You can start preparing for your birth in the early stages of pregnancy, thinking about classes and finding out what is available locally to suit you is important. Whichever type of birth you are having you are encouraged to think about how you would like to make it personal to you.
Speak with your midwife about your choices and use the NHS choices website for further information.
If you’ve had a previous caesarean, you might be feeling unsure about your birth options. There’s lots of myths and misinformation around vaginal birth after caesarean (also known as VBAC).
You might be sure that you want a VBAC this time, or anxious about the idea of it. You might feel that you don’t want to try a VBAC at all. If you’ve had a traumatic birth experience previously, it’s understandable that you might be feeling scared and anxious.
Whether a VBAC will be recommended will depend on lots of factors. Women have caesareans for all sorts of reasons – some of these are unlikely to recur in future pregnancies, while in others the team may think it’s safest for you to have another caesarean. The obstetric team will help you to understand the circumstances around your caesarean, why it was necessary, and whether your caesarean and any other issues will affect your birth options.
For example, if you had a caesarean because your baby was breech, it’s unlikely that you will need another caesarean. Women who’ve had one previous caesarean and are having a straightforward pregnancy have a 75% chance of a successful vaginal birth. If you had a vaginal birth before your caesarean, you have an even higher chance of success – about 80-90% of women in this situation are able to have a vaginal birth.
External cephalic version (ECV) is a method of turning babies who are breech or transverse into the head-down (cephalic) position. A doctor or specialist midwife will apply pressure to your abdomen with their hands.
Some women find this uncomfortable. This method works for around 50% of women and is generally safe. A small number of babies (approximately 1 in 200) will need to be delivered by emergency caesarean after an ECV, but your baby will be monitored throughout the procedure to ensure they are coping well.
If your baby needs help to turn into the right position, your midwife will refer you to the ECV clinic at University Hospitals Dorset, or to have the procedure in the day assessment unit at Dorset County Hospital.
Most mothers start producing colostrum about halfway through pregnancy, and some leak small amounts of colostrum while they are still pregnant.
Some women decide they would like to hand express and freeze colostrum during pregnancy. This is not usually necessary, but it might be recommended if you are diabetic or taking medication for high-blood pressure, or if your baby is likely to be premature.
If you do wish to try hand expressing colostrum, speak to your midwife so that they can advise you. You should wait until you are at least 36 weeks pregnant. If you are leaking before this, you can try to collect some of the colostrum with sterile syringes.
Please don’t worry if you aren’t leaking during pregnancy, or if nothing happens when you try to hand express. This does not mean you will be unable to breastfeed or that you aren’t going to produce colostrum or milk once your baby is born.
Some women are specifically advised not to attempt to express during pregnancy, including:
This is because of a slight risk of triggering labour in women who are already at risk of preterm labour.
If you experience any contractions while hand expressing during pregnancy, you should stop immediately.
Find out more about antenatal hand expression
It’s a good idea to think in advance about how you want to feed your baby, and to include this in your birth plan. You can discuss your thoughts with your midwife. There’s lots of evidence that breastfeeding has many health benefits for you and your baby, but it is up to you how you would like to feed your baby, and the team will support you whatever you choose.
Read more about feeding your baby.
During your pregnancy, you should think about where your baby is going to sleep. It’s a good idea to set up a safe sleep environment for your baby during late pregnancy, in case your baby is born early. Your health visitor can help advise you with this at your home antenatal visit from them.
There are lots of options for sleeping and it can feel a bit overwhelming. It’s really important to do your research and consider what will be both practical for you and safe for your baby.
The following resources will help you to decide what’s best for you and your family:
Please see the NHS website for advice on what to pack: