By Liz Wilkes
Many women describe feelings of at best, apprehension and at worst, terror when they consider pain in labour. Midwives however know that whilst, yes, labour is challenging, it does not have to be an experience to fear.
For many women with preparation, lots of self awareness and really good care from someone they know when they are in labour, it can be a life changing experience in a really positive way.
The best way to consider labour is that you will start with minor changes, a mild period like pain, possibly back pain which is often accompanied by things like a sticky mucous discharge called a “show”, an increase in bowel motions and perhaps changes in emotions. Whilst you may want to speak to your care provider, the beginning of labour changes, does not mean birth is imminent and does not mean you need to rush into hospital. In fact, research clearly demonstrates that staying home in your own environment in early labour is best. Support by phone or in person from your own midwife at this time is extremely reassuring.
Once labour contractions get more intense, they will come regularly with 3 contractions occurring regularly in every 10 minutes with the length of the contraction lasting around 1 minute.
If this is your first baby, it is fine to still be at home, in contact with your care provider, making sure that they advise you the best time to transfer to hospital, or birth centre if that is where you are having your baby. If it is your second baby, this is generally the time to think about moving to your birth place.
Once you are in active or established labour many things can assist, warm water either in the form of a shower or immersing in a bath is very useful. TENS applied early in labour and increased during labour is also very useful. Heat packs and massage, pressure points and Calmbirthing or Hypnobirthing techniques are also good. However the most important tool is having a care provider with you that you know and trust, throughout the whole process.
This means that you should know the midwife with you which can be achieved in a number of ways (public hospitals have ways care is provided called “caseload” or “continuity of care”; private midwives can go with you and admit you to hospital and provide your care through labour and a small number of obstetricians may work with a midwife who provides in labour care).
Your labour intensifies toward transition, which is the last part before your start to push and birth your baby. From 8cm to 10cm dilated requires focus, and good care from knowledgeable care providers who understand active labour. Many women in this period may seek a change, and a good midwife will be able to offer a range of suggestions. At times, more pain relief may be requested and at times, women will want anaesthesia such as an epidural. Midwives will certainly understand and assist with these requests. There are times where an epidural is useful for labours that are long and for about 20% of women, there is a need for intervention in some way. However, that is a minority of labours and it is important to recognise the times where this is needed rather than deal with all women as if they need help.
We encourage women to seek preparation early in pregnancy, but it is never too late to start before labour begins. Antenatal education provided by an independent provider, Calmbirth or Hypnobirthing classes and other sources of information such as the MMPOA Facebook page can give you good tips about how to prepare.
Labour is not to be feared, it is a truly special and amazing process to bring your own baby into the world. Supported by a loving team, for the majority of women it is a special day to prepare for and welcome.