Birth tips from a midwife

The midwife on your labour ward might spend more time with you in one shift than your obstetrician does in nine months. Here’s what she wants you to know.

A midwife: provides expert care of mother and baby through labour, birth and recovery; monitors foetal heart and contractions; cleans up mess; adjusts for quirks, temperaments and family dramas; coaches dad; pampers siblings; translates medical-speak; serves as cheerleader, drill sergeant and best friend.

You can’t shock or gross us out. We’ve seen it all. You aren’t the first woman to go into labour with unshaved legs, unwashed hair and a bikini zone that hasn’t seen wax in ages, if ever. We don’t care. If there’s time, start labour freshly showered. Bonus points for shaved legs and pedicures (who can reach?) Bikini area? Whatever. We don’t care how much (or little) hair there is or what colour it is.

Jewellery gets in the way. (Rings can stay.) Body piercings – remove first. Tiaras – optional, though you are the queen. And don’t worry about pooping, yelling, getting out of control. That said, pain is no excuse for being mean.

We aim to please – but please be flexible. Birth is unpredictable, and flexibility makes for a smoother delivery (not to mention parenting). Tell us, and your doctor, what you want well beforehand – we’ll try to deliver. However, we can’t guarantee every item on your birth plan wish-list. (For more on this, see “Insider Secrets!” right.)

It’s tough being born, and some babies need a little help getting out. It’s no picnic for mom, either, and sometimes plans fly out of the window once labour gets serious. So we won’t hold you to every pre-labour promise you made, like “I won’t, won’t, won’t get an epidural – just deep breathing for me!”

We really do need to perform all those vaginal exams. We can tell lots by how a cervix feels, its position and how fast it’s changing. But we know that no-one likes these exams, so we try to only do them to determine whether you’re ready for your next step, such as getting an epidural or starting to push.

We love to watch you move. Changing your position frequently lessens pain, helps guide the baby down into the birth canal and accelerates pushing. So we’ll encourage you to minimise the time you spend in bed, and instead walk, squat, use the rocking chair, birthing ball and Jacuzzi.

Sore back? Try labour dancing: elevate the bed, lean on it with your elbows, stick out your butt and swing slowly; or hug your partner and sway. Stay off your back (even though that’s probably what got you into this) to maximise blood circulation to the baby.

We don’t have a crystal ball. Will your labour be a sprint or a marathon? We can guesstimate how long it will last by juggling the variables (spontaneous labour or induced, first-timer or old pro?) and figure out when to summon your doctor. Timing is important when considering interventions and pain management, but labour’s a journey, not a race. Poky or speedy, one thing is guaranteed: your baby will arrive precisely on his or her very own birthday.

A few things midwives know but aren’t sure why:

• The longer the labour, the more likely the 5pm C-section. It’s not about dinner plans – most on-call doctors don’t schedule other activities. They may not want to leave your delivery for the next doctor on call. Evaluate the situation carefully if both you and the baby are doing well.
  
• The longer the birth plan, the more the interventions. Four single-spaced pages? You’re heading for the operating table. Make it short – one page or fewer and very flexible.
  
• The bigger the entourage, the longer the labour. Is it because you’re focused on your company instead of the labour? You’ll probably be less mobile and more concerned about modesty if have too many people around.