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Rock start birth magazine. Full of positive affirmations

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Rock start birth magazine. Full of positive affirmations

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I remember when I was pregnant with my first babe and I wanted a natural medication-free birth. I didn't like the idea of drugs, or forceps, or an episiotomy ( shiver) and I dreaded the thought of a caesarean. Whilst squeezing another human through my vagina was not high on my bucket list, the alternatives made me think that a drug-free natural birth sounded like the best option to me.

But almost all the women I knew had experienced some form of intervention or drug involvement in their births. And all the TV shows I had seen showed birth as a screaming, chaotic, medical emergency.

I began to wonder... How exactly does one push a baby out of her vagina without drugs?

Well, I can start by telling you what NOT to do. I would definitely not encourage you to simply turn up to the hospital and say 'I'm here! Please tell me what to do next.'.

I tried that approach.

And in doing so, I handed over my power - the very thing I needed to roar my baby out. I was quickly on a slippery slope of interventions that I had not expected and unsurprisingly, my ideal birth vision went completely to shit.

I remember lying there with my waters broken, gel inserted, syntocin/pitocin pumping, an epidural, a catheter, a fetal scalp monitor, and an obstetrician between my thighs unwrapping the episiotomy scissors, thinking 'How the fuck did I end up here?'.

Turns out choosing to just 'go with the flow' (with no idea of what that actually meant) was not necessarily my best idea for a birth plan.

When I became pregnant again a few years later, I made a different decision. I looked back on my first birth experience and thought "Nooooo fucking way am I doing that again". Instead of going with the flow, I decided to back myself in birth. I wasn't going to rely on the obstetrician, the midwife, or my man, to be the decision-maker in my birth. I I was going to be the expert.

First up, I researched my tail off. I looked at how contractions worked. And how to relieve the pain. I worked out how best to work with my body (instead of screaming like a banshee) to breath my baby out. And I booked a kickass birth team to back me whilst I did it.

And I got my woo-woo on. Oh yeah, I did. This former high-flying corporate chick who was used to dealing in mega-money deals, suddenly started doing visualisations, and meditations, and journaling, and repeating mantras. I danced naked under the full moon and drank birth potions from forest witches. Ok, maybe not that last part but you get the drift. I threw all that good hippy-lovin' juju at my birth.

I went after that natural drug-free birth like a woman possessed. And you know what? It worked.

By the time I birthed my babe, I was ready to rock and roll. In just 6 undisturbed hours, I birthed that baby like a freaking Rockstar. It was intense but pain-free, it was powerful AND pleasurable, and it was definitely the most incredible high (yep, even better than sex). I birthed that babe with every fibre of my being. I mean, I was on FIRE! Yeah baby.

And it was the difference between these two birth experiences that led to the creation of Rockstar Birth. Because I want EVERY woman to know that birth doesn't have to be shit-scary and traumatic.

I want YOU to know that the actions you take, and the decisions you make, can positively impact your birth experience. Like A LOT.

So I created the Rockstar Birth Magazine. And then the Rockstar Birth Radio podcast. And now I am beaming into your favourite technological device with my most comprehensive jam-packed, insightful and educational, confidence-boosting, digital baby - The Rock Your Birth Academy.
The Rock Your Birth Academy helped me through one of the most confusing and scary times of my life and helped me become empowered, enriched and educated. I discovered a new found respect for birth and I LOVED labour!!! It's hard not to love something so natural and beautiful when you're not scared. ~ Ashley
So what are you going to do... Stay in fear or overwhelm (or both!) and pretend that a baby isn't going to exit from your body? (Reality check. It is.)

Or take a deep breath, step up, and become an active participant in your birth?

Join The Rock Your Birth Academy now. We'll start preparing to rock your birth from the moment you sign up (like, right NOW!). You can grab all the details, including your invitation to Rock Your Birth here:
Rock Your Birth Academy
Beaming positive birthing vibes your way, Shalome x

shalome@rockstarbirth.com

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I remember when I was pregnant with my first babe and I wanted a natural medication-free birth. I didn't like the idea of drugs, or forceps, or an episiotomy ( shiver) and I dreaded the thought of a caesarean.

