So err, what happens at birth?

[Teds77]

This is more childbirth than pregnancy but thought it was a bit busier here..

I haven't been offered any NHS birth classes and haven't done NCT and now I'm a bit worried that I know nothing about childbirth. So now I'm wondering whether there is anything I should read or think about before childbirth actually happens??

I guess I'm wondering if I should be aware of any particular pain relief that might be offered and what the pros and cons are. Whether I need to, err, have done any breathing exercises etc. Have a birth plan (or even know what one is?)

I'm having twins and at the moment the plan is to induce if the labour doesn't start spontaneously (but there is a good chance it will). I know that's not for everyone but I feel that's been explained to me and I'm comfortable with that. Also means that it will definitely be a hospital birth but again that's fine with me. I don't know what advice or guidance others were offered by their midwives and if they would be good to talk to?

Gah, this sounds so unprepared....

Very quickly: but bear in mind this was a while back so don't know your hospital

pain relief: Gas and air (breathe into a rubber mask type thing) pethadine (can make baby sleepy) Epidural (needle in spine, needs topping up, sometimes you won't then feel when to push so not topped up)

labour: think period cramps, internals/sweeps can smart a bit, interventions like ventouse and sewing up after episiotomy/tearing can also smart a bit
the actual crowning of the head feels like burning/being split in two BUT some manage on a paracetomol, others gas and air, others an epi.

birth classes: i didn't do NCT - maybe for socialising afterwards it may have been an adv. Hospital ones were crap tbh - I went and all they talked about was feeling a bit of 'pressure' - the breathing bit didn't come in useful personally.

Some do find yoga hypnobirthing or other such classes a boon though.

Birth plan - up to you - thought it would have been offered as a fill in one on your notes. Tis not set in stone/shouldn't be ignored but can be and as with all things could be subject to change anyhow!

Is usually anything you feel you definitely want to have or want to avoid and is useful to think about in advance but tbh with many births all bets are off ifysim the best laid plans and all that - so if you are flexible then fine as long as you have a birth partner to fight your corner if need be for certain things.

Twins - congrats! - Main thing as with all babies will be getting them out safely.

No tips on that apart from don't forget your nipple cream, sanitary towels and choc/nuts/snacks for post-birth!

If asked whether a student mw can attend grab her with both hands. Best tip I ever got off mn. Just FYI.

the main thing I realised from having 2 dc was that contractions are like climbing a steep wall. They are intense and last for up to 60 secs, but once you are over the peak you get to rest for a bit. I was induced and so it was all quite quick, about 30 secs between contractions. But by visualising them like that, I coped far better.

With DS1 I panicked, but with DS2 I felt more in control. And breathe in and out as steadily as you can during a contraction. If you have ever run, do your running breathing. Slow and steady as possible.

Pain relief for me was G&A with DS2, breath it in and out like you are running! DS1's birth, I had everything going inc a spinal block for ventouse!

When pushing, push like you are having a big poo, ie from the bottom, not from the tummy. My lovely MWs tip.

Also very handy to know about something called transition - you go through a few stages in Labour, (if I remember correctly from NCT classes three years ago)

1. Dilation - where the cervix opens up, that's the whole how many cm thing at this point all the contractions are moving up in order to draw it open
2. Transition - this is where things can get a bit odd, some women try to go home, others this is where they start to feel like they can't cope or start asking for epidurals. Basically your body is transitioning from the contractions going up to open the cervix to heading down so that you can push, but during this bit they can be trying to do both at the same time or varying between and it all gets a bit intense not just physically but emotionally too. Nothing to be afraid of but it can be helpful for both you and if you have a birthing partner for them to know it's totally normal and just another part of giving birth.
3. Pushing - depending on pain medication, your body, position ect people seem to feel this differently but most say it's like trying to do a really big poo, and at this point don't be afraid but you might just poo and wee - but there is no way to hold things in and get baby out too so you just have to go with what your body is doing.
4. Placenta - you can choose whether to have an injection during the last contraction to help expel the placenta, most women have this but you do still have to push it out and once that's out they'll check to see if you need stitches or anything.

