Ask the Midwife: What to Expect When You're Expecting

Between finding out you're pregnant and beginning your life as a parent, there's a lot to navigate through. A midwife tells us what to expect and how to make it through the system.

With booking appointments and understanding what to expect in the pre and post-natal stages, navigating the system can feel like a maze, and it's easy to feel lost. There’s no roadmap to get everyone from A to Z as every baby adventure is different, but we asked a midwife - who's also a mum - how to navigate the system, along with what advice she had for expecting parents.

Antenatal classes

There are many sources of antenatal advice out there – including classes, books, the internet, family, friends, TV and social media. Where possible, there is a lot to be gained from the private classes out there - you meet local women in your area at the same stage of pregnancy to you, and get general advice about signs of labour, the labour itself, the postnatal period, and life with a newborn.

There is also a huge benefit in attending your local NHS antenatal classes. The NHS classes provide you with specific information about your local Trust, as well as specifics about what care you will receive in the hospital. You may find that your hospital offers a tour of the maternity unit or provides a virtual facility tour.

Either way, if you’d like to attend an antenatal class, it’s a good idea to speak to your midwife at around 20-25 weeks to ensure you are booked on to one that’s appropriate for your gestation stage.

First appointments

Your first midwife appointment is likely to be between 8-12 weeks into your pregnancy. Your GP will usually refer you to your midwifery service, unless you live in an area where your NHS Trust requires you to refer yourself; your GP will be able to instruct you in this matter.

At your first appointment with the midwife, it’s helpful to ask them to run through your 'schedule of care', which will detail all the appointments during your pregnancy. Depending on your NHS Trust, this care will either be midwifery-led, shared care with your GP or - if required - midwifery and obstetric care.

Whichever way your care is provided, it will be helpful to know when to expect your appointments to ensure you can juggle work, childcare, and family around your plans. Knowing when your appointments are scheduled and keeping a calendar where you can outline your plan, will help you to feel like you are in control in the months leading up to the birth.

Birth plans

Towards the end of your pregnancy, you are likely to have developed an idea of how you would like your labour and birth to progress. Your midwife will encourage you to write a birth plan. Depending on your NHS Trust, there may be a place in your maternity notes for you to write this; you can use the NHS Choices website to read about the options and write your plan, or you could print off and complete its ready-made template or that of other organisations such as the template from the National Childbirth Trust (NCT).

While it's great to write your birth plan based on what you would like as an ideal, be flexible and kind to yourself! Be open-minded and allow a space in your mind for things to change, so that you when you're in the thick of it you can go with the flow.

Remember this is your birth, and in years to come you want to look back on it and be happy with your choices. Having a rigid birth plan with what you expect for yourself while you're enjoying your pregnancy can be very different from the choices you make once in labour!

Birth partners

Being a birth partner is a huge privilege, whether it is the father of the baby, a family member, or a friend. Yet with the privilege comes responsibility; they must be a cheerleader, a confidant and a supporter to the mum-to-be.

It's important that the birth partner takes care of themselves through the process as well. Just as Mum will have her birth bag packed and waiting by the front door, so should the birth partner. Don't pack a suitcase; you won't need much, but just a few items can make for a far more pleasant experience. Useful items might include a few snacks, a book or some magazines, a toothbrush and a change of clothes.

I would strongly advise you pack shorts and flip-flops - regardless of the season - as delivery units keep the temperature rather high to keep those gorgeous new-borns warm.

Breastfeeding

Before the baby arrives, research local breastfeeding support and find out what is around in your local area in the way of breastfeeding cafés or groups. There are many peer support groups and midwife or health visitor led groups. Speak to your midwife during pregnancy to get an idea of what is local to you.

Your baby is here

You are on your way home to start your life as a family. Many new parents are keen to leave hospital and return home to begin their new life; however, before you are discharged be sure that you have answers to all your questions, are confident with your breastfeeding, and know what to expect in those first 24-48 hours.

Once home, it may take that length of time for the midwife to come and visit you - all NHS Trusts are a little different, but a midwife should have visited you within 48 hours of returning home. This block of time - between leaving the hospital and seeing the midwife in your own surroundings - can often seem daunting to a new family, so be sure to discuss all your questions with the midwife in the hospital before you go.

Once you're home with your baby and become more confident in those early days, you will still be receiving midwife visits and gaining a lot of information before they hand over your care to the health visitor. This happens approximately 10-14 days after you give birth. The midwife will provide you with details of when they will visit next, but on occasion due to their work load they may be vague about timings of visits. It is helpful to ask whether they’ll be visiting in the morning or afternoon so that if you feel up to it, you can take your baby out for a walk without being restricted by expecting a visit sometime between 9am-5pm.

Post-natal groups and classes

In the final weeks before you give birth, you will be keen to get things sorted as much as you can in anticipation of your little one's arrival. I would suggest taking the time to research postnatal classes and groups in your local area.

Life with a new-born can be lonely, despite all the support from family and friends. It is helpful to meet other women locally who have babies similar in age to your little one, as well as those a little older so you get an idea of what to expect as your baby grows.

Having a class or group that you know you can attend regularly can give you a reason to leave the house and make the transition into parenthood easier. Perhaps there is a local breastfeeding drop in or café, a music group, or playgroup - the list is endless.

Don't expect to make it to every class, but have something planned that you could attend if you and your baby feel ready. To begin with, I suggest afternoon groups as you will find the mornings disappear in those first few months.

A good place to start looking is your local NCT, Sure Start Children's Centre, and local church halls or libraries.

Coping with crying

Life with a new baby takes some adjustment for both parents. There are many incredible moments and memories in the making.

A baby's main form of communication is crying, and as adults it can take us time to work out what a baby is crying for. After a clean nappy, feeding, cuddles and tons and tons of love, a baby may continue to cry for another reason. It can be incredibly stressful to hear a baby cry and some babies do cry for longer periods of time.

It is helpful to be aware of this and dip into resources to ensure you are prepared. There are some great resources out there, including work carried out by Cry-Sis.

Support and visitors

Let me just say, you can never have enough support, but how you manage it can make all the difference between blessing and burden.

In those early weeks with your baby, it's important to spend time as a family to bond and not be overwhelmed with visitors; however, when friends and family ask to visit, don't be afraid to ask for help and support.

Before their visit, drop them a text saying "looking forward to seeing you, would be great if you could bring...", or you can ask for them to pop to the supermarket or bring a casserole to help you through those first weeks. Think about what they can do to make life easier for you...even if it’s to run the hoover around the house!

When you have visitors, instead of jumping up to make them a cup of tea, get them to put the kettle on and don't be afraid to ask them to wash the dishes or put the washing on. True friends will only be too glad to be helpful.

Work together

You and your partner are a team. Keep this in mind once you go home with the baby. Communicate and make time with each other, and remember this is a new experience for you both, no matter what number baby this is.

Be kind to yourself!

You are embarking on a lifetime of parenthood - be easy on yourself, as the expectations you had for yourself as a parent before may have changed once your baby is here. This is okay! Relax, breathe, and be kind to yourself.