what happens on the day of the birth
Labour & birth

What happens on the day of the birth

Every baby’s birth is different, but it’s good to know what to expect during the birth process.

Most women have a preconceived idea of childbirth, where a woman is lying on a bed propped up by pillows. However, keeping as upright as you can will help your labour to progress and will help you and your baby to cope better during labour. If you are upright rather than lying down, gravity can help push your baby’s head down onto the cervix (neck of the womb) to help your cervix dilate, and then assist your baby’s progress through your pelvis.

Many women choose to adopt positions such as kneeling on their hands and knees, or use birthing aides such as a birthing ball, bean bag or birthing stool. Some maternity units have birthing mats, as an alternative to birthing beds. Ask your doctor/midwife about a birthing pool or other birthing aides in your hospital. If you opt to use an epidural, you may be asked to lie flat on the bed. The anaesthetic will usually start to work after 10-20 minutes. Your legs will be numb, heavy and difficult to move, and you won’t be able to walk around.

The nerves in your bladder are also likely to be affected by the anaesthetic, so you won’t know when you need to go to the toilet. A small, plastic tube (catheter) will be passed into your bladder to drain the urine when your bladder becomes full.

what happens on the day of the birth

While most women and babies are healthy and labour/birth is a natural event, sometimes things don’t go according to plan. It is the role of your midwife to recognise this and seek the assistance of a doctor when necessary. In some instances an ‘instrumental birth’ (a forceps or vacuum) or a Caesarean section may be in the best interests of you and your baby. Your midwife and doctor will keep you informed at all times.

Monitoring your baby’s heartbeat

Your midwife will observe your baby’s wellbeing by listening to your baby’s heartbeat at regular intervals. This can be done by using a ‘pinnard’ (fetal stethoscope) or a Doppler (hand held, battery-operated device). For women/babies who may have risk factors, continuous fetal monitoring, known as cardiotocography (CTG) may be recommended.

If your waters have broken, your midwife will observe the colour of this water (amniotic fluid). Clear amniotic fluid is reassuring; meconium (green colour) or heavily blood-stained fluid is less reassuring. But, again your midwife will observe for this, call for the assistance of a doctor when necessary and keep you and your birth partner informed.

For the majority of normal births, your birth partner, a midwife, and a second midwife or midwifery student are present. The midwife will call for the assistance of a doctor when necessary, this includes a paediatrician if there are any concerns regarding your baby’s wellbeing. If you have opted to attend a consultant privately he/she will normally be contacted for the birth or another consultant in their absence.

The birth

As your baby’s head moves down through the birth canal and birth is about to take place, you will feel lots of pressure and the urge to push will increase. Your midwife will support you and guide you through this. Generally, women are encouraged to ‘go with their instincts’ and push when they feel the need. However, if you opt to use an epidural, note that the epidural cancels the reflex to push. In this case your midwife will palpate your abdomen and inform you when a contraction is coming to assist you with the pushing phase.

Your midwife will ask you to pant/blow gently just as your baby’s head emerges (crowning). This is done so your baby is born gently and will help to prevent tears. Once your baby’s head is born, usually with the next contraction your baby’s body is born. Your baby will be placed on your chest/abdomen for you and your birth partner to see and welcome into the world!

Generally, babies are a blueish/pale colour when just born. They become pink once they start to breath for themselves. Their head may appear a little mis-shaped/pointed. This is caused by the various manoeuvres that the baby had to do to exit the birth canal into the world. If their temperature is low, skin-to-skin contact may be encouraged or they may be left in the incubator for up to an hour.

First breath

Your baby will take his/her first breath shortly after birth and begin to turn pink once breathing becomes established. He/she may be covered in some blood, or meconium (if their bowels have opened in the womb) and/or a creamy, white substance (vernix). Some babies cry out loud, some just give a little whimper and others might be quiet as they get used to their new world outside the womb.

Finally meeting the baby

Don’t worry if oxytocin, the natural hormone of love, doesn’t kick in straight away. A whole range of feelings is normal from ecstasy to emptiness and skin-to-skin contact can help to promote feelings of closeness.

Q. Why is skin-to-skin so important?

A. Newborn babies bond through touch and smell. This is one of the reasons why your midwife will encourage skin-to-skin contact with your newborn baby, when she is placed on your chest. It’s also why your midwife may encourage you to breastfeed your baby soon after you have given birth.

Placenta delivery

The delivery of the placenta or afterbirth is known as the third stage of labour. This usually takes place 15-30 minutes after the birth of your baby. Your baby can remain on your chest (skin-to-skin) for this stage or commence breastfeeding.

The doctor/midwife will place their hand on your abdomen and pull the umbilical cord until the placenta is released and will check that it has been fully delivered. If any placenta is left in your womb, it could cause infection or bleeding. You may need an injection into your thigh to assist in the delivery of the afterbirth. Once separated, the afterbirth is delivered by controlled cord traction.

what happens on the day of the birth

Your doctor/midwife will check to see if you require any stitches. If you do, local anaesthetic is administered to ‘numb’ the area prior to the procedure. Once completed, your hygiene needs will be seen to. You will be assisted to feed your baby and you will be ready for a well-deserved cup of tea and some toast.

