From the moment we consider having children, and possibly even before this point, we are bombarded with information, opinion and stories about what birth and labour are like. From the stories of your peers of all the gruesome details, your own mama telling you how hard she worked to bring you into the world and your well meaning Aunt commiserating all the pain you’ll be in. You’ll be forgiven for thinking that you’ve had your fill of well meaning advice.

Thankfully its not all gruesome! Here are 14 informative things other mamas wished had been included in all the advice and horror stories!

That labour and contractions build up

Unlike some of the stories you hear, many mamas wish they had known that labour can start fairly slow and gentle. This is your body’s way of helping you deal with labour pain and conserving your energy.

That Your Body Knows what to do

Did you know that mamas have giving birth while unconscious and in comas? That’s because your body has a natural mechanism called the fetus ejection reflex. Your body knows exactly how to push your baby out and if we can turn our neocortex down, most of the time our bodies will do exactly that.

To trust our instincts

Many mamas wish they had known to trust their own instincts both positive and negative. And insisted that their attendants had listened to her instincts too. A lot of the time mum knows exactly when everything is OK and when she needs some extra help. She has, after all, lived with her body her whole life!

How big a part hormones play

As with everything that our bodies do naturally, various hormones play a huge part in labour and birth. The most important hormones in labour include Oxytocin (the love and connection hormone); Endorphin (the euphoric, pain relieving hormones) adrenaline and noradrenaline (the fight or flight hormone) and prolactin (the mothering and breastfeeding hormone).

Oxytocin, the love hormone, is the hormone in effect whenever we are in position to bond with others. When we fall in love? Oxytocin. During sex? Oxytocin. Giving birth? Oxytocin.

During labour and birth, Oxytocin is what’s called a uterotonic, it causes the uterus to contract and push the baby into the birth canal and eventually, earthside. Oxytocin is also the hormone that helps mama and baby bond soon after birth.

Endorphin, the euphoric hormone is the hormone our bodies release when we’ve exercised and feel that natural high. It acts as a reward and has natural, slow release pain relieving effects and are similar to opiates.

During labour, endorphin can actually inhibit oxytocin which sounds counterproductive but actually serves the purpose of slowing labour to a more acceptable level so mama is never overwhelmed.

Adrenaline, the fight – flight hormone, activates the central nervous system. This can inhibit oxytocin which in nature would be useful if mama senses danger.

During birth, too much adrenaline can disrupt contractions even stall labour completely. This is way mama feeling safe and secure can be so instrumental on her having an unassisted birth.

The reason for this is a hark back to our evolutionary roots. If mama sensed enough danger and had enough adrenaline pumping through her then labour would stop until she got herself and her babies to a safer spot.

Prolacting, the mothering hormone, prepares mamas breasts for feeding. It also helps mamas bond and increases vigilance towards her infant.

 That hospital and medical advise is exactly that; advice

Many mamas talk in terms of what she was allowed to do in labour only later realising that this left her feeling very out of control and disempowered. It is absolutely OK to follow the medical advice of your attendants so long as you realise that you have the power to question it. To ask for further information. And, ultimately, to say no if you want to.

Doing something because of blanket policies doesn’t make a lot of sense when each of our bodies and births are so different.

One way to make sure you are comfortable with all the decisions made is for you (our one of your birth partners) to employ B.R.A.I.N.

B- Benefits, what are the benefits to doing this procedure?

R- Risks; What are the risks involved in doing this procedure?

A- Alternatives; What are the alternatives?

I- Intuition; Can I see the sense in this procedure? What is my gut telling me?

N- Nothing; What happens if we wait or do nothing?

I wrote more about the impact of this here.

This sense of empowerment can be achieved through the entire birth process. It is worth asking questions regarding the risks vs benefits of induction, especially if the induction is suggested because you are ‘overdue’ to trusting your body to know exactly when to push and even so far as knowing that if you don’t feel supported and well provided for by your midwife you are within your rights to request a new one.

Saying ‘No Thank you’ when its appropriate can be very empowering.

There are different types of labour

We all hear about how contractions feel a lot like period pains that gain intensity but did you know that a lot of women get whats called ‘back labour’. This often feels like an intense back ache and is attributed in part to babies head pressing against your pelvis.

Breathing methods can be a natural form of pain relief

Many people hear about breathing techniques helping you through labour but did you know that that there seems to be significant anecdotal evidence to suggest notable relief from pain?

In Effective Birth preparation Your practical guide to a better birth Maggie Howell, founder of Natal Hypnotherapy™ says;

“As well as the emotionally and mentally calming effects of abdominal breathing, you will benefit physically in many ways:

• By expanding your abdomen as well as your lungs, you give the vertical muscles of your uterus more room to reach down and pull up the circular muscles.
• Your blood pressure remains at a healthy level.
• You increase the level of oxytocin (hormone responsible for regulating contractions).
• This increases the levels of prostaglandin (the hormone which softens the cervix)
• This increases the level of endoprhins (the hormone that dulls the sensations in the part of the brain which registers pain).”

