a baby is being born and even if they do hear some noises – people love a new baby! The ","4f4d054cec1b",{"marks":11280,"text":11282,"_key":11283,"_type":56},[11281],"fd9529b2e441","Positive Birth Movement","78eccb74a85c",{"marks":11285,"text":11286,"_key":11287,"_type":56},[]," has videos of women giving birth on their website, these can be really helpful to dispel common misperceptions about what birth looks and sounds like as portrayed in the mainstream media!","60cd0f30d85b","fc4318fdbae5",[11290],{"type":65,"url":11291,"_type":67,"_key":11281},"https://www.positivebirthmovement.org/watch-birth-films/",{"children":11293,"_type":58,"style":59,"_key":11298,"markDefs":11299},[11294],{"_key":11295,"_type":56,"marks":11296,"text":11297},"e48e3c7f604f",[],"Myth 6: You Can't Use a Birth Pool in a Flat","932cde0cb30b",[],{"children":11301,"_type":58,"style":78,"_key":11306,"markDefs":11307},[11302],{"_type":56,"marks":11303,"text":11304,"_key":11305},[],"A birth pool is safe to use in an upstairs room. Think about all the other things an upstairs room could hold – beds, wardrobes full of clothes, multiple people! Your birth pool is not going to fall through your ceiling! You can totally birth at home if you live in a second, third, fourth etc. floor flat – paramedics will be able to access you regardless of where you live if we need them.","7a720e99553f","056047b99b30",[],{"link":11309,"_key":11312,"_type":190},{"blank":192,"_type":67,"text":11310,"type":194,"internalLink":11311},"Want to Hire a Pool? Get in Touch!",{"_ref":2580,"_type":197},"690d2ce32045",{"_key":11314,"markDefs":11315,"children":11316,"_type":58,"style":59},"aa167d0c0fb8",[],[11317],{"marks":11318,"text":11319,"_key":11320,"_type":56},[],"Myth 7: Home Birth Is Too Messy","ebb20ad5ca6b",{"children":11322,"_type":58,"style":78,"_key":11327,"markDefs":11328},[11323],{"_key":11324,"_type":56,"marks":11325,"text":11326},"4c244eae0167",[],"There is of course ‘mess’ associated with birth, but you’d be surprised at how adept midwives and doulas are at cleaning up after a birth – nothing to see here! Absorbable bed pads (fondly known as ‘inco sheets’) go a long way, old towels and blankets, a shower curtain to protect a bed or a sofa all help to minimise the glorious mess that comes with birthing a baby. Don’t worry about the mess – there’s far more exciting things happening! That being said…if you do have cream carpets or a cream sofa – get prepared with some protective coverings beforehand!","87e2629e8fc0",[],{"_type":58,"style":59,"_key":11330,"markDefs":11331,"children":11332},"d4500231e826",[],[11333],{"text":11334,"_key":11335,"_type":56,"marks":11336},"Myth 8: There's No Pain Relief Available at a Home Birth","d33df64081e6",[],{"_key":11338,"markDefs":11339,"children":11340,"_type":58,"style":78},"b5ea123ec471",[],[11341],{"_key":11342,"_type":56,"marks":11343,"text":11344},"282c79ab389b",[],"Midwives have many things they can suggest to support you during your labour – movement, breathing techniques, massage, aromatherapy, birth pools, combs, TENS machines and even gas & air. What we don’t have at a home birth is access to an epidural. Childbirth is generally not without any pain, but how you prepare and approach this pain makes a huge difference to how you experience it. Using hypnobirthing techniques (and practicing these techniques beforehand) can make a huge difference to your birth experience. Even choosing wisely the people who you want in your birth space can make a difference to how you cope with labour. Got someone scared and tense in the room? You will pick up on that energy during your labour and birth. ",{"style":59,"_key":11346,"markDefs":11347,"children":11348,"_type":58},"632fc89bb472",[],[11349],{"text":11350,"_key":11351,"_type":56,"marks":11352},"Myth 9: Home Birth Is Only for Hippy, Alternative Types","5a4cc1db52fd",[],{"style":78,"_key":11354,"markDefs":11355,"children":11356,"_type":58},"c94934cde9c0",[],[11357],{"_type":56,"marks":11358,"text":11359,"_key":11360},[],"Women and birthing people choose home birth for a variety of reasons and come from all walks of life. Some people feel safest at home or perhaps associate hospitals with illness and death. Some people may have had a previous traumatic birth experience and wish to have a more positive birth experience the next time. Home birth is the logical, normal option for many – especially if there is a family history of home births. Some people have read the research and know that home birth is associated with excellent outcomes for women, birthing people and their babies. There’s no ‘type’ when it comes to women and birthing people who choose a home birth – even Queen Elizabeth II had home (or should we say, palace?!) births!","d5e4c0d435cc",{"children":11362,"_type":58,"style":59,"_key":11367,"markDefs":11368},[11363],{"_type":56,"marks":11364,"text":11365,"_key":11366},[],"Myth 10: Women Used to Die in Childbirth at Home, That's Why Hospitals Exist","c4321e433f64","a6000f139a1c",[],{"style":78,"_key":11370,"markDefs":11371,"children":11378,"_type":58},"fdbed66a2389",[11372,11375],{"type":65,"url":11373,"_type":67,"_key":11374},"https://www.hive.co.uk/Product/Julia-Allison/Midwifery-from-the-Tudors-to-the-21st-Century--History-Po/24894289","55ef9dba288d",{"_key":11376,"type":65,"url":11377,"_type":67},"9b985c3ce0a7","https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1960231/pdf/jroyalcgprac00164-0031.pdf",[11379,11383,11387,11391,11395],{"text":11380,"_key":11381,"_type":56,"marks":11382},"We are fortunate in the UK to have a low maternal death rate in childbirth and sure, historically more women would have died during childbirth before we understood about things like infection and sepsis or had medications to manage heavy bleeding at home, or access to a robust ambulance service for transfers when necessary. We have many things in place to keep women and birthing people safe when birthing at home. Julia Allison wrote a great book, ","c37352d306c3",[],{"text":11384,"_key":11385,"_type":56,"marks":11386},"Midwifery from the Tudors to the 21st Century","5c254ea33074",[11374],{"_key":11388,"_type":56,"marks":11389,"text":11390},"83ec9ca10526",[],", which explores birth and death registers from the Tudors and the provision of safe midwifery care. She also tracks the changes and challenges midwives have experienced over the centuries, highlighting how the move away from midwifery care saw an exponential increase in maternal deaths in the early 20th century from puerperal fever – a consequence of medical men not washing their hands after dissecting cadavers and before attending childbearing women! ",{"_type":56,"marks":11392,"text":11393,"_key":11394},[11376],"Marjorie Tew’s research in the 80s","5346d9d69ccd",{"_type":56,"marks":11396,"text":11397,"_key":11398},[]," also debunked the myth that hospital birth was improving outcomes. ","d920b67ee85e",{"_type":190,"link":11400,"_key":11403},{"blank":192,"_type":67,"text":11401,"type":194,"internalLink":11402},"Want dreamy home birth care? We’ve got your back",{"_ref":196,"_type":197},"21234b5b6b8a",{"_type":58,"style":78,"_key":11405,"markDefs":11406,"children":11407},"d4d2efb5cb9b",[],[11408],{"_type":56,"marks":11409,"text":11410,"_key":11411},[281],"If you’re considering home birth, we’d love to support you! Get in touch for a free, no strings attached consultation. It’s YOUR birth experience – we would love to help you make it a great one.","ab1593dee904",{"base":11413},{"rev":11414,"id":10494},"7l2KCMg711eQ9a3UN6uDfm",{"asset":11416,"_type":586},{"_ref":11417,"_type":197},"image-ca9785d7fcf33c3bd0af20fe7e44229bc35238e1-1205x1600-jpg","2024-02-27","lTiZ7ejil6ZSBCJHGJ8fOG",{"current":11421,"_type":8},"10-home-birth-myths-busted-separating-fact-from-fiction","2025-04-07T15:19:04Z","10 Home Birth Myths Busted: Separating Fact From Fiction","2026-03-17T12:16:49Z",{"publishedAt":11426,"_id":11427,"image":11428,"_rev":11431,"content":11432,"_updatedAt":11722,"slug":11723,"_createdAt":11725,"_system":11726,"title":11729,"_type":37},"2024-02-19","d9947042-3931-4dbd-8545-ad9032ba9a60",{"asset":11429,"_type":586},{"_type":197,"_ref":11430},"image-44233e4ecfe6c013b8ed81aabf1824eeeb0c6f3c-1080x1350-jpg","7l2KCMg711eQ9a3UN6ucrf",{"body":11433,"_type":49},[11434,11442,11450,11469,11477,11481,11489,11508,11516,11524,11532,11540,11545,11553,11561,11569,11584,11592,11629,11635,11643,11651,11659,11667,11675,11683],{"style":78,"_key":11435,"markDefs":11436,"children":11437,"_type":58},"1f4a3ef6c5cd",[],[11438],{"_type":56,"marks":11439,"text":11440,"_key":11441},[],"So you’ve done your research and you’ve decided on a home birth…but where do you start with the actual preparation? We get asked a lot of questions about this so here are some helpful pointers to get you started.","22d8dc4a3bdb",{"style":59,"_key":11443,"markDefs":11444,"children":11445,"_type":58},"787c6827a72e",[],[11446],{"_type":56,"marks":11447,"text":11448,"_key":11449},[],"Choosing Your Home Birth Team","1ea5b08d1384",{"_key":11451,"markDefs":11452,"children":11457,"_type":58,"style":78},"468ee005325d",[11453],{"internalLink":11454,"_type":67,"_key":11456,"type":194},{"_ref":11455,"_type":197},"5ff64a5f-f552-41a9-b855-42f93ddace70","2d8270a43095",[11458,11462,11465],{"text":11459,"_key":11460,"_type":56,"marks":11461},"Consider who you want around you during your birth. Find out if your local hospital has a dedicated home birth team – it’s not uncommon to have never met the midwife caring for you when accessing home birth care with the NHS. A stranger entering your birthing space, midwife or not, can have a really big impact on your labour and birth. Choosing an ","e344dc8852e1",[],{"text":1954,"_key":11463,"_type":56,"marks":11464},"10b7dfdbee81",[11456],{"marks":11466,"text":11467,"_key":11468,"_type":56},[],", getting to know them (and them you!) guarantees you both access to a homebirth and a known midwife at your birth.","308b24a0d279",{"markDefs":11470,"children":11471,"_type":58,"style":78,"_key":11476},[],[11472],{"marks":11473,"text":11474,"_key":11475,"_type":56},[],"Exploring the role of your partner during your labour and birth and what that looks like to you both will really help work out if and how they will be able to support you during labour or birth. It may be worth looking into different kinds of support to assist you and your partner – such as a doula. A doula can provide emotional and practical support in line with your wishes and birth plan.","44982e993794","c6b2979205e8",{"_key":11478,"_type":190,"link":11479},"7b57a04405eb",{"blank":192,"_type":67,"text":193,"type":194,"internalLink":11480},{"_type":197,"_ref":196},{"_type":58,"style":59,"_key":11482,"markDefs":11483,"children":11484},"044f8767f224",[],[11485],{"marks":11486,"text":11487,"_key":11488,"_type":56},[],"Making Your Home Accessible for Your Team ","4c7ae6a1ebda",{"_key":11490,"markDefs":11491,"children":11495,"_type":58,"style":78},"9825f0e7a71e",[11492],{"type":65,"url":11493,"_type":67,"_key":11494},"https://what3words.com/products/what3words-app","b8dab4d20be2",[11496,11500,11504],{"text":11497,"_key":11498,"_type":56,"marks":11499},"Once you’ve worked out who your birth team are, you want them to be able to access your home as easily as possible, especially if you live somewhere fairly remote. The app ","2dad5feff0dc",[],{"marks":11501,"text":11502,"_key":11503,"_type":56},[11494],"what 3 words","a7ebcb386a18",{"marks":11505,"text":11506,"_key":11507,"_type":56},[]," is a really useful way to share your location if you live a bit out of the way. Also think about where your midwife or doula can park – are there any restrictions on the road? Do you need to organise a permit?","7de2fac8397f",{"markDefs":11509,"children":11510,"_type":58,"style":59,"_key":11515},[],[11511],{"text":11512,"_key":11513,"_type":56,"marks":11514},"What to Do With Children and Pets During a Home Birth","55a48ff1e4e5",[],"5f8688bc9189",{"children":11517,"_type":58,"style":78,"_key":11522,"markDefs":11523},[11518],{"marks":11519,"text":11520,"_key":11521,"_type":56},[],"There is no right or wrong answer to whether you want your other children to be at home whilst you’re in labour and if you want them to join you in your birth space. It all depends on the relationship you have with them. It may be wise to make arrangements for someone to take care of them so you don’t have to worry about their needs. This goes for pets too. In my experience dogs are lovely but can be needy, whereas cats don’t have a care in the world! Either way don’t forget to consider them in your plans.","9958382ee0de","065144c3088e",[],{"style":59,"_key":11525,"markDefs":11526,"children":11527,"_type":58},"c0675ecef400",[],[11528],{"marks":11529,"text":11530,"_key":11531,"_type":56},[],"Setting Up Your Birthing Space at Home","add1f87235ec",{"_type":58,"style":78,"_key":11533,"markDefs":11534,"children":11535},"53b0aa5477b8",[],[11536],{"marks":11537,"text":11538,"_key":11539,"_type":56},[],"Being in your own home means you aren’t restricted to one room, like in a hospital or birth centre. You’ve got complete freedom to roam around your space. Movement can be a really important coping strategy in labour so you might find you naturally do this as labour unfolds. Do you want to be close to a bathroom? If you plan on using a birth pool, have you considered the best spot for that? It’s a good idea to also think about a post birth area and prepare this ahead of time (absorbent bed pads have saved many a mattress and sofa!), so you can settle down without having to think about organising anything. Your birth team can help you with all of this.","3308af41c580",{"_key":11541,"_type":190,"link":11542},"029da3c2ac69",{"_type":67,"text":11543,"type":194,"internalLink":11544,"blank":192},"Book Your Free Intro Chat",{"_ref":549,"_type":197},{"markDefs":11546,"children":11547,"_type":58,"style":59,"_key":11552},[],[11548],{"text":11549,"_key":11550,"_type":56,"marks":11551},"Creating the Right Environment for Labour","88bc288d4715",[],"99838ffa483e",{"_type":58,"style":78,"_key":11554,"markDefs":11555,"children":11556},"8c3f2cdcfbdf",[],[11557],{"marks":11558,"text":11559,"_key":11560,"_type":56},[],"Sound and lighting can trigger our senses in positive and negative ways. Low lighting is key to promoting oxytocin release. Think lamps and candles and avoid the big lights. Combining low lighting with a playlist of calming music and soundscapes can help to switch off the thinking brain and get into the zone for labour. Try to recreate the same sort of environment as you would for a romantic night in.","64b1dae03358",{"_key":11562,"markDefs":11563,"children":11564,"_type":58,"style":59},"8b7d4b039a54",[],[11565],{"_key":11566,"_type":56,"marks":11567,"text":11568},"0abdc4e18ab5",[],"What Equipment Do You Need for a Home Birth?",{"style":78,"_key":11570,"markDefs":11571,"children":11575,"_type":58},"6922279a8273",[11572],{"_type":67,"_key":11573,"type":194,"internalLink":11574},"008dfa906dc8",{"_ref":196,"_type":197},[11576,11580],{"marks":11577,"text":11578,"_key":11579,"_type":56},[],"Hospital birth rooms are always heavily equipped with things that beep! Remember this is your space and what you choose to have in it to aid your experience is up to you. Birth balls, peanut balls, labour combs, TENS machines, aromatherapy diffusers – whatever you wish. As independent midwives we carry these things but we find some people choose to invest in their own and use these in the latter few weeks of pregnancy. We're trained to support you in labour with aromatherapy specific to childbirth and this is included in our ","e4a6907448db",{"text":11581,"_key":11582,"_type":56,"marks":11583},"care packages.","6c0f81720b96",[11573],{"markDefs":11585,"children":11586,"_type":58,"style":59,"_key":11591},[],[11587],{"text":11588,"_key":11589,"_type":56,"marks":11590},"Setting Up a Birth Pool at Home: What You Need to Know","ce86d68c4b66",[],"e2ec888ddad6",{"markDefs":11593,"children":11601,"_type":58,"style":78,"_key":11628},[11594,11598],{"_type":67,"_key":11595,"type":194,"internalLink":11596},"46fcc02f05fc",{"_ref":11597,"_type":197},"ef60c469-56b2-4c7e-9468-90561e4c5f26",{"_key":11599,"type":194,"internalLink":11600,"_type":67},"476365fb01f3",{"_ref":196,"_type":197},[11602,11606,11610,11614,11617,11621,11625],{"_type":56,"marks":11603,"text":11604,"_key":11605},[],"If you’re planning a ","d1562301ab60",{"marks":11607,"text":11608,"_key":11609,"_type":56},[11595],"pool birth","122e3ddbd87e",{"_type":56,"marks":11611,"text":11612,"_key":11613},[]," it’s a really good idea to have a dry run. Inflate the pool and play around with it in your space to find where it fits best. Once the birth pool is full of water you won’t be able to move it! You need good access to taps but most birth pool kits come with reasonably long piping","bda8e15676f0",{"text":1183,"_key":11615,"_type":56,"marks":11616},"2c7db1c12384",[108],{"text":11618,"_key":11619,"_type":56,"marks":11620}," If you are planning on using a pool for birth you may need to hire one or if you are planning your care with us we offer this as part of your ","e67df628467c",[],{"_key":11622,"_type":56,"marks":11623,"text":11624},"caf931c1bd66",[11599],"home birth care package",{"text":1183,"_key":11626,"_type":56,"marks":11627},"1e8041da4619",[],"0cdf06202f52",{"_key":11630,"_type":190,"link":11631},"4e0b5dd3349e",{"blank":192,"_type":67,"text":11632,"type":194,"internalLink":11633},"FAQs",{"_ref":11634,"_type":197},"8d1f4c8c-699d-4bcd-8b60-43310e56e5b4",{"style":59,"_key":11636,"markDefs":11637,"children":11638,"_type":58},"5bb6003663d4",[],[11639],{"marks":11640,"text":11641,"_key":11642,"_type":56},[],"Towels, Blankets and Everything Else You'll Need","ac082138bf2a",{"_type":58,"style":78,"_key":11644,"markDefs":11645,"children":11646},"dc819425731f",[],[11647],{"_type":56,"marks":11648,"text":11649,"_key":11650},[],"They deserve their own bullet point! Collect all your old towels and put them somewhere within reach, they’ll come in handy. They are useful for if you get in and out of the pool during your labour. Once you’ve birthed they’ll help keep you and baby cosy and warm. Blankets, bedsheets and old duvets will come in handy too. Blankets will offer an extra layer of warmth once dry and your bedsheets can be used to protect furnishings and carpets from all the wonderful kind of mess that comes with birth. Don’t worry your midwives will clean up after!","e30cca23e6ad",{"_type":58,"style":59,"_key":11652,"markDefs":11653,"children":11654},"bef8b927b4e4",[],[11655],{"text":11656,"_key":11657,"_type":56,"marks":11658},"What Snacks and Food Should You Have Ready for a Home Birth?","251e01e52bf5",[],{"children":11660,"_type":58,"style":78,"_key":11665,"markDefs":11666},[11661],{"_type":56,"marks":11662,"text":11663,"_key":11664},[],"Snacks for you. Snacks for your partner. Snacks for after. A fridge and freezer stocked full of healthy pre-made dinners. Snacks for your midwives are not essential…but…ahem…we really like curly wurlys. You’ll find snacks that sustain you and give you a boost of energy are really good to stock up on. Nuts, dried fruit, grapes, a variety of cereal bars, ice lollies and a lovely isotonic drink to wash it all down with. Popping the grapes in your freezer will also make for a really great hydrating and healthy snack.","74a4ab4adc29","8198ad8b15e8",[],{"markDefs":11668,"children":11669,"_type":58,"style":59,"_key":11674},[],[11670],{"text":11671,"_key":11672,"_type":56,"marks":11673},"Should You Pack a Hospital Transfer Bag for a Home Birth?","5c4cf8385ed5",[],"3b245126f491",{"_type":58,"style":78,"_key":11676,"markDefs":11677,"children":11678},"9490241e59c4",[],[11679],{"text":11680,"_key":11681,"_type":56,"marks":11682},"On the rare occasion that you or your baby require medical input you want to be prepared. Pack a hospital transfer bag. Key items for you would be pads, underwear, a set of comfy pyjamas and some clean clothes, toiletries and a spare towel. Some clothes (vests and sleepsuits), nappies and cotton wool or wipes for your baby too. Partners, you’re going to need to pack one for yourself, just think of what you’d need for an overnight stay. Don’t forget a toothbrush!","5e6501b3d1bc",[],{"children":11684,"_type":58,"style":78,"_key":11716,"markDefs":11717},[11685,11689,11692,11697,11700,11704,11707,11712],{"_key":11686,"_type":56,"marks":11687,"text":11688},"59edd87e7a4f",[108],"If you have decided you’d like to plan a home birth but are struggling to put that plan into words then we offer in-depth",{"_type":56,"marks":11690,"text":4274,"_key":11691},[],"6abb72f47263",{"_type":56,"marks":11693,"text":11695,"_key":11696},[11694,108],"de7b864b3070","birth planning appointments","b9b2d7f4d987",{"_type":56,"marks":11698,"text":4274,"_key":11699},[],"499e2e4a8f4c",{"_type":56,"marks":11701,"text":11702,"_key":11703},[108],"as well as","e1f5f68b920f",{"marks":11705,"text":4274,"_key":11706,"_type":56},[],"e6fe408a52bc",{"marks":11708,"text":11710,"_key":11711,"_type":56},[108,11709],"90354596dcde","home birth care packages","0fef990e5a68",{"marks":11713,"text":11714,"_key":11715,"_type":56},[108],". Get in touch with us if you’d like to find out more.","685ad14d1874","058d8a6acfb4",[11718,11720],{"_type":67,"_key":11694,"type":194,"internalLink":11719},{"_ref":502,"_type":197},{"_type":67,"_key":11709,"type":194,"internalLink":11721},{"_ref":196,"_type":197},"2026-03-11T20:48:18Z",{"_type":8,"current":11724},"how-to-prepare-for-a-home-birth-a-practical-guide","2025-04-07T15:18:54Z",{"base":11727},{"rev":11728,"id":11427},"c1HqLtX09dCBnnfIQetO0A","How to Prepare for a Home Birth: A Practical Guide",{"_updatedAt":11731,"image":11732,"_system":11735,"_id":11738,"_type":37,"slug":11739,"_createdAt":11741,"title":11742,"content":11743,"publishedAt":11985,"_rev":11986},"2026-03-31T09:41:51Z",{"_type":586,"asset":11733},{"_type":197,"_ref":11734},"image-db7940f6df8bb6e0e53f6272643fab1d5f6034d8-1080x1080-png",{"base":11736},{"rev":11737,"id":11738},"c0ogPcjPPEHZG6wtA4B0PF","1e9da84f-436c-4615-8b53-de3e114dbaaf",{"current":11740,"_type":8},"home-birth-in-the-1960s-one-woman-s-story-of-giving-birth-at-home","2025-04-07T15:18:45Z","Home Birth in the 1960s: One Woman's Story of Giving Birth at Home",{"body":11744,"_type":49},[11745,11761,11769,11777,11785,11793,11801,11809,11817,11825,11831,11839,11847,11855,11863,11871,11879,11887,11895,11903,11911,11919,11927,11935,11943,11947],{"children":11746,"_type":58,"style":78,"_key":11759,"markDefs":11760},[11747,11751,11755],{"_key":11748,"_type":56,"marks":11749,"text":11750},"d67d400de8e8",[281],"Sophie’s Mum was born at home in 1965. Here, she interviews her Grandma to learn more about her experience of birthing at home almost 60 years ago",{"marks":11752,"text":11753,"_key":11754,"_type":56},[],", ","9ea27afb76fc",{"text":11756,"_key":11757,"_type":56,"marks":11758},"with some observations on the difference between her previous hospital birth