My birth plan has ON KNEES!!! a lot, I have pelvis and hip issues and also tend to like to be on my knees if I'm in pain - I know this, I'm in pain a lot and I know my body. They still tried to turn me a number of times into a sitting position and my partner had to stop them BUT he could refer to the birth plan and it gave him a bit of back up to get them to listen more so it can be handy to have anything written like that for that purpose. Obviously if I'd suddenly had a change of heart and wanted to turn over the birth plan wouldn't have stopped that happening - it's more of a best case scenario (I also said I wanted to be on the floor becasue I throw myself around when in pain - they pursuaded me onto the bed and my partner spent 2 hours in gibedash holding me in mid air!)

Most women find labour and birth more than a little uncomfortable. Pain relief as mentioned above although some hospitals now offer an alternative to pethidine which makes baby less sleepy.
Try not to have any set ideas about what pain relief you want, see how you feel. I had everything going with my first and with my second I declined pethidine as it sent me off my head and I went straight from g&a to epidural.
Many women manage with g&a, personally I found labour more painful than I could ever have imagined and the epidural actually helped me to dilate because I was fighting the pain so much without it. This was true in both my labours.
I also found a bath amazingly helpful in the early stages and if the birthing pool had been available second time around I may have been able to manage without the epidural!

Hi teds! With you having twins, they will probably recommend an epidural, especially if you are being induced. This is because even if the first one is born naturally the second may not follow and can sometimes end in an emergency section. There is an episode of OBEM with a woman delivering twins vaginally if you're feeling brave! Julie, Tyler and Lexi

excellent post trickle

Ladies - thanks for all the info, really helpful and feel slightly less clueless! Hello ellan hope all is going well with you?

This post was written in a slight panic but I ended up with a really good consultant appointment this morning and asked lots of questions so am generally feeling more calm! The hospital has also managed to squeeze me on some ante-natal classes starting next week so as long as babies stay put I've got those/if they arrive or classes are rubbish then they were free so don't feel so bad.

Not sure I'm brave enough to watch OBEM but it looks like we're going for 'natural' delivery as both LOs are head down and already very low. Also, as all is well with all three of us, they are fairly relaxed at the moment about hoping labour will happen spontaneously. Here's hoping!

There are some animated videos on www.babycentre.co.uk that you might find useful

Fab, fingers crossed you get the natural delivery you want- well done obliging twins for being in the right position! When are you due? I am great thanks, 21 weeks pregnant and finally starting to feel like I might actually get the baby we went through so much to make!
Glad hospital got you some antenatal classes, are they not usual in your area?

My advice would be to stay calm and take each step as it comes. I dont think u should look too much into the birth as each birth is different and if u go in with expectations and it doesnt go the way u thought u might start panicking and that wont b good for you or your twins.
Id recommend my exH as he was the best birthing partner that i could ever have. Pity he wasnt as good a dad but wont bore u with that).
Childbirth is scary but it is worth it in then end when u hold ur children. Just think of the beautiful children ul have at the end of it all.
Good luck with the birth.

JaneaneGruffalo thanks

why grap a student midwife with both hands?

I've heard that about students too, means someone with at least some experience is always there with you and you never get left all alone to panic if the actual midwife has lots of women to deal with.

Plus they're supervised by a v experienced mwand they're all keen and caring still. I had 2 students during my labour and they were one of the most positive aspects of the whole thing

Labour is different for everyone so 98% of what people tell you/you read will be useful. 2% will be really useful but you won't know which 2% until afterwards.

Example: statements above that you will get breaks between contractions. This is true unless a) you have back to back labour (I didn't) or b) you get something else called 'bridging pains' which I had never heard of until i had them but which just means you're in pain constantly. On the positive side, I think they are more likely to happen if you have a fast labour (I did) and the really positive part of that is that you are bright and bushy tailed within about 5 minutes of it all being over. But it just shows that there is no rule in labour to which there are no exceptions.

It's OK to talk to your midwife during labour. Some women don't want their midwives to talk to them. Mine was very quiet and I desperately wanted her to talk to me but it never occurred to me to say 'I'm frightened, please tell me what's happening and how I'm doing'. Though I'm not really sure if I could have sorted out that many words at one time.

98% will be useless [sigh]