Getting ready for birth

The last weeks of pregnancy have a strange rhythm: some days drag, and some days you realize the car seat is still in its box. This chapter covers the practical side of getting ready: where you will give birth, who will be with you, what to bring, how you will get there, and how to set up your home for afterwards. A little planning now means fewer decisions in labour.

The last weeks

From around 36 weeks, most care providers see you every week or two to check your blood pressure, measure your belly, listen to your baby's heart and feel which way your baby is lying. Most babies settle head down by now. If yours is bottom first or lying across, your midwife or doctor will talk with you about the options (see "Special situations").

Many people notice more Braxton Hicks tightenings, pressure low in the pelvis as the baby drops, broken sleep, and an urge to clean and organize. Keep paying attention to your baby's movements right up to the birth. Babies do not run out of room to move. The movements may feel more like rolls and pushes than kicks, but they should not slow down or stop.

Call your midwife or doctor if your baby is moving less than usual or the pattern changes, if you have any bleeding, if your waters break, or if you have a severe headache, changes in your vision, or new swelling of your face and hands. Do not wait until the next day to call about movements.

What "term" means

Your due date is 40 weeks from the first day of your last period, or the date set by an early ultrasound. It is an estimate, not a deadline: only about one baby in twenty arrives on the day itself.

Early term: 37 weeks 0 days to 38 weeks 6 days.

Full term: 39 weeks 0 days to 40 weeks 6 days.

Late term: 41 weeks 0 days to 41 weeks 6 days.

Post-term: 42 weeks or later.

A baby born before 37 weeks is preterm. Most first babies arrive after their due date, and later babies tend to come a little sooner, with plenty of exceptions.

Where to give birth

Your options depend on your health and what is available near you. It is reasonable to visit or take a virtual tour, ask questions, and change your mind if your situation changes.

Hospital

Most babies are born on a hospital labour and birth unit. You will usually have your own room, with a bed that adjusts into many positions, a bathroom, and often a shower or bath. Obstetricians, anesthesiologists and pediatricians are on site or close by, along with an operating room for caesarean births and a neonatal unit for babies who need extra care. A hospital is the recommended place if you have certain health conditions, twins, a baby who is not head down, or a baby expected to need extra care. It is also the only place you can have an epidural.

Birth centre

Birth centres are run by midwives for people with straightforward pregnancies. Some sit inside or beside a hospital; others are free-standing. They feel more like a home than a ward, often with a large bath or birth pool, a double bed and space to move. Epidurals are not available, but nitrous oxide often is.

If you or your baby need something a birth centre cannot offer, you will be moved to a labour unit, by a walk down a corridor or an ambulance ride. For first-time parents a fair share of birth centre labours end with a transfer, most for slow progress or a wish for an epidural, rarely for an emergency.

Home

For healthy people with a low-risk pregnancy, a planned home birth with trained midwives is an option in many places. Usually two midwives attend, bringing oxygen, medicines to control bleeding, and resuscitation equipment for the baby. For people who have given birth before, planned home birth with trained midwives appears about as safe for the baby as hospital birth. For a first baby, the chance of a serious problem for the baby is slightly higher and transfers are more common. There is more in "Special situations".

A birth plan is best thought of as a list of preferences. Labour cannot be scripted, and the most useful version is short, flexible, and readable in a minute by a busy nurse or midwife. Writing one is mostly a way to learn your options and talk them through before the day.

Keep it to one page. Lead with what matters most. Use "I would prefer" and "if possible", and include what you would like if things change, which is the part people most often wish they had thought about.

A sample outline

About us. Your name, your support person's name, and anything staff should know: a first baby, a previous difficult birth, a hearing impairment, a preferred language, a trauma history you would like handled gently.

Labour. Moving freely, the shower or bath, dim lights, music, intermittent listening to the baby's heart if all is well, eating and drinking lightly.

Pain relief. What you would like to try first, and how: "please do not offer, I will ask" or "please offer an epidural once I am in active labour". Birth. Positions to try, pushing when you feel the urge, a mirror, catching your baby yourself, who announces the sex if you have not found out. After the birth. Skin-to-skin straight away, delayed cord clamping, who cuts the cord, your plan for the third stage, how you plan to feed your baby.

If plans change. For an induction, assisted birth or caesarean: your partner present, explanations as things happen, skin-to-skin in the operating room, the screen lowered to see your baby born.

