1) My long first labour has left me fearful for my second…
Q. When I had my daughter, I had a long labour, which ended up with forceps. I lost a lot of blood and needed a blood transfusion. What’s the chance this will happen again with my second baby?
A. Losing a lot of blood is known as a postpartum haemorrhage, or PPH. You’ve mentioned two factors which increase the chance of that happening – a long labour and needing forceps. Mums often have a shorter labour with their second baby, and are also less likely to need the assistance of forceps.
As you previously lost a lot of blood, there is an increased risk of it happening again and it may be that you’ll be advised to have a cannula (a small needle) put into your hand during labour, just in case it was to happen, and then that would mean the staff would have quick access to your veins.
Try to keep your labour as normal as possible by avoiding unnecessary induction. Reduce intervention by moving around a lot and keeping energy levels up by eating and drinking at regular intervals.
2) What does ‘degrees’ mean when talking about tears?
Q. I had a second-degree tear when giving birth. What do the ‘degrees’ mean?
A. Tears to the perineum (the area between your vagina and anus) vary from a first degree to a less common fourth degree. A first-degree tear may be just a small ‘nick’ to the skin around the vagina. Often this doesn’t need suturing and heals quickly. A second-degree tear is deeper and involves muscle and will usually be stitched by a midwife. A third-degree tear extends to the muscle around the anus, and a fourth degree goes through the anal sphincter. Tears involving the anal sphincter are sutured by a doctor, usually under spinal anaesthetic (similar to an epidural).
Sometimes a tear close to the urethra or labia can cause stinging when passing urine but pouring warm water over the area when urinating can help ease this.
3) Will I need forceps for my second birth?
Q. I needed forceps with my first baby. Is this likely to happen again?
A. There are a few reasons for a forceps birth: if your baby is becoming distressed and needs to be born quickly; if the second stage of labour is lasting for a long time and the birth still isn’t imminent; or if you are so exhausted you don’t feel you can push your baby out.
Forceps may also be needed if you’ve had an epidural for pain relief, as that can often slow labour down. Doctors prefer to use ventouse (a suction cap) rather than forceps, but it can depend upon what position your baby is in.
Although you can’t guarantee that you won’t need forceps this time, you can reduce the likelihood of a need for them arising by trying to avoid an epidural and by staying upright during your labour. Research shows that remaining upright and mobile helps your baby to move down the birth canal and keeps the contractions coming.
Second time around, labour can often be quicker as your body has ‘been there and done it’ before. As a result, forceps or ventouse are less commonly called for.
4) My husband doesn’t want to be at the birth
Q. My husband seems reluctant to be at the birth of our baby and I’m feeling really hurt. How can I talk him round?
A. Many men are nervous about being present at the birth of their child. The most common fear is usually about seeing you in pain and not being able to stop it. If your husband is anxious about how he’ll feel during labour, encourage him to go to antenatal classes with you. Having the opportunity to talk with other men in the group and discovering that he’s not alone in his fears should help him feel more confident about being there. Hopefully the more prepared he is, the more confident he’ll become.
However, although most fathers want to be at the birth, this isn’t right for everyone. The most important thing is that you have good support in labour. Often if you choose a second birth partner such as your mum, sister or a friend, the pressure is taken off your husband and he’ll cope a lot better.
5) When should I head to hospital?
Q. My midwife has advised that I stay at home as long as I can during labour, but isn’t there a point when it’s too late to leave?
A. Women often find that if they get to the hospital too early, their contractions stop as they aren’t in established labour. You should make a move when you’re struggling to speak through your contractions and when they’re strong, regular and last approximately one minute. But don’t worry if you’re not sure what stage you’re at – you can always phone the labour ward and a midwife will chat to you to get an idea of the situation before advising you what to do.
If you did get an urge to push, it might be too late to go into hospital so you’d need to call an ambulance – and ideally your midwife – in order that help could come to you. But it would be unusual, particularly with a first baby, to leave it too late before arriving at the labour ward as you’re normally given enough warning.