This high-tech replacement for the ear trumpet is used to track the baby's heartbeat. Electronic fetal monitoring (EFM) will be used routinely in all cases of high-risk pregnancies, but most mothers and babies don't require it. You will have EFM if you are being induced or your labour is being accelerated for any reason, or if you have opted for epidural anaesthesia. Its main function is to give warning of fetal distress. If your doctors decide that you and your baby would be better off with EFM, try to see it as a source of reassurance. You can watch your ...

The most common reasons for deciding to have a Caesarean include the baby's head being too large to pass through your pelvis, the baby being in a breech position or lying across your pelvis; placenta praevia (where the placenta has implanted near or over the cervix); and certain medical conditions such as diabetes or AIDS. It may also be necessary if you have previously had a Caesarean. This was once thought essential, because it was feared that the scar of the previous Caesarean section would open up during labor. But experience has shown that this does not happen with the horizontal ...

Its important to master your chosen pain relief method, and familiarize your birth assistant with the technique, before you go into labour. If special equipment is required, make sure it is available at home or in hospital. One method alone may not be enough - you may need a combination for complete relief. Positions Walking around, leaning against your partner or the wall, and rocking your pelvis will probably feel much more comfortable than lying on your back in bed. There are also certain positions that you will find more comfortable than others, because these will relieve the pressure on your back. Massage This ...

When you arrive at the hospital, the midwife will prepare you for the birth. There are certain routine examinations that you will have to undergo. While consulting your notes, the midwife will ask you questions about your labours progress — whether your waters have broken and how often your contractions are coming. You will be asked to undress and put on a hospital gown or your own T-shirt or nightdress. You will then be examined; the midwife will palpate your abdomen to feel the baby's position; she will listen to the fetal heartbeat, take your blood pressure, pulse and temperature and give you ...

Although fetal monitoring may confine you to bed, lying on your back for delivery can have many disadvantages: - you have to work harder pushing the baby uphill; - pain may be greater in this position than in a vertical one; - the tissues of the birth canal may be slow to open and be stimulated by the descending baby, thus possibly prolonging labour; - there is a greater need for an episiotomy; - there may be an increased chance of a forceps delivery; - it inhibits spontaneous delivery of the placenta; - there is a greater possibility of lower back strain. Slow Deliveries What is considered to be ...

Some types of pain relief will only be available in large or teaching hospitals, others are widely available in all hospitals. Your midwife will also be able to offer you certain types during a home delivery. Regional anaesthetics These remove sensation from part of your body by blocking the transmission of pain from nerve fibres. Caudal anaesthesia is administered by an injection into your spinal area around the sacrum, and numbs your vagina and perineum. This may be used for short-term relief if the birth involves a vacuum extraction or forceps delivery. To administer a pudendal block, anaesthesia is injected straight into your ...

Coping with Pain The kind of pain you'll experience during contractions can vary. It may feel like a thick band being squeezed around your abdomen as the uterus hardens and tightens for several seconds before relaxing. Some women compare it to severe menstrual cramps, others experience backache, but there may be a combination of sensations as the contraction peaks and then subsides. Individual response You may prefer not to use certain drugs during your labour as they can dim your awareness of what is happening; however, it is very difficult to know the level of pain you can manage without relief, particularly if ...

The more comfortable and relaxed a mother feels during labour, the better her ability to cope with pain. She can find this security with loving support from a birth assistant. The partner is the natural choice, as he will probably be closely involved throughout the pregnancy, and eager to share the experience of his child's birth. Most hospitals now welcome fathers, friends or relatives to support the labouring mother. UNDERSTANDING YOUR ROLE Like many partners, you may be nervous or worry about feeling squeamish, or being inadequate at offering sufficient support. You can help combat this by prepar­ing yourself in advance. It ...

Each hospital has its own set of routine procedures for labour. If you have visited the hospital beforehand you will have some idea of the hospital routine. Admission to hospital Once you've arrived in hospital you may be offered a wheelchair to transport you from the hospital entrance to the labour ward. If your labour is well advanced, you'll welcome a wheelchair, but if not, you should be allowed to walk if you wish. You may have outlined in your birth plan how you wish your labour to go, and once youve met your midwife or doctor, this is the time to make ...

Forceps Forced Delivery Forceps look like large sugar tongs and are designed so that they will fit snugly over the sides of the baby's head, covering the ears. They are rather like a cage and protect the head from any pressure within the birth canal. The decision to use forceps is a medical one. Forceps are only applied when the first stage is complete, the cervix is fully dilated and the head is in the birth canal Why it is done Forceps are used when the baby`s head has descended into the mothers pelvis but fails to descend further; when the baby is presenting ...

Fatigue Getting enough rest and sleep is essential if you are to combat the inevitable fatigue of the first weeks of caring for your newborn baby. Try to rest whenever you can, especially during the first week or so when you will still be recovering from the exhaustion of labour. Avoid climbing stairs and heavy lifting as much as possible, and get your partner or someone else to help you with the baby and the general housework. Take advantage of your baby`s daytime naps to rest or nap yourself, and try not to waste these valuable chances for rest by using them ...

The increased size and weight of your breasts will mean that you need a good quality, well-fitting cotton maternity bra both for convenience and comfort. Wear a clean one every day and, if you are using breast pads to prevent leaking milk from staining your clothes, avoid those that are backed with plastic. Clean your breasts and nipples daily with cotton wool and baby lotion or water, but avoid using soap because it strips away the natural oils that protect the skin from drying and cracking, and it can aggravate a sore or cracked nipple. Always treat your breasts with care ...