TV images have a lot to answer for and we have built up an expectation of a bed and stirrups and pushing until we are red in the face. Birth can be like this but it is certainly not the norm.
I use images in my antenatal classes to provoke some discussion and a lot of parents are quite surprised at what real birth can look like – in pools, standing, kneeling, using upright positions on a bed. Even lying on your side after an epidural will probably be more effective than lying on your back.
Labour and birth is often about going with what feels right and what is more comfortable for you. However, exhaustion after a long labour can affect how involved you are – by that point, birth could be about lying on a bed because you are struggling to find the physical and emotional energy to do anything else.
But where there is energy and good support, there can be different positions and use of gravity and lying down really might not feel ok for you at all – I have seen really strong urges to get up and I have also physically helped women up into a kneeling position because they are tired and struggling. This is when birth partners, doulas and midwives can have such an impact – physical and emotional support at this point can transform the end of a long labour, so a woman knows she is safe and looked after, as well as being held up if needed so gravity can do its thing.
We can also expect to be told when to push and how to push – again, this can be part of birth but it really doesn’t have to be. In many births, being told when to push doesn’t really help – it can disconnect women from what their body needs and being told when to push can be about lack of gravity – if you can get up, it might feel better and less of a slog.
Not every woman gets a strong urge to push – just go with what your body is asking you to do. And the women who get a strong urge to push don’t need to be told when to push because it is happening. Needing to push is such an instinctive thing, going against it is hard and more uncomfortable – like being told not to blink, it just doesn’t feel right.
Being told not to push is only relevant if there is a medical need when you need to listen and when there may be a more authoritative tone in your midwife’s voice – this could be due to an issue with the umbilical cord or with your baby’s shoulders – or if you are pushing and there is no contraction. As your baby’s head is crowning and being born it can also help to change your breathing to slower breaths – blowing out birthday candles – so your body can stretch gently.
Assumptions can also be made about having to be on the bed – unless there is a medical need or unless that is where you want to be, you can be moving around the bed or you can find positions that are more comfortable for you.
The Royal College of Midwives recommends the use of active and upright positions to assist with labour and birth. And the NICE guidance (2017) recommends that women move and adopt positions they find most comfortable, and this includes women with epidurals.
For me, it is about doing what feels right for you and going with that rather than doing what you think you should be doing – if it feels comfortable and it is working then you will probably feel more control, calmer and happier. If your contractions slow, or it just doesn’t feel right, move into a different position, see if that helps. This is a time to really listen to yourself to work out what you need.
Panic can take over during the second stage – especially when your baby is close to being born, when your vagina and perineum are stretching. Try not to be scared of what your body needs to do to birth your baby. Knowing how to use and control your breathing is crucial for the birth of your baby – to head off panic, to slow things down, to focus and to listen to your body.
I can’t stress enough how important it is to know how to use your breathing – this is not about being zen, it is about focus, calm and control.
Birth might not look or feel how you expected it to – you could be excited and
re-energised or you could be exhausted or frightened. But it helps to…
- Say what you need
- Say how you feel
- Listen to your body
- Rest if there is chance in-between contractions
- Remember that you are close to having your baby
- Use your breathing for focus and calm so you can keep it together for a little while longer
- Know how your partner can support you, so talking this through in pregnancy can be really beneficial
If you have any queries about birth information and antenatal classes, please don’t hesitate to get in touch.
Janine | Birth, Baby & Family
A specialist in pregnancy, birth and early parenting