Ready, set, push!

Our secrets to speed up labour, writes Melany Bendix

NO ONE WANTS a long, drawn-out and exhausting labour, but a “cannonball birth” isn’t ideal either. (You know, that’s the kind you see in the movies where it all happens so fast, the woman gives birth en route to the hospital.) Aside from the back seat of a car just not being comfortable, it’s not an ideal or safe place for you or baby.

“If it’s too fast, there’s a greater possibility of tearing, and it can be stressful for the baby,” says Gayle Friedman, Cape Town based doula and chairperson of the South African doula association Women Offering Mothers Birth Support (WOMBS).

An extremely fast-moving labour is also difficult to cope with psychologically, adds Angela Wakeford, an independently practising midwife based in Cape Town. “It makes it very intense and difficult for you to get your mental coping strategies in place, so you can feel out of control and fearful.” What you want is that happy medium between a super-fast and agonisingly slow labour. Notwithstanding the fact that every labour is different, and there are often factors beyond your control, there are a few things you can do before and during labour to help you maintain a good, steady pace.

DURING PREGNANCY REST WELL AND LEARN TO RELAX

Research has shown that getting enough sleep increases your chance of a shorter labour. One study shows that the labours of women who get at least seven hours of shut-eye per night are 17 hours long on average (including the latent phase), which is substantially shorter than the average of 29 hours for women who sleep fewer than six hours

per night. “Rest is essential,” explains Gayle, “because if your central nervous system is calm and relaxed, your body will perform better during labour.” This is why practising relaxation and breathing exercises during pregnancy is so important, she adds. “Doing hypnotherapy or meditation classes can be helpful, but if you’re not comfortable with that type of thing, simple breathing exercises will also do.” Breathing and relaxation techniques will help you during labour too, says Michelle Walton, a therapeutic reflexologist and doula from Johannesburg. “These are your coping tools in labour – the more you practise them, the more effective they will be during labour.”

KEEP ACTIVE

Several research studies show women who exercise two to three times a week have shorter labours – by as much as one-third – than those who spend that time on the couch. It’s because women who exercise regularly are able to use their breath more effectively, Michelle explains. “Regular exercise increases your oxygen intake, which allows for greater endurance and more effective muscle functioning.”

While keeping fit and active is good, Gayle cautions against too much toning. “You don’t want your pelvic floor, in particular, to be too toned; you need it to be soft and relaxed, so there’s less resistance when baby comes down the birth passageway.

“That’s why I advocate gentler exercise during pregnancy, like swimming, yoga and walking.”

PRACTISE PUSHING

Gayle believes using the Epi-No, a pelvic-floor trainer, is good practice for the big push, especially for first-time moms. “It stretches the perineum as well as giving you some understanding of what pushing is all about; it shows that you need to push in your buttocks and vagina, not your throat or face.” A technique similar to this is perineal massage. It involves the gentle stretching and massaging of skin and tissues around the vagina and anus in order to condition the tissue for birth. Always check with your doctor before starting this. Remember that using an Epi-No or doing perineal massage does not guarantee no perineal trauma.

LOSE THE FEAR

Aside from babies who are not positioned correctly, Angela has found fear and having emotional issues weighing you down to be the biggest cause of overly long labours. “Being both relaxed and fear free makes an enormous difference to the length of your labour,” agrees Michelle. That’s because adrenaline is released when you’re scared, and this induces our natural fight-or-flight reflex, she says. “This reflex will cause the labour to slow down or even stop until the woman feels safe and secure once again. Adrenaline also slows down the release of oxytocin, the hormone that stimulates uterine contractions.” This can all contribute to putting the brakes on labour.

In addition, says Michelle, if a woman is scared during labour, she’ll “tend to clench her jaw, hold her breath, tighten her perineum muscles, tighten the other muscles of her body and mentally not want to release the baby – all of which will have adverse effects on the labour and slow it down, or prevent it from progressing”.

Angela says the best defence against fear is being well informed and prepared, and having full trust in the caretaker or team you’ve chosen to assist with the birth of your baby.

GET IN LINE

Visit a chiropractor or osteopath to ensure you have good pelvic alignment, suggests Angela. “A skew pelvis means less space for baby to get into a good position and descend.”

“Good alignment also allows for optimal functioning of the nervous and endocrine systems, which play vital roles in labour and birth,” adds Michelle.