body’s way of getting rid of anything that may hinder the baby’s progress. Poo is progress. Sometimes moving to the loo helps – it’s a place where we are used to pushing and you can totally empty your bladder and bowels before the birth. You may, however, poo without being able to stop yourself. For many women this can be a traumatic thought. Mary, who gave birth in Belgium says, ‘I sat on a birthing chair and kept saying “je ne veux pas faire kaka” because for me that would have been so embarrassing. They thought I didn’t want the baby to be born, but really it was the idea that I’d crap myself in public!’ You have to get past this one. Pooing happens at some point in virtually every birth. Your midwife will have seen women pooing several times a day, virtually every day of her career. The amount of poo is usually very small, she’ll be ready for it, and she’ll whisk it away without a second thought. Indeed, uniquely, she’ll probably be pleased you’ve done it: pooing is a fantastic and normal sign that you’re finally ready to get that baby out.
‘I CAN’T COPE’ AND HOW YOU WILL | You are probably tired or restless now, and you may doubt your ability to cope. ‘I couldn’t believe I still had the baby in there,’ says Sophia, 29, of her first birth. ‘I’d been in labour for nearly 36 hours and I was exhausted. I cried for a bit and asked if I needed a caesarean (I didn’t). With my second baby, also a long birth, I recognised that “downtime” and used it: I actually fell asleep for 5 or 10 minutes and woke up with some energy to push.’
This is a fairly common experience – your body may have a natural ‘rest’. (Though make no assumptions here either: you may well continue with the normal pattern of contractions with no break.) Take advantage of this ‘rest’ if you get one: many women panic thinking their labour has stalled and that they’re going to need intervention to get the baby out. ‘The midwife and her student wouldn’t leave me alone, insisting I start pushing, while all I wanted to do was sleep and wait for the urge to push,’ says Clare (28), mother of Siri (2). Your midwife should be monitoring you and the baby closely, but unless there is cause for concern, she should not be pressurising you to push, if your body is saying sleep. Julia attended one birth where the rest period was freakishly long but ‘Everything was just fine with Ana and the baby – she peed, ate, sang and laughed. When it came, her pushing stage was relatively short and she had plenty of energy for it, despite a long previous dilating stage.’
ABNORMAL FEELINGS AND WHY THEY’RE NORMAL | Some women, at this time in labour, feel surprisingly serene. Others feel relieved and suddenly more human. You may start joking with your partner, who will then wonder if you’ve become delusional, having got used to you incoherent, grumpy or focused. There may be downsides to this renewed lucidity: worries about how you are going to achieve the unthinkable next bit can flood in. You may simultaneously worry that you don’t feel normal. You are not normal – a large baby is about to come out of your vagina. There is, and should be, a phenomenal amount of lower pressure on your back and pelvis (though this may – honestly – not feel painful). If you can, at this point, shove aside your worries and rational thought. Focus on the fact that you’re about to meet your baby. The only way out is THROUGH. And you can do it.
PUSHING YOUR BABY OUT | Your cervix is fully effaced and dilated. Your body is ready to start active pushing. Many midwives now encourage women to give birth on hands and knees, or squatting – gravity can work in our favour this way.
Loads of us have preconceived ideas about the length of time we’ll push for. You may only push once or twice. Then again, it may take you much longer to get the baby out. If your body and baby are coping well, being closely monitored, and you are not obsessed with the clock this might not feel particularly relevant. Sometimes it just takes a while to get the hang of pushing. It is worth checking with your hospital, in advance, whether they have policies about how long you are ‘allowed’ to push for (see Chapter 5: Your Options, page). Most midwives will start to keep track of time when you start active pushing (that is, giving hard pushes during every contraction). The general policy is to let you push like this for about an hour. If you’re in a good pushing position, have waited until you get the urge to push before you start pushing, and have got the hang of how to do it, this should be fine. If you are still pushing like this after an hour the midwife will examine you to see how well the baby’s head is descending, to check what position the baby is in and to assess how you are both coping. If there are not enough signs of progress, she may suggest that you need some interventions to deliver the baby (see Chapter 5: Your Options, page). Though you’ve grown up hearing comparison jokes about pooing watermelons many women say the pushing part of labour was actually the least painful. It can actually feel empowering or productive to be doing something this active. This isn’t to say it won’t hurt. But the key thing about this stage is that you’re almost there.
THE MYSTERIOUS URGE TO PUSH | ‘I was told I’d experience an “overwhelming” urge to push,’ says Fay, 29, mother of Mia (4) and Claudie (1). ‘I never felt any urge to push whatsoever, with either of my babies. This panicked me the first time. I had to be ‘coached’ by my midwife the whole way through the second stage.’ Fay’s experience is quite common. ‘Mostly women who have had a vaginal birth before don’t need to be told how to push – they do it automatically,’ says midwife Jenny Smith. ‘But first time mothers often need lots of support and encouragement that they are doing well, and upright positions are essential.’
Pushing can feel like the greatest feat of physical endurance you’ll ever encounter. I remember using every single ounce of strength in my entire being to push Sam out. I was aware that I’d never done anything remotely strenuous before this point in my life. Getting a mirror and actually looking at your baby’s head appearing as you push may sound like something from a 1970s feminist workshop, but many women say it’s surprisingly helpful. It can seem unfeasible to you that your gargantuan efforts will actually make a baby emerge. And it is easy to lose heart if your baby does not pop out straight away. Seeing (or touching) a tuft of wet hair can be a shocking experience – one that helps you realise you’re really producing a baby. And – yes – it’s genuinely going to come out that way – soon.
This is what pushing may look like if you see it in a mirror: your vulva gently opens with each push and fluids trickle out. Your pubic hair blends in with the hair of your baby. (Many husbands need to have this pointed out to them. They then become very moved to see their baby’s hair coming out and disappearing in what can be a hide and seek game.) The smells may be very strong now – acrid and pungent. In a hospital the smells of birth combine with clean, medicinal smells as well.
Pushing tip:
‘Ask to use the birth stool if there is one, or sit on the loo at the beginning, when you are learning how to push properly – particularly in a first birth,’ says midwife Jenny Smith. ‘This helps you to feel the urge to push in the correct place, and can reduce the length of the pushing phase. You can come off the loo once you’ve got the hang of pushing so there’s no worry about your baby being born into it!’
OH, WHAT AN ATMOSPHERE | The room may feel busy as the midwife prepares to ‘catch’ and care for your baby. If there are any concerns for you or the baby another midwife, or a doctor, will be called in. The bustle can make you lose focus. Many of us, seeing all this action, get scared that something is wrong. In fact, activity, at this point, is normal, and a doctor can be called in as an extra safeguard. Touching your baby’s head can help you focus in again. It will feel a bit spongy and slimy.
YOUR PARTNER AND PUSHING | He can see his baby, along with a certain amount of blood and fluid, if he peers down there. If he has read Chapter 8 he should, at this point, not crash to the floor (he’ll be hydrated, fed and mentally prepared). You might have planned to video or photograph the actual birth. If your partner is overwhelmed (and
