Midwives are having a moment

One of South Africa’s most experienced antenatal experts gives you some great advice for labour day and the exciting lead-up to welcoming your baby into this world.

1 DEVELOP YOUR OWN BIRTH PLAN

Your birth plan should outline everything you want and need out of birth. Be sure to show this to your healthcare provider. Your birth plan should cover all aspects, from the medication you want or don’t want and the type of birth you prefer to the music you’d like to hear when Baby appears. Remember though that not all births go according to plan – so be prepared to alter your plan.

2 ANTENATAL CLASSES AND CHECK-UPS

The lessons learnt at these classes are invaluable, as you will learn everything you need to know about pregnancy, labour and childbirth. It also provides a space for you to ask questions and receive immediate feedback. Most antenatal classes are couples classes, so your partner can feel involved and learn about the process too. It is also important to go for regular check-ups with your gynae or midwife to identify any problems and to make sure baby is growing well. Having these check-ups and attending the classes will make you and your partner feel more reassured in your knowledge of each stage of your birth process.

3 EXERCISE DURING PREGNANCY

Pilates is a great example of beneficial exercise, as it can help strengthen the pelvic floor muscles to help during childbirth. Exercising in water provides gravity-free resistance with less risk of injury, while increasing muscle tone, your strength and your flexibility.

4 PERFORM PERINEAL MASSAGE

If you decide on a vaginal delivery, be sure to perform perineal massage as well as Kegel exercises to reduce the risk of episiotomy or tearing. These activities will help increase elasticity as well as strengthen and tone the perineum for childbirth. There is equipment available to assist in increasing your perineum’s elasticity – speak to your caregiver about the options.

5 DON’T COMPARE YOURSELF TO OTHERS

Everyone is free to make their own choices, and everyone has different experiences of pregnancy, labour and birth. Guilt is commonplace. The important thing is to do what makes you happy and comfortable. Try not to question your own decisions.

6 FORMULATE YOUR OWN EXPECTATIONS

Formulate your own positive expectations regarding birth. Don’t expect pain, as you will then experience pain. Dreading the idea of childbirth is sure to contribute to a negative experience. Recognise birth as the welcoming of a beautiful addition into your life.

7 BE PREPARED IN ADVANCE

Have Baby’s room ready, and be sure to have all the necessary equipment you’ll need for a newborn. Pack your hospital bag in advance. Being prepared will help you feel calm. Another preparation you shouldn’t leave out is how you are going to get to the hospital – which car you are going to use, who will drive you and what the best route to take is. This will save you time and stress so you need only focus on your labour.

8 RESEARCH OPTIONS THAT SUIT YOU…

... be it home birth, hospital birth, water birth, vaginal delivery or a caesarean section. Research all the different types of birth, and decide which one you are most comfortable with. Be informed, and make your own decision without being influenced by others.

9 KNOW YOUR PAINRELIEF OPTIONS

Even if you intend on having a completely natural, unmedicated birth, it is a good idea to know what pain-relief options you have at the hospital or clinic you are labouring in. Read up on all the options – from gas to epidurals – and find out from the hospital if you need to book it in advance (as some private hospitals ask for this). Another pain-relief option is hypnobirthing. This concept uses active birthing, which alters the way in which you view birth. For example, you view pain as ”pressure” and contractions as ”waves”. You allow your body to take over the process of birth. If, for any reason, pain relief is needed, knowing these options will help you make a good, confident choice during your labour.

10 TRUST THE CAREGIVER

Trusting your caregiver will make you feel reassured and relaxed. The right person to help you is one of the most important decisions. If you feel you are not being heard or your caregiver has a different approach to birth than you, you need to change that person.

11 BOND WITH YOUR BABY

Establish a relationship with your baby before you have given birth. Speak to your baby, play music, rub your tummy, and get your partner to do the same. When your baby is born, and you and your partner have spent time speaking to your bump during pregnancy, your baby will respond to both of your voices. This will help your partner feel part of the process and help them develop a bond with your newborn as well.

12 BE POSITIVE!

Thinking positively in labour can make a big difference to how you cope. Accept that labour is hard work and that it will hurt, but also that this pain is easily managed. Learn all the skills you can to cope, such as massage, acupressure, positioning, breathing and relaxation. Go with the flow of labour – don’t fight it. Try to think of it as positive pain, bringing you closer to your baby.

13 HAVE A SUPPORT PERSON WITH YOU ON THE BIG DAY

Whether it’s your partner, a family member or a doula, don’t labour alone. Knowing you have someone to support you will help you relax and feel confident.

