This is one of my favourite bits. Birth physiology is bloody fascinating, and I love seeing that little ‘lightbulb moment’ when you suddenly understand what’s actually happening inside your body, and how you can work with it, rather than against it.Your powerful hormonal system is designed to support the process of birth, and once you understand what’s happening and why, it can completely change the way you approach it.Below, you’ll find everything you need to dive into the physiology of childbirth and discover just how bloody incredible your body is.Enjoy! Want to understand your hormones?Hormonal Physiology of Childbearing :Cochrane Review: Hormonal PhysiologyWant to nerd out on Oxytocin?Maternal plasma oxytocin during physiological childbirth: Oxytocin during BirthInterested in the Brain + Stress connection?The Role of Oxytocin and the Effect of Stress During Childbirth : Role of Oxytocin & Stress Trusted Evidence-Led Voices and Researchers in Birth:Dr Sarah Buckley Dr Sara Wickham Dr Rachel ReedIf you’ve got the birth-physiology bug now, welcome to the rabbit hole. Below are some of the research papers, information and birth educators I recommend if you want to go beyond the basics and really understand the incredible biology behind birth…NCT: Hormones in PregnancyPubMed Paper: The Hormonal ControlPubMed Paper: Ferguson ReflexGiving Birth: ContractionsTommys: Stages of LabourWay's your body is preparing for labourTommy's: Signs of labour NCT: First signs of labourHealth Direct: oxytocinNavigating the Birth Canal Your baby in the Birth Canal Tommy's: Movement during labour Anatomy of the female pelvis & Fetal skull PubMeD Paper: The effect of Nervous System Regulation in BirthAIMS: Physiological Birth - How it works PubMed Paper: Your Brain during childbirthLabour Pain: From the Physical brain to the Conscious Mind Cochrane Review: Why Birth Environment Matters Cochrane Review: Why Continuous Support Matters3rd Stage of Labour: Placenta Delivery Cochrane Review: Placenta Delivery Options Placenta Delivery: NICE Review RCOG: Cord Clamping Optimal Cord Clamping: Penny Simpkin Unicef: skin-to-skin-contactWHO: Essential Newborn Care- Skin-to-SkinCochrane Review: Benefits of immediate skin-to-skinGolden Hour - What is it?PubMed Review: Golden Hour

If your waters release before labour starts, you’re in the roughly 10% of women whose waters break before contractions get going. And while it can feel like “SHIT, what happens now?!”- try not to panic.If your waters are clear, have no unusual odour and you feel well, many women will go on to start labour naturally, with around 60% going into labour within 24 hours. You’ll likely be offered a conversation about induction or waiting for labour to start naturally. Current NICE guidance recommends offering induction as soon as possible, or expectant management for up to 24 hours before offering induction if labour hasn't started. But this is a decision to understand- not something you need to blindly agree to, as other sources of evidence show that the ‘actual’ risk does not increase until closer to 4 days post-rupture. Of course, individual circumstances need to be considered. Your personal situation, preferences and the ‘actual’ risk/ benefits of each option should all be part of that conversation. Read the resources below, understand your options, ask the questions you need to ask, and make the decision that feels right for you and your baby.Dr Rachel Reed: Evidence on PROMEvidence Based Birth: Evidence on induction for PROMCochrane Review: Watchful waiting compared to induction Cochrane Review: Evidence on offering antibiotics for PROM

RCOG: PPROM- When your waters break prematurely Tommy's: PPROM- Waters breaking early Cochrane Review: Antibiotics for PPROMRCOG: PPROM Green top GuidelineSystematic review: Outpatient vs inpatient management of PPROM

Meconium is essentially your baby’s first poo, and finding it in your waters doesn't automatically mean there's a problem.Sometimes babies pass meconium before or during labour because they're maturing and their digestive system is developing, and it's more common as pregnancy progresses, particularly after your due date.Occasionally, though, meconium can be a sign that your baby isn't coping as well as we'd like, which is why your maternity team may recommend closer monitoring and will look at the whole picture, rather than the meconium alone. The colour and consistency of the meconium, your baby's heart rate and how you and your baby are doing all form part of that assessment. So, no panic-  but don't ignore it either. It's about understanding why monitoring or other options may be offered, asking your questions and making an informed decision about what feels right for you and your baby. Have a read through the resources below and let's take some of the fear out of baby’s first poo! Dr Rachel Reed: Meconium stained watersPubMed Review: Meconium stained waters