and her homebirth.","f2ded90cbcb8",[281],"23ceeed52f39",[],{"_type":58,"style":59,"_key":11762,"markDefs":11763,"children":11764},"6ac022dde334",[],[11765],{"text":11766,"_key":11767,"_type":56,"marks":11768},"What Was Home Birth Like in the 1960s?","98801e07e937",[],{"_key":11770,"markDefs":11771,"children":11772,"_type":58,"style":78},"51463ce070b2",[],[11773],{"text":11774,"_key":11775,"_type":56,"marks":11776},"When and where did you have your homebirth?","ee9f9f4bcaa2",[108],{"markDefs":11778,"children":11779,"_type":58,"style":78,"_key":11784},[],[11780],{"marks":11781,"text":11782,"_key":11783,"_type":56},[],"12 October 1965, at home in Witney, Oxfordshire.","ef59111bc70d","e46e0ad414eb",{"markDefs":11786,"children":11787,"_type":58,"style":78,"_key":11792},[],[11788],{"_type":56,"marks":11789,"text":11790,"_key":11791},[108],"Were you encouraged to have a homebirth or was it something you knew you wanted?","76f060ebfa44","49522e9957da",{"style":78,"_key":11794,"markDefs":11795,"children":11796,"_type":58},"4797a3ee135b",[],[11797],{"_type":56,"marks":11798,"text":11799,"_key":11800},[],"Back then, it was the norm to have your first baby in the hospital and to have subsequent babies at home and I felt it would be much nicer.","f9cd943a4eff",{"markDefs":11802,"children":11803,"_type":58,"style":59,"_key":11808},[],[11804],{"_type":56,"marks":11805,"text":11806,"_key":11807},[],"Was Home Birth Considered Safe in the 1960s?","faa6a083f135","fd5d7a686964",{"children":11810,"_type":58,"style":78,"_key":11815,"markDefs":11816},[11811],{"marks":11812,"text":11813,"_key":11814,"_type":56},[108],"Were you ever worried that it wasn’t the ‘safe’ option?","8a4ba1be4d52","06c8ae4944cb",[],{"style":78,"_key":11818,"markDefs":11819,"children":11820,"_type":58},"d6b3b454a269",[],[11821],{"_type":56,"marks":11822,"text":11823,"_key":11824},[],"Initially I was worried about the baby being born at home, but I certainly wasn’t worried that it wasn’t the ‘safe’ option. I was very disappointed when I couldn’t have my third baby at home because of my placental position and we lived in a rural village, so there were concerns about an ambulance being able to get to me.","83d6446c0646",{"link":11826,"_key":11830,"_type":190},{"text":11827,"type":194,"internalLink":11828,"blank":192,"_type":67},"Is Homebirth Safe?",{"_ref":11829,"_type":197},"efc07f28-17e1-4e41-b5f7-c4d670eb239a","45276d1934f8",{"markDefs":11832,"children":11833,"_type":58,"style":59,"_key":11838},[],[11834],{"_type":56,"marks":11835,"text":11836,"_key":11837},[],"What Happened on the Day of Her Home Birth?","fcb0025c67ae","0ef0c9fbd817",{"_type":58,"style":78,"_key":11840,"markDefs":11841,"children":11842},"611d7aa8dae2",[],[11843],{"_type":56,"marks":11844,"text":11845,"_key":11846},[108],"Can you describe what happened on the day you gave birth?","4a8e722cd8b4",{"_type":58,"style":78,"_key":11848,"markDefs":11849,"children":11850},"05f1130590cb",[],[11851],{"text":11852,"_key":11853,"_type":56,"marks":11854},"I woke early and then my waters broke. I phoned my midwife who came round and examined me. She said that as it was 10 days early she didn’t think I would be giving birth that day and I’d be having a dry birth, which could happen. Also it was an antenatal clinic that afternoon and she hoped nothing would happen then! I knew as the day went on that the baby would be born that day.","c6d49170245b",[],{"children":11856,"_type":58,"style":78,"_key":11861,"markDefs":11862},[11857],{"marks":11858,"text":11859,"_key":11860,"_type":56},[],"I remember feeling very relaxed and preparing loads of vegetables for a casserole we were having that evening. I started having mild contractions and the breathing exercises helped enormously. In the afternoon when the contractions became stronger and I felt I needed to go upstairs to lie down, my husband phoned the midwife who said she’d be there asap. The midwife said to try and wait for her.","99aa7ef6ce48","88d3c764e729",[],{"_type":58,"style":78,"_key":11864,"markDefs":11865,"children":11866},"d5c416643b88",[],[11867],{"marks":11868,"text":11869,"_key":11870,"_type":56},[],"Then everything happened very quickly and the baby’s head was born just as the midwife arrived and then the rest of her. This was about 1630. The placenta came about 20 minutes later and I pushed it out. I didn’t need any stitches and I had no painkillers.","9a42deca68e6",{"style":78,"_key":11872,"markDefs":11873,"children":11874,"_type":58},"afa3fbe913dd",[],[11875],{"marks":11876,"text":11877,"_key":11878,"_type":56},[],"The midwife weighed the baby in a net which she held up and then the doctor arrived to check everything was ok. The doctor wasn’t there for very long – he checked the baby over and then asked me some questions.","cc5a74a2c2cc",{"_key":11880,"markDefs":11881,"children":11882,"_type":58,"style":59},"dcf0ebc83f7b",[],[11883],{"marks":11884,"text":11885,"_key":11886,"_type":56},[],"\nHome Birth vs Hospital Birth: How Did the Experiences Compare?","692c9d07b17c",{"_key":11888,"markDefs":11889,"children":11890,"_type":58,"style":78},"f74ecc3b3813",[],[11891],{"_type":56,"marks":11892,"text":11893,"_key":11894},[108],"Was there a difference in how you felt afterwards when you compare your first hospital birth and then your second homebirth?","bc9a836325c9",{"_type":58,"style":78,"_key":11896,"markDefs":11897,"children":11898},"4f9f22ed51b8",[],[11899],{"_key":11900,"_type":56,"marks":11901,"text":11902},"b336b672266f",[],"I felt much calmer after the homebirth and I was able to breastfeed easily, with some help from my mother. I loved breastfeeding! I breastfed for about 4 or 5 months and it made me feel so close to the baby. In the hospital, the baby was taken to the nursery overnight so you could sleep and then brought to you during the day when it needed to be fed. I got mastitis the first time and had to stop breastfeeding. Being at home was lovely because the baby was with you all the time.",{"style":78,"_key":11904,"markDefs":11905,"children":11906,"_type":58},"9f2155d9372a",[],[11907],{"marks":11908,"text":11909,"_key":11910,"_type":56},[108],"Did you have the same midwife for your antenatal, birth and postnatal care?","e86c6a1fc4a7",{"children":11912,"_type":58,"style":78,"_key":11917,"markDefs":11918},[11913],{"_key":11914,"_type":56,"marks":11915,"text":11916},"186509dddc8f",[],"I did know my midwife beforehand and she did visit me afterwards for about a week to 10 days. I had my antenatal appointments with her and then she visited me everyday for about a week after the baby was born. She was an older lady in her fifties and dedicated to her job. I got on with her well, but she was quite old school. Everybody who had her as a midwife liked her and you felt you could trust her. She was kind.","5d6bf774f6b7",[],{"_key":11920,"markDefs":11921,"children":11922,"_type":58,"style":59},"41852dc2dcc6",[],[11923],{"_type":56,"marks":11924,"text":11925,"_key":11926},[],"What Was the Best Thing About Giving Birth at Home?","5b7435ae443c",{"style":78,"_key":11928,"markDefs":11929,"children":11930,"_type":58},"464c5e6e4261",[],[11931],{"_type":56,"marks":11932,"text":11933,"_key":11934},[108],"What was the best thing for you about giving birth at home?","d015d1a6e3a1",{"style":78,"_key":11936,"markDefs":11937,"children":11938,"_type":58},"f1d09ef76787",[],[11939],{"_type":56,"marks":11940,"text":11941,"_key":11942},[],"Having my second baby at home was a truly wonderful experience, nobody fussing and no rules and regulations. With my first experience in hospital I remember my legs being in stirrups and it felt very undignified. It felt very efficient in the hospital, everybody was just getting on with the job. My birth experience at home was so different to my hospital birth experience – my homebirth experience was very gentle. I had learnt breathing techniques from my midwife at an antenatal class, which helped so much.","0dc814c85096",{"link":11944,"_key":11946,"_type":190},{"internalLink":11945,"blank":192,"_type":67,"text":9,"type":194},{"_ref":1831,"_type":197},"e79f9c9c527c",{"_key":11948,"markDefs":11949,"children":11953,"_type":58,"style":78},"35f6608f8d4f",[11950],{"_key":11951,"type":194,"internalLink":11952,"_type":67},"6fbec2ef1da8",{"_ref":549,"_type":197},[11954,11958,11961,11965,11968,11972,11975,11978,11981],{"text":11955,"_key":11956,"_type":56,"marks":11957},"Everyone’s birth story is unique to them. Sharing experiences can inspire, educate & inform – or just give you all the feels! There’s no ‘right’ way to birth – what matters if you have choices and are supported in those choices. We","964ef2b61025",[281],{"marks":11959,"text":4274,"_key":11960,"_type":56},[],"2d0835148d4e",{"_type":56,"marks":11962,"text":11963,"_key":11964},[281],"fundamentally respect","2167036678a9",{"text":4274,"_key":11966,"_type":56,"marks":11967},"507b1f052dc5",[],{"marks":11969,"text":11970,"_key":11971,"_type":56},[281],"that women and birthing people are the ultimate decision makers in their care – if we sound like the midwives for you,","3de882056435",{"text":4274,"_key":11973,"_type":56,"marks":11974},"d0d7a58e92e5",[],{"_type":56,"marks":11976,"text":4724,"_key":11977},[281,11951],"76994c1b152c",{"_key":11979,"_type":56,"marks":11980,"text":4274},"adefce3f74e3",[],{"text":11982,"_key":11983,"_type":56,"marks":11984},"to book a free, intro chat. ","fa899b925d77",[281],"2024-02-07","c0ogPcjPPEHZG6wtA4K5Bl",{"_createdAt":11988,"_updatedAt":11989,"publishedAt":11990,"_rev":11991,"_system":11992,"_id":11994,"title":11996,"content":11997,"slug":12171,"image":12173,"_type":37},"2025-04-07T15:18:40Z","2026-03-11T20:51:59Z","2024-01-29","V3aI2QowveaYP3Z79uHbCm",{"base":11993},{"id":11994,"rev":11995},"62f56e74-d421-4c96-932f-41f58ee91b7b","lFrvlEMldmWjsfq3cbR6U2","Gestational Diabetes Myths Busted: What You Really Need to Know",{"_type":49,"body":11998},[11999,12014,12022,12030,12038,12046,12054,12066,12074,12082,12090,12098,12106,12114,12122,12130,12138,12153],{"children":12000,"_type":58,"style":78,"_key":12012,"markDefs":12013},[12001,12005,12008],{"_key":12002,"_type":56,"marks":12003,"text":12004},"ec96578cfcda",[281],"This week we have a guest blog from Independent Midwife Lynsey Adams who specialises in gestational diabetes.",{"_key":12006,"_type":56,"marks":12007,"text":4274},"ce48be69be99",[],{"_type":56,"marks":12009,"text":12010,"_key":12011},[281],"Read on to have some common myths busted!","09f3a4cfc7b9","e192a3fb8bce",[],{"_type":58,"style":78,"_key":12015,"markDefs":12016,"children":12017},"65efe104ab81",[],[12018],{"_key":12019,"_type":56,"marks":12020,"text":12021},"d65bdd9cea7b",[],"Approximately 1 in 20 pregnancies in the UK are affected by Gestational Diabetes(GDM). Let’s debunk some common myths and set the record straight:",{"children":12023,"_type":58,"style":59,"_key":12028,"markDefs":12029},[12024],{"_key":12025,"_type":56,"marks":12026,"text":12027},"6a953e8ff829",[],"Myth 1: You're Not Allowed a Home Birth If You Have Gestational Diabetes","acb33080cf7a",[],{"markDefs":12031,"children":12032,"_type":58,"style":78,"_key":12037},[],[12033],{"text":12034,"_key":12035,"_type":56,"marks":12036},"Fact: If you’ve managed your GDM well with stable glucose levels, a homebirth is absolutely on the table. Ensure good control during labour with the right snacks and drinks.","79f7c2227f8f",[],"921b005ad953",{"_key":12039,"markDefs":12040,"children":12041,"_type":58,"style":59},"8088c68c085f",[],[12042],{"text":12043,"_key":12044,"_type":56,"marks":12045},"Myth 2: You Have to Be Induced at 40 Weeks With Gestational Diabetes","727e77e550dc",[],{"children":12047,"_type":58,"style":78,"_key":12052,"markDefs":12053},[12048],{"_type":56,"marks":12049,"text":12050,"_key":12051},[],"Fact: While induction is recommended by 40 weeks and 6 days, stable blood sugars may allow you to wait for natural labour. Induction is offered earlier than 40 weeks for those on medication or with more unstable glucose levels.","0d9c8ab33d5a","f375d14bf7ed",[],{"children":12055,"_type":58,"style":78,"_key":12064,"markDefs":12065},[12056,12060],{"_type":56,"marks":12057,"text":12058,"_key":12059},[],"It is important that you understand the reasons behind recommendations and make informed decisions that suit you and your baby. ","69102809f541",{"_type":56,"marks":12061,"text":12062,"_key":12063},[108],"Make sure you ask questions and get detailed responses about the risks and benefits of each choice.","3d487bd57a85","7896dff60952",[],{"style":59,"_key":12067,"markDefs":12068,"children":12069,"_type":58},"31847fb4b1f5",[],[12070],{"_type":56,"marks":12071,"text":12072,"_key":12073},[],"\nMyth 3: You'll Need to Transfer to Hospital After a Home Birth With GDM","8e8c23c3655e",{"_type":58,"style":78,"_key":12075,"markDefs":12076,"children":12077},"941e9a90d4ff",[],[12078],{"_type":56,"marks":12079,"text":12080,"_key":12081},[],"Fact: Glucose level checks for the baby post-birth are recommended, but there are devices to do this at home. 3 hours after birth, and then before each feed. If levels above 2.0 mmol/L are achieved after 3 tests then testing is complete. As well as a blood glucose reading below 2.0mmols, physical signs of low blood glucose can be a jittery baby (looks like they are shivering), unstable temperature, very sleepy/lethargic, and reluctance to feed.","be857eb62893",{"markDefs":12083,"children":12084,"_type":58,"style":78,"_key":12089},[],[12085],{"marks":12086,"text":12087,"_key":12088,"_type":56},[],"The most effective way to help your baby regulate themselves is to have as much skin-to-skin as possible, breastfeed within the first two hours following birth, and offer colostrum if you have some expressed.","d873ab33a146","c70344385a51",{"style":59,"_key":12091,"markDefs":12092,"children":12093,"_type":58},"322966db07c7",[],[12094],{"_type":56,"marks":12095,"text":12096,"_key":12097},[],"Myth 4: Gestational Diabetes Is a Lifelong Condition","f38277391304",{"_type":58,"style":78,"_key":12099,"markDefs":12100,"children":12101},"9bf782b4e997",[],[12102],{"_key":12103,"_type":56,"marks":12104,"text":12105},"eab2e3c91dcd",[],"Fact: GDM increases the risk of type 2 diabetes, but it resolves post-birth. Yearly checks with your GP, understanding predisposing factors, and maintaining a healthy lifestyle are crucial to preventing Type 2 diabetes from developing.",{"_key":12107,"markDefs":12108,"children":12109,"_type":58,"style":59},"2dfe2ceac69c",[],[12110],{"_type":56,"marks":12111,"text":12112,"_key":12113},[],"Myth 5: You'll Definitely Have Gestational Diabetes in Future Pregnancies","2c4c41827fe9",{"style":78,"_key":12115,"markDefs":12116,"children":12117,"_type":58},"f621df42f768",[],[12118],{"marks":12119,"text":12120,"_key":12121,"_type":56},[],"Fact: While there’s an increased chance, it’s not inevitable. A healthy lifestyle and early pregnancy support can reduce the chances of GDM in subsequent pregnancies.","4facd9c0b7d5",{"markDefs":12123,"children":12124,"_type":58,"style":59,"_key":12129},[],[12125],{"_type":56,"marks":12126,"text":12127,"_key":12128},[],"Making Informed Decisions About Your Gestational Diabetes Care","fe21c4d4ac90","1a1e3a3a5c55",{"style":78,"_key":12131,"markDefs":12132,"children":12133,"_type":58},"1907e8aca1fe",[],[12134],{"text":12135,"_key":12136,"_type":56,"marks":12137},"Want to navigate your Gestational Diabetes journey with confidence? As a specialist midwife in GDM, Lynsey can guide you through everything, from diagnosis to post-birth care. Lynsey is based in Reigate, Surrey.","27af3ec02eae",[],{"_key":12139,"markDefs":12140,"children":12144,"_type":58,"style":78},"cd53715a97f9",[12141],{"_key":12142,"type":65,"url":12143,"_type":67},"603f0c58cc81","http://www.brighterbirths.co.uk/",[12145,12149],{"_type":56,"marks":12146,"text":12147,"_key":12148},[281],"Book a consultation now: ","e8f06d56f427",{"_key":12150,"_type":56,"marks":12151,"text":12152},"933e3e20eb9a",[281,12142],"www.brighterbirths.co.uk",{"style":78,"_key":12154,"markDefs":12155,"children":12159,"_type":58},"726ba595d780",[12156],{"url":12157,"_type":67,"_key":12158,"type":65},"https://www.instagram.com/brighterbirths/","f7aa46cf26ac",[12160,12164,12167],{"text":12161,"_key":12162,"_type":56,"marks":12163},"Instagram:","60b060133493",[281],{"marks":12165,"text":4274,"_key":12166,"_type":56},[],"9b893ecd0dad",{"_type":56,"marks":12168,"text":12169,"_key":12170},[281,12158],"@brighterbirths","df1861ddd6b0",{"current":12172,"_type":8},"gestational-diabetes-myths-busted-what-you-really-need-to-know",{"_type":586,"asset":12174},{"_type":197,"_ref":12175},"image-694ee8284239a885adf6c28a1465720ed1905d69-1080x1350-jpg",{"_system":12177,"publishedAt":12180,"_updatedAt":12181,"content":12182,"slug":12518,"_id":11597,"image":12520,"_createdAt":12523,"_rev":12524,"title":12525,"_type":37},{"base":12178},{"rev":12179,"id":11597},"lFrvlEMldmWjsfq3cYocDs","2024-01-10","2026-03-11T20:57:02Z",{"_type":49,"body":12183},[12184,12192,12200,12208,12227,12235,12254,12273,12281,12289,12297,12305,12313,12321,12329,12337,12342,12350,12377,12385,12401,12414,12422,12430,12438,12446,12454,12482,12490,12498,12506,12510],{"_key":12185,"markDefs":12186,"children":12187,"_type":58,"style":59},"358fad1fa0f0",[],[12188],{"marks":12189,"text":12190,"_key":12191,"_type":56},[],"What Is the Difference Between Water Immersion in Labour and a Water Birth?","6b8d21098905",{"markDefs":12193,"children":12194,"_type":58,"style":78,"_key":12199},[],[12195],{"_type":56,"marks":12196,"text":12197,"_key":12198},[],"Water immersion during labour and birth has been around for several decades and continues to gain popularity today. There is growing evidence demonstrating the benefits of water immersion for women and birthing people and the safety for babies when compared to ‘land’ births. In the literature, water immersion may only refer to being in water for the labour only, whereas waterbirth refers to actually giving birth in water. So, are there any benefits or is it just a ‘nice’ thing to do? Are there any risks to birthing in water? Read on to find the answers!","6bd906426d8b","c9d354584624",{"_key":12201,"markDefs":12202,"children":12203,"_type":58,"style":59},"ec42e3238be7",[],[12204],{"_type":56,"marks":12205,"text":12206,"_key":12207},[],"What Does the Research Say About Water Birth Safety?","4c9567a18ab4",{"_key":12209,"markDefs":12210,"children":12214,"_type":58,"style":78},"34015a64db30",[12211],{"_type":67,"_key":12212,"type":65,"url":12213},"a593ecb5824d","https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD000111.pub4/full",[12215,12219,12223],{"marks":12216,"text":12217,"_key":12218,"_type":56},[],"There have now been several studies into the safety of waterbirth, including randomised controlled trials (RCTs) which are considered the ‘gold standard’ in research. A ","4052c77dbbc7",{"marks":12220,"text":12221,"_key":12222,"_type":56},[12212],"2018 Cochrane review","2223b47b5e74",{"text":12224,"_key":12225,"_type":56,"marks":12226}," (a review of available RCTs) on waterbirth, found that for low-risk women, with uncomplicated pregnancies, immersion in water in the first stage of labour probably reduces the need for regional analgesia (epidural or spinal). With regards to the second stage of labour, the evidence reviewed did not determine any difference, when comparing waterbirth to land birth, in the following outcomes: spontaneous vaginal birth, instrumental birth, caesarean section or neonatal unit admissions. The rate of third- and fourth-degree tears, estimated blood loss or third stage outcomes were unfortunately not reported on in the included trials. This review also concluded that there was no evidence to demonstrate any adverse effects on either the unborn baby, the newborn baby, or the woman from labouring of giving birth in water.","63cfabf1cf48",[],{"_type":58,"style":59,"_key":12228,"markDefs":12229,"children":12230},"33c75f88167f",[],[12231],{"_type":56,"marks":12232,"text":12233,"_key":12234},[],"What Are the Benefits of Using Water During Labour and Birth?","fc6490660116",{"children":12236,"_type":58,"style":78,"_key":12250,"markDefs":12251},[12237,12241,12246],{"_type":56,"marks":12238,"text":12239,"_key":12240},[],"A ","9d03f52dc38f",{"marks":12242,"text":12244,"_key":12245,"_type":56},[12243],"7f6d2b7b9a7e","2015 integrative review","61f4f9f13ac6",{"_type":56,"marks":12247,"text":12248,"_key":12249},[]," of peer reviewed research (this means research not limited to RCTs), highlighted several benefits of water immersion and waterbirth. Nutter et al. (2015) found that waterbirth increases maternal satisfaction with pain relief and the birth experience, decreased the chance of perineal trauma, including episiotomy and severe perineal tears and may decrease the likelihood of postpartum haemorrhage. For newborns, they found that there were no differences in neonatal mortality (death) rates, neonatal infection rates or admissions to a neonatal nursery, between waterbirths and uncomplicated land births.","364ff6d5a845","aeeda672f505",[12252],{"_type":67,"_key":12243,"type":65,"url":12253},"https://onlinelibrary.wiley.com/doi/10.1111/jmwh.12194",{"_type":58,"style":78,"_key":12255,"markDefs":12256,"children":12260},"7b2a22fc0d6c",[12257],{"_key":12258,"type":65,"url":12259,"_type":67},"d148ac779c11","https://evidencebasedbirth.com/waterbirth/",[12261,12265,12269],{"_type":56,"marks":12262,"text":12263,"_key":12264},[],"The great people over at ","80833d345518",{"_type":56,"marks":12266,"text":12267,"_key":12268},[12258],"Evidence Based Birth","eec6588eda4d",{"marks":12270,"text":12271,"_key":12272,"_type":56},[]," have done a thorough review of the literature on waterbirth and from that summarised the following potential benefits of waterbirth for women and birthing people:","f9938de4d0ed",{"markDefs":12274,"children":12275,"level":921,"_type":58,"style":78,"_key":12280,"listItem":914},[],[12276],{"_key":12277,"_type":56,"marks":12278,"text":12279},"88f4bdcda9b4",[],"Higher rates of spontaneous vaginal birth","d27151a8bf29",{"children":12282,"level":921,"_type":58,"style":78,"_key":12287,"listItem":914,"markDefs":12288},[12283],{"marks":12284,"text":12285,"_key":12286,"_type":56},[],"Lower rates of have oxytocin augmentation","d60dff3fea9e","1f2e1657839b",[],{"_type":58,"style":78,"_key":12290,"listItem":914,"markDefs":12291,"children":12292,"level":921},"c328f5381f50",[],[12293],{"_type":56,"marks":12294,"text":12295,"_key":12296},[],"Lower rates of episiotomy (cut to the vagina)","4156c44a5dcf",{"listItem":914,"markDefs":12298,"children":12299,"level":921,"_type":58,"style":78,"_key":12304},[],[12300],{"_key":12301,"_type":56,"marks":12302,"text":12303},"d309af987586",[],"Higher rates of intact perineum (particularly in high episiotomy settings)","2c78dc3b8e1d",{"style":78,"_key":12306,"listItem":914,"markDefs":12307,"children":12308,"level":921,"_type":58},"6e57cffd2e35",[],[12309],{"text":12310,"_key":12311,"_type":56,"marks":12312},"Less pain and greater satisfaction with the birth experience","d1d05a1d9aac",[],{"children":12314,"level":921,"_type":58,"style":78,"_key":12319,"listItem":914,"markDefs":12320},[12315],{"_key":12316,"_type":56,"marks":12317,"text":12318},"dbaec452d862",[],"Less medication needed for pain relief","b2ea6189f6c4",[],{"listItem":914,"markDefs":12322,"children":12323,"level":921,"_type":58,"style":78,"_key":12328},[],[12324],{"text":12325,"_key":12326,"_type":56,"marks":12327},"Possible lower rates of postpartum haemorrhage (heavy bleeding after birth)","92cbbbcf71ab",[],"410577dbdf65",{"_type":58,"style":78,"_key":12330,"listItem":914,"markDefs":12331,"children":12332,"level":921},"d07a97374522",[],[12333],{"_type":56,"marks":12334,"text":12335,"_key":12336},[],"Possible lower rates of severe perineal trauma (third- and fourth-degree tears – particularly in high episiotomy settings)","470577666075",{"link":12338,"_key":12341,"_type":190},{"text":12339,"type":194,"internalLink":12340,"blank":192,"_type":67},"Check out our home birth care packages",{"_ref":196,"_type":197},"914690918876",{"_type":58,"style":59,"_key":12343,"markDefs":12344,"children":12345},"fa67cfb028c6",[],[12346],{"text":12347,"_key":12348,"_type":56,"marks":12349},"Can You Use a Birth Pool If You Are Considered High Risk?","e263c3c2d64c",[],{"style":78,"_key":12351,"markDefs":12352,"children":12356,"_type":58},"8fa202190f09",[12353],{"url":12354,"_type":67,"_key":12355,"type":65},"https://www.sarawickham.com/plus-size-pregnancy/","e3f173abcaf8",[12357,12361,12365,12369,12373],{"marks":12358,"text":12359,"_key":12360,"_type":56},[],"It’s important to note that most of the literature refers to women with healthy, uncomplicated pregnancies, those labelled ‘low risk’ women. There is a glaringly obvious lack of research into water immersion and waterbirth for ‘high risk’ women, some of whom undoubtedly would benefit from using water for labour and/or birth in the same way that their ‘low risk’ counterparts do. Hospitals frequently have policies stating that women and birthing people with a BMI over a certain amount (often 35 or 40) are either not ‘allowed’ to use a birthing pool or require a meeting with a consultant midwife or obstetrician to plan a birth ‘out of guidelines’. One of the worries here is that in the unlikely event of a maternal collapse, it may be difficult to get someone out of the pool who has a higher BMI. Most hospitals have hoists for this purpose and the counterargument to this, is that ","fdf91af3d45f",{"_type":56,"marks":12362,"text":12363,"_key":12364},[281],"anyone","f360ae5a8917",{"_key":12366,"_type":56,"marks":12367,"text":12368},"35a854236849",[]," who has collapsed and is unconscious would be difficult to extract from a birth pool. On the topic of BMI, Sara Wickham has recently written a book called ",{"marks":12370,"text":12371,"_key":12372,"_type":56},[12355],"‘Plus Size Pregnancy’","38f721af1856",{"marks":12374,"text":12375,"_key":12376,"_type":56},[],", which I would highly recommend all midwives, doulas and indeed pregnant women and people read. The book contains a section specifically on using a birth pool or a bath for labour and questions and dispels many myths associated with care provided to those with a high BMI during pregnancy. Another issue that prevents women and birthing people using the pool is where they have been advised to have continuous electronic fetal monitoring (CEFM). There are forms of wireless, waterproof CEFM that can be used in birthing pools and these need to be utilised far more frequently. Some NHS labour wards do have birthing pools, which is a step in the right direction, but whether ‘higher risk’ women and birthing people are being encouraged to use them is another question.","fa6c2e7f524f",{"children":12378,"_type":58,"style":59,"_key":12383,"markDefs":12384},[12379],{"marks":12380,"text":12381,"_key":12382,"_type":56},[],"What Are the Risks of Water Birth?","8a3c7db6432b","ac52bd3ff8c0",[],{"style":78,"_key":12386,"markDefs":12387,"children":12388,"_type":58},"8df415a0c3e8",[],[12389,12393,12397],{"marks":12390,"text":12391,"_key":12392,"_type":56},[],"Those opposed to waterbirth will cite many very scary sounding risks. Birth is never without risk; this is something that is not very well accepted by mainstream maternity and obstetric care. As mentioned earlier, both the Cochrane review and the Nutter et al. (2015) review did ","868262f97d4c",{"text":12394,"_key":12395,"_type":56,"marks":12396},"not ","2e00d106418e",[108],{"_type":56,"marks":12398,"text":12399,"_key":12400},[],"demonstrate any increased risk to women or babies with waterbirth.","d25218d07645",{"_type":58,"style":78,"_key":12402,"markDefs":12403,"children":12406},"9e027799e847",[12404],{"url":12259,"_type":67,"_key":12405,"type":65},"2a2da10a2f26",[12407,12410],{"text":12267,"_key":12408,"_type":56,"marks":12409},"c2214df5f40e",[12405],{"_key":12411,"_type":56,"marks":12412,"text":12413},"0e598c76bed1",[]," summarised the risks from their mega literature review as follows:",{"_type":58,"style":78,"_key":12415,"listItem":914,"markDefs":12416,"children":12417,"level":921},"5418a7a73555",[],[12418],{"text":12419,"_key":12420,"_type":56,"marks":12421},"In low episiotomy settings (midwife-led units, home) there may be a higher chance of mild labial tears","0025317c36c3",[],{"level":921,"_type":58,"style":78,"_key":12423,"listItem":914,"markDefs":12424,"children":12425},"96f29138d84d",[],[12426],{"_type":56,"marks":12427,"text":12428,"_key":12429},[],"Snapping of the baby’s umbilical cord is a rare, but possible occurrence","337f58c1d075",{"level":921,"_type":58,"style":78,"_key":12431,"listItem":914,"markDefs":12432,"children":12433},"3dd263eaad2a",[],[12434],{"marks":12435,"text":12436,"_key":12437,"_type":56},[],"Aspiration of water (where the baby breathes water into their lungs) has been reported, however not in prospective research since 1999, and most babies made a full recovery","8a2266cd5af7",{"level":921,"_type":58,"style":78,"_key":12439,"listItem":914,"markDefs":12440,"children":12441},"46aa07571b96",[],[12442],{"marks":12443,"text":12444,"_key":12445,"_type":56},[],"There have been individual case studies reporting newborn infection (however large research studies do not demonstrate an increase in infection)","c8dd9ef3f05d",{"_type":58,"style":59,"_key":12447,"markDefs":12448,"children":12449},"b2bb7fd9fd88",[],[12450],{"text":12451,"_key":12452,"_type":56,"marks":12453},"What Are Your Birth Pool Options: Hospital, Birth Centre or Home?","6f305cc9ed0a",[],{"children":12455,"_type":58,"style":78,"_key":12476,"markDefs":12477},[12456,12460,12465,12469,12473],{"_key":12457,"_type":56,"marks":12458,"text":12459},"1e160d69cdce",[],"Most midwife-led birth centres, whether directly attached to a hospital or freestanding, will have birth pools and some labour wards have or are installing pools too. These pools are generally big, with hard walls and taps (think like a huge bath or jacuzzi – but without the jets!). Some of them have lights in them, so you can change the ambience. At home births, a large, soft-walled, inflatable birth pool is used – we like ",{"_type":56,"marks":12461,"text":12463,"_key":12464},[12462],"64fd8ec6d39a","these ones","177d58a848d7",{"_type":56,"marks":12466,"text":12467,"_key":12468},[],", but there are many on the market! A long hose is used to fill up birth pools at home. These pools are available to buy or hire. Sometimes local independent midwives or doulas will rent them out too, and then all you need to buy is a fresh liner, hose and all the attachments. The only way to guarantee access to a pool during your labour and birth is to plan a homebirth. This is not saying everyone should plan a homebirth, rather giving a realistic picture of NHS maternity services. If you’re lucky, when you go into labour and you want to use a birth pool, the midwife-led unit will be open, and the pools will be free and available for you to use. It is worth noting however that in our experience staffing issues can cause midwife-led units to close, or the pools may be in use by someone else. Additionally, most (but not all) labour wards we have worked on do not have birth pools. Think about this when you’re writing your birth plan – have a plan B for if a pool is not available to you. Read more about birth plans ","347b26c7fc65",{"_key":12470,"_type":56,"marks":12471,"text":249},"cd914cae6ed0",[12472],"2f992c377a99",{"text":1183,"_key":12474,"_type":56,"marks":12475},"2239b7a10e22",[],"6ee43bf27134",[12478,12480],{"url":12479,"_type":67,"_key":12462,"type":65},"https://www.birthpoolinabox.co.uk/",{"_type":67,"_key":12472,"type":65,"url":12481},"https://junomidwives.co.uk/a-deep-dive-into-birth-plans/",{"_key":12483,"markDefs":12484,"children":12485,"_type":58,"style":78},"9811ea2237cf",[],[12486],{"marks":12487,"text":12488,"_key":12489,"_type":56},[],"Overall, the research so far shows that using water for labour and birth is beneficial to women and birthing people, whilst also being safe for them and their babies. More research is emerging all the time, so I’m sure as time goes on more benefits to waterbirth will be revealed. We love witnessing waterbirths – anecdotally in our experience women and birthing people report finding the water incredibly soothing and it seems like a very gentle way for a baby to be born – into a warm, wet, dimly lit environment – just like in the womb! Water provides a sense of weightlessness and allow women and birthing people to adopt many different positions naturally and instinctively. All this intuitive movement is beneficial & supportive of the baby making their journey through the pelvis.","ec7a2342e328",{"children":12491,"_type":58,"style":59,"_key":12496,"markDefs":12497},[12492],{"text":12493,"_key":12494,"_type":56,"marks":12495},"How to Guarantee Access to a Birth Pool for Your Labour","38beef6ce71e",[],"4ad1a485791c",[],{"children":12499,"_type":58,"style":78,"_key":12504,"markDefs":12505},[12500],{"marks":12501,"text":12502,"_key":12503,"_type":56},[],"If you think you would like to use water for your labour and birth and are planning to birth in a hospital or a birth centre, but already know that this is not recommended for you for whatever reason, it can be worth either getting a second opinion from an independent midwife or seeking an appointment with your local NHS trusts consultant midwife (if they have one!) to make an ‘out of guidelines’ care plan. This may help you to create an individualised birth plan.","3f4fb9f9f10f","09c34d04f723",[],{"_type":190,"link":12507,"_key":12509},{"blank":192,"_type":67,"text":2953,"type":194,"internalLink":12508},{"_ref":502,"_type":197},"ec7d9c73c5c0",{"children":12511,"_type":58,"style":78,"_key":12516,"markDefs":12517},[12512],{"_type":56,"marks":12513,"text":12514,"_key":12515},[],"If you want to guarantee access to a birth pool for your labour and birth, get in touch to discuss the option of having a home birth with us. We can’t wait to hear from you!","a2f88fec87df","01568dd6714e",[],{"current":12519,"_type":8},"water-birth-and-labour-in-water-benefits-risks-and-what-the-evidence-says",{"asset":12521,"_type":586},{"_ref":12522,"_type":197},"image-41b82c289e49813a2de95d3d9fb8ab3489d9f482-1080x1350-jpg","2025-04-07T15:18:34Z","V3aI2QowveaYP3Z79uJgFg","Water Birth and Labour in Water: Benefits, Risks and What the Evidence Says",{"_type":37,"publishedAt":12527,"_createdAt":12528,"image":12529,"_id":1450,"_updatedAt":12532,"slug":12533,"content":12535,"_system":12771,"_rev":12774,"title":12775},"2023-12-30","2025-04-07T15:18:28Z",{"_type":586,"asset":12530},{"_ref":12531,"_type":197},"image-1eb39b1e74f45b520ae37c8f977922b0e8ae6ce5-1080x1350-jpg","2026-03-11T20:59:31Z",{"current":12534,"_type":8},"the-newborn-bobble-hat-system-what-it-is-and-why-you-should-question-it",{"_type":49,"body":12536},[12537,12545,12553,12561,12569,12628,12636,12644,12662,12673,12689,12697,12705,12713,12721,12729,12737,12745,12763],{"_type":58,"style":59,"_key":12538,"markDefs":12539,"children":12540},"af14407ebaa2",[],[12541],{"_type":56,"marks":12542,"text":12543,"_key":12544},[],"Why Skin-to-Skin After Birth Matters More Than You Think","715693b04804",{"_type":58,"style":78,"_key":12546,"markDefs":12547,"children":12548},"64aa605c9b23",[],[12549],{"text":12550,"_key":12551,"_type":56,"marks":12552},"Picture this…the first few minutes after the birth of your baby are full of emotion, when your baby is born and you reach out to pull them close to your body, skin-to-skin. This has the power to do something incredible to you, biologically, spiritually. You try to block out the rest of the world just for these few precious moments when suddenly you are interrupted by your midwife who has a long list of tasks to do, to you and your baby. The first being to put a coloured knitted hat onto your baby’s head! A lot of people might be wondering why this is even an issue – allow me to explain.","123102081821",[],{"_type":58,"style":78,"_key":12554,"markDefs":12555,"children":12556},"0411bd096712",[],[12557],{"text":12558,"_key":12559,"_type":56,"marks":12560},"Not only will skin to skin regulate your baby’s temperature and heart rate but it will also increase the flow of oxytocin (the love hormone) in your body. As you look into your baby’s eyes, and draw her in closer, you will smell her head. This interaction is what it is all about. A hat on your baby’s head disrupts this flow of oxytocin. Oxytocin is needed to help stimulate contractions in your uterus to prevent excessive bleeding after birth, it’s needed to initiate breastfeeding, and it helps you and your baby build a secure bond. As you can see, interrupting skin to skin even to do something seemingly so innocuous, such as placing a hat onto your baby’s head, can have a huge impact on you both.","cd37de1c53b5",[],{"style":59,"_key":12562,"markDefs":12563,"children":12564,"_type":58},"21217650d80c",[],[12565],{"_type":56,"marks":12566,"text":12567,"_key":12568},[],"Do Newborn Hats Actually Help With Temperature Regulation?","d25bbd3d7372",{"markDefs":12570,"children":12583,"_type":58,"style":78,"_key":12627},[12571,12574,12577,12580],{"_key":12572,"type":65,"url":12573,"_type":67},"7fe2fa3f713e","https://www.nhs.uk/start-for-life/baby/baby-basics/caring-for-your-baby/how-to-dress-a-newborn/",{"type":65,"url":12575,"_type":67,"_key":12576},"https://www.lullabytrust.org.uk/safer-sleep-advice/baby-room-temperature/?fbclid=IwAR3S0iMfd0fNjkENAk33tfdT_mx0HNIVCPsOfluOENb9GFHrj49vFkFSk1o","dc42b22c8aeb",{"type":65,"url":12578,"_type":67,"_key":12579},"https://www.tommys.org/pregnancy-information/after-birth/safe-sleep-babies","fc5441f17af3",{"type":65,"url":12581,"_type":67,"_key":12582},"https://www-archive.ekhuft.nhs.uk/patients-and-visitors/services/pregnancy-and-childbirth/postnatal-care/care-for-your-baby/index.html#","4a2370ec7359",[12584,12588,12592,12595,12599,12603,12607,12611,12615,12619,12623],{"_key":12585,"_type":56,"marks":12586,"text":12587},"fa8ed6d8fde7",[],"Perhaps more alarmingly, hats can cause a baby to overheat as they obstruct the baby’s natural ability to get rid of excess heat via their heads. Overheating can lead to sudden infant death (cot death) and you will find the ",{"text":12589,"_key":12590,"_type":56,"marks":12591},"NHS","dacec32f698b",[12572],{"marks":12593,"text":11753,"_key":12594,"_type":56},[],"dbea2edd1507",{"_key":12596,"_type":56,"marks":12597,"text":12598},"6ee43a7f8b2c",[12576],"Lullaby Trust",{"text":12600,"_key":12601,"_type":56,"marks":12602}," and ","a6d09e3f02c2",[],{"_key":12604,"_type":56,"marks":12605,"text":12606},"a89ccdad9b10",[12579],"Tommy’s",{"_key":12608,"_type":56,"marks":12609,"text":12610},"dd8356281a83",[]," charity all advise ",{"_type":56,"marks":12612,"text":12613,"_key":12614},[108],"against","09ce54798a03",{"text":12616,"_key":12617,"_type":56,"marks":12618}," wearing hats indoors. And in fact, the ","5f014abdf76b",[],{"_key":12620,"_type":56,"marks":12621,"text":12622},"10abfeb382ea",[12582],"East Kent",{"text":12624,"_key":12625,"_type":56,"marks":12626}," website contradicts itself as directly beneath the explanation for the ‘bobble hat system’ is a paragraph on safe sleeping which includes the advice to remove hats when sleeping. Can you see how the ‘bobble hat system’ completely contradicts the evidence around newborn safety and care?","9849d66cda3b",[],"95018d227e00",{"markDefs":12629,"children":12630,"_type":58,"style":78,"_key":12635},[],[12631],{"text":12632,"_key":12633,"_type":56,"marks":12634},"As a result, the use of a hat on newborns has become a divisive one. A number of hospital trusts in England have implemented newborn hat policies in the last 5 years, including East Kent. This trust has been under scrutiny for the poor outcomes of babies under their care, so it comes as no surprise that an influx of ‘action’ is in process. One such ‘action’ is to enforce the ‘bobble hat system’.","519242846b37",[],"abb6ce00d139",{"markDefs":12637,"children":12638,"_type":58,"style":59,"_key":12643},[],[12639],{"text":12640,"_key":12641,"_type":56,"marks":12642},"What Is the Bobble Hat System in East Kent Hospitals?","6c1c87d397ad",[],"80ba5283f4b5",{"_key":12645,"markDefs":12646,"children":12650,"_type":58,"style":78},"951b8584e5c9",[12647],{"url":12648,"_type":67,"_key":12649,"type":65},"http://www-archive.ekhuft.nhs.uk/patients-and-visitors/services/pregnancy-and-childbirth/postnatal-care/care-for-your-baby/index.html#","9ae27c805779",[12651,12655,12658],{"marks":12652,"text":12653,"_key":12654,"_type":56},[],"On the ","b5adf27d85d2",{"text":12622,"_key":12656,"_type":56,"marks":12657},"16723d93019a",[12649],{"_key":12659,"_type":56,"marks":12660,"text":12661},"dd1416d74c0c",[]," website a simplified explanation can be found:",{"_type":58,"style":78,"_key":12663,"markDefs":12664,"children":12665},"715c8caf0811",[],[12666,12670],{"_type":56,"marks":12667,"text":12668,"_key":12669},[281],"“within one hour of birth, the bobble hat assessment tool and care plan will be completed and the correct hat will be put onto your baby. This lets staff know what level of care the baby will need”.","3820bd67c4a4",{"text":4274,"_key":12671,"_type":56,"marks":12672},"723de4071b04",[],{"_type":58,"style":78,"_key":12674,"markDefs":12675,"children":12676},"cf73f11bb1e3",[],[12677,12681,12685],{"text":12678,"_key":12679,"_type":56,"marks":12680},"The language used does not imply this is up for discussion as the statement demonstrates, “the correct hat ","9356cb16cbd8",[],{"_type":56,"marks":12682,"text":12683,"_key":12684},[108],"will","dc5cdf7c4078",{"_key":12686,"_type":56,"marks":12687,"text":12688},"a5acb81612a2",[]," be put onto your baby”. Therefore, in order to achieve this instruction of “within an hour” your golden hour of skin to skin will be interrupted in order for the midwife to ascertain where your baby fits into the ‘bobble hat system’. In the trust guidelines, staff are also advised to immediately apply the hat after a birth in theatre, regardless of how you have given birth or the wellbeing of your baby.",{"markDefs":12690,"children":12691,"_type":58,"style":59,"_key":12696},[],[12692],{"_type":56,"marks":12693,"text":12694,"_key":12695},[],"What Is the Aim of the Colour-Coded Hat System?","64ddd62022e0","4c9c2e324305",{"_type":58,"style":78,"_key":12698,"markDefs":12699,"children":12700},"d06caa5618d0",[],[12701],{"_type":56,"marks":12702,"text":12703,"_key":12704},[],"It is a task oriented coding system used to identify babies with additional medical needs where observations are clinically recommended. The idea of the colours is to assist staff to identify which babies are in greater need so they can be prioritised appropriately, using a traffic light system. Red hats for the most vulnerable, amber – a mixed bag, and green for a well baby. What counts as red, amber and green is a whole other blog post! Why a well baby needs a hat at all should be questioned. My opinion is that it ‘aids’ staff understanding of the bobble hat traffic light system. Without green it wouldn’t work, right?","140400e7952e",{"_key":12706,"markDefs":12707,"children":12708,"_type":58,"style":59},"aa8aef553ea1",[],[12709],{"marks":12710,"text":12711,"_key":12712,"_type":56},[],"Why the Bobble Hat System Is Fundamentally Flawed","ec2b61def4a9",{"markDefs":12714,"children":12715,"_type":58,"style":78,"_key":12720},[],[12716],{"text":12717,"_key":12718,"_type":56,"marks":12719},"The ‘bobble hat system’ completely fails to acknowledge the challenges midwives face in meeting the demands of their workload. The hats are no fail safe. Newborn observations are often delayed or missed because of these challenges. Because maternity wards across the NHS are short staffed and you may find you have one midwife to 10 mums and babies and they simply can’t get round to everyone that promptly. Or maybe because handovers are so impersonal, they’re often not by the bedside of the woman and her baby, so you’re not going to even see the colour of the hat. Or equally problematic, handovers are repeatedly interrupted so important aspects of someone’s care are missed.","f6b544ea206b",[],"fe53618c8ebf",{"_key":12722,"markDefs":12723,"children":12724,"_type":58,"style":59},"9516e5c047a8",[],[12725],{"_type":56,"marks":12726,"text":12727,"_key":12728},[],"Better Ways to Keep Your Newborn Warm After Birth","211b8623c36d",{"_key":12730,"markDefs":12731,"children":12732,"_type":58,"style":78},"54e12e536dc6",[],[12733],{"_key":12734,"_type":56,"marks":12735,"text":12736},"bd6634747160",[],"In practice, the focus of this ‘bobble hat system’ is not on those in need of clinical input but it seems to be more on thermoregulation (keeping baby warm). There are many ways this can be facilitated at birth and in the immediate postpartum period. For instance, we can ensure the birth space is warm by occluding drafts, closing windows, turning AC off. We can warm up towels and remove cold wet towels. We can ensure the birth pool temperature is maintained so mother and baby can bask in the warm water that little bit longer. And ultimately we can support the mother and baby to be skin to skin for as long as they wish, including during ward transfers, in theatre and recovery, and on the postnatal ward, which for the majority of the time feels like you are slowly roasting behind a set of stark curtains in a cramped four bedded bay!",{"markDefs":12738,"children":12739,"_type":58,"style":59,"_key":12744},[],[12740],{"_type":56,"marks":12741,"text":12742,"_key":12743},[],"What Should You Know Before Agreeing to the Bobble Hat Assessment?","583937065d17","012a9fb1e5c0",{"_type":58,"style":78,"_key":12746,"markDefs":12747,"children":12751},"c2b3f01153fc",[12748],{"url":12749,"_type":67,"_key":12750,"type":65},"https://journals.lww.com/jpnnjournal/abstract/2023/10000/hats_off_for_full_term_healthy_newborns__no.15.aspx#ContentAccessOptions","395b568840e1",[12752,12756,12759],{"_type":56,"marks":12753,"text":12754,"_key":12755},[],"The