Q: Will I be able to eat and drink during labour as there seems to be so much conflicting advice?
A: First of all, rest assured that you’re allowed to take food and drink on to the ward. In a normal labour you’ll be encouraged to eat and drink to keep your energy levels up. Giving birth’s exhausting, and it’s important your body has fuel to keep going. In the early stages, have what you’d have normally and when you go to the hospital, take some light snacks with you, such as fruit, crackers or biscuits. You can bring treats too, but bear in mind a short sugar rush won’t be as helpful as slower releasing carbs. Sports drinks are good as your body is running its own marathon and needs energy. To be honest, when you’re in the throes of labour you won’t feel like a big meal but having stuff on hand means you don’t have to worry if you do fancy something.
Q: I’ve heard the placenta doesn’t always deliver after the birth. Why is this?
A: In the third stage of labour, after the baby is delivered, the uterus contracts and the placenta usually separates from the uterine wall and comes out through the vagina. Some women choose a natural third stage, where your baby stays attached to the umbilical cord and you push the placenta out within an hour. Others choose to have an oxytocic drug just as your baby’s being born to make the uterus contract. The cord is clamped and the baby separated as the cord is cut. The midwife then gently tugs the cord and pulls the placenta out a few minutes after the birth.
In around 3% of births there may be a retained placenta – when the placenta doesn’t separate or gets trapped behind the closed cervix. If this happens, there’s an increased risk of heavy bleeding, so the placenta mustn’t stay in too long. You’d be advised to have a spinal anaesthetic and a doctor would remove the placenta in the operating theatre.
Q: When will I know when it’s time to head to the labour ward?
A: It can be tricky to judge when exactly you should go in. The best advice I can give is: if you’re not sure whether you’re in labour, then you’re not! As long as you’re considered low risk and you’ve had a straightforward pregnancy, the best place to be in the early stage of labour is where you feel most relaxed – which is usually at home.
A quick chat with your midwife or one on the labour ward, can reassure you. You can ask your community midwife if she can come and assess you, or even offer to go down to her clinic. Most women reach a point when they instinctively know they need someone with them. If you do end up getting sent home because you’re still in the very early stage, try to be patient – it won’t be too long before labour really kicks in.
Q: During labour, my cervix got to 8cm dilated before I had to have a c-section. Will I need one next time round?
A: No, this doesn’t automatically mean that you’ll need another c-section. Most women who choose to go for a vaginal birth after caesarean (VBAC) will achieve one.
Assuming that the baby is well positioned and there are no medical problems, VBAC is a safe option for you and your baby, although you’ll be advised to have continual monitoring of your baby’s heart rate during labour.
The main risk of VBAC is the breaking down of the scar, which in turn could cause uterine rupture. If this happens the woman would need to have a caesarean very quickly. However, this only happens in around 0.3% of all VBAC labours, so it’s still a safe option than a repeat caesarean section, which itself carries extra risks.