shaking legs, chattering teeth
Thirst
Loss of appetite, nausea, vomiting
Hiccups/burping
Intense concentration on contractions
Not wanting to be touched
Not wanting to be left alone
Tiredness
Asking for medication/help
Emotional signs:
Anger/frustration/demoralisation
Confusion or apprehension
Surprising lack of modesty
Obsession with ritual
General irritability
Amnesia between contractions
Restlessness
‘Hard’ labour is usually shorter than early labour, thank goodness. If you don’t have drugs or clocks you may not have any idea of how long it lasts. You may get into a trance-like state, needing weird rituals or objects. This is when you really rely on your birth partner(s) and midwife: they’ll help you with positions, find ways with you to keep the labour progressing, and will keep you confident and calm. You might sound odd at this point. During the hardest part of Ted’s birth my husband John says I sounded like an old drunkard. I’d be moaning ‘Penny, is ‘e ok?’ and Penny (my midwife) would say ‘Yes, he’s doing very well. He’s fine.’ And two minutes later I’d slur, ‘Is ’e ok Penny?’ Lucky midwives are so patient.
Your waters might break (if they haven’t already) during this phase. This can help your labour to progress. This is why sometimes your midwife might want to break your waters for you – ‘artificial rupture of membranes’ – to help the birth along. You may become irritable or even angry between contractions. ‘Many of my clients are totally bitchy here,’ says Julia ‘and I’m usually relieved – it’s a sign that they are moving to the next part of labour. Most also tear at their clothes and become naked as this part of labour goes on.’ If you’re shy about nudity, wear a sports bra. Do not let incidental worries like baring your boobs stand in the way of this birth.
Many women begin to lose touch with what is going on around them during hard labour. This sounds scary for the control freaks among us, but it can be strangely liberating. With Sam, I was extremely concerned not to go to the hospital too soon (as I did in my first labour). It took John nearly two hours to get me from the bathroom in our house to the hospital car park (a five minute car ride away). Julia watched through the hospital window as it took me another 20 minutes to get from the car to the door of the hospital. I arrived on the labour ward in the lift on hands and knees, baying like a cow. If you find this disturbing remember: the midwives, doctors and nurses (and, presumably your husband) have seen it all before. They do not care what parts of your anatomy are showing or what noises you are making.
Hard labour tip:
‘Labour hurts,’ says Chari, 30, mother of two. ‘Why don’t women speak realistically about that? My mother said it felt like menstrual cramps – but if that’s what her cramps felt like, she should have had a hysterectomy. I had trouble catching my breath; they started with BAM! one on top of the other, and all my natural childbirth plans flew out the window. Labour hurts but it doesn’t have to be scary, that’s what I tell my friends.’
TEN WAYS TO COPE WITH HARD LABOUR
1 Move around and change positions often. You can walk around then stop and lean against someone when the next contraction comes.
2 Don’t lie on your back. This can slow things up and lead to other interventions.
3 See each contraction as a separate entity – not as part of a chain. This can stop you getting too demoralised.
4 Try every comfort measure you can, and do what works, while it works.
5 Relax between contractions: try not to stay braced for the next one as this can really tire you out.
6 Drink and pee regularly. Sometimes just moving to the loo can move things along.
7 Wear something you are comfortable in – if you’re shy about showing your bottom, wear a longer nightie or robe. Your knickers will be lost at some point. Make your ‘outfit’ something you don’t mind ruining.
8 Make sure your partner knows you may yell at him and other people so you can just do it if you feel the need.
9 Do not be afraid to make a lot of noise if it helps.
10 Do not be afraid to be quiet either, if that helps.
GETTING YOUR HEAD AROUND HARD LABOUR | One of the most important aspects of hard labour is your head. Women in hard labour often say things like ‘I can’t go on’, ‘How will I do this?’, ‘Make it stop’. This may sound a bit scary when you’re sitting reading this in the real world. Indeed, the immediate injection of large quantities of narcotics might seem like the obvious answer. This is usually an option. But many women say that they knew they were coping, internally, at the time they said these things and were glad no one gave them the epidural so late in the day. I know that when I was in the peak of labour with Ted, a small part of my logical brain was still up there, calmly narrating events to myself. At one point I heard the noises I was making turn from high pitched squealing to low grunts. I’d been working on this chapter before Ted’s birth, and the little logical narrator in me said, ‘Right, good – a sign that you’re ready to push.’ Weird, this split personality thing, but it shows that even when you are in the height of labour, it is possible also to feel you are on top of things.
Most experienced midwives will look on your yells and demands, in the later stages of labour, as excellent signs. But don’t panic – any request for drugs at this stage will not go unheeded; if you are clear about your needs, and have good support, you will end up with what you want. (See Chapters 5 and 9.) Support is crucial here. Your midwife and birth partner should have techniques for helping your body and your head get through this part of labour. But you – and your partner – need to know that expressing doubts and despair are totally normal and in fact a good sign at this stage. Hard labour is hard. But the good thing about it is that your baby is really on its way.
YOUR PARTNER AND HARD LABOUR | When your cries meet your partner’s high emotions head on it can be a powerful cocktail. He wants you out of pain, and now, finally you’re asking to be. There is one crucial thing he needs to know and remember: comfort is essential in the early stages of labour but sometimes pain, towards the end, can turn labour into motherhood. Drugs can actually slow and complicate things, so they’re not always your best policy if labour is progressing well (see Chapter 5: Your Options).
Dilated, effaced and ready to push
POOS AND WHY THEY ARE GOOD | Your cervix is now fully dilated (which means it is 10
