Your most-asked questions about giving birth ??answered!
Midwife Claire Friars, manager of baby charity Tommy's* Pregnancy Information Line, says: 'Often I find the same questions come up again and again, so it's great to be able to answer them, and I hope to provide, not just information but reassurance too.'
Q: How I will I know when it's time to go to hospital?
A: Unless you're given special instructions by your midwife or doctor, or you're less than 37 weeks pregnant when you go into labour, there is usually no rush. Most people don't deliver in the car park like they do on TV! As a guide, if it's your first baby, head for hospital when you're contracting every five minutes and each contraction lasts more than 30 seconds. Second babies tend to be quicker, so head in when you're contracting every 10 minutes for 30 seconds or more. Whenever your waters break do go in as the midwives will need to check the baby is happy. If you are ever not sure what to do or if you are worried, call the labour ward for advice.
Q: Will I know the midwife delivering my baby?
A: This really depends on the system in your area. Ask your midwife during the pregnancy whether this is likely. Don't forget that like everyone else midwives have holidays and sickness, so don't be too disappointed if it doesn't happen.
Q: How long will the birth take and how long will I be in pain?
A: This can vary dramatically from woman to woman. As midwives and doctors we don't usually say you're in established labour until your cervix is 3cm dilated, which can take a day or so of niggling pains. Once you are 3cm dilated, with a first baby, we would usually expect your cervix to open 1cm an hour. This would mean taking seven hours until you are 10cm (or fully dilated), when you can start pushing! Pushing your baby out can take up to two hours for a first-time mum.
Q: Will I be able to get an epidural?
A: If you think you might want an epidural ask your midwife during the pregnancy whether they are available 24 hours a day in your birth unit. Once in labour the best advice is to try the different methods of pain relief available. However, if you are having a long or very painful labour and decide you want an epidural ask your midwife for one as soon as possible. An anaesthetist has to come to give you the epidural and if they're busy giving epidurals to other women or are in theatre for a caesarean there could be a delay. It takes around 15 minutes to put the epidural in and another 15 minutes to fully work. If it looks like you might deliver before or soon after the epidural is working the midwife may suggest you try alternatives such as gas and air instead.
Q: Why might I need a caesarean or forceps delivery?
A: There are two sorts of caesarean - those that are planned and carried out before a woman goes into labour, and those that become necessary due to a complication during the labour. If the caesarean is planned it is usually due to a medical problem such as a low placenta (which may be blocking your baby's exit route) or a breech baby (which is lying across your tummy and will not descend head first as he should). If a caesarean becomes necessary during the labour it can be for a number of reasons such as if the cervix doesn't dilate in the expected time or stops dilating at a certain point, or if the baby seems to be distressed. If you are fully dilated and pushing furiously, but the baby still refuses to come out, doctors may try to help things along by using ventouse (a suction cap which sticks to your baby's head, allowing the doctor to pull in time with your pushes) or forceps (two large metal spoons that are gently put around the baby's head to pull on as you push).
Q: What is a show?
A: A 'show' is a plug of mucus which forms soon after you become pregnant and usually sits inside the cervix, acting as a barrier. Towards the end of your pregnancy the cervix may start to open a little and move around, this means you can lose little bits of the mucus and you may notice them in your knickers or when you wipe yourself after going to the loo. It looks like jelly and can often have streaks of blood in it. Unfortunately it isn't a sign that you are about to go into labour and you may even see it two weeks before the baby is born. Some women don't see any at all until they are in labour. If you do see a show and are less than 37 weeks you should call the labour ward for advice, otherwise they don't need to know. As at any other time, if you see bright red blood you must go to the hospital.
Q: How long will I have to stay in hospital afterwards?
A: If you have had a normal delivery and you and the baby are well you may be able to go home after a few hours or the same day. If you have had a caesarean, any complications, or the baby needs monitoring you may need to stay a few days. Once you are home the community midwives will visit you regularly to check on your progress.
Q: Will my partner be able to cut the cord? And how soon can I hold my baby?
A: If the baby appears well at the birth then your partner should be able to cut the baby's cord, just ask the midwife during the labour. If your baby needs a little help at birth, such as a little oxygen to start his breathing the midwife may need to cut the cord for speed. Normally the baby will be delivered straight onto your chest. If you would rather the baby was given a quick wipe first ask the midwife (or write it into your birth plan).
Q: How can I tell what stage of labour I am in?
A: There are three main stages of labour: the first, second and third stages. The first stage of labour is when the cervix is dilating up to 10cm (fully dilated). You will know how many centimetres you are dilated when the midwife does a vaginal examination. The second stage is when you are fully dilated and now actually pushing your baby out. This can require a lot of energy and inner strength so prepare yourself for some hard work! The third stage is after the baby is born and involves delivering the placenta or afterbirth. You may also hear some midwives mention the 'transition phase' - this is the time when you are changing to fully dilated. It is thought by some that this period of time is when women gather the strength for all the pushing. Some women (and partners) find that the woman's voice and facial expressions change and they may even say some funny things. I even had one woman get up, put her coat on and say: 'I've changed my mind, I think I'll do this another day!'