Baby’s first feed

  • Have your head and shoulders well supported.
  • Let your baby’s whole front touch your front.
  • Since you’re leaning back, you don’t have a lap, so your baby can rest on you in any position you like. Just make sure his whole front is against you.
  • Let your baby’s cheek rest somewhere near your bare breast.
  • Help him as much as you like.
  • Hold your breast or not, as you like. You’re a team. Relax and enjoy each other!

Laid back breastfeeding

Laid back breastfeeding means getting comfortable with your baby and encouraging your own and baby’s natural breastfeeding instincts. Immediately after a natural, unmedicated birth, a healthy newborn can be placed onto his mother’s stomach and he will move his body up toward the breast, find the nipple, latch on and begin to nurse all by himself.

This is a normal reflex of a newborn where you can lean back and be well supported – not flat, but comfortably leaning back so that when you put your baby on your chest, gravity will keep him in position with his body moulded to yours. Follow the steps in the box below to help encourage your baby’s first feed.

More like this:

Caesarean sections in Ireland
Labour pain relief options
Outlining your birth preferences

 

Ask Tracey

Midwife Tracey Donegan answers your questions about pregnancy and birth

Q When should I have my first pregnancy scan? And how many scans should I get throughout my pregnancy?

A
Your first scan is known as your dating scan and is routine in all hospitals. Most mums will have this scan at their booking visit, which can be anywhere between 12-18 weeks. The earlier the scan the more accurate it will be. If you have experienced recurrent miscarriages some hospitals will scan you earlier. Contact your antenatal clinic for more information. In Ireland, most women will have two scans in a healthy pregnancy – a dating scan and an anomaly scan at around 20 weeks. However, some units provide a dating scan only. Private scans are also available in most cities and many parents use these services for additional reassurance and to find out the sex of their baby.

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Ask Allison

Q My sister-in-law and I both work three-day weeks and we help each
other out with child minding on our working days, which up until recently has worked out really well. Between us, our kids are aged between five and nine years – the problem is that it’s now become quite apparent that we have very different parenting styles. I prefer my two daughters (seven and nine) to have a structured day. For example, in my house, we have allocated times for television and iPads, etc. My sister-in-law, however, lets the kids run loose after school – homework is ignored and my kids end up wired after eating sugary treats all afternoon. I am considering looking at after-school childcare for the kids, but I’m worried that this is going to cause a family argument. Is there a diplomatic way that I can ask my sister-in-law to introduce some discipline into her child-minding days? It certainly doesn’t do her two kids any harm when I am minding them in my own house!

A
In a word, no, there is no diplomatic way to do this as it may very likely seem like your saying that your parenting style is better than
hers. As L’Óreal says, ‘now here comes the science bit.’ Dr. Kaylene
Henderson, a child psychiatrist, wrote a very interesting blog about ‘the
science behind the Mummy Wars’. She explains that before she had
children of her own she hadn’t been aware of how parents have a
very specific sense of the right parenting style. She also found that parents could be very definite in defending their chosen parenting style. Dr. Henderson, who describes herself as a curious, scientific, open-minded person, was surprised at how defensive parents could be and, at times, of their judgemental attitude towards each other. She explained the neurology of the Mummy Wars; okay, I’ll need you to bear with me for a second. Warning; I’m about to use some neuro-techie language.

Why do we judge each other?
As we have all had different experiences, this means that we all have very different memories stored in our brains. Most of our memories are ‘explicit’ memories – these are ones that we can recall easily such as important dates that mean something to us; important birthdays, special events or stories of and about our lives.
There is another type of memory called ‘implicit’ memory that plays a
key role in our parenting. This type of memory is the stuff that you do on autopilot. Psychologists call these heuristics or rules of thumb –
such as tying your shoelace, or driving your car (once you have learnt
to do both first!). Otherwise we’d really waste a huge amount of time
pondering over tasks that we have readily available to us. This seems to be where the science bit of our parenting style kicks in. This implicit memory goes all the way back to when you were an infant being parented by your parents. This is when you started the process of storing up how they did it into your memories.
Unless you make a conscious choice and effort to parent differently, what you saw and unconsciously learnt will be your automatic go-to parenting style.

We learn habits
This can really kick into gear when we feel our parenting style is
being mirrored or highlighted by disapproval from another parent. I know the cold sweat you feel when your child decides to make their outstanding bad behaviour performance at, of course, the most public and worst time. The implicit autopilot of how your parents dealt with these outbursts will flow unconsciously from you if you haven’t worked super hard to be aware and consciously change the old habits.
What’s happening for the on-looking parent is that they see you doing something they are used to doing, but you are doing it all wrong. Simply, because that is not how they know how to do it.

Find a way that works
You both have different parenting styles – who is to say which type is correct? You just need to know what works best for your family and that’s the bottom line. The irksome feelings won’t go away. You can talk to your sister-in-law, but I’m adding a caveat that it would be hard not to hurt her feelings. What we’re possibly looking at is that you prefer a more structured form of parenting, whereas your sister-in-law has a more permissive style. I’m not sure the two styles can mix, the mixture is a bit like oil and water.
If a collaborative shared form of parenting style can be agreed upon, then that is great, but our learnt hardwiring may prove difficult to change despite the intent to do so.
Perhaps, your own instinct of changing childcare might work best for you. In terms of making childcare work; the fit is ultimately the most
important aspect as you want a cohesive congruent feeling of the other caregiver to just ‘getting it’, like in any good partnership. Best of luck
with this and I wish you both well.