Okay Mama - this is a BIGGIE!Induction of labour is a HUGE subject, and there is a lot to unpack. And for that reason, we're going to discuss this openly and properly during our in-person sessions, where we can really get into the evidence, your individual circumstances, what the steps of induction look like, and any questions that come up along the way.But if you want to get ahead of the curve, I've popped some useful resources below.I'm going to be really honest with you here: I believe induction is vastly overused within modern maternity care. It absolutely has its place when there is a ‘genuine’ clinical reason to recommend it, but I don't believe that every pregnancy needs to be managed towards induction simply because a particular date has arrived, a guideline has been triggered or a perceived risk has been identified.And here's why I want you to understand this stuff: you may be offered an induction even when there isn't an obvious, immediate clinical concern. Most of the time it's ‘recommended’ because of ‘post-dates’, estimated baby size, BMI, previous birth history, reduced movements, blood pressure, diabetes or a whole host of other reasons. Being ‘offered’ an induction doesn't automatically mean you ‘need’ one.I want you to understand why it's being offered, what the actual evidence is for your individual situation, what the different methods involve, what the potential risks are, what happens if you wait, and where the cascade of intervention can begin.My job isn't to scare you away from induction. It's to make sure you aren't agreeing to something simply because you were told it's the next step.Understand it. Question it. Look at the evidence. Then make a decision that feels right for you and your baby.Dr Sara Wickham / AIMS: 10 things I wish every woman knew about inductionBMJ Review: What should be discussed when considering InductionRachel Reed: Induction-step-by-stepBirthrights: Consenting to TreatmentNICE: Methods of InductionNHS: How is labour inducedAIMS: The Big Baby TrialMaking decisions about your care Research on the ARRIVE trial EBB: Evidence on the ARRIVE Trial AIMS: Induction of LabourNICE Guidance: Inducing LabourAIMS: Induction and the chance of CaesareanDr Sara Wickham: Good reasons to induce labour 5 Questions to ask if you're offered induction of labour Dr Sara Wickham: Inducing Labour BookCochrane Review: Which method of labour is best to induce after 37 weeks Cochrane Review: Mechanical methods of induction Understanding quantitative researchAIMS: Glossary of terms Podcast Recommendation: Induction from your baby's perspective

If you have been recommended an induction because you have reached your “due date”, it’s worth taking a moment to understand what that date actually means, and what the evidence says about inducing labour versus continuing to wait.40 weeks is an estimate, not an expiry date. Healthy pregnancies commonly extend beyond up to (and beyond) 42 weeks, and your Estimated Due Date (EDD) is just that: an estimate. Even with modern ultrasound dating, we cannot predict the exact day your baby will be born. The traditional calculation behind the EDD is based on outdated assumptions about ovulation and cycle length that do not apply to every woman.As pregnancy continues beyond 41 weeks, some risks may marginally increase, which is why induction is often recommended. But the decision is not simply “induce because you are overdue.” It is about weighing the potential benefits and risks of induction against those of continuing your pregnancy.Use the resources below to understand the evidence, the limitations of your EDD, and what we know about induction versus expectant management, so you can make an informed decision that is right for you and your baby.PubMed: Length of Pregnancy ReviewF.F.Childbirth: 3 Reasons why your EDD is wrong Dr Sara Wickham: Myth of the aging placenta Sophie Messenger: The-myth-of-the-aging-placentaEvidence Based Birth: Going past your EDD- What's the evidence?

CTG monitoring has become routine in many hospital births, but it’s important to understand that more monitoring does not necessarily mean better outcomes. In low-risk labour, continuous CTG has not been shown to improve important outcomes for babies, but it does increase interventions such as instrumental and caesarean birth.And there is another important consideration: your freedom to move. CTG can be incredibly restrictive. Being attached to monitors can make walking, changing positions, using the birth pool and moving instinctively through contractions much more difficult, and can inadvertently encourage you to remain on the bed. ‘NICE’ itself acknowledges that continuous CTG “may restrict her mobility” and recommends helping women to remain as mobile as possible and change position as often as they wish. This matters because how you move and position yourself in labour can have a significant impact on your experience. (See the UFO: Upright, Forward & Open section below) Continuous Monitoring may feel reassuring to you, or it may feel restrictive, distracting or anxiety-provoking. There is no one-size-fits-all approach.Read below to understand what the evidence says about CTG, and intermittent auscultation, and decide what approach feels right for you. When evidence fails to change practice: Examining the use of CTG NICE: Fetal monitoring in labour- RecommendationsNICE: Rationale & ImpactDr Rachel Reed: Listening to baby during Labour Dr Sara Wickham: Fetal Monitoring Research Cochrane Review: Electronic fetal monitoring (CTG) versus intermittent monitoringCochrane Review: Intermittent auscultation of fetal heart rate in labour

