Childbirth


You can choose to give birth:

  • In hospital
  • At home
  • At Midwife Unit or birthing centre

Unless there are specific circumstances preventing this, such as chronic illness or complications during previous birth(s).

Whatever you decide, it is important to be well informed. Childbirth and labour can be frightening. Antenatal classes help you prepare for this by giving you advice on what to expect and managing pain.

Visit your hospital and discuss the options available to you with your midwife and GP. It is also important to be aware that if you decide to have your baby at home, at a Midwife Unit or birthing centre and complications arise requiring specialist medical attention, you may have to be transferred to hospital by ambulance during labour.

You should have packed a hospital bag and have a birth plan prepared by the time you go into labour. To be on the safe side, ensure that this is done by week 37 of your pregnancy. See sections on birth plan and hospital bag.

*Remember to take your medical notes with you when you go to hospital!


THE THREE STAGES OF CHILDBIRTH 

Stage One
The cervix dilates (opens up) until it reaches 10cm dilated. In a first labour, the time from the start of established labour to full dilation is between 6 and 12 hours. It is often quicker for subsequent births.

You may have early signs that labour is starting including backache, diarrhoea, nausea, vomiting or a ‘show' of sticky pink mucus. This is not the same as bleeding. If you are bleeding, something may be wrong so call the hospital immediately.

The most obvious signs of labour are:

  1. Regular contractions. These will continue to get stronger and more frequent. Call your hospital/midwife when regular contractions begin but do not go to hospital until contractions are coming approximately every five minutes and are lasting a minute each. The hospital will not admit you until you are in established labour (when the cervix is 3cm dilated).
  2. Waters breaking. If your waters break, call the hospital/midwife and they will probably advise you to come in immediately.

Pain Relief at home
  • You are likely to be at home for quite some time. Try different positions to make yourself more comfortable - you may like to walk around a little, go down on all fours and sway your hips from side to side or in a figure of eight movement; or lean over a chair/sofa. This helps the baby's head move down into the correct position.
  • Breathe in and out slowly and deeply.
  • Soak in a warm bath.
  • Ask your partner to give you a massage.
  • Use a TENS machine (Transcutaneous Electrical Nerve Stimulation). TENS is a battery-operated machine that sends pulses via electrodes that are taped onto your back, stimulating the body to produce endorphins (natural painkillers). This may help early labour pains but will probably be ineffective during the later stages of established labour.

Pain Relief in Hospital

  • Gas and Air - This is a mixture of oxygen and nitrous oxide and is inhaled through a mouthpiece. Gas and air takes the edge off the pain but will not take the pain away completely. Can cause nausea but has no side affects for the baby.
  • Pethidine - An intramuscular injection, which takes about 20 minutes to work and the effects last approximately 3 hours. It may cause nausea and make it more difficult to push when administered too close to delivery. Pethidine may also affect your baby causing the baby to be dozy or floppy. It also may affect the baby's breathing but in this event, an antidote is given.
  • Epidural - A local anaesthetic administered intravenously into the space between your vertebrae. It numbs the nerves, thereby giving most women complete pain relief. There are a few drawbacks:
    1) An epidural can make your legs feel heavy, maybe even numb in some cases, leaving you less mobile e.g. to go to the loo or change positions during labour.
    2) You will also be put on a drip to maintain your blood pressure.
    3) You made need a catheter if you are having problems passing water.
    4) A few women suffer from backache after having an epidural
  • Water Birth - Most hospitals have birthing pools available. Some women find that this helps them to relax. If labour progresses normally it may be possible to deliver the baby in the pool. You will probably need to book a birthing pool in advance.
  • Holistic pain relief can include acupuncture, aromatherapy, homeopathy, hypnosis and reflexology. 

 

Stage Two
This is the ‘pushing' stage after your cervix has reached 10cm dilated and takes approximately one hour. Find the position that you are most comfortable with - standing, sitting, kneeling or squatting are often more comfortable than lying on your back, if you are able to do so. It is also a better position for your baby. Your midwife will be with you throughout this stage and will advise you when and how to push. If you or the baby become distressed, the midwife and doctors can help you with an episiotomy (a cut to the perineum, which will be stitched afterwards), forceps or vacuum (Ventouse) delivery.

 

Stage Three
After your baby is born your womb will continue to contract in order to deliver the placenta. This may take another 20-60 minutes. However, your midwife will probably administer a Syntometrine injection to speed up the process and to prevent heavy bleeding. If you do not want this, you should say so on your birth plan.

Labour and delivery is painful but only lasts a few hours and the instant your baby is born, you won't remember the pain!!!

 

Caesarean Section

A Caesarean section involves major surgery and will only be performed where there is a clinical need, making it the safest option for you or your baby. The baby is delivered by cutting through the lower abdomen and into the womb, normally under an epidural anaesthetic. The cut is usually done horizontally, just below the bikini line.