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.
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.
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.
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.
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.
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.
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Labour pain relief options
Outlining your birth preferences