Month 5: Ten labour ward myths

Old wives’ tales about birthing can confuse you and make you anxious. How do you know what to take and what to leave?

Your belly’s just started showing and then the stories start: your hips are too narrow to birth naturally, labour pains are the most excruciating ever… and everyone shares the absolute worst birthing stories. Labour scenes in movies also don’t help much to put you at ease… You often see wide-legged women with their feet in stirrups screaming and shouting in pain and doctors, gogos, anties and dads anxiously running around.

It’s enough to give anyone nightmares. But how true is all of this? We separate fact from fiction…

1 LABOUR ALWAYS STARTS WITH WATERS BREAKING

In the movies, the birthing process often starts with the woman standing somewhere in the shopping aisle or dealing with a crisis when her waters break, and she suddenly finds herself in a pool. But only about a third of women find their labour starting with waters breaking, says Heather Pieterse, a private midwife in Gauteng. For most women, labour starts with contractions, and their waters only break in the active phase, or they get broken in hospital by the staff. If your water does break spontaneously (when the membranes of the amniotic sac tear), it’s also not always a stream – you’ll often just find your undies are a little wet. Phone your doctor if you suspect your waters have broken and you’re leaking amniotic fluid, because it increases the chances on infection.

2 LABOUR IS A NATURAL PROCESS, SO YOU DON’T NEED TO PREPARE

Your mom did it, and so did your gogo. So why do you need to prepare for such a natural process? Every woman should prepare herself psychologically for labour, so that you know what to expect and are empowered with information, Heather says. “If not, you’re more scared, and that can trigger the pain-and-fear cycle,” she says. Research has shown that stress and fear cause stress hormones to be released that can delay the contractions and extend labour. With preparation, you can learn techniques and positions that can make birth easier and less painful. Prep should also include light exercise. Studies show that exercise can help speed up the labour process and shorten the recovery period following birth.

3 THEY HAVE TO SHAVE YOU AND GIVE YOU AN ENEMA BEFORE BIRTH

Although some doctors prefer the perineal area (around the vagina) to be clean shaven, and their patients get an enema before a natural birth, it’s not a requirement.

You can discuss your preferences with your doctor and convey them to the labour-ward staff as part of your birth plan. But if you don’t say anything, they will do what the doctor prefers.

For a c-section, the pubic area where the incision is made is, however, shaven clean to limit the risk for infection, Heather explains. Enemas are usually given to prevent you from pooing during labour, but your gut usually clears itself before birth. Heather says midwives seldom give an enema, unless you’re constipated and this holds baby back from being born.

4 IF YOU HAVE NARROW HIPS, YOU CAN’T LABOUR NATURALLY

You can’t look at someone and claim her hips are too narrow for natural labour, because you don’t know the shape of her pelvis, Heather says. “Your pelvis needs to be the right shape for Baby to be able to come through. Even a woman with broad hips can battle to labour if the pelvis is not ideally shaped for birth.” She says it’s really hard to predict ahead of time, as the pelvis opens during labour to allow Baby through. Baby’s skull is also soft and can easily adapt to slip through the opening. The position of Mom and Baby during birth also plays a role. If you’re lying on your back, it’s harder for the pelvis to dilate and allow Baby through, while the pelvic opening can dilate by 30 percent more if you squat. “The only way to see if a baby is indeed able to fit through the pelvis is with a false labour, where you start labouring and see what happens.”

5 YOU HAVE TO LIE IN BED FOR THE WHOLE LABOUR

You might be asked to lie down, so that the nurses and doctors can attach monitors to check your baby’s heartbeat and your contractions, but this does not mean you have to lie motionless on your back all the time. Ask the nurse to hook you up to the monitors every now and then, and move around. It helps the contractions, takes your attention away from the pain, and gravity does wonders for the labour process when you’re upright. So walk around, kneel, and lean forward over the bed.

6 ALL MEDICAL INTERVENTION DURING LABOUR IS BAD

Sometimes we become so swept up in the idea of natural delivery that we see all medical intervention as bad. This is looking for trouble, Heather warns. “Medical intervention is wonderful if it’s done for the right reasons. It can save lives. We do see that intervention happens too quickly, or for the wrong reasons, and that’s where it gets a bad rap.” So remember, a birth without any help is wonderful, but in the end, a healthy and happy baby and mom trumps all of that.

7 LABOUR PAINS ARE ALWAYS UNBEARABLY TERRIBLE

Every person handles pain in their own way, and not every birth is equally painful. In one study, about 20 percent of women said they found labour very painful and bad, but 20 percent said their pain was slight. The rest fell in between these two groups. Heather says we need to remember that labour is not one continuous pain, but that it comes in spurts. The body also releases endorphins that help manage pain. Women who are nurtured and supported during birth experience less pain. Warm water, movement and massage can also help. And if you don’t feel up to the pain, you always have the option of painkillers.

8 YOU HAVE TO LIE DOWN, LEGS WIDE, FEET IN STIRRUPS, TO BIRTH

The good news is that very few doctors still use stirrups, Heather explains. Most prefer us to lie on our back when we push, so that the gynae has a better view when they baby comes out. A good option is to lift the bed slightly at the top, so that you can still make the most of gravity. Midwives encourage a variety of birthing positions, and many women squat when Baby comes out.

9 OF COURSE LABOUR STRETCHES YOUR VAGINA, SO YOU WON’T ENJOY SEX ANYMORE

Most women labour without permanent damage to the pelvic-floor muscles (which determine the tightness of the vagina) and enjoy a normal sex life following birth, says Prof. Zeelha Abdool, an obstetrician and gynaecologist from Pretoria who’s done quite a bit of research about the matter. Labour can cause damage to the pelvicfloor muscles, especially if the second phase takes very long or in cases where forceps are used, and this could have an impact on sex after birth. “Remember that the pelvic muscles stretch up to three times their normal size. Between 13 and 36 percent of women can contract an injury to the pelvic floor,” Prof. Abdool explains. Pregnancy itself also weakens the pelvic-floor muscles temporarily. The contraction ability of these muscles should, however, be back to normal about a year after birth. Regular Kegel exercises can help.

10 YOU GET YOUR PREPREGGIE BODY BACK IN NO TIME

We lose about 4,6kg during birth, while we gain considerably more than that during pregnancy. Give yourself time: Remember, you had nine months to gain all that weight, and it could take a while to shake it off. But breastfeeding can help get you back into your skinny jeans!