Getting ready for the birth
You’ve feathered your nest, you’ve packed your bag and now you’re playing the waiting game. “Use this time to tackle any remaining fears,” says Lucy Atkins, co-author of Blooming Birth (HarperCollins, £9.99), and one of our resident experts. “The more relaxed and confident you are, the better you’ll cope.”
Natural pain relief
Self-help techniques are especially useful in the early stages of labour in helping to relieve pain. The advantage is that they do not involve the use of drugs, so there are no side effects for you and your baby. However, they only help you cope with the pain – they don’t take it away.
• Active birth positions
These help to keep you moving. The more mobile you are, the faster your baby's likely to be born.
• Breathing
Slow breathing in the early stages of labour will help you to relax, and other breathing techniques can help relieve contractions and focus attention away from the pain. You can find out more about different methods from your antenatal class.
• Complementary therapies
Massage, reflexology, acupuncture, hypnosis and aromatherapy can all help to relieve pain. If you’re planning to give birth in a hospital, make sure you ask permission for your chosen practitioner to be present.
• TENS
A transcutaneous nerve stimulation (TENS) machine is a device that delivers small electrical pulses to the body via electrodes placed on the skin. These can help some women to cope with early labour pain.
• Water
Bouyancy makes it easier to manoeuvre and water soothes and takes the edge off contractions – this is why some women use a birthing pool. If you don’t have access to one, a bath may help.
Medical pain relief
If you give birth in hospital, you will have access to a range of pain-relieving drugs. Talk your options through with your midwife, as the type of pain relief you choose will depend on how far into labour you are and how quickly your labour is progressing. For a home birth, gas and, in some cases, pethidine are usually available.
• Gas (entonox)
Often known as gas and air, this is a mixture of oxygen and nitrous oxide (laughing gas), which you breathe in through a hand-held mask. Entonox takes the edge off the pain but doesn’t remove it altogether. However, it can be combined with pethidine for more effective pain relief.
o Advantages: Entonox does not harm your baby and is quickly expelled from your body once you stop using it
o Disadvantages: You may dislike the feel of the mask or feel sick or dizzy. Gas and air on its own might not provide effective relief
• Pethidine
Injected into your thigh or bottom once labour is well-established, pethidine helps reduce pain to a more manageable level. If it works well, you will find you feel relaxed and sleepy, and this can ease labour if you are very tense. The effects wear off after four hours.
o Advantages: Pethidine can reduce pain without you losing all feeling in your lower half
o Disadvantages: You may find that it makes you feel drowsy or nauseous. It can also make your baby sleepy or affect her breathing or urge to feed if it’s given to close to delivery
• Epidural
A local anaesthetic is injected into the epidural space in the lower back via a fine, hollow tube. The tube is inserted through a needle and left in place during labour so that top-ups can be given.
o Advantages: For most women, an epidural blocks out pain completely. As a result, it is often used where labour is prolonged and painful. An epidural can also lower high blood pressure
o Disadvantages: Sometimes an epidural does not work completely or works on one side only and you might not like the numb feeling in your legs. Traditional epidurals stop you from moving around in labour, which can cause things to slow down, although most hospitals offer mobile epidurals which do allow some movement
Your birth plan
Writing a birth plan will tell the midwives and doctors about the kind of labour you would (ideally) like to have. Include the following:
• Your birthing partner’s name
• The positions you'd like to use during labour and birth
• How you want your baby’s heart monitored during labour
• What kind of pain relief, if any, you would like
• Your preferences if you need an assisted delivery
• Any other special requirements, such as if you want to breast or bottle feed your baby.
It's time
Most labours start slowly, and you’ll probably be wondering if this is really “it”. Here are some signs to look out for:
• Contractions You’re in labour if your contractions are lasting about 40 seconds every 3-10 minutes
• “Show” Some women experience a loss of pink mucus
• Waters When your waters break, the membrane holding the amniotic sac (which holds your baby) has started to leak. If you think you’re in labour, call the hospital – a midwife will be able to advise you.
Stages of labour
Early (0- 3cm)
What’s happening? Labour can last anything from an hour to a few days. In the early stage you’ll experience mild contractions, around 15 to 20 minutes apart.
How will I feel? Slightly uncomfortable and probably a bit anxious, try not to worry though, you may have a while to go yet!
What can I do? Try taking your mind off the contractions by going for a gentle walk, watching TV, knitting – whatever helps. A TENS machine can help early labour pain. This is a device that delivers small electrical pulses to your body via electrodes, which are placed on your skin. TENS machines are available to hire from Tesco Pharmacies for a period of six weeks at a cost of £27.50. For more information on participating stores, call 0800 59 16 88 (have your Tesco Clubcard number to hand).
Active (4 to 10cm)
What’s happening? At 3-4cm dilated your baby will start to slowly move downwards; as contractions increase and you reach 10cm, you’ll begin to feel the urge to push.
How will I feel? This is hard work, as active labour can last from one to six hours, or even much longer! Staying upright and mobile can help the labour progress. You should ask for pain relief if you need it.
What should I do? Listen to your midwife. Once the baby’s head has “crowned”, you may feel some more contractions. Push – just as if you were doing a poo! As the baby’s head comes through, you’ll feel huge pressure (and possibly some burning pain), followed by a rush of relief and joy as your baby is born!
Third stage
What’s happening? It’s not over yet, the placenta’s on its way.
How will I feel? This is a breeze compared to giving birth!
What should I do? You may be offered an injection to speed up this process and you’ll need to push again.
Final thoughts
“Labour in the real world bears little relation to the textbook version,” says Lucy. “The best thing you can do is to focus on getting through it the best way for you.” Good luck!