policy appears to have been established for two reasons – patient safety and temperature control. The ","234ed6765aae",{"_key":12757,"_type":56,"marks":12758,"text":11158},"458754c3bb4d",[12750],{"marks":12760,"text":12761,"_key":12762,"_type":56},[]," tells us that hats have no benefit on newborn thermoregulation for a term baby born without any abnormalities. But what we don’t know is what impact this policy is having on care provision for your baby. I have put this question to the staff at East Kent and I eagerly await their response. Fundamentally the benefits of not wearing a hat are huge. So we need to be asking more questions to work out what are the risks or benefits of this ‘bobble hat system’ and what do they mean to you and your baby. Only with this information can you truly make an informed decision. ","ccfbb0d270c6",{"_type":58,"style":78,"_key":12764,"markDefs":12765,"children":12766},"27d385c8dca4",[],[12767],{"marks":12768,"text":12769,"_key":12770,"_type":56},[],"And whilst it is mainly a bunch of adorable nannies knitting these newborn hats, their time might be better spent knitting blankets for the homeless!","0524b9ff18a1",{"base":12772},{"rev":12773,"id":1450},"qDOmh6wX4opKbq8CiPWbHA","V3aI2QowveaYP3Z79uLciK","The Newborn Bobble Hat System: What It Is and Why You Should Question It",{"_id":1722,"_updatedAt":12777,"content":12778,"image":13321,"publishedAt":13324,"_rev":13325,"_system":13326,"title":13329,"slug":13330,"_createdAt":13332,"_type":37},"2026-03-11T21:03:51Z",{"_type":49,"body":12779},[12780,12788,12837,12845,12853,12861,12888,12896,12912,12920,12936,12944,12960,12968,12984,12992,13019,13027,13063,13071,13087,13095,13130,13138,13182,13190,13214,13222,13246,13296],{"_key":12781,"markDefs":12782,"children":12783,"_type":58,"style":59},"ed428176b27c",[],[12784],{"_key":12785,"_type":56,"marks":12786,"text":12787},"cf6e38ef2afe",[],"What Is a Birth Plan and Why Does It Matter?",{"_type":58,"style":78,"_key":12789,"markDefs":12790,"children":12791},"367321c64557",[],[12792,12796,12800,12803,12807,12810,12814,12818,12822,12826,12830,12833],{"_type":56,"marks":12793,"text":12794,"_key":12795},[],"A birth plan is a great tool for you to ","66743b7f0dfa",{"text":12797,"_key":12798,"_type":56,"marks":12799},"explore your options","120bef77f4ae",[108],{"_type":56,"marks":12801,"text":2815,"_key":12802},[281],"6c8ab3afe4be",{"_type":56,"marks":12804,"text":12805,"_key":12806},[],"for labour and birth and to figure out the things that are","8be825292bb8",{"_type":56,"marks":12808,"text":2815,"_key":12809},[281],"5b83175698c0",{"_type":56,"marks":12811,"text":12812,"_key":12813},[108],"important to you","9839f4420fe0",{"marks":12815,"text":12816,"_key":12817,"_type":56},[],". They also help to ","d988630b48ca",{"_key":12819,"_type":56,"marks":12820,"text":12821},"6f7d67240148",[108],"communicate your wishes ",{"_type":56,"marks":12823,"text":12824,"_key":12825},[],"to your healthcare professionals. Within mainstream maternity care, birth plans are often undertaken between 34 and 36 weeks and often seem to be a ‘tick box’ exercise. We believe that you can create a birth plan at","aa7fc5de1d2e",{"_type":56,"marks":12827,"text":12828,"_key":12829},[108]," any gestation","2647386f0bba",{"_type":56,"marks":12831,"text":2815,"_key":12832},[281],"e83d79fa3fd1",{"marks":12834,"text":12835,"_key":12836,"_type":56},[],"and include as little or as much information as you like.","dbcacc41d34d",{"_type":58,"style":78,"_key":12838,"markDefs":12839,"children":12840},"6967a552673f",[],[12841],{"text":12842,"_key":12843,"_type":56,"marks":12844},"Sometimes people prefer to use the phrase ‘birth preferences’ because it’s thought that ‘birth plan’ sounds too rigid, when we all know that there are no guarantees in birth. However, I think that ‘birth plan’ is totally appropriate, you plan for other things in your life and you don’t always know the outcome of them, so why is birth any different? ","89e0d561bd40",[],{"markDefs":12846,"children":12847,"_type":58,"style":78,"_key":12852},[],[12848],{"text":12849,"_key":12850,"_type":56,"marks":12851},"So, semantics aside, what are some things to consider for your birth plan? ","55c9ea7a1968",[],"d21f5eb6de46",{"children":12854,"_type":58,"style":59,"_key":12859,"markDefs":12860},[12855],{"_key":12856,"_type":56,"marks":12857,"text":12858},"d15052341ac1",[],"Choosing Your Place of Birth","eb6083704805",[],{"_key":12862,"markDefs":12863,"children":12867,"_type":58,"style":78},"ef189f1b3672",[12864],{"_key":12865,"type":194,"internalLink":12866,"blank":192,"_type":67},"9b29a1f642a2",{"_type":197,"_ref":11829},[12868,12872,12876,12880,12884],{"_type":56,"marks":12869,"text":12870,"_key":12871},[],"Do you want to birth at ","40b8c0ea6329",{"_type":56,"marks":12873,"text":12874,"_key":12875},[12865],"home?","06e7907aad14",{"_type":56,"marks":12877,"text":12878,"_key":12879},[]," On a midwife-led unit or labour ward? Are you still undecided? That’s okay. Think about what’s driving your decisions – are you making a ","beaad32f4356",{"_key":12881,"_type":56,"marks":12882,"text":12883},"3a7ea54d4fc3",[108],"decision based on fear?",{"_type":56,"marks":12885,"text":12886,"_key":12887},[]," Or making the decision that feels intuitively right to you? There’s no right or wrong answer here…what makes one person feel safe won’t make someone else feel safe. ","a1c9108aee3f",{"_key":12889,"markDefs":12890,"children":12891,"_type":58,"style":59},"77b5555861dc",[],[12892],{"marks":12893,"text":12894,"_key":12895,"_type":56},[],"Who Do You Want at Your Birth?","fe747f22b26b",{"style":78,"_key":12897,"markDefs":12898,"children":12899,"_type":58},"e72c9682a9e0",[],[12900,12904,12908],{"marks":12901,"text":12902,"_key":12903,"_type":56},[],"Have you thought about who you might want present at your birth? Do YOU want this person there, or have they assumed they will be? Have your birth partners educated themselves about birth and how to support someone in labour? Or have your birth partners had traumatic experiences of birth? What energy will they bring into your birth space? This is SO important. It can be unhelpful to have someone in your birth space who doesn’t trust the process or is fearful – even if that person is your mum, your sister, your best friend, your partner. ","eded696ba051",{"_type":56,"marks":12905,"text":12906,"_key":12907},[108],"Hiring a doula ","b2255d51599c",{"_type":56,"marks":12909,"text":12910,"_key":12911},[],"can offer invaluable birth support, taking the pressure off your partner to be wearing all the hats: advocate, emotional support, hip squeezer, snack bringer - it's a lot! ","701bdc0dc116",{"style":78,"_key":12913,"markDefs":12914,"children":12915,"_type":58},"54e8412d34e3",[],[12916],{"_type":56,"marks":12917,"text":12918,"_key":12919},[108],"Students","441f2db51496",{"_type":58,"style":78,"_key":12921,"markDefs":12922,"children":12923},"215c6209864d",[],[12924,12928,12932],{"_type":56,"marks":12925,"text":12926,"_key":12927},[],"If you birth in hospital often there are midwifery and medical students on the wards. They are there to learn and they often need to witness births. You might be completely happy to have an extra person in the room but you are absolutely ","f506518a0187",{"_key":12929,"_type":56,"marks":12930,"text":12931},"f1f22001d8ab",[108],"allowed to decline ",{"text":12933,"_key":12934,"_type":56,"marks":12935},"having students present if it does not feel right for you. Do not feel bad about this. They will see births.","42b18ac8c324",[],{"markDefs":12937,"children":12938,"_type":58,"style":59,"_key":12943},[],[12939],{"_key":12940,"_type":56,"marks":12941,"text":12942},"33b2f70379c8",[],"How to Create the Right Birth Environment","43ee7d10684d",{"children":12945,"_type":58,"style":78,"_key":12958,"markDefs":12959},[12946,12950,12954],{"_type":56,"marks":12947,"text":12948,"_key":12949},[],"Wherever you choose to birth, it’s important to think about how to optimise the environment to ","40172332fb4d",{"marks":12951,"text":12952,"_key":12953,"_type":56},[108],"promote oxytocin ","f10f76f6ffe2",{"_type":56,"marks":12955,"text":12956,"_key":12957},[],"and keep the space calm. If you’re birthing in hospital you might choose to bring an eye mask to block out light, or headphones so you can listen to hypnobirthing tracks or a birth playlist to get yourself in the zone. You might bring a pillow from home, your comfy dressing gown, electric tea lights or aromatherapy to really make the space cosy. You might make a sign for the door, requesting people use low voices and knock before entering. You can bring whatever you need to make yourself feel comfortable.","785fff9a6f48","594f1c99b9ee",[],{"style":59,"_key":12961,"markDefs":12962,"children":12963,"_type":58},"07a11f92c04e",[],[12964],{"_key":12965,"_type":56,"marks":12966,"text":12967},"6103a0654f73",[],"Coping Strategies for Labour: What Are Your Options?",{"_key":12969,"markDefs":12970,"children":12971,"_type":58,"style":78},"1eb81085cd4f",[],[12972,12976,12980],{"_type":56,"marks":12973,"text":12974,"_key":12975},[],"Have you thought about ","2558c34764ea",{"_type":56,"marks":12977,"text":12978,"_key":12979},[108],"coping strategies ","393448f74605",{"_key":12981,"_type":56,"marks":12982,"text":12983},"b4ae594e0de9",[],"for labour? Perhaps you’re interested in hypnobirthing and have done a course? Or know that warm water is particularly soothing to you – maybe using water for labour and birth will work for you. Note that most labour wards don't have birth pools, so this may influence where you plan to give birth. Maybe gas & air is in your plan. Perhaps you’ve always known you want to have an epidural. Perhaps you want to try opioid medication in early labour? Or maybe, you definitely do not want that. Have you considered aromatherapy, a TENS machine or a birthing ball to support yourself during labour? Have you heard of the comb?!",{"_type":58,"style":59,"_key":12985,"markDefs":12986,"children":12987},"8ac85202b901",[],[12988],{"_key":12989,"_type":56,"marks":12990,"text":12991},"c8fe348895ad",[],"Positions and Movement During Labour",{"style":78,"_key":12993,"markDefs":12994,"children":12998,"_type":58},"cda94cc607a5",[12995],{"_type":67,"_key":12996,"type":65,"url":12997},"57276f95db75","https://mamastefit.com/3-pelvic-levels-fetal-station-understand/",[12999,13003,13007,13011,13015],{"_type":56,"marks":13000,"text":13001,"_key":13002},[],"Did you know that movement and positions may aid your labour? If you labour spontaneously without any painkillers you’ll likely move ","5b8878f113c0",{"_type":56,"marks":13004,"text":13005,"_key":13006},[108],"intuitively,","9823c81592b5",{"marks":13008,"text":13009,"_key":13010,"_type":56},[]," but if you opt for an epidural it’s useful to consider what positions to get in to support your baby’s journey through your pelvis – basically you want to stay off your back. Consider side-lying with pillows between your knees, use a peanut ball, use a birth ball, kneel, stand, sit, dance! Keep that ","e4b046c73880",{"_key":13012,"_type":56,"marks":13013,"text":13014},"d73841a0e102",[12996],"pelvis open",{"_type":56,"marks":13016,"text":13017,"_key":13018},[]," and allow your sacrum to move!","70d3a17a90b0",{"markDefs":13020,"children":13021,"_type":58,"style":59,"_key":13026},[],[13022],{"text":13023,"_key":13024,"_type":56,"marks":13025},"Fetal Monitoring in Labour: What Are Your Choices?","7788320aea4c",[],"572d144cea05",{"markDefs":13028,"children":13034,"_type":58,"style":78,"_key":13062},[13029,13031],{"type":65,"url":10816,"_type":67,"_key":13030},"54c8c59d0a5c",{"internalLink":13032,"blank":192,"_type":67,"_key":13033,"type":194},{"_ref":3379,"_type":197},"016eb5b03bea",[13035,13039,13042,13046,13050,13054,13058],{"marks":13036,"text":13037,"_key":13038,"_type":56},[],"Midwives follow the ","835161044a48",{"_key":13040,"_type":56,"marks":13041,"text":4070},"5f8e5b202db1",[13030],{"_type":56,"marks":13043,"text":13044,"_key":13045},[],"  and local hospital policies when offering monitoring in labour. This includes monitoring a woman or birthing persons vital signs and the fetal heart rate at regular intervals. It is again, ","775bb7ec2195",{"_key":13047,"_type":56,"marks":13048,"text":13049},"fae0f0d62f79",[108],"your choice",{"_key":13051,"_type":56,"marks":13052,"text":13053},"9cef5c8bc367",[]," if you want to be monitored as frequently as the guidelines recommend, if at all. There are two types of fetal monitoring – intermittent auscultation, where the midwife listens in every 15 minutes or so and ",{"text":13055,"_key":13056,"_type":56,"marks":13057},"continuous fetal monitoring","4300ae9684b8",[13033],{"text":13059,"_key":13060,"_type":56,"marks":13061},", where your baby’s heartbeat is continuously monitored throughout labour. In relation to continuous monitoring, there is also the option to have this done abdominally via your tummy or to have a small clip placed on the baby’s head via your vagina. Both these options may be presented to you and you always have a choice. You may be recommended to have one form of monitoring over the other, but it is worth remembering that continuous monitoring has not been shown to improve outcomes but has been shown to increase interventions. ","2e313709fe96",[],"4acadbe415cc",{"style":59,"_key":13064,"markDefs":13065,"children":13066,"_type":58},"0e70b31124b5",[],[13067],{"_type":56,"marks":13068,"text":13069,"_key":13070},[],"Planning for Your Mode of Birth, Including Caesarean and Instrumental Birth","8641ea0cf256",{"_type":58,"style":78,"_key":13072,"markDefs":13073,"children":13074},"619d4f680a18",[],[13075,13079,13083],{"marks":13076,"text":13077,"_key":13078,"_type":56},[],"Some women and birthing people know before they labour that they are having a caesarean section – birth plans are still totally relevant here. You can consider if you want to do skin-to-skin with your baby in theatre, asking for ","017e69caf814",{"_key":13080,"_type":56,"marks":13081,"text":13082},"3cef88bc07b4",[108],"optimal cord clamping",{"_type":56,"marks":13084,"text":13085,"_key":13086},[],", having the lights lowered in theatre, having music of your choice playing and having the drape lowered at the time of birth so you can your baby immediately. You may wish to think about what your wishes are in relation to instrumental assisted birth – if you’re offered a forceps or a ventouse.","0dd938009b32",{"markDefs":13088,"children":13089,"_type":58,"style":59,"_key":13094},[],[13090],{"text":13091,"_key":13092,"_type":56,"marks":13093},"Your Perineum: Hands-On, Hands-Off and Episiotomy","58219458e7af",[],"ff80c991f58d",{"children":13096,"_type":58,"style":78,"_key":13125,"markDefs":13126},[13097,13101,13105,13109,13114,13118,13121],{"text":13098,"_key":13099,"_type":56,"marks":13100},"Most women who birth vaginally will sustain some form of tear to their perineum during birth, but most of these tears are considered minor. You may be recommended to have a tear sutured, think about if this is something you are happy to have. There is some ","b614a929bd21",[],{"text":11158,"_key":13102,"_type":56,"marks":13103},"15b9dcc1038d",[13104],"4755a15bf15b",{"_type":56,"marks":13106,"text":13107,"_key":13108},[]," to show that warm compresses applied to the perineum when pushing can reduce the incidence of severe tearing – put this on your birth plan if it’s something you want! On the other hand, a ","29f793042dc5",{"text":13110,"_key":13111,"_type":56,"marks":13112},"‘hands-on’","ae88c78a8ad3",[13113],"bec734290645",{"marks":13115,"text":13116,"_key":13117,"_type":56},[]," technique by care providers may increase your chance of tearing – so be specific about if you want ‘hands on’ or ‘hands off’ the perineum at your birth. Episiotomy (a cut to the vagina to make it wider) may be recommended at the point of birth, but you ultimately have to give your ","3fb90b060a9f",{"_type":56,"marks":13119,"text":6767,"_key":13120},[108],"3ffd6549dd7f",{"_type":56,"marks":13122,"text":13123,"_key":13124},[]," for one to happen.","3e6eaf6a1b9c","21815687139a",[13127,13128],{"type":65,"url":8546,"_type":67,"_key":13104},{"_key":13113,"type":65,"url":13129,"_type":67},"https://evidencebasedbirth.com/evidence-on-warm-compresses-and-hands-on-vs-hands-off-for-protecting-the-perineum/#:~:text=It%27s%20true%20that%20randomized%20control,higher%20rates%20of%20severe%20tears.",{"markDefs":13131,"children":13132,"_type":58,"style":59,"_key":13137},[],[13133],{"_key":13134,"_type":56,"marks":13135,"text":13136},"1d83c932373b",[],"Planning for the Birth of Your Placenta","b890cf308f78",{"children":13139,"_type":58,"style":78,"_key":13177,"markDefs":13178},[13140,13144,13149,13153,13157,13161,13165,13169,13173],{"_key":13141,"_type":56,"marks":13142,"text":13143},"9e9484128443",[],"The placenta can be birthed ",{"_key":13145,"_type":56,"marks":13146,"text":13148},"2ade81082d29",[13147],"e26ecc84171c","physiologically",{"_key":13150,"_type":56,"marks":13151,"text":13152},"4c10bd43c2e7",[]," – this means you push it out yourself with no medication. Alternatively you can have an ‘actively managed’ placental birth, whereby you’ll be given an injection into your thigh, after hopefully some delayed cord clamping the midwife will likely clamp and cut the cord and then they will pull on your placenta to remove it. There are even options for injections, although in practise I do not see a choice being offered. Syntometrine is often the first drug offered – it is a combination of synthetic oxytocin and ergometrine. Syntocinon is the other – this is synthetic oxytocin alone. When compared, ",{"marks":13154,"text":10407,"_key":13156,"_type":56},[13155],"fc7733878ec4","15de6f5915ed",{"text":13158,"_key":13159,"_type":56,"marks":13160}," state that syntometrine ","15be40db2a40",[],{"_key":13162,"_type":56,"marks":13163,"text":13164},"ecfdcceb2d7e",[281],"may ",{"_key":13166,"_type":56,"marks":13167,"text":13168},"6f5b357fedc5",[],"be more effective than syntocinon alone in preventing post-partum haemorrhage (blood loss greater than 500ml) but it also carries potential side effects including nausea and vomiting and hypertension (raised blood pressure). Do you want risk vomiting when you could be enjoying skin-to-skin with your newborn, if you don’t really need to? For some people, an actively managed placental birth may be the safest option. ",{"_type":56,"marks":13170,"text":13171,"_key":13172},[108],"The choice, as always is yours","e990a9d4e504",{"_key":13174,"_type":56,"marks":13175,"text":13176},"e5f240d4b430",[],". What happens during your labour and birth may influence this choice.","4d9938eb7403",[13179,13181],{"type":65,"url":13180,"_type":67,"_key":13147},"https://junomidwives.co.uk/why-continuity-of-carer-is-key-in-supporting-physiological-birth-of-the-placenta/",{"url":10415,"_type":67,"_key":13155,"type":65},{"_key":13183,"markDefs":13184,"children":13185,"_type":58,"style":59},"7e72c0e8bc1e",[],[13186],{"_key":13187,"_type":56,"marks":13188,"text":13189},"b1a3b2a9dd01",[],"The Golden Hour: Your Wishes for Immediately After Birth",{"_key":13191,"markDefs":13192,"children":13193,"_type":58,"style":78},"136bfa7d9788",[],[13194,13198,13202,13206,13210],{"marks":13195,"text":13196,"_key":13197,"_type":56},[],"This can be a glorious time of getting to know your newborn, have you heard about the ","46d96451961f",{"marks":13199,"text":13200,"_key":13201,"_type":56},[108],"Golden Hour?","9c858f65608b",{"_type":56,"marks":13203,"text":13204,"_key":13205},[]," Do you want to pick your own baby up first when they’re born? Do you want your birth partner to announce the sex if you don’t already know? Do you want to be the first person to speak to your baby? Do you want ","77d1292684d2",{"_key":13207,"_type":56,"marks":13208,"text":13209},"e0cc2646d274",[108],"uninterrupted skin-to-skin",{"text":13211,"_key":13212,"_type":56,"marks":13213}," for as long as possible, because you’ve read about the benefits and know this is the best thing for you and your baby? Do you want to delay the newborn checks or any perineum checks for yourself until you’ve had the chance to gently meet your baby?","d8e2e6e9d825",[],{"_key":13215,"markDefs":13216,"children":13217,"_type":58,"style":59},"f03a4b45d68c",[],[13218],{"_type":56,"marks":13219,"text":13220,"_key":13221},[],"Do You Need More Than One Birth Plan?","c15423b1a03d",{"style":78,"_key":13223,"markDefs":13224,"children":13225,"_type":58},"e7c28673b964",[],[13226,13230,13234,13238,13242],{"_type":56,"marks":13227,"text":13228,"_key":13229},[],"This list is by no means exhaustive. There are so many options and things to choose during birth. There may be things that are very specific to you or you may have particular needs. Writing everything down in a birth plan communicates your needs, wishes and desires with your healthcare provider. ","4a64dc04583c",{"text":13231,"_key":13232,"_type":56,"marks":13233},"It’s not frivolous or silly to write birth plan","d152548d3798",[108],{"marks":13235,"text":13236,"_key":13237,"_type":56},[],". ","311136a8fefc",{"text":13239,"_key":13240,"_type":56,"marks":13241},"It’s not silly to make a plan for one of the most transformative events of your life.","07bb3c73440e",[108],{"text":13243,"_key":13244,"_type":56,"marks":13245}," Sure, things might not go to plan…but that doesn’t mean the plan wasn’t worth doing. The plan helps you to get to the nitty gritty of what matters most to you during your birth and have a sense of agency. ","193c590c24fb",[],{"markDefs":13247,"children":13251,"_type":58,"style":78,"_key":13295},[13248],{"_type":67,"_key":13249,"type":65,"url":13250},"8ea751520182","https://www.positivebirthmovement.org/visualbirthplanicons/",[13252,13256,13260,13264,13268,13272,13276,13280,13284,13288,13292],{"_key":13253,"_type":56,"marks":13254,"text":13255},"e31c4d30438e",[],"We recommend having a couple of plans. Your dream, ",{"_key":13257,"_type":56,"marks":13258,"text":13259},"6a759dd8e0e3",[281],"‘everything goes how I want it’",{"marks":13261,"text":13262,"_key":13263,"_type":56},[]," plan and your alternative birth plan, eg. Your caesarean section plan. The internet is full of birth plan templates, like ","54ca3361c336",{"_key":13265,"_type":56,"marks":13266,"text":13267},"f175fe23c8ab",[13249],"this visual one",{"_key":13269,"_type":56,"marks":13270,"text":13271},"221b6022fab7",[]," from ",{"text":13273,"_key":13274,"_type":56,"marks":13275},"The Positive Birth Movement","bbc3e5972222",[281],{"text":13277,"_key":13278,"_type":56,"marks":13279},". But you can make one in whatever format you want. And of course, it goes without saying…you don’t have to make a birth plan, but we would ask you ","2c7ff707a30a",[],{"_type":56,"marks":13281,"text":13282,"_key":13283},[108],"what do you have to lose ","c383a2f0b336",{"_type":56,"marks":13285,"text":13286,"_key":13287},[],"by thinking about your birth options – and perhaps more importantly, ","948dffe6274c",{"_key":13289,"_type":56,"marks":13290,"text":13291},"ef1848090f5d",[108],"what