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 Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.

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ASK JESSICA

Q. I’m would like to start an exercise programme that will benefit my emotional health as much as my physical health, but I don’t know which type of class would be best. Should I consider choosing from yoga, pilates, tai chi, or could you recommend a class, please?

A It’s great that you have decided to get into exercise. The benefits to you are going to be great. You’ll sleep better, have more energy, better skin, reduced stressed, not to mention all the amazing physical benefits of your clothes fitting better, and looking healthy, trim and toned! My advice to you would be to try them all. Even if some don’t offer pay-as-you-go sessions, if you get in touch directly with the instructor, they will almost always let you try it out first to see if it’s for you. All of the above things that you mentioned are great for mental health, so it really will be a personal preference as to which you go for. On top of the classes you mention, all forms of exercise will give you great mental rewards so consider the not so obvious interval training sessions, bootcamp, and circuits too, as you will also feel on top of the world after a class like that.