Now, I think it’s safe to say that the most overwhelming and daunting part of any womans pregnancy is when she realises that, somehow, this baby has to come out of her! Yes, the giving birth part! Minor detail eh. Admittedly I haven’t been too nervous about the thought of labour through my pregnancy, but that is most likely due to the fact that until yesterday I didn’t know if I’d need to have an elective cesarean section or not. Having said that, I have done a decent amount of reading on labour and birth through my pregnancy in the hope that I wouldn’t need the C-Section (which I don’t – Hooray), and I am very glad I have. And now that I am only about 4 weeks away from giving birth I am indeed, like any normal woman, getting increasingly nervous.
I think one of the most overwhelming things about putting together a birth plan, or at least considering how you’d like to deliver, is the amount of decisions you have to make, and choices you have; natural birth or pain relief assisted, natural placenta delivery, or injection, deliver in the water or on dry land. I personally found writing a birth plan a really helpful way of getting an idea of how I would like to give birth. I have had some people find the idea of me (or anyone) writing a birth plan amusing because half the time these things can go out the window; birth is flung at you at a moments notice and as prepared as you might be on paper, it doesn’t mean nature and your baby will allow you to have things the way you want! So I think it is definitely good to go into these things with an open mind. Remember a birth plan is a record of how you’d like things to go ideally and you need to be prepared to be flexible; there is no way of knowing how straight forward your birth will be. But if you have this within your notes, your midwife will do their best to stick to this for you.
I found it helpful because it helped me make some of the many decisions thrown your way in preparation for labour.
One of the first things to consider is where you want to give birth; a hospital delivery suite, a midwife led unit or at home. There are pros and cons to all of these; at home you are surrounded by familiar comforts which can really relax you, but should you need medical intervention you’d need to allow time to get to hospital, and the options of pain relief are restricted at home. A midwife led birthing unit is a nice halfway option; you will be with qualified midwives who will support you to have a labour with less medical interventions, and there is often a “home from home” feel to them with plenty of cushions, birthing pools, birthing balls and you’re less likely to have to change rooms, as you might do in a hospital. But if you wanted an epidural these are not available, and should things take an unexpected turn you’d need to be transferred to a hospital if you need a C Section. The third option is a hospital delivery suite. This is the option I will definitely be taking as I have no doubt in my mind that I will want an epidural. This is one of the benefits of delivering in hospital; you have access to all types of pain relief and are able to be quickly transferred and looked after should an emergency C Section be required. Of course hospitals are somewhat clinical and it’s not going to be like giving birth somewhere homely but, my reasoning, aside from the epidural, for wanting to deliver on a hospital ward is that I will feel far more relaxed knowing medical staff are nearby. I’ve been told I might have a slightly higher risk of a bleed and will need to be on an IV drip throughout labour so even if I hadn’t wanted to, I’d be giving birth on a hospital ward. I love the idea of a birthing unit and having a water birth, but seeing as I know myself well enough to know that even if I stub my toe it is the end of the world, pain relief was a high priority to me!
Speaking of pain relief, if you’ve read my past blogs (in particular “Stop the Epidural Shaming: https://beautybabyandme.wordpress.com/2015/09/19/stop-the-epidural-shaming/) you’ll know my opinion on epidurals and other pain relief options. Again, there is a minefield of choices and it’s important that you do what you feel is right for you and your baby. Please don’t let other people’s opinions, or the stigma put on women who opt for pain relief, get to you. I have no shame in saying how I want to deliver, with the help of pain relief. I’ll be bringing the baby into the world, and should have just as much praise as a woman who bravely does it with no pain relief. Take your time in considering the options available to you and the things to consider; some pain relief can cross over to baby which in my mind is a big thing to consider (and not something I would want at all), you need to think about what facilities are available to you at wherever you decide to deliver, who will be with you (and we’ll get to that in a minute) and how mobile you want to be. It’s also worth having a back up in case the options you want are not available to you. I found the following websites, along with my NCT classes, a great help with making decisions relating to pain relief:
Another thing I’ve come to notice about labour is there is some confusion out there about some of the things you’re asked to consider and decide with your midwife. There are some options that you never really hear about and probably wouldn’t unless you are pregnant so I thought I might try and help make things a little bit clearer.
I had no knowledge of vitamin K and it’s involvement in birth until quite late on in pregnancy. But towards the end of the pregnancy and as part of your birth plan included in your NHS notes, you’ll be asked to consent to your baby being given vitamin K shortly after delivery. This is because babies are born with low levels of vitamin K in their little bodies, and this vitamin is crucial to help blood clot and prevent bleeding.It is rarely so low that it causes any major issues, however the Department of Health recommends that all newborn babies are given a dose of vitamin K just to boost their levels and prevent any chances of complications. For me this is a no brainer and I’ve already given my consent to my baby being given an injection of this once he or she is born. The vast majority of the time this is given with a quick injection which I think is something a lot of mothers don’t like the idea of. The way I’ve looked at it is that baby will have already gone through the epic journey of childbirth, so a quick injection that will be of great benefit will be a minor detail in the grand scheme of things. But this is only MY opinion. There is also the option of giving the baby the dose orally, over the course of the first month of the babies life in three separate doses, however you will need to remember when to get your babies dose topped up so he or she receives all three doses. This could easily be forgotten in the hectic first month of babies life so it’s crucial if you take this option, to stay on top of the doses to ensure baby has full protection.
And of course there is the option of not giving your baby the Vitamin K at all. Again, this is a hugely personal choice and because it’s not the choice I’d make, I haven’t read too much into why you would decline it. I assume a lot of people might prefer to trust nature and of course there are a million forums out there which can give so much conflicting advice which I personally find a bit of a nightmare because it can easily confuse people and create scare mongering. My personal opinion is that I’d give anything to my baby that might protect it and I don’t believe these injections would be administered without a great deal of research and medical approval. So go with what is right for you and be sure to weigh up all your options.
