‘After I gave birth the first time, I realised my childbirth class had been useless,’ says Saadia, 35, mother of Imaan (4) and Zahra (2 months). ‘The birth was nothing like what I’d been taught it should be – I ended up with an emergency caesarean and I was totally shocked by it.’ Second time around, Saadia took a very different approach. ‘I read tons, I did a prenatal yoga class, built up an honest picture of birth, hired a doula, worked on my emotions and fears, made conscious choices about my care and ended up having faith in my body. Zahra’s birth was phenomenal.’
My own experience was a lot like Saadia’s. I remember that in my first antenatal classes there seemed to be no doubt in anyone’s mind that, around my due date, labour would begin spontaneously. I’d have a ‘bloody show’ in my knickers, move seamlessly into ‘pre-labour’ experiencing manageable, erratic, early contractions which would, after a bit, settle into a regular pattern of painful contractions (known as Stage One, page above). I’d then go to hospital with my beanbag and CD player. My cervix would proceed to dilate at 1 cm per hour. My waters, at some point (probably early on), would break and labour would speed up. I might choose analgesia. And after a tricky period of ‘transition’ (during which I might – good Lord – swear and be sick), I would push my baby out of my vagina (Stage Two), preferably standing and making grunting noises, possibly sustaining a tear to the perineum (the skin between your vagina and anus). I would then, about 20 minutes later, push out a placenta, thereby completing Stage Three.
What really happened bore little relation to this. No one talked about emergency caesarean in our antenatal class. Half the class, including me, ended up with one. My experience – the ‘failure to progress’, the drugs, hormone drips, monitors and interventions – is a surprisingly common one for first time mothers. It’s really not that normal, first time round, to have a straightforward, nicely timed birth. In Julia’s 14 years as a doula, she’s only attended a couple of births that followed this neat, regular childbirth-education pattern. So, use your childbirth class as a starting point: follow up issues raised with reading, research and discussions. Your teacher, if she’s good, will be able to help you with this.
A WORD ABOUT HOSPITALS | Many of us have never stayed in a hospital before. If we have, chances are it was because something rather unpleasant was happening. Hospitals can smell, look and feel intimidating. Taking a tour of your hospital is a good idea because you do not want the surroundings to panic you when you come in to give birth. On the tour, they will show you the clinical equipment in the labour room. This can be worrying, particularly if you’re scared of hospitals. I remember going home from my first hospital tour in tears: I found all the medical paraphernalia deeply scary. I couldn’t help but picture myself in the midst of a medical crisis. I’m slightly hysterical about this sort of thing, but even if you’re not, it’s better to look at the hospital in advance. Being somewhat familiar with your surroundings will help you feel safer, and more confident. (See Chapter 5: Your Options for tips for hospital tours, page)
Labour: the real woman’s version
So, you’ve had the official version of birth. And we hope you will end up with one. But it is equally likely that your labour will have quirks and kinks all of its own. Many of the women we spoke to for this book used words like ‘panic’ ‘excitement’, ‘confusion’, ‘fear’ or even ‘demoralisation’ when talking about their first experiences of labour. Most said that much of what they learned in their childbirth classes seemed inadequate on the day. They felt they’d not been ‘warned’ in advance of how painful, difficult and confusing labour could be, or how it could deviate from the ‘safe’ pattern they’d memorised. So here goes.
Nesting
This is your inner cavewoman speaking to you: you get a primal urge to make your ‘nest’ clean, safe and warm for the baby. This usually happens in the last weeks of the pregnancy, escalating just before you go into labour. It can take many forms but it usually involves you doing something domestic that is completely out of character. Before Izzie, my first baby, was born, I sewed curtains, something I’d now rather die than attempt. A friend of mine who can’t cook a boiled egg found herself trying to prepare elaborate meals involving tons of obscure ingredients. ‘I’m not into excessive cleaning,’ says midwife Jenny Smith, ‘but before Oliver, my first baby, was born, I decided to clean the outdoor step. This took all day and involved a multitude of cleansing preparations and an old type of scrubbing brush. I remember showing my husband the step at 10 p.m. I slept deeply to be woken at 6 a.m. with contractions.’ You may not nest at all. Or you may behave like a deranged Mrs Beeton. If you do, you’ll think it’s normal. Everyone who knows you will, of course, know you’re crazed.
In the beginning: labour kicks off
WHEN TO CALL YOUR MIDWIFE
You feel firm, fairly regular contractions (e.g. contractions that come three to four minutes apart, lasting about a minute each, over the course of an hour).
You are leaking fluid from your vagina (with or without contractions).
You have any vaginal bleeding.
You have had a bloody show in your knickers (can be pinkish, brown, yellowy-green).
You feel headachy, dizzy or your vision is blurred.
You feel burning or stinging when you pee, or feel a frequent urge to pee.
You feel abdominal pain.
You have diarrhoea or backache that may come and go.
You have a slight fever.
You feel anything unusual to you – any sensations that concern you. Labour comes in different packages, so don’t be afraid to call.
‘Latent labour’
Your labour may not begin with thunderclaps, a strike-me-down contraction, and the gushing of broken waters. And it may not begin when you think it should. Roughly three out of ten babies come before their due date, and seven out of ten are born after it.
How the earliest bit of labour feels and how long it takes varies greatly from woman to woman and from pregnancy to pregnancy. Your labour may actually have begun days before you realise it. You can be watching a movie, going to the hairdressers, cleaning your loo, and all the while your cervix is slowly opening – without a twinge. If only this pattern went on until it was time to push, you’d have no need for a book like this. But things do hot up – eventually.
VAGINAL CHECK-UPS | Some women ask for a vaginal exam around their ‘due date’, so that they have something to report. This may not be helpful. First of all, the fewer checks you have the lower your risk of infection, and secondly, the numbers at this stage really don’t mean much in an average pregnancy. You can dilate rapidly or slowly no matter when the process begins. Latent labour may take a couple of hours or it may go on – literally – for days. It may be unnoticeable at first, or really quite painful. There are, however, a few signs that indicate some action:
BLOODY SHOW | The ‘mucous plug’ which blocks your