Worried about labour? Our midwife answers your questions
When will you know when to push?
1) I’m worried about how I’ll sound during labour
Q: I can’t bear the thought of labour in case I sound like a farmyard animal. How can I retain some dignity?
A: The thing to remember if and when you’re screaming during labour is that when it’s happening you really won’t care too much. In a natural birth, women can become more vocal when they enter the second stage of labour.
As the contractions push the baby out, you may instinctively grunt. It’s very natural and means the birth is close. Some people say that the environment you give birth in should be like one that you’d want to make love in – private and quiet, with low lights.
Birth can still be dignified, there’s no reason why your body needs to be exposed during most of labour, and your privacy should be respected, with only people who have been invited entering the room where you are labouring.
2) Am I in labour?
Q. Can you please explain to me, what does a proper contraction actually feel like and how will I be able to tell when I’m really in labour?
A. Different women will describe a contraction in a variety of ways, but many say it’s like a wide belt being tightened over their bump. The pain that most women feel is usually cramp-like, similar to a severe period pain, and travels from the top to the bottom of the abdomen.
Many women get a lot of the discomfort in their back and feel as if they need pressure applying to alleviate it. Once their contractions are regular and strong, women can often become very focused on what they’re feeling and get irritated by distractions around them.
Braxton Hicks are ‘fake’ contractions where the womb tightens for around a minute. These shouldn’t be painful and you’ll recognise real contractions as they’ll gradually become closer and closer together and stronger. A good guide is “if you’re not sure whether or not you’re in labour, then you’re not”. There are always exceptions, but that usually applies.
3) Can I eat during labour?
Q. Can I eat when I’m in labour? I keep hearing conflicting advice.
A. In short, yes. Eating and drinking in labour are the best ways to maintain your energy and keep contractions coming.
Once in established labour you can still have snacks and drinks. Don’t bother with sugar-free. Get some high-energy drinks in and a bag of sweets or dried fruit. Toast and jam or a banana can go down well when you’re tired and need an extra boost.
The only time you wouldn’t be advised to eat during labour is if you’re high risk, or need a general anaesthetic or have had opoid drugs such as pethidine, meptid or diamorphine. Even when you don’t want to eat any longer, chances are you’ll still be thirsty so cartons of drink with a straw will be useful. Ice lollies are also refreshing, so buy a bag of ice pops or small fruit lollies for at home.
4) What’s transition?
Q. A friend told me that during labour she was in transition for over an hour. What does that mean?
A. The transition phase happens when you go from the first stage of labour (when the contractions gradually open the cervix) to the second, pushing stage. During this phase, some women can become despondent and irritable and feel that they can’t cope any more. If this happens to you, it’s important to realise these feelings are very typical of transition and you’ll get through it.
However, for some, transition means contractions stop completely. This happens because, after the exertions of the first stage, the body needs time to get energy for the second stage. Some woman even doze off and find that the contractions return spontaneously after resting.
It’s impossible to say exactly how long transition will last for you. It could be minutes, it could be hours, but as long as there aren’t any complications, it should be a chance to take a well-earned rest.
5) Will I do a number two during labour?
Q. I’m petrified of doing a poo during labour! Please help!
A. This is one the most common fears that expectant mums have about labour, and unfortunately there’s nothing you can do to stop it happening. Many women do open their bowels during the second stage of labour but it’s only a small amount as nature usually has a ‘clear out’ before labour begins.
Even if you don’t open your bowels you’ll feel as though you are. Probably the only person who will know if you’ve actually done a poo is the midwife, who will see it as a sign that progress is being made and your baby’s on her way, as she is putting pressure on your back passage.
If you try to ‘hold back’, you’ll end up feeling really uncomfortable and will just prolong this stage of labour, so it’s much better to just listen to your body and ‘go for it’, knowing that your baby’s birth is imminent.
6) When will I know to push?
Q. This is my first baby. How will I know when it’s time to push?
A. It’s difficult to imagine how labour will feel when you haven’t been through it before. During the first stage of labour your contractions will encourage your cervix to open (dilate). Once the cervix is fully dilated, the sensations of the contractions start to change and for the vast majority of women their body makes it very clear to them that it’s time to ‘push’ their baby out. The contractions will become ‘expulsive’ and you’ll spontaneously push with a contraction. It’s a bit like when you know that you’re about to vomit and you can’t do anything about it.
During the second stage of labour the contractions push the baby down the birth canal. If you have an epidural then you probably won’t feel this sensation but the contractions will still be moving your baby in the right direction.