do you have to gain?",{"text":4274,"_key":13293,"_type":56,"marks":13294},"28e17353f78f",[],"713c2fae20b2",{"children":13297,"_type":58,"style":78,"_key":13316,"markDefs":13317},[13298,13302,13305,13309,13313],{"marks":13299,"text":13300,"_key":13301,"_type":56},[281],"We offer birth planning sessions online, or face-to-face if you're local","0fa0c743c307",{"text":2815,"_key":13303,"_type":56,"marks":13304},"3733d4f1f2de",[],{"_key":13306,"_type":56,"marks":13307,"text":13308},"af9542e93333",[281],".We can help you figure out what’s important to you, discuss the evidence for recommendations, help you formulate your plan and help you navigate the maternity system. Book a birth planning session ",{"_key":13310,"_type":56,"marks":13311,"text":803},"b7865013d07e",[281,13312],"a9c7cb0761a8",{"_type":56,"marks":13314,"text":2815,"_key":13315},[281],"7d29de352ed3","f552fa8d81d4",[13318],{"blank":2434,"_type":67,"_key":13312,"type":194,"url":13319,"internalLink":13320},"https://calendly.com/hello-junomidwives/one-off-appointment",{"_ref":502,"_type":197},{"_type":586,"asset":13322},{"_ref":13323,"_type":197},"image-5069cc2e8d4827c90c8db191b80d13cf9846f532-3648x5472-jpg","2023-12-19","7l2KCMg711eQ9a3UN6vmwJ",{"base":13327},{"id":1722,"rev":13328},"vZgrbeYNrw5E7XyUHFniQz"," How to Write a Birth Plan: A Complete Guide to Your Options",{"current":13331,"_type":8},"how-to-write-a-birth-plan-a-complete-guide-to-your-options","2025-04-07T15:18:18Z",{"title":13334,"image":13335,"_rev":13338,"publishedAt":13339,"_updatedAt":13340,"content":13341,"_system":13856,"_createdAt":13860,"_id":13859,"slug":13861,"_type":37},"Language in Maternity Care: Why the Words Used During Birth Matter",{"_type":586,"asset":13336},{"_ref":13337,"_type":197},"image-1731d14fb2bd7610d25bb4c4dba639e6a12cb835-1080x1350-jpg","5fd977pr5Ct4pKgLygyacM","2023-11-10","2026-03-11T21:08:22Z",{"body":13342,"_type":49},[13343,13351,13359,13367,13393,13422,13430,13459,13467,13475,13483,13491,13516,13524,13532,13540,13548,13556,13567,13575,13583,13591,13599,13607,13615,13623,13631,13639,13647,13655,13663,13671,13679,13687,13706,13714,13722,13734,13742,13750,13771,13788,13796,13804,13812,13819,13837],{"style":59,"_key":13344,"markDefs":13345,"children":13346,"_type":58},"57a2645738dd",[],[13347],{"_key":13348,"_type":56,"marks":13349,"text":13350},"28ba0c44fef7",[],"Why Communication in Maternity Care Can Make or Break a Birth Experience",{"style":78,"_key":13352,"markDefs":13353,"children":13354,"_type":58},"20fca4a91dba",[],[13355],{"_type":56,"marks":13356,"text":13357,"_key":13358},[],"Language is a key component of how we humans communicate with each other, and good communication is a cornerstone of safe and effective care. In our combined 20 years or so of experience as midwives, we have heard fellow midwives, doctors and anaesthetists communicate beautifully with women and birthing people. We have seen how kind, respectful, and supportive words can make all the difference to how someone feels and possibly even make a difference to their birth outcome. Unfortunately, we also frequently witness healthcare professionals using language that belittles, disrespects, coerces, puts down and demeans women and birthing people.","6b663ad2aaf7",{"children":13360,"_type":58,"style":59,"_key":13365,"markDefs":13366},[13361],{"text":13362,"_key":13363,"_type":56,"marks":13364},"Do Women and Birthing People Have the Right to Make Their Own Decisions?","f6235ddd91f0",[],"f55d5cfbd30e",[],{"markDefs":13368,"children":13372,"_type":58,"style":78,"_key":13392},[13369],{"type":65,"url":13370,"_type":67,"_key":13371},"https://www.birthrights.org.uk/","e17978d86ac2",[13373,13377,13380,13384,13388],{"_type":56,"marks":13374,"text":13375,"_key":13376},[],"To paraphrase Elizabeth Prochaska (former chair and co-founder of ","df3d99cde17b",{"marks":13378,"text":5325,"_key":13379,"_type":56},[13371],"8e9248c4595d",{"marks":13381,"text":13382,"_key":13383,"_type":56},[],"), women are allowed to make decisions that we as healthcare professionals may find morally incomprehensible. It is a great reminder, for those that need it, that all decisions during pregnancy and childbirth ultimately lie with the woman/birthing person. It is not the role of a midwife or doctor to persuade or coerce women into making decisions that ","e0df22a28532",{"_type":56,"marks":13385,"text":13386,"_key":13387},[281],"they","cdb4c0286694",{"marks":13389,"text":13390,"_key":13391,"_type":56},[]," believe to be the right ones. We forget in maternity care that women and birthing people are autonomous human beings and they can make decisions that do or do not align with hospital guidelines and policies or the expectations and beliefs of a healthcare professional.","95d40b991fdd","2cf91581d9dd",{"_key":13394,"markDefs":13395,"children":13402,"_type":58,"style":78},"8e0f7d349815",[13396,13399],{"internalLink":13397,"_type":67,"_key":13398,"type":194},{"_ref":2756,"_type":197},"a353653e0f97",{"type":65,"url":13400,"_type":67,"_key":13401},"https://www.birthrights.org.uk/factsheets/human-rights-in-maternity-care/","818aca6c9aad",[13403,13406,13410,13414,13418],{"_type":56,"marks":13404,"text":7319,"_key":13405},[],"d9eb7ed8d776",{"text":13407,"_key":13408,"_type":56,"marks":13409},"previous blog post","cbceb2d34969",[13398],{"marks":13411,"text":13412,"_key":13413,"_type":56},[],", we explored the idea of ‘Am I allowed…?’ in relation to commonly offered screening tests and interventions. We hear the word ‘allowed’ being used frequently in maternity care – both by women and birthing people and by midwives and doctors. ‘Allow’ suggests someone else (i.e. a midwife or a doctor) has to give a woman or birthing person permission to do something. In truth, ","0dd859c3bb17",{"marks":13415,"text":13416,"_key":13417,"_type":56},[13401],"human rights law","c212bec24db0",{"text":13419,"_key":13420,"_type":56,"marks":13421}," states that women and birthing people have the right to make decisions about their care. It does not state that midwives or doctors must make decisions on behalf of women and birthing people in their care. ","703adb5249a2",[],{"_type":58,"style":59,"_key":13423,"markDefs":13424,"children":13425},"a08a3739353c",[],[13426],{"_type":56,"marks":13427,"text":13428,"_key":13429},[],"When an \"Offer\" in Maternity Care Isn't Really an Offer","a7edd0228b18",{"children":13431,"_type":58,"style":78,"_key":13453,"markDefs":13454},[13432,13436,13441,13444,13449],{"_type":56,"marks":13433,"text":13434,"_key":13435},[],"The NICE ","fe70d468ac3b",{"text":13437,"_key":13438,"_type":56,"marks":13439},"pregnancy","dbe8f6156036",[13440],"533874207523",{"_type":56,"marks":13442,"text":12600,"_key":13443},[],"b37ecf3cbe35",{"_type":56,"marks":13445,"text":13447,"_key":13448},[13446],"479776ab725d","birth","42aef4945bf1",{"text":13450,"_key":13451,"_type":56,"marks":13452}," guidelines frequently use the word ‘offer’, when discussing interventions and common screening tests. Which sounds innocuous, right? Offering something would suggest that women and birthing people can accept or decline that offer equally. Based on experience, we know this is frequently not the case and there are a couple of key issues here.","d48d033cbd32",[],"aa219709c978",[13455,13457],{"_type":67,"_key":13440,"type":65,"url":13456},"https://www.nice.org.uk/guidance/ng201/chapter/Recommendations",{"url":13458,"_type":67,"_key":13446,"type":65},"https://www.nice.org.uk/guidance/ng235",{"style":59,"_key":13460,"markDefs":13461,"children":13462,"_type":58},"715ca83d3b8f",[],[13463],{"text":13464,"_key":13465,"_type":56,"marks":13466},"The Problem With Language Around Vaginal Examinations","8079aaa33d9e",[],{"markDefs":13468,"children":13469,"_type":58,"style":78,"_key":13474},[],[13470],{"_type":56,"marks":13471,"text":13472,"_key":13473},[108],"When the ‘offer’ is often not really an offer. Let’s look at that in terms of ‘offering’ a vaginal examination.","434164ae217a","62a5c8e867be",{"_key":13476,"markDefs":13477,"children":13478,"_type":58,"style":78},"3d2ad7ab6fdd",[],[13479],{"_type":56,"marks":13480,"text":13481,"_key":13482},[108],"This is what we would expect an offer from a healthcare professional to look like:","245aacee909c",{"markDefs":13484,"children":13485,"_type":58,"style":78,"_key":13490},[],[13486],{"_type":56,"marks":13487,"text":13488,"_key":13489},[281],"“NICE guidance suggests offering women a vaginal examination every 4 hours when in established labour. It is your choice if you would like to have one or not. The benefits to having one are: they may help aid clinical decision-making by knowing how dilated your cervix is and what position your baby is in. The risks are: the chance of infection increases the more vaginal examinations you have, they are painful for some women and they provide limited information in that they only tell us how dilated the cervix is at that point in time – they cannot predict when a baby will be born. There are alternative ways of knowing if someone is progressing in labour. There is also no research to say that doing routine vaginal examinations during labour improves outcomes. Would you like some time to discuss with your birth supporters if you do or do not want a vaginal examination?”","149556417345","d3d0afad2e7b",{"_key":13492,"markDefs":13493,"children":13494,"_type":58,"style":78},"d67da679f6ca",[],[13495,13499,13502,13506,13509,13513],{"_key":13496,"_type":56,"marks":13497,"text":13498},"76b1b62440c5",[108],"Versus what we",{"marks":13500,"text":4274,"_key":13501,"_type":56},[],"46fc5a14b48e",{"_type":56,"marks":13503,"text":13504,"_key":13505},[108,281],"actually","94783d834c2d",{"marks":13507,"text":4274,"_key":13508,"_type":56},[],"0691921ce498",{"marks":13510,"text":13511,"_key":13512,"_type":56},[108],"see in hospital practice","1f304245e35c",{"marks":13514,"text":4263,"_key":13515,"_type":56},[],"31d938afc3e5",{"children":13517,"_type":58,"style":78,"_key":13522,"markDefs":13523},[13518],{"_type":56,"marks":13519,"text":13520,"_key":13521},[281],"“You’re due an examination now.”","990dd7ab83b9","87ac2ce5838c",[],{"children":13525,"_type":58,"style":78,"_key":13530,"markDefs":13531},[13526],{"_type":56,"marks":13527,"text":13528,"_key":13529},[281],"“Can I examine you?” (with no conversation about benefits/risks/alternatives)","f12fd4c9a063","a473db753558",[],{"children":13533,"_type":58,"style":78,"_key":13538,"markDefs":13539},[13534],{"text":13535,"_key":13536,"_type":56,"marks":13537},"“We’ll examine you at X time.”","8d3603155214",[281],"b6a71faead99",[],{"_key":13541,"markDefs":13542,"children":13543,"_type":58,"style":78},"f2d7022e5f1d",[],[13544],{"_type":56,"marks":13545,"text":13546,"_key":13547},[281],"And even…the healthcare professional entering the room and putting their gloves on without actually asking for consent before getting ready to do a vaginal examination.","672dfcbf79b9",{"style":59,"_key":13549,"markDefs":13550,"children":13551,"_type":58},"55312f6770d5",[],[13552],{"_key":13553,"_type":56,"marks":13554,"text":13555},"d5de8bcf9c07",[],"What Happens When Women Decline Interventions in Labour?",{"children":13557,"_type":58,"style":78,"_key":13565,"markDefs":13566},[13558,13562],{"marks":13559,"text":13560,"_key":13561,"_type":56},[108],"When an ‘offer’ is declined, we have heard the following","25ff0efe11da",{"_key":13563,"_type":56,"marks":13564,"text":4263},"6666d41aaf47",[],"6724098e593e",[],{"markDefs":13568,"children":13569,"_type":58,"style":78,"_key":13574},[],[13570],{"marks":13571,"text":13572,"_key":13573,"_type":56},[281],"“She’s refusing to do X.”","ccd65f0d0dad","a0484cd946e2",{"_key":13576,"markDefs":13577,"children":13578,"_type":58,"style":78},"f9ef0d97b5f0",[],[13579],{"marks":13580,"text":13581,"_key":13582,"_type":56},[281],"“She’s uncooperative.”","d9d47c2f6a1d",{"_key":13584,"markDefs":13585,"children":13586,"_type":58,"style":78},"956aaa82d382",[],[13587],{"_type":56,"marks":13588,"text":13589,"_key":13590},[281],"“She’s being difficult.”","3b9c5d3349c4",{"children":13592,"_type":58,"style":78,"_key":13597,"markDefs":13598},[13593],{"_type":56,"marks":13594,"text":13595,"_key":13596},[281],"“She’s crazy.”","6951baeff4ec","81aa84eed48d",[],{"_type":58,"style":78,"_key":13600,"markDefs":13601,"children":13602},"2ab34c0c42c7",[],[13603],{"_key":13604,"_type":56,"marks":13605,"text":13606},"c1a71fe54d9d",[281],"“Go and speak to her and persuade her to have X.”",{"style":78,"_key":13608,"markDefs":13609,"children":13610,"_type":58},"b6332f4b0c35",[],[13611],{"_key":13612,"_type":56,"marks":13613,"text":13614},"2e3f988d9e56",[],"Where an intervention is considered the norm and routine by healthcare professionals, such as routine 4 hourly vaginal examinations, it often isn’t presented as something that women and birthing people have a choice in.",{"children":13616,"_type":58,"style":78,"_key":13621,"markDefs":13622},[13617],{"marks":13618,"text":13619,"_key":13620,"_type":56},[],"The language used around vaginal examinations and the interventions that require a vaginal examination (artificially rupturing the membranes, doing a membrane sweep, applying a fetal scalp electrode) can be extremely problematic:","b672663f2298","d23ff722dab4",[],{"_type":58,"style":78,"_key":13624,"markDefs":13625,"children":13626},"aaa6f3fc149f",[],[13627],{"text":13628,"_key":13629,"_type":56,"marks":13630},"“Good girl”","b7a9804f1ea7",[281],{"_key":13632,"markDefs":13633,"children":13634,"_type":58,"style":78},"37f0bd3e4029",[],[13635],{"marks":13636,"text":13637,"_key":13638,"_type":56},[281],"“Just relax”","ccd72d5516c1",{"style":78,"_key":13640,"markDefs":13641,"children":13642,"_type":58},"6566823ad7a3",[],[13643],{"marks":13644,"text":13645,"_key":13646,"_type":56},[281],"“This won’t 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This is worth thinking about when accepting or declining an intervention.",{"_type":58,"style":78,"_key":14281,"markDefs":14282,"children":14283},"286688c7524e",[],[14284],{"text":14285,"_key":14286,"_type":56,"marks":14287},"It is absolutely fine to accept every test and/or intervention recommended to you during pregnancy, if that feels right for you. It is also absolutely fine to decline them, if that feels right for you. 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Your story will be unique to you and whilst you can’t control exactly what happens, you can influence your birth story by getting informed during each pregnancy, gathering a fantastic birth support team around you, and getting clear on what you want from your birth. Read our clients birth stories ","cd819d07beba",{"marks":14516,"text":249,"_key":14517,"_type":56},[14508],"fec8c473a8bb",{"_key":14519,"_type":56,"marks":14520,"text":1183},"80be783b1e28",[],{"style":59,"_key":14522,"markDefs":14523,"children":14524,"_type":58},"9d6596411183",[],[14525],{"marks":14526,"text":14527,"_key":14528,"_type":56},[],"Birth Doesn't Have to Mean Excruciating Pain","9e29f1f9efea",{"markDefs":14530,"children":14531,"_type":58,"style":78,"_key":14536},[],[14532],{"_key":14533,"_type":56,"marks":14534,"text":14535},"f2516323987f",[],"This may sound hard to believe to some, but head over to @orgasmicbirth on Instagram to see some amazing photos and videos of women in ecstatic birth. Even if you don’t experience birth as orgasmic, it is good to know that birth doesn’t have to mean excruciating pain. Most women and birthing people describe birth as hard work to us, but those have had an intervention-free birth often also say they feel they could do it again!","76fd224881d5",{"style":59,"_key":14538,"markDefs":14539,"children":14540,"_type":58},"3583a43c6104",[],[14541],{"_type":56,"marks":14542,"text":14543,"_key":14544},[],"You Can Choose Where to Give Birth in the UK","9b9133807f03",{"markDefs":14546,"children":14547,"_type":58,"style":78,"_key":14552},[],[14548],{"_type":56,"marks":14549,"text":14550,"_key":14551},[],"Your options are: home, at a midwife-led unit or in an obstetric-led unit. You can even choose an NHS trust that suits your needs, rather than just the closest one. Despite having this right to choose, access to midwife-led units and an NHS home birth can be difficult to come by due to nationwide midwife shortages and restrictive hospital policies. Choosing an independent midwife guarantees you access to home birth.","8fca2b6b127c","85ff5ad97669",{"_key":14554,"markDefs":14555,"children":14556,"_type":58,"style":59},"26fad178338c",[],[14557],{"text":14558,"_key":14559,"_type":56,"marks":14560},"The Hormones Released After Birth Are Incredible","1d8dad989667",[],{"_type":58,"style":78,"_key":14562,"markDefs":14563,"children":14567},"ac69c86a48f3",[14564],{"_type":67,"_key":14565,"type":65,"url":14566},"aa8d8e1cce8c","https://sarahbuckley.com/articles/",[14568,14572,14576],{"marks":14569,"text":14570,"_key":14571,"_type":56},[],"Oxytocin helps to contract your womb, release the placenta, and decrease bleeding. It also facilitates mother-baby bonding. A rush of beta-endorphins (your body’s natural painkiller) can create a high, which is why some women and birthing people feel euphoric after they’ve given birth. Prolactin levels soar, to tell the body to start making milk. Pretty cool, right? ","9f3cf07022b5",{"marks":14573,"text":14574,"_key":14575,"_type":56},[14565],"Sarah Buckley","696a0263fc0f",{"marks":14577,"text":14578,"_key":14579,"_type":56},[]," has done heaps of research into the hormones of labour – her work is well worth a read.","3343f4f09060",{"_key":14581,"markDefs":14582,"children":14583,"_type":58,"style":59},"9ee6567ff602",[],[14584],{"marks":14585,"text":14586,"_key":14587,"_type":56},[],"You Might Poop During Birth (And That's Completely Normal)","9550375e03e2",{"markDefs":14589,"children":14590,"_type":58,"style":78,"_key":14595},[],[14591],{"_type":56,"marks":14592,"text":14593,"_key":14594},[],"But you know what? Nobody else cares – literally nobody. It is a completely normal thing to occur during birth. Try not to overthink this or it let throw you off course – it really is very minor in the grand scheme of things. Often in the lead up to a spontaneous labour, women & birthing people report pooping more frequently, or having loose stools – your body’s way of having a clear out and creating more space for your baby to be born!","7cdaf48431ea","a0d54ac0c373",{"children":14597,"_type":58,"style":59,"_key":14602,"markDefs":14603},[14598],{"_type":56,"marks":14599,"text":14600,"_key":14601},[],"Birth Isn't Over Until the Placenta Is Born","bb60d18a9114","5d0feccb9867",[],{"markDefs":14605,"children":14609,"_type":58,"style":78,"_key":14620},[14606],{"url":13180,"internalLink":14607,"_type":67,"_key":14608,"type":194},{"_type":197,"_ref":10327},"14ab9ebe4e8d",[14610,14614,14617],{"text":14611,"_key":14612,"_type":56,"marks":14613},"It’s so important immediately after birth for your care providers and/or birth supporters to maintain an environment of calm, warm and quiet once your baby is earthside. These conditions support that big release of oxytocin discussed above, which helps the placenta to release. In that first, ‘golden hour’ you don’t need to be doing anything other than meeting your baby. Put the phones away, delay the newborn check (if safe to do so) and enjoy these special moments meeting your baby. Read more about the importance of continuity of care when it comes to physiological birth of the placenta ","bf9faef692c8",[],{"marks":14615,"text":249,"_key":14616,"_type":56},[14608],"76e677eeb3e3",{"_type":56,"marks":14618,"text":1183,"_key":14619},[],"94496dcd0854","c30709cf7ff4",{"_key":14622,"markDefs":14623,"children":14624,"_type":58,"style":59},"9561eab7e6e4",[],[14625],{"_type":56,"marks":14626,"text":14627,"_key":14628},[],"You Can Give Birth in Almost Any Position","7b89cf029b0e",{"style":78,"_key":14630,"markDefs":14631,"children":14635,"_type":58},"229316ade1fb",[14632],{"_type":67,"_key":14633,"type":65,"url":14634},"3bc6c490b152","https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748987/#:~:text=To%20facilitate%20the%20desired%20upright,to%20support%20the%20woman's%20legs.",[14636,14640,14644],{"_type":56,"marks":14637,"text":14638,"_key":14639},[],"You may instinctively know what position feels right for you – that may be standing up, on all fours, lying on your side, kneeling in a birth pool, squatting on a birth stool. It may even be on your back (although in spontaneous labour this is not usually the case!) – the point is, do what feels good and right to you – rather than what you think you ought to be doing. If you have an epidural, you may not feel this so instinctively and it’s worth taking a proactive approach to different positions during labour and birth to help your baby through your pelvis – using a ","1ee61941fd9b",{"_type":56,"marks":14641,"text":14642,"_key":14643},[14633],"peanut ball","9f46810ad83e",{"_key":14645,"_type":56,"marks":14646,"text":14647},"a7254c0de10e",[]," can be super helpful!",{"_key":14649,"markDefs":14650,"children":14651,"_type":58,"style":59},"6f03f40c7e1e",[],[14652],{"_type":56,"marks":14653,"text":14654,"_key":14655},[],"Birth Has the Power to Be Transformative","09c197809220",{"_type":58,"style":78,"_key":14657,"markDefs":14658,"children":14663},"281a2683a99e",[14659],{"type":194,"internalLink":14660,"_type":67,"_key":14662},{"_ref":14661,"_type":197},"865673ef-1f11-4de7-bcb7-01b2b32504f9","44e38180c9d4",[14664,14668,14672],{"_key":14665,"_type":56,"marks":14666,"text":14667},"b8ed23307075",[],"Ultimately you have to do it yourself, albeit with support. It is considered a rite of passage – you will learn things about yourself you didn’t know and hopefully come out the other side feeling strong and powerful. As with any big life event, you need to prepare. Sign up to ",{"marks":14669,"text":14670,"_key":14671,"_type":56},[14662],"antenatal classes","b8d2b685e646",{"_type":56,"marks":14673,"text":14674,"_key":14675},[],", follow birth educators on your socials, listen to the podcasts!","515e906291e1",{"style":59,"_key":14677,"markDefs":14678,"children":14679,"_type":58},"4bc3e93d35d4",[],[14680],{"_key":14681,"_type":56,"marks":14682,"text":14683},"00e7f5e39bb1",[],"Who You Have in Your Birth Space Matters More Than You Think",{"style":78,"_key":14685,"markDefs":14686,"children":14687,"_type":58},"30e216024692",[],[14688],{"marks":14689,"text":14690,"_key":14691,"_type":56},[],"Choose wisely! You need people who aren’t afraid of birth, who you feel entirely comfortable with and who you know will advocate for you when you’re feeling vulnerable. This may not be your partner or your Mum. It may involve investing in doula support, to have someone by your side who is truly able to advocate when you’re vulnerable.","860e8c0ca55c",{"children":14693,"_type":58,"style":59,"_key":14698,"markDefs":14699},[14694],{"marks":14695,"text":14696,"_key":14697,"_type":56},[],"You Don't Have to Give Birth With the