deviation in the figures. I almost forgot Kat was there.’ If your partner is doing frantic mental arithmetic, one eye on the machine, he is unlikely to be the fully reassuring presence you need.
When I had my first baby I was hooked up, or so it seemed, to every mechanical device available to modern obstetrics. At any given moment I could probably have told you exactly how many minutes I’d been in labour for and the exact dilation, or lack of it, of my cervix. Midwives and doctors came and went, barking stats, checking and rechecking print outs, monitors, IVS. I felt increasingly inhuman and irrelevant and slowly it dawned on me that I’d never be able to push a baby out like this.
When I was having Sam, my second baby, Julia encouraged me (and my midwives supported this) to approach the whole thing differently. I asked to have as few vaginal exams as possible while in labour. I asked not to be told how dilated my cervix was. I didn’t want anything to do with a clock or a watch. I negotiated so that no abstract time restrictions would be placed on how long I could labour for – unless there was a pressing medical reason for them. This allowed me just to get on with giving birth. The whole experience was radically different. The only time I heard a fact was when my midwife told me I was fully dilated and ready to push. Consequently, my confidence that I could give birth to Sam never wavered. The same happened when I gave birth to Ted, my third baby, at home. My midwife Penny knew I didn’t want any ‘interference’. I had no vaginal exams, no sense of time, or progress, and just got Ted out my way (with Penny monitoring his heart rate frequently, and unobtrusively, the whole time).
When Julia had Larson, this strategy really came into its own. She’d agreed in advance with her midwife, Kim, that they wouldn’t ‘talk numbers’. After she’d been in hard labour for a few hours, Kim checked her cervix and reassured her that she was progressing well. I noticed a fleeting look of concern on Kim’s face as she turned to her notes and Julia was clearly in a lot of pain. I peered at what Kim had written – she was only 5 cm dilated. I had assumed Julia must be almost there (10 cm), and began to worry that she’d never make it through the long hours it would take her to dilate another 5 cm. Over the next 20 minutes, and a few massive contractions, Julia’s cervix dilated to 10 cm. Julia says not knowing the numbers was crucial. ‘Regardless of my experiences as a doula and my strong belief that labour happens in its own time, I know I would have succumbed to the pressure if I’d known I was only 5 cm at that point. I was in a lot of pain and I would have felt utterly defeated. Instead, I trusted both my midwife and my husband to keep me safe and I was able to labour without my brain undermining me.’
Progress tip:
Real labours can progress in spurts. Sharon, 28, mother of Joshua (2) and Maria (6 months) says, ‘With Maria I’d been in painful labour for several hours, with regular contractions and when I was told I was only 1 to 2 cm dilated I was distraught… I kept labouring but increasingly I felt that my pain wasn’t being acknowledged. I couldn’t breathe through the contractions anymore. I wanted out. The midwife gave me some pethidene [an injected drug for pain management] to calm me down (I was hyperventilating) then went out to find the doctor. But then I felt I needed to push. She said that was ridiculous as it had only been half an hour since I was 1 to 2 cm but she examined me and could actually see the head. So I pushed and pushed and my baby was born at 10.16 p.m.!!! No extra help, no major tears. My first words this time were “I did it!”’
Midwife Jenny Smith says, ‘It helps to remember that labour progress is multifactorial – it’s not just about cervical dilation, it’s about contractions building up, the head descending, the cervix thinning.’ You can, then, decide to ditch the maths. This is not something many of us think about – or many midwives are asked to do – but this strategy, laid out in your birth plan and reinforced during labour by your birth partner, can be immensely helpful. A great many experienced doulas encourage their clients to do this. Your midwife may be taken aback when you ask her to do this, but explain your reasoning to her and she should respect your wishes.
EIGHT TIPS FOR A NUMBERS-FREE LABOUR
1 Do not assume your labour – or any stage of it – will last for any particular length of time. (A favourite doula adage: ‘Prepare for a long labour, hope for a short one’.)
2 Cover the clocks (literally) – at home and in the hospital room.
3 Ask people not to discuss time with you during labour – how long you’ve been at it, how long you may have to go on for.
4 Eat, drink, pee, sleep when you want – your body knows best.
5 Do not accept medical intervention to speed things up unless there is a good clinical (or personal) reason to do so.
6 Negotiate about your hospital’s imposed time restraints on the stages of labour unless there is a good clinical reason to stick to them.
7 Ask the midwife to do as few vaginal exams as possible: they can be distracting and uncomfortable.
8 Ask the midwife not to tell you how dilated you are unless there is a good medical reason to do so.
Vaginal exam coping tip:
No one tells you, but vaginal exams done by the midwife when you are in labour can be painful. If it’s a routine check of your progress ask her to wait until you are ready and can catch your breath. Then prepare as if for a big contraction – use whatever was just working for you. Arching your back slightly might relieve the pressure you feel from her fingers, but the best defence is to breathe and get through it. Most midwives will be gentle and as quick as possible.
Now that’s what I call real labour
When labour hots up you’ll become very serious about your contractions which will probably be longer and more regular than before. This kind of contraction can feel overpowering. Women talk of ‘sledgehammer’ contractions, ‘fierce’ ones, feeling pain around their middle, in their back and sometimes up and down their thighs. This sounds scary, but when it is happening, if all is well and you feel safe, your body will somehow be coping. You will soon be unable to talk through this kind of contraction and you’ll have to focus on breathing and making noises. Remember, too, that each contraction lasts less than a minute and there are breaks between them for you to ‘regroup’ mentally. By this time, if you’re having a hospital birth, you are either in your delivery room or on your way there. Your partner may be baffled if you were cracking jokes before, and have now gone silent, concentrated or snappy. (Partners should remember to follow your lead – if you’ve gone all introverted and they’re still jesting, they’re not going to be helping you much.)
Another progress tip:
Regular contractions don’t happen in every birth, so try not to attach yourself to timing them rigidly. The Signs of Progress list (below) is also a good way to tell how you are doing.
SOME GOOD SIGNS THAT YOUR LABOUR IS PROGRESSING
Frequent contractions
Backache
Deep pelvic pain
Waters breaking
More bloody show
Breathing changes
Tender belly or back
Curling
