Common labour fears
Your pressing birth questions answered by Tina Otte.

Many women worry about what will happen when they go into labour and lose control of their bodies to one of the most powerful forces in nature – childbirth. Remember that your fears are similar to those of women across the ages, and that nurses and doctors in the labour ward have seen it all before. Some of the more common fears and frequently asked questions are tackled below.

I don’t handle pain well. How will I cope with the pain of labour?

This is a very common concern. It is important to know that the pain has a purpose – it means your body is working with and communicating with you.

Attending childbirth classes can help you learn how to manage this pain, as well as your birth options and medicated and non-medicated forms of pain relief and pain management.

What if something goes wrong?

Medical technology is an amazing thing, and these days we have a “window” into the womb, so potential problems are usually picked up early. Your labour should be closely monitored and if a problem occurs your doctor will be notified immediately.

Trust your instincts and don’t be afraid to ask for information, assistance, explanations and alternatives if things don’t seem to be going according to plan. It helps if you already have a relationship with a trusted doctor and/or midwife, and if you have a supportive birth partner (usually your spouse) who can speak up with you.

I am terrified that I will need an assisted delivery with the use of forceps.

If you learn the correct pushing techniques and listen to your midwife’s instructions during the pushing phase of labour, you should push effectively.

However, if you are exhausted, or the baby is tiring and showing signs of distress, or perhaps you have had an epidural and you don’t feel the pushing urge, you may need help in getting your baby out. This may mean forceps or a vacuum delivery.

Trust you doctor’s expertise, but be sure to let him know how you feel.

Will the doctor and the nursing staff respect my wishes when I'm feeling out of my depth and comfort zone?

Everybody has a preconceived idea of how they see their labour process. A great idea is to draw up a wish list, which is a way to let everyone know what kind of labour you are hoping to have.

Keep your wishes short and simple, flexible and reasonable: this is a list of wishes and not a list of commands and demands. Discuss this with your caregiver before labour. Being involved in the decision-making concerning your care is important in empowering yourself for birth.

What happens if my waters break when I am out shopping or at work?

If you suspect that your waters have broken, it’s important that you get to hospital right away, even if you don’t have contractions. Once your water breaks there is a chance that labour could progress very quickly, as well as a small chance of infection once the protection of the membranes has gone.The most concerning risk is the possibility of the cord moving down in front of the baby, known as prolapsed cord.

Many women are concerned that their waters may break in a public place, but your waters are more likely to gush if you have been lying down. If you have been upright, the baby’s head usually moves down and acts as a plug, stemming the flow.

What if I poo during pushing?

A “loose tummy” may signify the start of labour as your body naturally cleans out. The action of pushing does put all your bits under pressure, but the staff are equipped to handle this and will quickly and efficiently clean you up without making you feel embarrassed.

Giving birth involves the production and secretion of so many bodily fluids that a little bit of poo isn’t going to make much difference. An enema will force clean your system and if you are concerned, perhaps this could be an option for you.

Remember, the sensation of wanting to push is very similar to that of wanting a bowel movement, so if you are at the pushing stage, don’t hold back for fear of a bowel movement.

Do I have to be shaved?

This is optional in most South African hospitals for natural birth, but shaving is necessary for a caesarean birth.

Will I tear?

There is no easy answer to this. During delivery the chances are high that you may tear a little or be giving a small cut into the perineum (called an episiotomy). Research has shown that in many cases a slight tear is preferable to a large cut. This is a controversial issue, so it is important to discuss this with your caregiver well in advance.

Doing pelvic floor exercises and perineal massage from 35 weeks may help prevent tearing. Good pushing techniques also play a vital role in preventing unnecessary tears or cuts.

How long will I be in labour?

The average time for a first labour is 12 hours. Of course there are many factors that influence the length of your labour with some babies arriving within a few hours from the first painful contraction, and others taking longer.

As long as you and your baby are tolerating labour well and there is progress there is no need to worry. If your labour continues beyond 24 hours, you can expect some type of intervention. An emergency c-section will only be done if your or your baby’s life is in danger.

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