Delivery of the Placenta
This is another decision you need to make your midwife aware of prior to giving birth. As you most likely know, the third stage of labour involves the delivery of the placenta (delightful)! You can either be patient and wait for this to be delivered naturally or you are offered an injection to speed up the process. For me, the decision was always going to be to have the injection to hurry things up and get it out. This was just because I don’t feel strongly about nature taking its course in this respect, I want to just get the delivery done with as quickly as possible and I don’t personally feel it will have an effect on my baby. Upon being told I didn’t need a C Section, I was told I would have to have this injection anyway because of the placement of my placenta and the consultant being very keen to get it out without any complications. So for me it has worked out as I would want.
I do understand why some women prefer to have a natural delivery of placenta though. There is the belief that it is how nature intended, and you may feel you want your baby to continue to receive blood from the placenta until the pulsating of the cord stops naturally (although you can have delayed cord clamping with an assisted placenta delivery, the cord would not pulsate as long as it would with a natural delivery of the placenta). It is crucial you bear in mind that a natural placenta delivery will increase your chances of further heavy bleeding after birth, as if we weren’t going to suffer enough!
Either way, you will have to do a bit of pushing to get the placenta out, although obviously less if you have the injection as the placenta will be expelled within approximately 10-20 minutes. The babies cord will be cut just before the injection is administered so it doesn’t receive any of the hormone being injected into you. Having the injection doesn’t completely rule out a delay in clamping the cord. The injection causes more rapid contractions, but a minute or two is likely to be enough time for most of the blood to transfuse to your baby. With a natural placenta delivery you may be contracting for up to an hour to expel the placenta, although of course these contractions will be far less strong than those you’ll have endured delivering the baby.
I think this decision is a really personal choice. I thought all women would automatically have the injection to quicken up the process, but since being pregnant I’ve spoken to several friends who have, or plan to, take the natural option. And I take my hat off to them. I can fully appreciate their desire to keep things as natural as possible. Fortunately this is a decision not too many discuss so you can make your decision privately and without the, sometimes unwanted, opinions of others.
The final thing I wanted to comment on was your birth partner! Poor sod – they are going to endure swearing, blood, sweat, tears and of course the unspoken fear they might see you poo yourself!!! Most women already know who they want as their birth partner with husbands, partners and their mums as top choices. Obviously I can only write here about my own choices and I always only ever wanted my husband to be the person with me when I give birth. This is because it’s our lives that are changing and I feel strongly that it’s something we should experience privately and alone. When I first told my mother this I think she was momentarily hurt, because I said I didn’t want her there too. I love my mum to pieces and I know I’ll want to see her as soon as I can after the birth, but for me, it just didn’t feel right to have her there too. My husband is one of the calmest and most level headed people I know. He is a great influence on me and calms me down if and when I get a bit stressed or uptight. Being as calm as I can be during labour is so important to me so his influence will be such a big factor. I know he’ll be supportive and encouraging. I know he would not be one to panic necessarily and if he saw panic in me, he is the person who knows me best in the world and will know exactly how to calm and comfort me. I love the idea of us going into the hospital as husband and wife, a little team, and leaving as a parents and a little family! And I also know one thing I will look forward to seeing so much is seeing my husbands face when I’ve brought his son or daughter into the world. I know he will be the proudest man in the world at that point and I cannot wait to see that in him, I already know it will be a beautiful moment. I know the time I’ll want my Mum’s guidance and advice will be in the first few days after birth when your hormones are going wild and you have a million questions because you’ve forgotten everything you were told in your antenatal classes! And I love my mother so much for respecting that choice. I can imagine some mothers could make you feel guilty as they may feel less involved as they want but it’s your day, your moment, and you must do what is right for you. For many women, their mother is their best friend and it would be a no brainer to have them at the birth, comforting you as only a mother really knows how to. So I can imagine for some women it must be lovely to have that during such a painful and scary time. All I’d say is this is a life changing moment; you want to be supported by someone who knows you well, knows how to calm and soothe you, and who you feel very comfortable with, because lets face it, this isn’t going to be your most dignified hour and they are going to see everything!!!
Have Faith in Yourself
So as you can see, this is a really long post and it’s only touched on some of the decisions and choices you have to consider where labour and giving birth is concerned! There is so much to think about and it really can be so overwhelming. But try to keep it in perspective. This is coming from a woman who is pathetically scared of a blood test but has come to have no issue at all with an enormous needle going into her spine whilst pushing a tiny human into the world! I like to think when you find out you’re pregnant, a huge amount of womanly and motherly instinct kicks in. Pregnancy is tough (and that’s something else I will be blogging on in the near future) but you’ve coped with sickness at all hours of the day and night, a million blood tests, internal examinations, back ache, headaches, round ligament ache, acid reflux, heartburn, extreme tiredness, and 9 months without a glass of prosecco; you can do this last bit! It’s hard; it’s going to hurt, you’re going to bleed and you’ll have moments when you think you’re going to die and you can’t possibly do this. You can; you’re effectively superwoman! You’ll deliver that baby, you’ll have complete faith in yourself and you will be the proudest and most happiest person in the world. You can do this. You’ve got this – trust me!
And yes, when I am in labour and swearing like a trooper thinking that I am being disemboweled with a red hot poker, I will read that last paragraph and remind myself of the faith I have in myself. And I’ll do it (with the help of an epidural and no shame in that). I’ll bring my baby into the world and I’ll be the proudest and most grateful woman on earth for that.
Remember, you’ve got this