Bring a few printed copies and keep one on your phone. Then hold it lightly. A birth that goes differently from your plan is not a failure, and staff can follow your wishes far better when they know them.

Choosing and preparing your support people

Continuous support in labour, from the same person or people throughout, is one of the most reliably helpful things you can have. It is linked to shorter labours, less pain medicine, fewer assisted births, and more positive feelings about the birth.

Think about who helps you feel safe and calm: your partner, a friend, a parent, or a doula (a trained, non-medical labour companion). Check how many support people your hospital or birth centre allows. Some people choose one person for the long haul and a second to give them breaks. Talk through your preferences together and share "The partner's guide to labour and birth". Agree who drives, who calls whom, who handles the phone, and how you will signal that you need quiet, a hand to squeeze, or someone to speak up for you.

What to pack

Have your bag ready by about 36 weeks, earlier if you have had a fast labour before. Pack labour things, after-birth things and baby things separately so they are easy to find.

For labour: birth preferences and any notes or health card you need; lip balm; hair ties; a water bottle with a bendy straw; snacks for you and your partner; a loose top you do not mind getting messy; warm socks; your phone, a long charging cable and headphones; anything that helps you relax, such as your own pillow or a playlist.

For after: a comfortable going-home outfit (you will still look several months pregnant, and that is normal); front-opening tops or nursing bras; large, high-waisted underwear, dark or disposable; maternity pads; toiletries, glasses or contact lenses; slippers; any regular medicines.

For the baby and your partner: a few sleepers or bodysuits in newborn and 0 to 3 month sizes, a hat, a blanket, diapers and wipes (check what is provided), and layers for the trip home; for your partner, a change of clothes, toothbrush and snacks.

Getting there

Plan your route and a backup, and try it at different times of day. Find out which entrance to use at night and where to park. Save the labour unit's number in both your phones. If you do not drive, arrange a lift in advance, and know how you would call an ambulance.

Install the car seat now, not on the way home. In most places a rear-facing infant seat is required to take a newborn home by car. Read both the car seat and vehicle manuals, and check that the installed seat moves no more than about 2.5 cm (1 in) at the belt path. Avoid second-hand seats unless you know their full history: a seat that has been in a crash or is past its expiry date may not protect your baby.

If you have other children, line up at least two people who can care for them at short notice, day or night, and explain the plan to the children in simple words. Write down routines, allergies and phone numbers. Do the same for pets: who feeds and walks them, and who has a key.

Going past your due date

If you reach your due date with no sign of labour, you are in good company. Around 40 to 41 weeks your care provider will usually offer a membrane sweep, a quick internal examination in which they sweep a finger around the cervix to release hormones that may help labour start within a few days. You will also talk about extra monitoring if you choose to wait, and about induction, commonly offered between 41 and 42 weeks because risks to the baby rise slowly after 41 weeks, and sometimes sooner for health reasons. Each option is your decision. "When labour needs help: induction, speeding things up and assisted birth" explains them in full.

Staying active and resting

Unless you have been told otherwise, keep moving. Walking, swimming, prenatal yoga and sitting forward on a birth ball help your mood, sleep and stamina. Stop if anything hurts or you feel unwell.

Rest matters just as much: sleep on your side, nap when you can, and remember labour often starts at night.

Preparing your home for after

The first weeks go more smoothly when the basics are in place.

Sleep: a crib, bassinet or cot with a firm, flat mattress and fitted sheet, in your room, with nothing else in it.

Feeding: a supportive chair, pillows, water and snacks within reach; bottles and sterilizing equipment if you plan to formula feed or pump. Changing: diapers, wipes, and a safe surface on the floor or a change table with raised sides.

Food: easy meals in the freezer, and friends willing to bring more. Your recovery: pads, a peri bottle for rinsing while you pee, and pain medicine or stool softeners you have checked with your care provider. Help: a short list of who does what, from groceries to walking the dog, and a visitor plan that protects your rest.

In short

Term is 37 to 42 weeks; your due date is an estimate, and most first babies come after it.

Choose where to give birth based on your health and what you value, and understand how transfers work from a birth centre or home.

Keep birth preferences to one flexible page, including what you would like if plans change.

Pack by 36 weeks, install the car seat, and plan care for older children and pets.

Keep track of your baby's movements to the end, and call the same day if they slow down.

Prepare a safe sleep space, food and help at home before the birth.