NHS","58780c3e6773","a60f6948aacb",[],{"_key":14701,"markDefs":14702,"children":14707,"_type":58,"style":78},"a5a32cba9b43",[14703],{"_type":67,"_key":14704,"type":194,"internalLink":14705},"0f07ac7fcd30",{"_ref":14706,"_type":197},"0e0d7a6b-b2fb-4a0e-8659-55e637e037fa",[14708,14712,14715],{"_type":56,"marks":14709,"text":14710,"_key":14711},[],"You can choose to have an ","96df17e76e77",{"_type":56,"marks":14713,"text":1954,"_key":14714},[14704],"e48c7bdb887f",{"text":14716,"_key":14717,"_type":56,"marks":14718}," who can provide all your midwifery care, including labour and birth care at home. You can choose to have some NHS care with some independent midwifery care. You can choose to not have any care at all if you don’t want to. You always have options.","0c1c9c3a234f",[],{"link":14720,"_key":14723,"_type":190},{"type":194,"internalLink":14721,"blank":192,"_type":67,"text":14722},{"_type":197,"_ref":2580},"Contact us","e91d1cb95086",{"children":14725,"_type":58,"style":78,"_key":14729,"markDefs":14730},[14726],{"text":3988,"_key":14727,"_type":56,"marks":14728},"b4f70feca753",[108],"eb2f0ad1f096",[],{"markDefs":14732,"children":14736,"_type":58,"style":78,"_key":14745},[14733],{"_type":67,"_key":14734,"type":65,"url":14735},"f29dc145aad4","https://www.rachelreed.website/rcrp",[14737,14741],{"_type":56,"marks":14738,"text":14739,"_key":14740},[],"Reclaiming Childbirth as a Rite of Passage by ","206eaf933e2e",{"_key":14742,"_type":56,"marks":14743,"text":14744},"aec355745088",[14734],"Rachel Reed","ea88a1e24ffb",{"style":78,"_key":14747,"markDefs":14748,"children":14749,"_type":58},"5e4782764312",[],[14750],{"marks":14751,"text":14752,"_key":14753,"_type":56},[108],"Follow…","eabcfcb9a84d",{"children":14755,"_type":58,"style":78,"_key":14765,"markDefs":14766},[14756,14761],{"_type":56,"marks":14757,"text":14759,"_key":14760},[14758],"91ca856ca7a0","Orgasmic Birth","24e34cd866e1",{"_key":14762,"_type":56,"marks":14763,"text":14764},"7b1bc7a4ba88",[]," on Instagram","944971633c79",[14767],{"type":65,"url":14768,"_type":67,"_key":14758},"https://www.instagram.com/orgasmicbirth/?hl=en",{"_key":14770,"markDefs":14771,"children":14772,"_type":58,"style":78},"2161bd851f72",[],[14773,14776],{"text":6845,"_key":14774,"_type":56,"marks":14775},"201c037b4e6e",[108],{"_type":56,"marks":14777,"text":6850,"_key":14778},[],"4efc00de1ad4",{"_type":58,"style":78,"_key":14780,"markDefs":14781,"children":14785},"8f2e6c9e6d58",[14782],{"_type":67,"_key":14783,"type":65,"url":14784},"8b1c3e7ae79f","https://open.spotify.com/episode/2EzDGWkIivsHN8FgMjdqzo?si=5cadb2264ce044ac",[14786,14790],{"marks":14787,"text":14788,"_key":14789,"_type":56},[14783],"The Hormones of Labour","6fba923de294",{"_key":14791,"_type":56,"marks":14792,"text":14793},"06640c757270",[]," – The Great Birth Rebellion Podcast",{"base":14795},{"id":14484,"rev":14796},"c1HqLtX09dCBnnfIQf8bXL",{"content":14798,"slug":14977,"image":14979,"_system":14982,"_createdAt":14985,"_updatedAt":14986,"_rev":14987,"_type":37,"_id":14706,"publishedAt":14988,"title":14989},{"_type":49,"body":14799},[14800,14808,14824,14832,14840,14844,14852,14860,14868,14875,14883,14891,14899,14907,14912,14920,14928,14936,14944,14952],{"_type":58,"style":59,"_key":14801,"markDefs":14802,"children":14803},"08263437fcaf",[],[14804],{"_key":14805,"_type":56,"marks":14806,"text":14807},"0b9ffef66424",[],"Can Anyone Hire an Independent Midwife?",{"_key":14809,"markDefs":14810,"children":14811,"_type":58,"style":78},"90bf72018fbf",[],[14812,14816,14820],{"_key":14813,"_type":56,"marks":14814,"text":14815},"fd2ceb68ae8e",[],"Hopefully you’ve guessed that that is a trick question! ",{"_key":14817,"_type":56,"marks":14818,"text":14819},"9fcf44ff03e4",[108],"Anyone",{"_key":14821,"_type":56,"marks":14822,"text":14823},"96fa4fcc6dd1",[]," pregnant or post-partum can hire an independent midwife. ",{"children":14825,"_type":58,"style":59,"_key":14830,"markDefs":14831},[14826],{"text":14827,"_key":14828,"_type":56,"marks":14829},"Hiring an Independent Midwife for a Home Birth","30bb8ff5c7da",[],"f265dda1de7a",[],{"children":14833,"_type":58,"style":78,"_key":14838,"markDefs":14839},[14834],{"_type":56,"marks":14835,"text":14836,"_key":14837},[],"An independent midwife will see you at home for all aspects of your pregnancy & postpartum journey and be on call you 24/7 from when you’re about 37 weeks pregnant","40db2e36f0c1","a5081d1cefa6",[],{"link":14841,"_key":14843,"_type":190},{"_type":67,"text":193,"type":194,"internalLink":14842,"blank":192},{"_ref":196,"_type":197},"7dab23df44fb",{"children":14845,"_type":58,"style":59,"_key":14850,"markDefs":14851},[14846],{"text":14847,"_key":14848,"_type":56,"marks":14849},"Hiring an Independent Midwife for a Hospital Birth or Planned (Elective) Caesarean","89c2638c5edb",[],"83ea15f02bd0",[],{"style":78,"_key":14853,"markDefs":14854,"children":14855,"_type":58},"9ed6802ce1a9",[],[14856],{"_type":56,"marks":14857,"text":14858,"_key":14859},[],"An independent midwife can be a great advocate for you in the maternity system, helping you navigate choices in an unfamiliar environment","3964e26b5799",{"markDefs":14861,"children":14862,"_type":58,"style":59,"_key":14867},[],[14863],{"_key":14864,"_type":56,"marks":14865,"text":14866},"5409ab33caeb",[],"Hiring an Independent Midwife if You Are Planning to Freebirth","57b2055dc996",{"_key":14869,"markDefs":14870,"children":14871,"_type":58,"style":78},"c151bfe81133",[],[14872],{"_type":56,"marks":14873,"text":14874,"_key":14864},[],"Maybe you want an independent midwife just for one aspect of your care, for example your antenatal and postnatal care and the newborn examination.",{"style":59,"_key":14876,"markDefs":14877,"children":14878,"_type":58},"83e709195a20",[],[14879],{"_type":56,"marks":14880,"text":14881,"_key":14882},[],"Consulting an Independent Midwife for a Second Opinion","c716ad0c65c1",{"_key":14884,"markDefs":14885,"children":14886,"_type":58,"style":78},"1efb2abda928",[],[14887],{"text":14888,"_key":14889,"_type":56,"marks":14890},"Perhaps you’ve been told something that doesn’t sit quite right; independent midwives look at you and your individual circumstances and they’ll give you truly evidence-based, non-judgemental information in a relaxed and unhurried setting.","316207a69367",[],{"markDefs":14892,"children":14893,"_type":58,"style":59,"_key":14898},[],[14894],{"_type":56,"marks":14895,"text":14896,"_key":14897},[],"Hiring an Independent Midwife to Help Write Your Birth Plan ","0cd79af3af0d","7e4075f8c033",{"style":78,"_key":14900,"markDefs":14901,"children":14902,"_type":58},"5a9dbaf06653",[],[14903],{"_key":14904,"_type":56,"marks":14905,"text":14906},"af6e7282b304",[],"Independent midwives want you to have a positive birth experience, whatever kind of birth you have. They can support you to write your plan A, B and C with their in-depth knowledge of birth and the maternity system and by helping you identify what is important to you",{"_type":190,"link":14908,"_key":14911},{"type":194,"internalLink":14909,"blank":192,"anchor":14910,"_type":67,"text":2953},{"_ref":502,"_type":197},"#antenatal","ccdbdf9ce5a3",{"markDefs":14913,"children":14914,"_type":58,"style":59,"_key":14919},[],[14915],{"text":14916,"_key":14917,"_type":56,"marks":14918},"Does Being High Risk Mean You Can't Have an Independent Midwife?","6a912a1df5c9",[],"81ff8c455757",{"_key":14921,"markDefs":14922,"children":14923,"_type":58,"style":78},"b43410af6bf6",[],[14924],{"_key":14925,"_type":56,"marks":14926,"text":14927},"6323d9a46074",[],"It’s worth remembering that no additional factors in your pregnancy restrict you from having an independent midwife and in fact, having additional pregnancy considerations may be a great reason to hire an independent midwife. Having, for example, had a previous caesarean section, a breech baby, a multiple pregnancy, gestational diabetes or an existing medical condition do not exclude you from having an independent midwife.",{"_key":14929,"markDefs":14930,"children":14931,"_type":58,"style":78},"8f93872a485b",[],[14932],{"text":14933,"_key":14934,"_type":56,"marks":14935},"Your independent midwives can liaise with your local NHS maternity services and other health professionals if indicated and wanted by you. Whatever your background, you deserve excellent care during your pregnancy. Continuity of care, and midwife-led models of care have been proven time and time again by research to support excellent outcomes in women and birthing people.","fe8bbcfff8a5",[],{"style":78,"_key":14937,"markDefs":14938,"children":14939,"_type":58},"1b2127a831bd",[],[14940],{"_type":56,"marks":14941,"text":14942,"_key":14943},[],"We are based in Folkestone but provide midwifery care all over Kent, so get in touch if you’re interested to learn how we could support you in your pregnancy.","355d02442fd7",{"style":59,"_key":14945,"markDefs":14946,"children":14947,"_type":58},"323891ce7258",[],[14948],{"_type":56,"marks":14949,"text":14950,"_key":14951},[],"How to Find an Independent Midwife Near You","c64c76332a20",{"markDefs":14953,"children":14959,"_type":58,"style":78,"_key":14976},[14954,14957],{"url":14955,"_type":67,"_key":14956,"type":65},"https://www.findmymidwife.co.uk/","5089c4e04596",{"_type":67,"_key":14958,"type":65,"url":1082},"07a69d0cf63d",[14960,14964,14968,14972],{"marks":14961,"text":14962,"_key":14963,"_type":56},[14956],"Find My Midwife","ba71e6389852",{"_key":14965,"_type":56,"marks":14966,"text":14967},"dcd5e122b0aa",[]," have a whole national directory of Independent Midwives, offering a variety of services – so if you’re not Kent based but would like an independent midwife, check it out! ",{"_type":56,"marks":14969,"text":14970,"_key":14971},[14958],"ZEST","809b498007ed",{"marks":14973,"text":14974,"_key":14975,"_type":56},[]," is another great place to find an independent midwife.","8d41b9bb5f78","e1659c81fa2c",{"current":14978,"_type":8},"who-can-hire-an-independent-midwife-hint-anyone-can",{"_type":586,"asset":14980},{"_ref":14981,"_type":197},"image-4f4a71d7f90cbebb9d4d8e83bb4969b9aa3b0fb3-1365x2048-jpg",{"base":14983},{"rev":14984,"id":14706},"lFrvlEMldmWjsfq3cbebmK","2025-04-07T15:17:39Z","2026-03-17T12:34:57Z","qT2iNI6jkBV9oItpl1PXLg","2023-09-08","Who Can Hire an Independent Midwife? (Hint: Anyone Can)",{"publishedAt":14991,"_rev":14992,"title":14993,"_updatedAt":14994,"content":14995,"image":15172,"_type":37,"_system":15175,"slug":15179,"_createdAt":15181,"_id":15178},"2023-08-28","lTiZ7ejil6ZSBCJHGJFPSG"," How the Formula Industry Undermines Breastfeeding,  And Why It Matters","2026-03-17T12:38:07Z",{"_type":49,"body":14996},[14997,15005,15024,15032,15040,15048,15056,15064,15082,15090,15098,15106,15114,15122,15138,15157],{"markDefs":14998,"children":14999,"_type":58,"style":78,"_key":15004},[],[15000],{"_key":15001,"_type":56,"marks":15002,"text":15003},"45b6a8cd17ba",[],"No sooner than the end of breastfeeding week did we see the true nature of the politics of breastfeeding. Whilst our instagram feeds were filled with pictures of famous pop stars breastfeeding and health services were busy promoting the wonders of skin to skin and the benefits of breastfeeding, the seedy nature of corporate conglomerates were hard at work undermining the international effort to promote breastfeeding.","95819d174eb5",{"_type":58,"style":78,"_key":15006,"markDefs":15007,"children":15011},"743ab419af5d",[15008],{"url":15009,"_type":67,"_key":15010,"type":65},"https://www.bbc.co.uk/news/business-66582141","e53c58be7319",[15012,15016,15020],{"text":15013,"_key":15014,"_type":56,"marks":15015},"It was no surprise to me when I scrolled through the BBC news app this week, that I came across this headline; ","bc3135fb0a89",[],{"_type":56,"marks":15017,"text":15018,"_key":15019},[15010],"“Boots infant formula adverts broke rules – watchdog”","b139e0e082c9",{"_type":56,"marks":15021,"text":15022,"_key":15023},[],". Deeply concerning to see this emerge, it is not the first such headline over the years and it won’t be the last. What is more alarming is that it is not until you read the article that you see another high street store, this time Iceland, getting in on the act. According to this BBC article Iceland is calling for changes to laws on formula milk advertising. Utilising the current vulnerabilities for many families brought on by the cost of living crisis, it claims that many people who have to use formula are unfairly disadvantaged by the cost of infant formula in this current climate. In this instance we need to consider who actually sets these prices in the first place!","3e8a93eabeb7",{"style":59,"_key":15025,"markDefs":15026,"children":15027,"_type":58},"842ab7f9dffc",[],[15028],{"text":15029,"_key":15030,"_type":56,"marks":15031},"What Do UK Laws Say About Formula Milk Advertising?","3717bb9989bb",[],{"markDefs":15033,"children":15034,"_type":58,"style":78,"_key":15039},[],[15035],{"marks":15036,"text":15037,"_key":15038,"_type":56},[],"So what do the current laws say? In the UK the law prohibits advertising and promotion of infant formula that is marketed for use from birth. It is worth noting that ‘follow on milk’ and ‘specialist milks’ are not under these same regulations despite their unsubstantiated scientific claims that they offer benefits to babies’ health and neurological development.","6f7ee09f16b7","186bf472e1bf",{"_key":15041,"markDefs":15042,"children":15043,"_type":58,"style":59},"f399f781350f",[],[15044],{"_type":56,"marks":15045,"text":15046,"_key":15047},[],"Why Formula Companies Breaking Advertising Rules Is Not Surprising","f4611c555269",{"_key":15049,"markDefs":15050,"children":15051,"_type":58,"style":78},"27e6f9a560ec",[],[15052],{"_type":56,"marks":15053,"text":15054,"_key":15055},[],"It is these claims that really highlight the importance of this issue. Whilst profit is prioritised over people, society continues to be influenced by advertising that undermines women’s abilities to breastfeed and degrades the value of breastfeeding. We see this in the lack of funding for community based breastfeeding support, which relies heavily on volunteers and acts of kindness. Employment laws are not well enforced and we see many women struggling to maintain breastfeeding on their return to work. Hospital staff are not adequately trained to support women to breastfeed when they birth their babies and the medical model has historically been heavily influenced by the lobbying of the formula industry. Essentially, breastfeeding is bad for business. ","3de8bfe62492",{"style":59,"_key":15057,"markDefs":15058,"children":15059,"_type":58},"e00c040bf4ed",[],[15060],{"_type":56,"marks":15061,"text":15062,"_key":15063},[],"How Big Is the Infant Formula Industry?","7bc6c4a4ed73",{"_key":15065,"markDefs":15066,"children":15070,"_type":58,"style":78},"d908c6ddf700",[15067],{"type":65,"url":15068,"_type":67,"_key":15069},"https://www.precedenceresearch.com/baby-food-market#:~:text=The%20global%20baby%20food%20market,forecast%20period%202023%20to%202032.","0e5dc8932ff0",[15071,15074,15078],{"text":15072,"_key":15055,"_type":56,"marks":15073},"The infant formula industry is BIG business! ",[],{"_key":15075,"_type":56,"marks":15076,"text":15077},"aade0a710eda",[15069],"“The global baby food market size was estimated at USD 83.92 billion in 2022 and is expected to hit around USD 155.32 billion by 2032” (Prescedence Research, 2023)",{"text":15079,"_key":15080,"_type":56,"marks":15081},". The hold this business has on society can be seen in poor breastfeeding rates worldwide despite the overwhelming evidence of the social, environmental and health benefits of breastfeeding.","98ad7b7ab534",[],{"style":59,"_key":15083,"markDefs":15084,"children":15085,"_type":58},"6542412b93e8",[],[15086],{"_type":56,"marks":15087,"text":15088,"_key":15089},[],"How the Formula Industry Influences Breastfeeding Rates","b7cd2316acdd",{"_type":58,"style":78,"_key":15091,"markDefs":15092,"children":15093},"93e8cc126cdb",[],[15094],{"_type":56,"marks":15095,"text":15096,"_key":15097},[],"I write this mainly out of frustration that we are still here and discussing this in 2023. But people need to be made aware. A new generation of mothers and children are being born as I write this. My local hospital trust (East Kent) recently reported that in July only 68% of babies had breast milk as their first feed. This is not the lowest but I am yet to see the 70% mark breached at this trust. That is despite them having a brilliant breastfeeding support team in house on their postnatal ward. They are not alone as the average initiation rate recorded by Public Health England, was only 71% in 2020/21. This figure sharply drops at 6-8 weeks with only 49% of babies still breastfeeding at this age.","d8feaff82a47",{"_type":58,"style":59,"_key":15099,"markDefs":15100,"children":15101},"7817107ac08f",[],[15102],{"marks":15103,"text":15104,"_key":15105,"_type":56},[],"Why Undermining Breastfeeding Is Harmful to Mothers, Babies and Society","e422f811e36a",{"markDefs":15107,"children":15108,"_type":58,"style":78,"_key":15113},[],[15109],{"_key":15110,"_type":56,"marks":15111,"text":15112},"6dccbe452adb",[],"What has always been clear to me is that there are bigger players at work here. To truly understand the scale of the problem and the impact of targeted advertising we need to look back in time and reflect on society’s often negative perception of breastfeeding, women’s bodies and the milk they make. Addressing this issue must come from all corners of society. Advertising ultimately influences our behaviour. That’s why it matters. Undermining women’s belief in their abilities to breastfeed is harmful to individual mothers and babies and to society as a whole.","39369be44503",{"_type":58,"style":59,"_key":15115,"markDefs":15116,"children":15117},"7788a4e2b693",[],[15118],{"marks":15119,"text":15120,"_key":15121,"_type":56},[],"How to Get Informed About the Politics of Breastfeeding","bc187788bb85",{"markDefs":15123,"children":15124,"_type":58,"style":78,"_key":15137},[],[15125,15129,15133],{"text":15126,"_key":15127,"_type":56,"marks":15128},"For bookworms, read ","3f26455ef910",[],{"_type":56,"marks":15130,"text":15131,"_key":15132},[281],"The Politics of Breastfeeding","72f030d3d5f4",{"_type":56,"marks":15134,"text":15135,"_key":15136},[]," by Gabrielle Palmer.","71502c909ba3","2e00fb85e1d3",{"children":15139,"_type":58,"style":78,"_key":15153,"markDefs":15154},[15140,15144,15149],{"_type":56,"marks":15141,"text":15142,"_key":15143},[],"For the science geek, access ","091092e95972",{"text":15145,"_key":15146,"_type":56,"marks":15147},"The Lancet’s latest series on Breastfeeding","0fc379889152",[15148],"75d4804680c9",{"_key":15150,"_type":56,"marks":15151,"text":15152},"c4ad0594d4c3",[]," published Feb 2023. 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The NIPE is offered again by the GP at approximately 6 – 8 weeks of age, with the aim of further identifying any abnormalities that may present later.","70a85356c1e8","96754ff0a179",{"_key":15228,"markDefs":15229,"children":15230,"_type":58,"style":59},"99fd8f40c9d9",[],[15231],{"marks":15232,"text":15233,"_key":15234,"_type":56},[],"What Does the Newborn Examination Involve?","0c5b94cf17b1",{"style":78,"_key":15236,"markDefs":15237,"children":15238,"_type":58},"d0becaae5e05",[],[15239],{"_type":56,"marks":15240,"text":15241,"_key":15242},[],"The NIPE involves a specially trained midwife, neonatal doctor or GP, undertaking a thorough examination of a newborn baby – basically looking over a baby’s entire body to check for any anomalies which could be a sign of an underlying condition. It is a ‘top-to-toe’ examination where everything from the top of the baby’s head to the tip of their toes and everything in between is checked.","b200907d6a2d",{"style":78,"_key":15244,"markDefs":15245,"children":15246,"_type":58},"dfff0f3cf9a0",[],[15247],{"marks":15248,"text":15249,"_key":15250,"_type":56},[],"An important aspect of doing a NIPE is getting a thorough history prior to doing the check. This includes asking questions about the mother or birthing parent’s health and wellbeing (e.g. any pre-existing medical conditions), and the well-being of any other immediate family members – for example, siblings. It is important to check any scans from the pregnancy and to note the events of labour that may be relevant, including mode of birth. This history taking helps to inform the overall well-being of a newborn baby, and identify if any referrals to other specialists are needed. In addition to doing the physical check, NIPE practitioners will also ask about feeding and if there are any issues in this respect. They’ll also want to know if a newborn baby is passing urine and pooing as much as would be expected for their age.","008389866851",{"_key":15252,"markDefs":15253,"children":15254,"_type":58,"style":59},"87718a822ae0",[],[15255],{"_type":56,"marks":15256,"text":15257,"_key":15258},[],"The Four Key Areas Checked During the Newborn Examination","3e3cd664fb3e",{"style":78,"_key":15260,"markDefs":15261,"children":15262,"_type":58},"4cc89b44f9ce",[],[15263],{"text":15264,"_key":15265,"_type":56,"marks":15266},"Whilst a NIPE practitioner will be looking at the whole baby, there are four key areas included in the check:","c7f51a4805e7",[],{"style":78,"_key":15268,"listItem":7440,"markDefs":15269,"children":15270,"level":921,"_type":58},"6bc290c6bcd2",[],[15271,15275],{"text":15272,"_key":15273,"_type":56,"marks":15274},"Heart ","5a5b24b6e2ed",[108],{"_type":56,"marks":15276,"text":15277,"_key":15278},[],"– the practitioner will listen to a baby’s heartbeat to screen for congenital heart disease, which is an umbrella term meaning there is an issue with the structure or function of the heart from birth.","cedc2c20c516",{"style":78,"_key":15280,"listItem":7440,"markDefs":15281,"children":15282,"level":921,"_type":58},"c76bb85d28e2",[],[15283,15287],{"_key":15284,"_type":56,"marks":15285,"text":15286},"90f0a116c8cc",[108],"Eyes ",{"text":15288,"_key":15289,"_type":56,"marks":15290},"– the practitioner will shine a torch into the baby’s eyes to assess for the presence of a red-eye reflex. This is to screen and detect congenital cataracts.","30aeb5a81e14",[],{"level":921,"_type":58,"style":78,"_key":15292,"listItem":7440,"markDefs":15293,"children":15294},"a3190207edbf",[],[15295,15299],{"_key":15296,"_type":56,"marks":15297,"text":15298},"e8029f7df36e",[108],"Hips",{"_key":15300,"_type":56,"marks":15301,"text":15302},"9ae3239f387b",[]," – the practitioner performs two manoeuvres on the baby’s hips to identify the presence of a dislocated and/or a dislocatable hip, which may be a sign of congenital hip dysplasia.",{"_key":15304,"listItem":7440,"markDefs":15305,"children":15306,"level":921,"_type":58,"style":78},"f28ebc5fc3ee",[],[15307,15311],{"_type":56,"marks":15308,"text":15309,"_key":15310},[108],"Testes (in boy’s only!)","42b1cedca876",{"marks":15312,"text":15313,"_key":15314,"_type":56},[]," – the practitioner palpates the testes to check that both have