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How about filling you facebook, instagram and pinterest feed with positive birth stories! You could follow sites like these. Share any others you find on your whatsapp group.

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How about filling you facebook, instagram and pinterest feed with positive birth stories! You could follow sites like these. Share any others you find on your whatsapp group.

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To tell you about the birth of my second child, I have to tell you about the birth of my first child. With my first pregnancy I had Gestational Diabetes, and Gestational Hypertension and due to mounting concerns from my midwives from my rising blood pressure and heart rate, I was induced at 39 weeks. My cervix was dilated with a foley balloon, and then my water was broken. After 10 hours of intense labor, I was hooked up to pitocin which caused back to back, incredibly painful contractions with no break in between. I quickly became overwhelmed and frightened, and I gave up on my natural birth plan and got an epidural. Several hours later, I gave birth to a beautiful baby boy my husband Josh and I named Henry. Despite the fact that I had a beautiful and healthy baby, I had this irrational feeling that I had somehow failed at his birth.

Fast forward 4 years to my second pregnancy. This second time around I had several goals so that I would get the birth experience that I wanted. The first was to go into labor on my own. The second was to have a natural birth with no interventions (I wanted to stay as far away from pitocin as I could), and the third goal was to have a water birth.

So to prepare for the natural birth, I tried to cement into my head that I can do anything for one minute. Meaning, that when those contractions became difficult, painful and/or overwhelming, I could focus on the fact that it would be over in one minute, and then I'd get a break. I would meditate on that subject, and go to sleep at night thinking about it, building my foundation for this natural birth that I so wanted.

With both of my pregnancies I had Gestational Diabetes, but the second time around I did not have the hypertension that I had in the first; my blood pressure stayed beautiful the whole time. The main difference between my pregnancies were the false labor (practice labor) contractions that I had. For the last several weeks of my pregnancy (and by "several weeks" I mean at least 5 weeks) I would have timeable contractions that would start, increase in intensity and then all of a sudden stop. Starting at 36 weeks we had several false alarms. Some that even sent us to the Midwife's office to be assessed, but each time, it turned out to be braxton hicks contractions. The longer I stayed pregnant the more I felt like a ticking time bomb. I was more than ready for my baby to decide on its birthday. Having to relinquish the control and let the baby decide when it wanted to be born was one of the hardest parts of my pregnancy, and I struggled with that aspect almost every day.

When I hit 40 weeks, I was a bit shocked. I assumed that since this was a second kiddo that I wouldn't make it to my due date, but June 12th came and went. I started to feel like I'd be pregnant forever, and that I'd be enrolling my gigantic belly into kindergarten. The longer I stayed pregnant the more my brain started to assess every cramp, twinge and pain that I felt, which at 40+ weeks is about every 4.3 seconds. I felt like I was slowly losing my sanity while waiting for my baby to decide what day it wanted to be born. This kid wanted to stay put despite all the red raspberry leaf tea I was drinking, all the evening primrose oil I was taking, all the squats that I did, and the daily walks I took.

On Friday the 17th, at 5 days past my due date, I broke down and called my midwife's office and asked if I could come in and talk about options. I was starting to get a bit nervous about going over my due date because of the Gestational Diabetes, as well as just wanting to be done being pregnant. I'm one of those people who don't love being pregnant. I love the end result, but the actual process of growing a human is extremely hard on me. I had horrible morning sickness the first 20 weeks of my pregnancy, and then had two trips to the hospital in my third trimester because of gallbladder issues, and let's be honest, GD, although manageable, doesn't make things easy either.

Anyway, on June 17th, I was really hoping that I could get my membranes stripped, and that it might propel me into labor. However, at the appointment one of my midwives informed me that she couldn't reach my membranes to strip them, so unless I wanted to schedule an induction, I was just to wait. Josh and I had talked about having an induction, and we were considering it as an option. However, when the midwife brought it up and described how she would induce me, I firmly decided against it. Hearing the process she would take for the induction brought back all of the memories of my first birth. So, we went home a bit sad and discouraged, and resigned ourselves to wait.

