happen two to three minutes apart and last about 60 seconds. Takes five minutes to two hours.
Second stage With a fully dilated cervix (10 cm), you start to push the baby out. This phase may last five minutes to an hour (or longer). Contractions may slow to two to five minutes apart and last 60–90 seconds.
Third stage This last stage of childbirth begins once the baby is born and ends with the delivery of the placenta and membranes. Usually happens within 15–30 minutes of the baby’s delivery. It is a short stage lasting 15 minutes or less. Contractions are closer together and may be less painful. The placenta separates from the uterine wall and is delivered.
Wot no drugs?
You will not find descriptions of drugs, implements and surgical procedures in this chapter. This is not because we’re trying to encourage you to give birth in a field, gnaw through your own umbilical cord and evoke only the goddess Kali for relief. We know (we’ve been there) that you may need, want, or have to have drugs or interventions at any stage of childbirth. We cover medical interventions, pain relief, and other common eventualities in Chapter 5: Your Options. However, normal birth can frankly feel anything but normal (shifting an 8lb object through your pelvis and vagina is hardly an everyday event after all). Birth can be outrageous and amazing. If you know this in advance you’re less likely to lose it when you encounter some of the weirder, less publicised ‘stages’ of childbirth.
A note to second timers
You may have been there once already but don’t think you can get away with skipping this chapter. You may experience different things this time (if you had a difficult first birth, we’re here to make sure you will have a better one this time). It’s possible you will not need the intervention you had last time, and things may be quicker or slower, or feel utterly different. So read this chapter.
A WORD ABOUT CHILDBIRTH CLASSES | Childbirth classes can be extremely useful, and it’s definitely worth enrolling in one if this is your first baby (see different classes in Chapter 5: Your Options, page). But be aware that some classes may give you the impression that the birth will follow a pre-arranged, easily identifiable pattern of three distinct ‘stages’ (see above). Most of us, before giving birth, actually learn little more than what really ought to happen on a good day. This, of course, is immensely seductive to your average squeamish worrier. We all want nice, manageable, safe facts to cling to when facing an abyss of bodily lunacy. And once a week, as our bellies swell to alarming proportions, this is exactly what we get. We learn nice round facts about drugs, plugs and pushing. We look at neat diagrams. And if we’re lucky we learn some useful relaxation techniques.
‘After I gave birth the first time, I realised my childbirth class had been useless,’ says Saadia, 35, mother of Imaan (4) and Zahra (2 months). ‘The birth was nothing like what I’d been taught it should be – I ended up with an emergency caesarean and I was totally shocked by it.’ Second time around, Saadia took a very different approach. ‘I read tons, I did a prenatal yoga class, built up an honest picture of birth, hired a doula, worked on my emotions and fears, made conscious choices about my care and ended up having faith in my body. Zahra’s birth was phenomenal.’
My own experience was a lot like Saadia’s. I remember that in my first antenatal classes there seemed to be no doubt in anyone’s mind that, around my due date, labour would begin spontaneously. I’d have a ‘bloody show’ in my knickers, move seamlessly into ‘pre-labour’ experiencing manageable, erratic, early contractions which would, after a bit, settle into a regular pattern of painful contractions (known as Stage One, page above). I’d then go to hospital with my beanbag and CD player. My cervix would proceed to dilate at 1 cm per hour. My waters, at some point (probably early on), would break and labour would speed up. I might choose analgesia. And after a tricky period of ‘transition’ (during which I might – good Lord – swear and be sick), I would push my baby out of my vagina (Stage Two), preferably standing and making grunting noises, possibly sustaining a tear to the perineum (the skin between your vagina and anus). I would then, about 20 minutes later, push out a placenta, thereby completing Stage Three.
What really happened bore little relation to this. No one talked about emergency caesarean in our antenatal class. Half the class, including me, ended up with one. My experience – the ‘failure to progress’, the drugs, hormone drips, monitors and interventions – is a surprisingly common one for first time mothers. It’s really not that normal, first time round, to have a straightforward, nicely timed birth. In Julia’s 14 years as a doula, she’s only attended a couple of births that followed this neat, regular childbirth-education pattern. So, use your childbirth class as a starting point: follow up issues raised with reading, research and discussions. Your teacher, if she’s good, will be able to help you with this.
A WORD ABOUT HOSPITALS | Many of us have never stayed in a hospital before. If we have, chances are it was because something rather unpleasant was happening. Hospitals can smell, look and feel intimidating. Taking a tour of your hospital is a good idea because you do not want the surroundings to panic you when you come in to give birth. On the tour, they will show you the clinical equipment in the labour room. This can be worrying, particularly if you’re scared of hospitals. I remember going home from my first hospital tour in tears: I found all the medical paraphernalia deeply scary. I couldn’t help but picture myself in the midst of a medical crisis. I’m slightly hysterical about this sort of thing, but even if you’re not, it’s better to look at the hospital in advance. Being somewhat familiar with your surroundings will help you feel safer, and more confident. (See Chapter 5: Your Options for tips for hospital tours, page)
Labour: the real woman’s version
So, you’ve had the official version of birth. And we hope you will end up with one. But it is equally likely that your labour will have quirks and kinks all of its own. Many of the women we spoke to for this book used words like ‘panic’ ‘excitement’, ‘confusion’, ‘fear’ or even ‘demoralisation’ when talking about their first experiences of labour. Most said that much of what they learned in their childbirth classes seemed inadequate on the day. They felt they’d not been ‘warned’ in advance of how painful, difficult and confusing labour could be, or how it could deviate from the ‘safe’ pattern they’d memorised. So here goes.
Nesting
This is your inner cavewoman speaking to you: you get a primal urge to make your ‘nest’ clean, safe and warm for the baby. This usually happens in the last weeks of the pregnancy, escalating just before you go into labour. It can take many forms but it usually involves you doing something domestic that is completely out of character. Before Izzie, my first baby, was born, I sewed curtains, something I’d now rather die than attempt. A friend of mine who can’t cook a boiled egg found herself trying to prepare elaborate meals involving tons of obscure ingredients. ‘I’m not into excessive cleaning,’ says midwife Jenny Smith, ‘but before Oliver, my first baby, was born, I decided to clean the outdoor step. This took all day and involved a multitude of cleansing preparations and an old type of scrubbing brush. I remember showing my husband the step at 10 p.m. I slept deeply to be woken at 6 a.m. with contractions.’ You may not nest at all. Or you may behave like a deranged Mrs Beeton. If you do, you’ll think it’s normal. Everyone who knows you will, of course, know you’re crazed.
In the beginning: labour kicks off