14 WAIT FOR THE RIGHT TIME

We know that the temptation to rush to the hospital at the first sign of a contraction is a big one. After all, you want to make sure you and baby are alright, and especially if you are hoping you will be one of those women who have a ”half an hour labour”. (Don’t we all?) The downside of going in right away is that you’re more likely to receive medical intervention. This is because the doctors see that you have been in labour for a certain amount of hours, and feel the need to intervene. Being at home during the early phases of your labour will help you feel more relaxed and comfortable – which in turn will help you to deal with the contractions, as your muscles will not be as tense.

15 FIGHT THE FEAR

Fear is the biggest cause of pain in labour. If you understand the birth process and anticipate your behaviour during labour, you will have insight and confidence that your body has a unique wisdom that you really can trust. Your partner should lean in too!

16 WEAR COMFY CLOTHES

Oversized T-shirts that you don’t mind getting soiled will allow you to feel more comfortable. If you are planning to use water as pain relief or for birth, pack in a strappy T-shirt to wear.

17 MAKE SPACE

Empty your bladder and your bowels. A full bladder can be extremely uncomfortable during pregnancy and during labour. It can also hold up the labour process and significantly increase your pain level. If your tummy has not worked, having an enema is not a bad idea. An empty rectum will make more room for your baby to move through.

18 VISUALISE TO RELAX

The ability to release tension at will, as well as turn inner positive thoughts into pictures (visualisation) is a labour tool and life skill. Tension in labour brings more pain and will draw out your labour. Every time you have a contraction, welcome it and release yourself into it. Become as limp as a floppy doll.

19 DRINK WATER

Dehydration can make uterine contractions more painful. If you become dehydrated, this can slow down the process. Try to drink whenever you are thirsty, and if you’re not, have sips of water or suck on ice chips.

20 FUEL YOUR LABOUR

One thing that a lot of us forget to do when we go into labour is to eat. While you may not feel like it, eating energy-rich foods will help you get through your labour. When you have your initial contractions, try eating a slow-releasing carbohydrate, like pasta, between the contractions. Once you are in your active phase of labour, eating energy foods and snacks is vital. Think energy bars, energy drinks and sugary sweets for an instant release of energy into your system.

21 GET MOVING

In the earlier stages of labour, in between contractions and if you aren’t bedridden by a drip, taking a walk is a great idea. Moving around will get your labour on track and help ease your muscles. You can literally walk out some of your labour pains. The weight of your baby on your pelvis while you are in an upright position will help your pelvic bones open. It is also a great way to distract yourself from the labour process, and getting some fresh air can do you the world of good.

22 USE A BIRTHING BALL

A great accessory to take with you to the hospital is a birthing ball. It is not only used for exercises during pregnancy but also for relieving pain and discomfort during labour. The squatting position that your body takes when sitting on this ball can ease so-called back labour and help turn baby into an optimal position, and the rocking motion can help you ride out contractions. It can also give your partner better access to rub your back.

23 GET INTO WATER

Water has amazing pain-relieving powers, so don’t take it for granted. Use water to soothe and settle you before and during your labour. A powerful showerhead directed onto your back can ease backache. Make sure the bath is deep enough to make you feel buoyant.

24 CHANGE YOUR POSITION

Adopting different positions while you are in labour will help your body cope with the pain, and can hurry your birth along. Squatting will help you dilate quicker while positions such as the all-fours as well as kneeling or leaning with the aid of a support person are great. Change positions and move around. Learning these positions during antenatal classes or from your midwife or doula will make them feel more natural when you actually have to do them.

25 ASK FOR A MASSAGE

The power of massage during labour is widely known. It eases your muscles, encourages blood circulation and can alleviate pain. More and more women are using reflexology during their labour, where a reflexologist or birthing partner massages certain pressure points on your body to ease pain. If you can’t get a reflexologist, ask your midwife to show your birthing partner some massage techniques that can be used during labour. Using certain oils such as clary sage, lavender and jasmine during the massage will further promote relaxation and pain relief.

26 KNOW YOUR RIGHTS

This is a biggie. Knowing your rights at whichever hospital or clinic you are will make for a better birth, that you are in control of. Not just as a labouring woman, but as a patient, you have legal rights to certain things. South African government hospitals have taken something called The Better Birth Initiative on as a policy to protect women in labour. Some of these rights include the right to eat and drink during labour, to have a birthing partner with you, to be able to move around and adopt different positions during labour, to not have to undergo an enema before the birth, the right to avoid an episiotomy, and to have bonding time with your baby where you can immediately breastfeed after birth (assuming that the baby does not need urgent medical care). Find out from your hospital or clinic whether they have implemented this initiative and what your rights are. It is important to know without a doubt that you must be treated with care, respect and dignity at all times by hospital and clinic staff. Think of yourself as a customer at a restaurant – your worries and complaints must always be heard and attended to. ●