We are sure that you will have lots of questions or even concerns about labour and birth; so we try to prepare you as much as we can for this during the antenatal period when you see your midwife in clinic.
Birth planning is part of our midwifery care and alongside this we get the opportunity to have discussions about your options. We discuss a lot of information that is individualised and therefore not displayed on here but below are some things to think about.
Where do you want to give birth?
Choosing where to birth your baby is one of the most important decisions you will make during your pregnancy.
The Ministry of Health advises that women who give birth at home or in a birthing centre or small maternity unit are more likely to have a normal birth than those who give birth in hospital. However if you have pregnancy complications or need specialist support, you will be encouraged to give birth in hospital.
NZ Ministry of Health: Where to give birth
NZ College of Midwives: Consensus Statement on Normal Birth.
Maternity Services Consumer Council: Choosing where to labour and birth.
We are very fortunate here in Christchurch to have an amazing choice of places to birth. We have 3 amazing primary birthing units (St Georges, Lincoln Maternity and Rangiora Maternity) which are midwife led only and Christchurch Womens Hospital. It is worth noting that if you choose to birth your baby at Christchurch Womens Hospital, you cannot plan to stay there after having your baby. The plan should be to transfer to one of our primary units for your postnatal stay.
www.stgeorges.org.nz/patient-information/maternity-unit/
www.cdhb.health.nz/hospitals-health-facilities/lincoln-maternity-hospital/
www.cdhb.health.nz/hospitals-health-facilities/rangiora-health-hub/
Signs of Labour
You’re likely to know once labour starts, but if you’re not sure talk to your midwife.
Labour and birth are different for everyone – and they’re different each time too. Only about 1 in 20 women goes into labour or has her baby on the date that she is ‘due’. Most times the labour starts some time between 1 week before the due date and 2 weeks after it (being ‘overdue’ means that you are more than 2 weeks after the due date).
For many women with their first baby, the start of labour is a gradual thing that lasts for hours – and it may be a stop-and-start thing over several days.
You usually have time to talk to your midwife and you don’t have to dash to hospital straight away like in the movies!
There are many signs of labour; here are a few:
- You get cramps low down in your tummy like period pain, or pain in your lower back.
- A tablespoon of blood or brown-coloured, sticky mucus comes out of your vagina (a ‘show’)
- You leak fluid that you think is wee but it’s from your vagina, and it smells different from wee.
- The only definite sign that you are in labour is having regular contractions.
Your midwife may talk about only contacting them when you are in ‘established labour’. This means that the neck of your womb (the cervix) has started to open and is 3–4 cm wide and you are getting regular contractions.
The stages of labour
Midwives and doctors often talk about three stages of what’s happening to your body and your baby in labour. The first stage is when the neck of the womb stretches to let baby out. The second or pushing stage is when baby is born. And the third stage is when the whenua/afterbirth (placenta) comes out. Labour feels different for each woman.
What to Pack?
Packing your pregnancy bag is a job best done by around 36 weeks unless you have reason to think you are going to go early. The lists below are suggestions – you might not want to take everything. It may work best to pack different bags – one for when you are in labour and the hours after and then another for your postnatal stay.
For you:
- Comfortable loose clothes to labour in
- Clothes / nightwear / for afterwards (preferably easy to breastfeed in) and a set of clothes / shoes to wear home
- Water bottle / labour snacks (don’t forget your support people too!)
- Money for parking / vending machines etc
- Maternity bras, underwear (old comfy big sized knickers are the best), slippers (or socks) and a dressing gown.
- Sanitary pads (maximum absorbency, extra long – some women find the extra absorbent style incontinence pads / disposable pants are great for the first few days)
- Lipbalm, your lips can get very dry and nipple cream (lanolin is reccommended)
- Personal toiletries (hairbrush, soap, shampoo, deodorant, toothbrush, etc.) including your regular medications & glasses/contact lenses
- Optional: mobile phone & charger, camera, wheatie bag, music & player, massage oils, your own pillow, ear plugs, swim wear for partner (if getting into birth pool)
For Baby:
Babies chill quickly after birth and when dressed need 2-3 layers of clothing made from natural fibres (eg wool / cotton) to stay warm. Avoid synthetics e.g. polyester and polar fleece as these fabrics don’t breathe and may cause baby to overheat. We suggest you bring a set of clothes to put on soon after the birth (old is OK as baby will be un-washed) and 3 more sets of clothes:
- Woollen / cotton singlets
- Stretch and grows, or tops and pants that cover arms and legs
- Hoodless long sleeve cardigans / tops
- Hat & booties (or socks)
- Wraps (cotton or wool)
You will also need a car seat. Make sure you practice putting it in the car first!
Pain Management
Pain is a normal part of labour and birth. In a normal labour and birth, pain is protective and allows the woman to prepare for and give birth to her baby. It tells her to move to a place where she feels safe, focus on herself and call the people she trusts to be close by. Every woman will respond to the pain of labour differently depending on her physiological, social, emotional and cultural experience and environment. When considering how you will manage your pain when giving birth it is very important that you understand your options and remain flexible on your choices.
www.healthinfo.org.nz/index.htm?home.htm
If considering an epidural please be aware that this is essentially secondary care, which means a handover to hospital staff who provide secondary care. We will stay and support you if epidural is needed unless we are exhausted and need to go home for some much needed sleep. Sleep deprivation is very real in our line of work! And is not safe for you or your baby if we are not able to think quickly due to tiredness.
You can find out more about Pain relief options on the National Women’s Health website.
Waterbirth
Waterbirth is an amazing form of pain relief!
Many women find using water in labour is relaxing and relieves pain. The NZ College of Midwives supports warm water immersion during labour and for birth where the labour has been normal. Birthing pools are available at our primary maternity units as well as Christchurch Womens Hospital.
NZ College of Midwives – Consensus Statement on the use of water for Labour & birth
Birth
Sometimes things don’t go as planned for the labour or you need help with the birth.
Inducing labour
An induced labour is one that is started artificially, rather than starting naturally on its own. Labour can be induced by breaking the bag of water around the baby and using medicines, or just using medicines and other methods. Your midwife may recommend induction:
- if your baby is overdue
- if your waters have broken before labour starts on its own
- if you or your baby have a health problem.
- Your midwife will give you information and answer your questions to help you to decide about induction. This includes how the induction will be done, why they recommend it and what the risks are.
- You can find out more at Induction of labour on the National Women’s Health website.
When you need help with the birth
A small number of women need the help of instruments with their births. Forceps or a ventouse suction cup can be used on the baby’s head to help to birth the baby.
Caesarean section
A caesarean section is an operation to remove the baby through a cut in the mother’s tummy. Caesareans can be planned or urgent (emergency). During your pregnancy, a caesarean may be planned when your midwife (or specialist doctor) believes that labour may be dangerous for you or your baby. An urgent caesarean is needed when complications happen during pregnancy or labour and the safest option is to deliver the baby straight away.
Your midwife (or specialist doctor) will give you information and answer your questions about a caesarean. This includes what happens during and after a caesarean, why they recommend it and what the risks are.
You can find out more about caesareans at Mode of birth from the National Women’s Health website.
Placenta
Some people choose to take their placenta (whenua) home. You may wish to bring a special container, such as an ipu whenua with you. We encourage you to send the placenta home with family members as soon as possible as there is no storage available at the hospital.