descended into the scrotum, this is to screen for unilateral or bilateral undescended testes.","96b9a8ca1753",{"markDefs":15316,"children":15317,"_type":58,"style":59,"_key":15322},[],[15318],{"_type":56,"marks":15319,"text":15320,"_key":15321},[],"What Happens If Something Is Found During the NIPE?","7c211c319611","e1cc7a92d998",{"style":78,"_key":15324,"markDefs":15325,"children":15326,"_type":58},"0eb83798f195",[],[15327,15331,15335],{"_key":15328,"_type":56,"marks":15329,"text":15330},"ed5b0b621dfa",[],"The NIPE is a ",{"_type":56,"marks":15332,"text":15333,"_key":15334},[281],"screening","e4c6215acf1c",{"_key":15336,"_type":56,"marks":15337,"text":15338},"1d0e9f46d5af",[]," test, not a diagnostic test and any abnormalities identified will need further testing to make a diagnosis. The practitioner will make the appropriate referral if they identify an abnormality during the NIPE or if there the baby has known risk factors for certain conditions. The urgency of the referral depends on the findings of the NIPE and this will be discussed with parents. A baby may need to be urgently reviewed within 24 hours and another may only require follow up with the GP at the 6-8 week appointment.",{"children":15340,"_type":58,"style":59,"_key":15345,"markDefs":15346},[15341],{"_type":56,"marks":15342,"text":15343,"_key":15344},[],"When and Where Does the Newborn Examination Take Place?","7bdb9f0e408f","d9418ec482f1",[],{"style":78,"_key":15348,"markDefs":15349,"children":15350,"_type":58},"f058fe23c9d5",[],[15351],{"_type":56,"marks":15352,"text":15353,"_key":15354},[],"If you birth in hospital, the NIPE usually takes places before you are discharged home. Some people choose to go home before it has been done and will return to the hospital the next day to have it completed. The NIPE can also be done at home – although this can depend on if there are midwives available who have been trained to do them.","bf4dbb565762",{"children":15356,"_type":58,"style":59,"_key":15361,"markDefs":15362},[15357],{"marks":15358,"text":15359,"_key":15360,"_type":56},[],"Can You Decline the Newborn Examination?","71f68a414935","bc3c3db9f5ec",[],{"style":78,"_key":15364,"markDefs":15365,"children":15366,"_type":58},"48ca47647d4b",[],[15367],{"_type":56,"marks":15368,"text":15369,"_key":15370},[],"Finally, it is worth noting that the NIPE is a test that parents absolutely have the right to decline. It should always be offered, with an explanation of what it involves, but it is then up to parents to make an informed choice about if they want their baby to have this screening test or not.","49eb782eb67f",{"_key":15372,"markDefs":15373,"children":15377,"_type":58,"style":78},"0a10cdbbda79",[15374],{"_type":67,"_key":15375,"type":65,"url":15376},"7f9c728a7b27","https://www.gov.uk/government/publications/newborn-and-infant-physical-examination-programme-handbook/newborn-and-infant-physical-examination-screening-programme-handbook#nipe-screening-examination",[15378,15382,15385],{"_type":56,"marks":15379,"text":15380,"_key":15381},[],"Click ","55d9c1faed28",{"text":249,"_key":15383,"_type":56,"marks":15384},"9c44c6fbd248",[15375],{"_type":56,"marks":15386,"text":15387,"_key":15388},[]," for more information about the NIPE.","1a2f9fed8d21",{"children":15390,"_type":58,"style":59,"_key":15395,"markDefs":15396},[15391],{"marks":15392,"text":15393,"_key":15394,"_type":56},[],"Can You Have the Newborn Examination Done at Home?","431702221c23","d578c8208d87",[],{"style":78,"_key":15398,"markDefs":15399,"children":15400,"_type":58},"8cc7f27bf198",[],[15401],{"_key":15402,"_type":56,"marks":15403,"text":15404},"29f5fbcacff6",[],"Sophie is trained to undertake the NIPE and can do this at your home if you live in Kent. The NIPE will be offered to anyone who books with us for their pregnancy and birth care, but it can also be offered as a standalone appointment, for example if you have had a free birth or an NHS home birth.",{"children":15406,"_type":58,"style":78,"_key":15410,"markDefs":15411},[15407],{"text":525,"_key":15408,"_type":56,"marks":15409},"f4c6c9a1892e",[],"93e81fae4ee3",[],{"_type":190,"link":15413,"_key":15416},{"anchor":6795,"_type":67,"text":15414,"type":194,"internalLink":15415,"blank":192},"Book a NIPE",{"_ref":502,"_type":197},"3739decb1f9d",{"_type":586,"asset":15418},{"_ref":15419,"_type":197},"image-4ecbe0a2fd53c29ef47eed6406522cad00753b2d-1080x1350-jpg","2023-07-30",{"_createdAt":15422,"_type":37,"_updatedAt":15423,"content":15424,"title":15712,"publishedAt":15713,"_rev":15714,"_id":11829,"slug":15715,"image":15717,"_system":15720},"2025-04-07T15:17:06Z","2026-03-17T12:46:35Z",{"_type":49,"body":15425},[15426,15434,15442,15461,15469,15476,15481,15489,15497,15505,15547,15555,15573,15581,15597,15605,15613,15621,15629,15637,15645,15650,15658,15666,15674,15689,15702],{"markDefs":15427,"children":15428,"_type":58,"style":78,"_key":15433},[],[15429],{"marks":15430,"text":15431,"_key":15432,"_type":56},[],"Home birth is a safe option for many women, although figures from the ONS in 2020 show that only 2.4% of women in the UK had one.","e2a5d385076b","df54bccc3fb5",{"_key":15435,"markDefs":15436,"children":15437,"_type":58,"style":59},"33db03938627",[],[15438],{"_type":56,"marks":15439,"text":15440,"_key":15441},[],"What Do NICE Guidelines Say About the Safety of Home Birth?","fb758319b686",{"style":78,"_key":15443,"markDefs":15444,"children":15448,"_type":58},"0bb03f363315",[15445],{"url":15446,"_type":67,"_key":15447,"type":65},"https://www.nice.org.uk/guidance/cg190/chapter/recommendations#place-of-birth","9bf4658fd46f",[15449,15453,15457],{"marks":15450,"text":15451,"_key":15452,"_type":56},[],"The ","e496d72cfe3c",{"_type":56,"marks":15454,"text":15455,"_key":15456},[15447],"National Institute for Health and Clinical Excellence (NICE) guidelines","e091cc9e72d5",{"_key":15458,"_type":56,"marks":15459,"text":15460},"ddb5155ca42b",[]," in the UK say that home birth is safe for ‘low risk’ women, with uncomplicated pregnancies and the evidence supports this. ",{"style":59,"_key":15462,"markDefs":15463,"children":15464,"_type":58},"ba07bd6b796c",[],[15465],{"_type":56,"marks":15466,"text":15467,"_key":15468},[],"Is Home Birth Safe for High Risk Women?","cfc9e0882e4b",{"_type":58,"style":78,"_key":15470,"markDefs":15471,"children":15472},"20cec59f082a",[],[15473],{"marks":15474,"text":15475,"_key":15458,"_type":56},[],"There is also evidence to show that home birth and midwifery-led models of care result in good outcomes in women labelled ‘high risk’ – a reminder that it’s important to recognise that birthing women and people are more than the sum of their ‘risk factors’, which are often based on standardised guidelines. We shouldn’t be automatically excluding women with, for example, a BMI >40, an uncomplicated twin pregnancy or with breech babies on board from having home birth if they want to. What we do need to ensure is that these women have access to skilled professionals (if they want to engage with maternity care), who can support them to birth at home, with good hospital back up if needed, and crucially we need to collect the outcome data on these women, so the evidence can be updated. There are of course women who will be better off birthing in hospital, where there is access to the multidisciplinary team and specialist facilities. Ultimately, the decision on where to birth lies with the woman.",{"_key":15477,"_type":190,"link":15478},"c5689dcc5dc2",{"type":194,"internalLink":15479,"blank":192,"_type":67,"text":15480},{"_type":197,"_ref":196},"Homebirth Care with Us",{"children":15482,"_type":58,"style":59,"_key":15487,"markDefs":15488},[15483],{"_type":56,"marks":15484,"text":15485,"_key":15486},[],"What Factors Affect the Safety of a Home Birth?","5dc855429332","9dd50c9fcb18",[],{"_key":15490,"markDefs":15491,"children":15492,"_type":58,"style":78},"5a46df0bc793",[],[15493],{"_key":15494,"_type":56,"marks":15495,"text":15496},"9e1af3ed42ad",[],"The safety of home birth depends on various factors which can include, the overall health and wellbeing of the woman and baby, the competency and skills of the midwives attending the birth and access to emergency transfer if needed. Experienced midwives, who can both sit on their hands when birth is unfolding physiologically and anticipate and act quickly when complications arise are vital to ensuring homebirth is safe.",{"_key":15498,"markDefs":15499,"children":15500,"_type":58,"style":59},"067acd7f7a67",[],[15501],{"_type":56,"marks":15502,"text":15503,"_key":15504},[],"Is Home Birth Safe for First Time Mothers?","deb8db8bc25c",{"_key":15506,"markDefs":15507,"children":15510,"_type":58,"style":78},"6e24ba492a90",[15508],{"_type":67,"_key":15509,"type":65,"url":11143},"c8e7f0c1f03d",[15511,15515,15519,15523,15527,15531,15535,15539,15543],{"text":15512,"_key":15513,"_type":56,"marks":15514},"The NICE guidelines further state that for women with uncomplicated pregnancies, who have birthed before, planning to give birth at home or in a midwife-led unit is ","79f505bcdd87",[],{"text":15516,"_key":15517,"_type":56,"marks":15518},"as safe as hospital birth for the baby","ae0ae9d99bce",[108],{"_type":56,"marks":15520,"text":15521,"_key":15522},[]," and can have ","698786c2c22e",{"text":15524,"_key":15525,"_type":56,"marks":15526},"several benefits for the mother","25a50743dfe6",[108],{"_type":56,"marks":15528,"text":15529,"_key":15530},[],". NICE maternity guidelines generally look at short-term outcomes for babies, for example, admission to neonatal units or neonatal mortality (death) rather than the long-term health and wellbeing of women and babies. For first time birthing women who are ‘low risk’, NICE continues to recommend that a midwife-led unit is the most suitable place to birth, as the 2011 Birthplace study demonstrated an increased rate in adverse outcomes for these babies. In contrast, more ","dfb8da9c5900",{"_type":56,"marks":15532,"text":15533,"_key":15534},[15509],"recent evidence","1791e4f67669",{"text":15536,"_key":15537,"_type":56,"marks":15538}," published in the Lancet in 2019 has shown there to be ","6467dd231a8d",[],{"_key":15540,"_type":56,"marks":15541,"text":15542},"68b34616fe41",[108],"no difference in outcomes",{"marks":15544,"text":15545,"_key":15546,"_type":56},[]," for babies whether they are born at home or in hospital, even if they’re a first baby.","dffd6ba367f8",{"children":15548,"_type":58,"style":59,"_key":15553,"markDefs":15554},[15549],{"_key":15550,"_type":56,"marks":15551,"text":15552},"88396787339e",[],"What Are the Benefits of Home Birth? 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It’s pretty magical.",{"_type":190,"link":15646,"_key":15649},{"type":194,"internalLink":15647,"blank":192,"_type":67,"text":15648},{"_ref":549,"_type":197},"Book Your Intro Chat","3a932bf92a23",{"markDefs":15651,"children":15652,"_type":58,"style":59,"_key":15657},[],[15653],{"marks":15654,"text":15655,"_key":15656,"_type":56},[],"How to Find Out More About Home Birth in Kent","0e6fdf331e20","287571bd3b14",{"markDefs":15659,"children":15660,"_type":58,"style":78,"_key":15665},[],[15661],{"_type":56,"marks":15662,"text":15663,"_key":15664},[],"Local home birth circles are a great place to learn more about home birth, meet people who’ve had one and hear birth stories – they are run all over the UK. Locally, Folkey Birth Club host birth circles in Folkestone and Riding the Waves host circles in Deal. 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Understanding what to expect, what your options and rights are and what maternity services look like in your area, can help you to make informed decisions about your care during pregnancy and birth. This can help you to labour and birth with confidence. Check out our other blog post, ",{"_type":56,"marks":15746,"text":15747,"_key":15748},[15738],"‘Am I allowed...?’.","632ddaf17a5a",{"markDefs":15750,"children":15751,"_type":58,"style":59,"_key":15756},[],[15752],{"text":15753,"_key":15754,"_type":56,"marks":15755},"Preparing for Birth and Beyond","3cd3459176d6",[],"8513bf346c80",{"children":15758,"_type":58,"style":78,"_key":15763,"markDefs":15764},[15759],{"_key":15760,"_type":56,"marks":15761,"text":15762},"a5642f6c328f",[],"You and your birth partner(s) can learn specific techniques to support your labour – think: breathing techniques, positions to adopt during labour and massage to name a few. 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Antenatal classes can demonstrate to birth partners the many ways they can provide vital support and advocacy during the birth experience.","920b5596a203",[],"a10f5ae0fab3",[],{"children":15782,"_type":58,"style":59,"_key":15787,"markDefs":15788},[15783],{"marks":15784,"text":15785,"_key":15786,"_type":56},[],"Building Your Support Network Before Baby Arrives","0fd76aedeadb","e28040ac9f84",[],{"markDefs":15790,"children":15791,"_type":58,"style":78,"_key":15796},[],[15792],{"marks":15793,"text":15794,"_key":15795,"_type":56},[],"You get to meet other expectant parents who are going through a similar experience, which provides the opportunity to form new social support networks and friendships. Sharing questions and concerns with others can provide reassurance – you’re not alone in this experience. This networking can be invaluable in the early days of parenthood – and who knows, you may make lifelong friends!","cf119758b329","bbe64697faa4",{"markDefs":15798,"children":15799,"_type":58,"style":59,"_key":15804},[],[15800],{"_type":56,"marks":15801,"text":15802,"_key":15803},[],"Access to Experienced Birth Workers and Local Resources","e2cf4e768b1e","c26187f4fd86",{"_key":15806,"markDefs":15807,"children":15808,"_type":58,"style":78},"11d49f7e5cc5",[],[15809],{"_type":56,"marks":15810,"text":15811,"_key":15812},[],"Classes are often run by midwives, or other birth workers who can provide advice on support services in the area (e.g. breastfeeding support), local maternity units and alternative options. They often have a lot of maternity care experience and can help you navigate your pregnancy journey. 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One way of getting to learn about your body is through exercise. Exercise in pregnancy has long been pushed aside as the pregnant body, or rather the baby growing inside you, is deemed too ‘fragile’ for exercise! This is not evidence-based advice, and you wouldn’t be alone if you told me you were advised by your midwife, obstetrician or perhaps more likely…family, to not exercise during pregnancy. Equally you will find images of heavily pregnant women lifting weights and running ultra marathons on social media. With these conflicting ideas you may be asking yourself what do I do with all this information?","91170469ae28","1b7604aa36d0",{"_type":58,"style":59,"_key":15973,"markDefs":15974,"children":15975},"65caa8730e5a",[],[15976],{"_type":56,"marks":15977,"text":15978,"_key":15979},[],"What Are the Benefits of Exercise in Pregnancy?","3031071645a8",{"markDefs":15981,"children":15982,"_type":58,"style":78,"_key":15987},[],[15983],{"marks":15984,"text":15985,"_key":15986,"_type":56},[],"What the evidence about exercise does show, in and out of pregnancy, is that the physical and mental health benefits are huge. Evidence has shown exercise can significantly reduce your risk of diseases, like heart disease and diabetes. It can strengthen muscles and bones, improving movement in pregnancy. 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It could mean taking the stairs at work instead of the lift. Parking your car further away from the shops so you can walk that extra distance. Equally, a kitchen disco could give you that boost of endorphins and get you moving without even leaving the house! Or it might mean some quality time with the family on a walk in the countryside. There is a lot of evidence about the benefits of movement in green and blue spaces for all the family, so now could be the time to take advantage of your surroundings. 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Everything You Need to Know",{"_type":49,"body":16123},[16124,16131,16139,16147,16151,16159,16174,16182,16190,16198,16215,16219,16227,16252,16260,16268,16272,16280],{"_key":16125,"markDefs":16126,"children":16127,"_type":58,"style":78},"438ea5b8253d",[],[16128],{"_key":16129,"_type":56,"marks":16130,"text":525},"3df7cad97a77",[],{"markDefs":16132,"children":16133,"_type":58,"style":59,"_key":16138},[],[16134],{"marks":16135,"text":16136,"_key":16137,"_type":56},[],"What Is an Independent Midwife and How Are They Qualified?","7bd7b37213b9","9c92ff27017d",{"_key":16140,"markDefs":16141,"children":16142,"_type":58,"style":78},"0742b459d7b0",[],[16143],{"_key":16144,"_type":56,"marks":16145,"text":16146},"54b5f0800854",[],"An independent midwife (IM) is a self-employed, qualified and registered midwife who has chosen to work outside of the NHS. IMs have done the same university degree as NHS midwives and are registered with the Nursing & Midwifery Council (NMC). Many will have worked within the NHS at some point during their career, but some go straight into independent midwifery after qualifying. IMs may choose to offer antenatal, labour & birth and postnatal care – they can offer these services individually or offer the full scope of pregnancy care. Women and birthing people can book with an IM from the moment they find out they’re pregnant or they can book part way into their pregnancy.",{"_key":16148,"_type":190,"link":16149},"0bcf26fccd0b",{"_type":67,"text":193,"type":194,"internalLink":16150,"blank":192},{"_ref":196,"_type":197},{"_key":16152,"markDefs":16153,"children":16154,"_type":58,"style":59},"213a82afc805",[],[16155],{"marks":16156,"text":16157,"_key":16158,"_type":56},[],"\nWhy Do People Choose an Independent Midwife in Kent?","9a25941eb7d4",{"children":16160,"_type":58,"style":78,"_key":16172,"markDefs":16173},[16161,16165,16168],{"_key":16162,"_type":56,"marks":16163,"text":16164},"851a71c08b6f",[],"Some people choose to book an IM because they want the same, trusted midwife throughout their pregnancy and birth journey. Some choose it because they want to have a homebirth and their local NHS maternity unit doesn’t offer this service or staff shortages make it difficult to ensure a midwife would be able to go out to them at home. Some people have had a previous traumatic birth experience in the hospital system and choose to birth out of the system for subsequent births. Some people wish to have care that is considered ‘outside of guidelines’ and don’t feel supported by their maternity team in their choices, so choose to find an IM who ",{"_type":56,"marks":16166,"text":10797,"_key":16167},[281],"184f30095c10",{"_key":16169,"_type":56,"marks":16170,"text":16171},"1e418529914e",[]," support their choices. There are many reasons why people choose an IM!","a15b17ed7900",[],{"_type":58,"style":59,"_key":16175,"markDefs":16176,"children":16177},"a6bd005cfc6f",[],[16178],{"_key":16179,"_type":56,"marks":16180,"text":16181},"bd6a353feff6",[],"Can You Still Access NHS Services If You Hire an Independent Midwife?",{"style":78,"_key":16183,"markDefs":16184,"children":16185,"_type":58},"edef8637bf8f",[],[16186],{"_type":56,"marks":16187,"text":16188,"_key":16189},[],"Choosing an IM does not exclude people from NHS care if they want or need it. IMs have the same referral rights as NHS midwives, this means that if they need to, they can refer you to members of the multidisciplinary team within the NHS (e.g. an obstetric doctor, an anaesthetist, a consultant midwife, a neonatal doctor). If an IM has concerns about a woman or baby’s wellbeing, they’ll discuss this with them and make the appropriate recommendation – this could be to attend the local maternity triage or having a review with an obstetrician. It is ultimately the woman or birthing person’s choice if they wish to follow any recommendations made.","29f33aaf8c61",{"children":16191,"_type":58,"style":59,"_key":16196,"markDefs":16197},[16192],{"_type":56,"marks":16193,"text":16194,"_key":16195},[],"How Does Independent Midwife Insurance Work?","8fb54728f11c","8ef6a5cdc92c",[],{"style":78,"_key":16199,"markDefs":16200,"children":16203,"_type":58},"874f7f99a57b",[16201],{"_type":67,"_key":16202,"type":65,"url":1082},"f7a70c43c9a6",[16204,16208,16211],{"_key":16205,"_type":56,"marks":16206,"text":16207},"2cf2af854645",[],"It is a legal requirement for midwives to have indemnity insurance for their practice. For NHS midwives, this insurance is covered by the hospital they work in. IMs are required to access this insurance individually. Until last summer, there was only one insurance option available for IMs who wanted to provide the full scope of midwifery care, including labour care. There is now a new indemnity insurance product on the market, thanks to ",{"marks":16209,"text":14970,"_key":16210,"_type":56},[16202],"3811438ab58c",{"_key":16212,"_type":56,"marks":16213,"text":16214},"8d6bfd743fb2",[]," – which is fabulous news for independent midwives and women and birthing people. ",{"_type":190,"link":16216,"_key":16218},{"blank":192,"_type":67,"text":9,"type":194,"internalLink":16217},{"_ref":1831,"_type":197},"a6bd3ce956bc",{"children":16220,"_type":58,"style":59,"_key":16225,"markDefs":16226},[16221],{"_type":56,"marks":16222,"text":16223,"_key":16224},[],"\nWhat Are the Benefits of Hiring an Independent Midwife?","ed861450e6ee","77e2f4c7910b",[],{"_key":16228,"markDefs":16229,"children":16232,"_type":58,"style":78},"51197fed4034",[16230],{"_type":67,"_key":16231,"type":65,"url":851},"d35c82569f70",[16233,16237,16240,16244,16248],{"text":16234,"_key":16235,"_type":56,"marks":16236},"Independent midwifery is not above the law – all midwives are regulated and must abide by the ","62fea99e9cda",[],{"_key":16238,"_type":56,"marks":16239,"text":868},"91d4dbd5fdbd",[16231],{"_type":56,"marks":16241,"text":16242,"_key":16243},[],". IMs, however, are not bound by hospital policies or appointment times – which means they have the time to provide truly individualised care. It is a way of working that allows midwives to truly be ‘with woman’ (the definition of the word ‘midwife’), to build trusting relationships that result in excellent outcomes for women, birthing people, and babies. Choosing to have an IM is an investment – the way someone is treated and cared for during pregnancy, birth and the postnatal period can have enduring effects on the wellbeing of them and their baby. Choosing an IM gives people a greater chance of that effect being a positive one. Pregnancy is special and sacred, and women and birthing people deserve to be treated as such. The dream is that one day, ","480d388e8011",{"_type":56,"marks":16245,"text":16246,"_key":16247},[108],"everyone ","6281cf3d2b26",{"_type":56,"marks":16249,"text":16250,"_key":16251},[],"will be able access the type of care that independent midwifery care offers. 