When you imagine giving birth, do you picture yourself lying on a bed?Let’s change that image.Ask yourself: would you poo lying flat on your back? Probably not! You’d sit, squat or lean forward and let gravity do its thing. So why do we so often default to lying down when giving birth?There’s strong evidence to support upright and mobile positions during labour, with potential benefits including a shorter first stage of labour and fewer instrumental /  caesarean births.Read the evidence below, get familiar with your UFO positions (Upright, Forward & Open), and we’ll explore how you can use them instinctively during our in-person session too.EBB: Evidence on Birthing Positions Cochrane Review: Mother's Position for BirthHSE: Upright positions for BirthNHS: Birthing Positions

Maybe you planned a vaginal birth last time and ended up with an unplanned caesarean. Or perhaps a caesarean was the plan from the beginning. Either way, having had a caesarean before does not mean you have to have another one. A vaginal birth after caesarean (VBAC) is a safe and realistic option for many women, and your desire for a vaginal birth this time should be heard, respected and supported. RCOG states that planned VBAC is a clinically safe choice for the majority of women with one previous lower-segment caesarean.There are important considerations to understand, but your previous birth does not determine how this birth has to go. Your individual circumstances, preferences and previous experience all matter when making this decision.Ahead of our sessions, use the resources below to familiarise yourself with the current evidence and guidance around VBAC. We’ll then explore your individual circumstances and how you can prepare for the birth you want. RCOG: Birth after CaesareanRCOG" Green top Guideline Dr Sara Wickham: HBACDr Rachel Reed: VBAC- Making a Mountain of our a molehill NICE Guidance: C Section ACOG: VBAC Patient Information Cochrane Review: VBAC v's Planned repeat C-Section PubMed Paper: Good practice for VBACPubMed Paper: Frequency of successful VBAC's

You may be welcoming your baby via caesarean birth- perhaps a planned caesarean because of a medical complication, a planned caesarean because you choose one       (a completely valid choice), or an unplanned caesarean that becomes part of your birth story.Whatever your circumstances, the more you understand, the more prepared you can feel. I’ve gathered the resources below to help you understand what a caesarean involves, the choices you may have around the experience, and what recovery can look like, so you can make an informed decision about whether a caesarean birth is right for you.NHS: Caesarean Section NHS: Caesarean Recovery WHO: Caesarean SectionCochrane Review: Caesarean for non-medical reasons at termC-Section Recovery: real-story-what-to-expect13 Things no one tells you about C-SectionsBreastfeeding after a C-SectionLa Leche League: C Section & Breastfeeding Best Sleeping Positions after a C-Section The Ultimate C-Section Recovery Foods Gentle C-Section Video (*Warning: Graphic Operation) Baby Friendly C-Section Video (*Warning Graphic Content)

Forceps and ventouse are sometimes recommended during labour, but being offered an instrumental birth doesn't automatically mean you have to accept it.Understanding why it is being suggested, the urgency involved, the potential benefits and risks, and what alternatives may be available can help you make an informed decision in the moment.RCOG: Assisted Vaginal BirthNHS: Forceps and Vacuum Delivery Exploring Informed consent in Midwifery CareCochrane Review: Instruments for assisted vaginal birthPerineal Tears during ChildbirthACOG: Assisted Vaginal Delivery

Let’s talk about the absolute obsession with vaginal examinations in labour! Somehow, we’ve come to treat the number of CM’s you're dilated as though it’s the ultimate measure of how your labor is progressing, when in reality, a VE gives you a snapshot of what is happening in that moment, nothing more. That snapshot can be useful, but it can also be the start of a cascade of other non-evidence based interventions, that also can’t accurately tell you how long you have left before your baby is born. Have a dip into the links below, and make your own informed choice about whether accepting a VE feels right for you. Dr Rachel Reed: VE's in LabourDr Sara Wickham: Can I say no to a VE?Dr Sara Wickham: Labour Progress Resources Birth ED: VE's are NOT a requirement for birth.