(page 147,

Effective birth preparation

Your practical guide to a better birth,

Intuition UN Ltd.

2009)

First births can be filled with the unexpected

Did you know that often when a baby crowns, especially during a first (nulliparous) birth, a baby will crown and then retreat a few times before crowning and being born. It seems to be to aid the blood flow to the perineum to aid it to stretch and avoid tearing.

Degrees of separation?

We all hear horror stories about mamas tearing during delivery but did you know this one word covers a large range of tears of varying intensity? Yes, some mama’s do tear ‘badly’, the worst stage being a 4th degree tear which needs to be rectified by surgery but much more common is a 1st degree tear which are usually superficial and only involve the skin usually in and around the entrance to the vagina and doesn’t need any stitches. These are often called grazes instead of tears.

An episiotomy is automatically a 2nd degree tear which will need stitches to heal properly.

Induction and assisted deliveries

Did you know that according to the NHS 1 in 5 labours need induction in the UK?

Induction of labour is offered if:

• you are overdue by 1 week (41 weeks gestation)
• your waters have broken but your labour has not yet begun
• you or your baby are distressed or suffering with any health issues.

There are risks and benefits to accepting the offer of induction but know that you always have a choice. It’s worth asking lots of questions and getting as much information as possible to make your decision.

All inductions are different and many women go on to have very positive labours after being induced.

However it is worth noting that less than 2/3 of induced labours progress with further assistance, 15% of inductions result in instrumentally assisted births (this means that an episiotomy is needed and an instrument such as forceps or a ventouse is used to help you birth your baby) and 22% of induced labours result in an unplanned (emergency) cesearean birth.

There is still a lot of ways to have a positive birth experience even if things don’t go to plan but knowing the risks can be a big help.

What happens during an induction

It might also help to know exactly what the common procedures are with inductions.

• the first thing you will be offered will be a membrane sweep and stretch. This involves your midwife running her fingers around the inside of your cervix, separating the membranes of the amniotic sac from your uterus.

If your cervix is soft and already opening this can often be enough to get labour going and become fully established.

If it doesn’t then they they may offer your you a pessary of synthetic prostagladins (these are the hormones that soften and help open your cervix) and try another membrane sweep and stretch a few days later in the hopes that the cervix will be a little softer and more ready to open.

• the next stage is often the Artificially Rupture of Membranes (ARMs) also known as the manual breaking of your waters.

This will often result in full blown labour starting quite quickly but you do increase your chances of infection once your waters have broken.

• Finally, if these steps haven’t got you into established labour you may be offered a drip of synthetic oxytocin (remember the love and bonding hormone from previous points?). As mentioned above oxytocin is considered a uterotonic which means it can help stimulate and regulate your uterus to contract.

There are other ways of telling how ‘far along’ you are

While many midwives like to do regular internal exams to see how dilated a mama is there are others ways of assessing this. Remember that, especially once your waters have broken, you are at an increased risk of infection if anything not sterile is inserted into your vagina.

These other ways include listening to the changing noises a mother is making. There is evidence to suggest that mamas in labour use deeper and deeper tones the further along in labour they are.

Another is ‘the purple line’. This line appears to lengthen as your labour progresses.

If you feel uncomfortable with internal exams ask about these other methods of telling how far along your labour is and remember; dilation is a quick check of where you are right then and there, it won’t tell you where you might be in 5 minutes, 10 minutes or 2 hours from now.

Birth doulas

Here at earthside we’ve previously spoken to Vikki Young, a birth doula about the importance of advocacy and support of birthing mothers. Having someone on side from the very beginning of labour can really help to increase your chances of having the birth you dream of. It also frees up your birth partner to fully support you physically and emotionally without having to worry about making sure your birth plan is stuck to wherever possible.

Negative previous experience?

Having had a less the positive previous birth experience can have a profound impact on each subsequent experience, with some women feeling scared, nervous or even so traumatised that they are wary of having any more children.

The decision to have more children is a deeply personal one with no 1 right or wrong choice. However, there are ways of dealing with past traumas to help you move on if that is what you want to do.

Birth debriefings are often offered by experienced family counsellors as a way of talking and working through your feelings and understanding why certain things happened during your birth. If this is something you feel you might benefit from ask your G.P. who should be able to point you inthe direction of local counsellors offering this service.

Another good resource is the PALs (Patient Advice and Liason service) with the NHS. Through them you can find support groups with and without the NHS and also make a complaint if you feel you were mistreated at any point. They can also help you make a complaint through an independent body if this is something you feel would be helpful.

It is also worth remember that a negative birth experience can be traumatic for your birth partner too and all the above information can be very beneficial to them to let go of any trauma that they might bring in to the birth with them.

And being informed is always a positive step for everyone.

Is there anything you wish you had known about birth before you went into labour? Did you only hear negative stories? Did you feel informed? We’d love to hear from you in our comments!