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","a08bff206c68","7e789e07f2e2",[],{"_key":16269,"_type":190,"link":16270},"a6257e5b1c06",{"_type":67,"text":15648,"type":194,"internalLink":16271,"blank":192},{"_ref":549,"_type":197},{"style":59,"_key":16273,"markDefs":16274,"children":16275,"_type":58},"8a15f261ff93",[],[16276],{"_type":56,"marks":16277,"text":16278,"_key":16279},[],"Further reading","0de9bc9685d2",{"markDefs":16281,"children":16285,"_type":58,"style":78,"_key":16297},[16282],{"_type":67,"_key":16283,"type":65,"url":16284},"0f995900ed82","https://www.all4maternity.com/independent-midwifery-is-back/",[16286,16290,16293],{"text":16287,"_key":16288,"_type":56,"marks":16289},"‘Independent Midwifery is Back!’","2c4374788dde",[281,16283],{"_type":56,"marks":16291,"text":4274,"_key":16292},[],"529c5baf2831",{"text":16294,"_key":16295,"_type":56,"marks":16296},"Sarah Fitzsimmons, 2022","1ceeb5a90691",[108],"d4095fd08aa8","2025-04-07T15:12:27Z","lTiZ7ejil6ZSBCJHGJNDP6","2026-03-17T13:04:34Z",{"base":16302},{"rev":16303,"id":11455},"lFrvlEMldmWjsfq3cYnWBs",{"title":16305,"slug":16306,"_system":16308,"_type":37,"_id":16310,"_updatedAt":16312,"_rev":16313,"publishedAt":16314,"_createdAt":16315,"content":16316,"image":16580}," Continuity of Care in Midwifery: Why It Matters and How Independent Midwifery Delivers It",{"current":16307,"_type":8},"continuity-of-care-in-midwifery-why-it-matters-and-how-independent-midwifery-delivers-it",{"base":16309},{"id":16310,"rev":16311},"79b2c13b-793a-4033-9879-6838cba9140f","lFrvlEMldmWjsfq3cYp3XK","2026-03-17T13:07:54Z","A1BL058D1L1LG4bFNGTGAS","2023-04-26","2025-04-07T15:11:54Z",{"_type":49,"body":16317},[16318,16326,16370,16378,16382,16390,16398,16406,16420,16428,16436,16444,16452,16470,16478,16486,16494,16502,16521,16529,16537,16545,16573],{"children":16319,"_type":58,"style":59,"_key":16324,"markDefs":16325},[16320],{"_key":16321,"_type":56,"marks":16322,"text":16323},"30e0719c7426",[],"A Brief History of Midwifery and Continuity of Care","728a087769d5",[],{"_key":16327,"markDefs":16328,"children":16334,"_type":58,"style":78},"ca14533e693f",[16329,16332],{"internalLink":16330,"_type":67,"_key":16331,"type":194},{"_ref":11738,"_type":197},"e7feee5a6aa3",{"_key":16333,"type":65,"url":3492,"_type":67},"cad18616a300",[16335,16339,16343,16347,16351,16355,16359,16363,16366],{"text":16336,"_key":16337,"_type":56,"marks":16338},"Women have been supporting other women during birth for millennia. The history of midwifery is an interesting and complicated one. Before midwifery became a regulated profession in the UK in the early 1900s, most midwives could be considered to have been ‘independent’ – that is they were self-employed, and women sought their services to assist at births and during the postnatal period. Most births occurred in the ","3ba1c0e699cf",[],{"_type":56,"marks":16340,"text":16341,"_key":16342},[16331],"home","a34643aa4b6a",{"text":16344,"_key":16345,"_type":56,"marks":16346},". Birth in the UK began to shift to the hospital for more women in the late 1940s, and by the 1970s it was recommended that ","95114c7dba57",[],{"_type":56,"marks":16348,"text":16349,"_key":16350},[281],"all ","7cb28418b775",{"text":16352,"_key":16353,"_type":56,"marks":16354},"women birth in the hospital. It is important to note that this was not based on scientific evidence, rather a belief that birth in hospital ","15d1b72ed416",[],{"text":16356,"_key":16357,"_type":56,"marks":16358},"must","f91a616ac27c",[281],{"_key":16360,"_type":56,"marks":16361,"text":16362},"974adc7ebe12",[]," be safer for all women – more ",{"text":15533,"_key":16364,"_type":56,"marks":16365},"5a41673416fa",[16333],{"text":16367,"_key":16368,"_type":56,"marks":16369}," has disputed this belief. As a result of this shift, maternity care became centralised and fragmented, with care provided in hospitals and clinics rather than in women’s homes.","f4d062c0f999",[],{"_type":58,"style":78,"_key":16371,"markDefs":16372,"children":16373},"c1c71d230c5b",[],[16374],{"_key":16375,"_type":56,"marks":16376,"text":16377},"1f608c1b9392",[],"Most women and birthing people today are not cared for by the same midwife throughout their pregnancy or for their birth. Julia Allinson wrote a great book documenting midwifery from the Tudors to the 21st Century – a must read for anyone interested in the history of midwifery.",{"link":16379,"_key":16381,"_type":190},{"text":193,"type":194,"internalLink":16380,"blank":192,"_type":67},{"_ref":196,"_type":197},"d95f11b27d4a",{"_key":16383,"markDefs":16384,"children":16385,"_type":58,"style":59},"96f6b274d304",[],[16386],{"marks":16387,"text":16388,"_key":16389,"_type":56},[],"What Is Continuity of Care in Midwifery?","491549f101b5",{"markDefs":16391,"children":16392,"_type":58,"style":78,"_key":16397},[],[16393],{"_type":56,"marks":16394,"text":16395,"_key":16396},[],"Central to independent midwifery, is the continuity of care model, whereby women see the same midwife throughout their pregnancy and birth journey and during the postnatal period. Continuity of care is a key component of good quality midwifery care. It has been shown to result in better, or at least as good, outcomes for women and babies and in higher levels of satisfaction with care amongst women. ","34420dfb8d09","4a468b29e5c4",{"markDefs":16399,"children":16400,"_type":58,"style":59,"_key":16405},[],[16401],{"_type":56,"marks":16402,"text":16403,"_key":16404},[],"What Are the Benefits of Continuity of Care for Women and Babies?","e1ac60728e7a","d2c72cd6e43d",{"style":78,"_key":16407,"markDefs":16408,"children":16412,"_type":58},"5b68f441d8e8",[16409],{"url":16410,"_type":67,"_key":16411,"type":65},"https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004667.pub5/full","eec76abde9c5",[16413,16416],{"text":891,"_key":16414,"_type":56,"marks":16415},"337bbfeabb15",[16411],{"_key":16417,"_type":56,"marks":16418,"text":16419},"47ebbef1cf15",[]," has found several benefits of the continuity of care model for ‘low-risk’ women including: ",{"_type":58,"style":78,"_key":16421,"listItem":914,"markDefs":16422,"children":16423,"level":921},"7ba57bf8b979",[],[16424],{"_key":16425,"_type":56,"marks":16426,"text":16427},"209d01d9320a",[],"more likely to have a spontaneous vaginal birth",{"children":16429,"level":921,"_type":58,"style":78,"_key":16434,"listItem":914,"markDefs":16435},[16430],{"marks":16431,"text":16432,"_key":16433,"_type":56},[],"women were less likely to need regional anaesthesia (i.e. an epidural)","31e961fcde27","f341bd8d4fd0",[],{"style":78,"_key":16437,"listItem":914,"markDefs":16438,"children":16439,"level":921,"_type":58},"f2b21e58cbfc",[],[16440],{"marks":16441,"text":16442,"_key":16443,"_type":56},[],"fewer instrumental assisted vaginal births","a22e8599fe10",{"listItem":914,"markDefs":16445,"children":16446,"level":921,"_type":58,"style":78,"_key":16451},[],[16447],{"_type":56,"marks":16448,"text":16449,"_key":16450},[],"higher satisfaction with birth experience","422f8f8f82a7","9a7ddd0f5196",{"style":78,"_key":16453,"markDefs":16454,"children":16458,"_type":58},"5c5997381a3c",[16455],{"_type":67,"_key":16456,"type":65,"url":16457},"023ec0140b2c","https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021789/",[16459,16463,16466],{"_type":56,"marks":16460,"text":16461,"_key":16462},[],"In addition, ","213a53834c23",{"_key":16464,"_type":56,"marks":16465,"text":3132},"7cc5f3a96f2f",[16456],{"_type":56,"marks":16467,"text":16468,"_key":16469},[]," has shown than for women at ‘low’ or ‘mixed risk’ of complications continuity of care, when compared to other models of care, is associated with the following:","e81cb5150aca",{"listItem":914,"markDefs":16471,"children":16472,"level":921,"_type":58,"style":78,"_key":16477},[],[16473],{"_type":56,"marks":16474,"text":16475,"_key":16476},[],"lower rates of preterm birth","68d0eb0ecb08","15340ebc107f",{"listItem":914,"markDefs":16479,"children":16480,"level":921,"_type":58,"style":78,"_key":16485},[],[16481],{"_type":56,"marks":16482,"text":16483,"_key":16484},[],"lower rates of losing a baby before or after 24 weeks","c0bd467fff6f","fc1dbb2e16c2",{"markDefs":16487,"children":16488,"level":921,"_type":58,"style":78,"_key":16493,"listItem":914},[],[16489],{"_type":56,"marks":16490,"text":16491,"_key":16492},[],"lower rates of neonatal death","61fad3fdda48","04cae686d195",{"markDefs":16495,"children":16496,"_type":58,"style":59,"_key":16501},[],[16497],{"marks":16498,"text":16499,"_key":16500,"_type":56},[],"Does Continuity of Care Benefit Midwives Too?","9e7e339027f5","ec40f05ec6b5",{"_type":58,"style":78,"_key":16503,"markDefs":16504,"children":16508},"f0fd1daa36b4",[16505],{"_type":67,"_key":16506,"type":65,"url":16507},"34eb7e74792c","https://pubmed.ncbi.nlm.nih.gov/28697882/",[16509,16513,16517],{"_type":56,"marks":16510,"text":16511,"_key":16512},[],"Continuity of care models have also been found to be beneficial to midwives, with one ","3336b50b7ccc",{"marks":16514,"text":16515,"_key":16516,"_type":56},[16506],"research study","e192155f3e0e",{"_key":16518,"_type":56,"marks":16519,"text":16520},"4bd8ca453cf0",[]," finding that midwives providing fragmented, shift-based care are at greater risk of psychological distress. Continuity of care models allow midwives to develop meaningful relationships with the women in their care, relationships that are based on trust and mutual respect. Our own personal experience of providing continuity of care has been a joyful one, we leaving appointments feeling satisfied that we have provided excellent care and information and have received extremely positive feedback from our clients.",{"_key":16522,"markDefs":16523,"children":16524,"_type":58,"style":59},"cca505526221",[],[16525],{"_type":56,"marks":16526,"text":16527,"_key":16528},[],"How Does Continuity of Care Work With an Independent Midwife?","5f6e28d4473b",{"children":16530,"_type":58,"style":78,"_key":16535,"markDefs":16536},[16531],{"text":16532,"_key":16533,"_type":56,"marks":16534},"In the context of independent midwifery, continuity of care means that you see the same midwife (and hopefully meet her ‘buddy’ midwife at some point) for all your care. Appointments are not restricted to NHS time frames (which typically only allow 20 minutes for an appointment) and can take place in your own home at a time that suits you, your family, and your midwife. 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found out we were expecting twins when I was 21 weeks pregnant, at the anomaly scan. I had declined the 12-week scan and had chosen not to book my pregnancy care with the NHS at that point. Twins were not on our radar so to say we were surprised is an understatement! I’d always known I would plan a home birth if I had a baby and decided I would stick with planning a home birth with my twins, if I was well, and they were well. Natasha was my midwife throughout my pregnancy, although I did a lot of self-midwifing too! I booked with the NHS at around 23 weeks as I wanted to be in their system in case the twins decided to come early.","63acde60315c","f5868b4cf6fe",[],{"markDefs":17367,"children":17368,"_type":58,"style":78,"_key":17373},[],[17369],{"text":17370,"_key":17371,"_type":56,"marks":17372},"My pregnancy was plain sailing up until about 40 weeks when I developed pre-eclampsia. I had high blood pressure and protein in my urine but otherwise felt well. I started on antihypertensive medicine which helped to bring the blood pressure down slightly. I declined induction of labour at this point as I felt confident that the babies were well and wanted to monitor the pre-eclampsia instead.","285a25570703",[],"1fb6246ef4c0",{"markDefs":17375,"children":17376,"_type":58,"style":78,"_key":17381},[],[17377],{"_type":56,"marks":17378,"text":17379,"_key":17380},[],"At 40+6 I went into labour after watching the Olympics on TV all afternoon (plenty of feel-good hormones going around!). My labour felt like it started thick and fast, I recall texting Natasha asking if I was being a wuss as I didn’t feel like I’d been contracting for very long, but they were very strong. I put the TENS on and was mobilising around as much as I could, although I’d developed pelvic pain in the final few weeks of pregnancy so moving was very painful. Pretty soon I asked Sam to fill the pool up – hoping the water would provide relief. I got into the pool and it did feel nice, although contractions continued to come one on top of the other. I asked Sam to call Natasha at this point.","bd60673296d7","cd60bcd9ce86",{"markDefs":17383,"children":17384,"_type":58,"style":78,"_key":17389},[],[17385],{"_type":56,"marks":17386,"text":17387,"_key":17388},[],"Natasha arrived and I was relieved to see her. I declined any monitoring of myself or the babies. The babies were very wriggly, so I had no concerns about their well-being. Contractions continued to come back-to-back with very little respite, but I knew birth wasn’t close. I asked for a vaginal examination – I’d attempted a self-examination prior to this but my bump was so huge and the first baby’s head still high in my pelvis that I couldn’t feel a thing. I wanted to know what my cervix was up to and where the first baby was in my pelvis to try and make sense of the mega contractions I was having. My cervix was 2cm dilated and the baby’s head was at ‘spines’ in my pelvis. I got back in the pool and after a small lull in contractions, they came back in full force – long, strong and back-to-back. I was vomiting a lot and peeing became increasingly difficult – sitting on the toilet was excruciating and I would have a very long contraction every time I tried. 5 or so hours after my previous vaginal examination, I requested another – at this point I wanted to make a decision about whether to stay at home or transfer to hospital for pain relief and because a couple of things just felt ‘off’. Again, I didn’t feel like the birth was imminent…but my contractions were relentless, and I knew that the vomiting and being unable to pee were not the best signs! This time my cervix was 4cm dilated and the baby was in the same position. I decided to transfer to hospital for an epidural as I did not feel I was about to have the babies imminently and the hours of intense, long and very regular contractions was taking its toll on me. Natasha called the hospital to let them know we were coming in and then we drove in. As this wasn’t an emergency transfer, we chose to drive as an ambulance transfer was going to take 2 hours.","1476cb741fd3","3d1409d68fcd",{"markDefs":17391,"children":17392,"_type":58,"style":78,"_key":17397},[],[17393],{"_type":56,"marks":17394,"text":17395,"_key":17396},[],"On arriving at the hospital, I was immediately put in a room on labour ward and assigned a midwife. After having a cannula sited, a scan to determine the positions of the babies and a CTG commenced…I had the epidural. I started feeling pain relief soon after this. The scan showed that the second twin, who had been head down all pregnancy, had flipped to being in the breech position – which was a surprise as I was amazed he had any space to do such a big move! I had a good chat with the consultant about my birth plan and what I did and didn’t want – it felt like a respectful discussion and at no point did I feel like I was being pushed into one thing or another. When I was comfortable, we sent Natasha home to get some rest as she had been up all night with us and I felt like I was in good hands with the team who were on shift at the hospital that day.","2304da815752","ef5b5e38898e",{"children":17399,"_type":58,"style":78,"_key":17404,"markDefs":17405},[17400],{"_key":17401,"_type":56,"marks":17402,"text":17403},"4e9877d973e1",[],"At my next examination, which I’d requested to be later than the routine 4 hours after my previous one, my cervix was 8cm dilated. Contractions were still coming regularly without any need for the hormone drip (this can often follow an epidural!), and the babies were happy. At the next examination my cervix was 9cm dilated and the first baby was still at ‘spines’. I asked for the waters of the first twin to be broken as I wanted an FSE clip put on to monitor their heartbeat. Prior to this, monitoring was only possible in one very specific position on my abdomen, which meant changing position was difficult as we kept losing contact. Upon breaking my waters, there was thick meconium – which didn’t faze me as I was 41 weeks and knew my babies were happy because of all the movements. After the FSE was applied I was able to lie on my side and use a peanut ball – I was trying to encourage the first twin to rotate and descend!","ad223aee028a",[],{"_type":58,"style":78,"_key":17407,"markDefs":17408,"children":17409},"a97911b80b45",[],[17410],{"_type":56,"marks":17411,"text":17412,"_key":17413},[],"My epidural started to become ineffective at some point and I had a lot of breakthrough pain, which after having pain relief for several hours, was rather unpleasant. After breaking the waters I also started to feel lots of pressure in my bottom. This felt quite exciting (although I had sent Sam home to grab some bits…whoops!) as it was the first time I’d felt like the babies might be close. This sensation went on for an hour or so and I had another examination, which confirmed my cervix was fully dilated…but I knew immediately that the first twin was still in the same position in my pelvis. I remember saying to the midwife something along the lines of, ‘the baby’s not just sitting there, your fingers have gone too far!’. I think at this point my body was trying its best to turn the first baby into a more favourable position.","ec3f39c2053f",{"markDefs":17415,"children":17416,"_type":58,"style":78,"_key":17421},[],[17417],{"_key":17418,"_type":56,"marks":17419,"text":17420},"84b81a00dbd6",[],"After this the epidural wore off completely and I had to have it re-sited, which was also unsuccessful, so the anaesthetist gave me a combined spinal-epidural (CSE) and that provided some relief. I met the nighttime consultant and discussed my birth plan with him – again, I felt respected in my decisions. I then started pushing and did so for an hour or so – the CSE was providing pain relief, but I was still fully mobile, so I was able to get into lots of different positions for pushing. Although the monitoring of the babies’ heartbeats kept losing contact, which was annoying probably more so for my midwives, but I never once worried about their well-being during labour. The CSE started to wear off and I was getting nasty breakthrough pain after an hour or so of pushing. At this point I was reviewed by the consultant again and he examined me. We discussed having an instrumental assisted birth, which I felt was what needed to happen at this point. The first twin was in exactly the same position he’d been in since the start of the labour. I was asked where I wanted the instrumental birth to happen, and I requested theatre (I think to the relief of the doctor…!) as I wanted proper pain relief given that mine had worn off. There was a short delay in getting there as the theatre was busy, during which time I was huffing on gas and air as the CSE faded away.","1d528f2116d9",{"children":17423,"_type":58,"style":78,"_key":17428,"markDefs":17429},[17424],{"text":17425,"_key":17426,"_type":56,"marks":17427},"When we got to theatre, I had a spinal sited and felt true relief as I went completely numb from the waist down. The midwives kept me informed of what was happening at each stage – I requested this as despite being numb, I strongly believe that we should know what’s happening to our bodies in theatre! I also requested my head be raised so I could see the doctor more clearly – my midwife brain was very much engaged. A ventouse was attempted but after a few pulls, the consultant said it wasn’t going to work. He asked at that point if I wanted him to try forceps (which he was confident he could do) or if I wanted a caesarean section. I said I would rather attempt a vaginal birth than have a caesarean…even though I knew this would mean having an episiotomy – something I had reiterated that I really did not want unless absolutely necessary. I said that I accepted that I would need an episiotomy in this scenario and remember thinking what a bummer it would be if the second twin then needed to be born via caesarean section..!","a16f01b2febf",[],"3033985d8f61",[],{"markDefs":17431,"children":17432,"_type":58,"style":78,"_key":17437},[],[17433],{"_type":56,"marks":17434,"text":17435,"_key":17436},[],"So, the first twin, Finn, was born via forceps and placed onto my abdomen skin-to-skin, where me and my midwife provided some gentle stimulation as he was a little surprised to be born. His cord was quite short and after about 4 minutes, it was clamped and cut. Then, 22 minutes later, the second twin, River, was born also with the help of forceps. River had flipped himself head down following the birth of Finn – there had been no scanning or stabilising, he’d just done it himself. Pushing with a spinal is the weirdest feeling – you really don’t feel like you’re doing anything, but you get told that you are and, in my case, have a team of friendly theatre staff all rooting for you. River also was placed skin-to-skin and had about 3 minutes before his cord was clamped and cut. Then my two, good sized babies were on my chest! Wild.","becb0300167b","91646a53fed6",{"_key":17439,"markDefs":17440,"children":17441,"_type":58,"style":78},"da662d4d7254",[],[17442],{"_type":56,"marks":17443,"text":17444,"_key":17445},[],"I was bleeding from my episiotomy, and I recall looking over at the suction bottle, seeing it rather full of my blood, and calmly asking the anaesthetist if I was having a post-partum haemorrhage…to which he calmly replied, ‘yes, and we’re just going to give you some blood if that’s okay!’. After my episiotomy had been sutured and we left theatre, the midwives said they could weigh and check the babies later after more skin-to-skin. At this point I requested they quickly be weighed before returning for skin-to-skin as I was too curious to know their weights. Both were just over 4kg each – I knew they weren’t going to be small, but I was amazed (and so was everyone else I think) that I’d grown twins that size!","e96fade80749",{"markDefs":17447,"children":17448,"_type":58,"style":78,"_key":17453},[],[17449],{"marks":17450,"text":17451,"_key":17452,"_type":56},[],"So, my birth did not go according to my plan A. I had pictured a home waterbirth and instead had a forceps birth in theatre, with an episiotomy and a PPH…oh and a dash of transient kidney damage in there too. I absolutely would have preferred them to have been born at home, in a slightly more straightforward manner, but that is not my birth story this time. What surprised me the most is how good I felt about my birth experience despite it being so off plan. It’s the type of birth that possibly looks ‘traumatic’ on paper, but that is not how I experienced it at all. 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