I had a few contractions on Friday night after the appointment, some even timeable, but I didn't think anything of them. As always, I was disappointed that I was able to go to sleep and that they seemed to have stopped. On Saturday, the day before I hit 41 weeks, I had some projects to do around the house (making Josh's Father's Day gift with Henry), and as the day wore on, I noticed that I had been having contractions for most of the morning. At some point I texted Josh to tell him that I was having them, but I didn't know if it would lead to anything, so not to get excited. He got similar texts to that one for about the last 5 weeks, so he didn't think much of that text either. My contractions were irregular in length, and really far apart - 40 minutes or so, and very mild, I could ignore them easily. To me they still felt like braxton hicks.

In the afternoon Josh and I took a 2+ mile walk in our neighborhood. It was great time to spend just the two of us. We talked about how we wanted labor to go, when we thought the baby would come, and how our first son Henry would do as an older sibling. We were so excited for this baby to join us! I was contracting all through the walk, but didn't think anything of it, those contractions had become so routine.

We had a friend's birthday party to attend that night, and I really wanted to go. So, Josh and I got ready and headed out of the house around 5:30. We dropped Henry off at the in-laws for him to spend the night (that turned out to be very serendipitous), and drove out to the party downtown.
All through the party I was having contractions, and after a while I was noticing that I needed to zone out while they were happening. They were still really far apart, and I could still talk through them if I needed to, but they were getting harder and harder to ignore. They still weren't painful, but I was starting to have to focus on them and my breathing during them.

Josh and I had a really great time, and as we walked around downtown I had a lot of people comment on my belly. Around 9 pm, we stopped at a restaurant and got something to eat. While eating dinner, I noticed that my contractions were getting closer together, and I was getting more and more uncomfortable. At one point I got up to go to the bathroom and I had a strong contraction while in there. It's at that point that I started to think these contractions might actually lead to something. A short time later I noticed another contraction that was strong as well. After 4 strong contractions (at 10:15ish) I told Josh that we probably needed to head home. So, we paid for our meal, packed up to-go boxes, and said goodbye to our friends. As we were walking to our car, I heard a guy yell out of his car window "Are you going to have that baby on Elm St?!" I yelled back "I wish!"

As we were walking to the car I told Josh about the contractions and that we should start timing them as we drive home. He seemed surprised at that statement, but pulled the app up on the phone to time them. As Josh had had a few beers that night, I ended up driving home while having contractions that were about 10 minutes apart. I supposed I should have mentioned the contractions earlier...It's a good thing that my excitement trumped any kind of pain I was feeling. The first contraction we timed was at 10:45. As soon as we got home, we finished packing the go bag and got everything ready in case this was really it.

Once the bag was packed, everything seemed to get more intense fairly quickly. By midnight my contractions were about 5 minutes apart. They were starting to get strong, and to get through them, I was leaning over the yoga ball and having Josh do counter pressure on my lower back. It's around this time that my back labor started. My pelvis and lower back were really starting to hurt, but leaning over the ball and firm pressure on my lower back really helped and kept them manageable.

We called our doula to let her know what was happening. She asked how I was handling everything, and I told her I was ok. She told us to keep her posted, but because I hadn't had any bloody show, or lost my mucus plug she wasn't convinced that this was it, especially with all of the false alarms we'd had. She told us to call her the moment I saw bloody show, or if I needed help and wanted her to come to the house. I was handling everything well at this point, so I just kept laboring.

Some more time passed and when my contractions hit around 4 minutes apart Josh and I called our midwife to let her know what was up, and she said to head to the hospital at any time. I wanted to wait as long as possible at home, so we just kept going. Me leaning over the yoga ball, breathing through contractions, Josh doing counter pressure on my back and The Office streaming from Netflix to distract us between contractions.

By 1:00, my contractions were 3 minutes apart, and I was really having to concentrate to get through them, and had started to vocalize during them. My mom joined us around this time and was helping to get things ready for us to head out. I kept waiting for my contractions to become as painful as what I remembered from my first pregnancy, but that never happened. And because I never reached that pain threshold, I was really unsure about when to head to the hospital. As long as I was in a position that took the pressure off of my lower back, I was good.

Still unsure that it was time, Josh, my mom and I left for the hospital at around 1:30. As we were getting ready to get in the car I just stood at the car door and had 2 contractions standing there because I didn't want to sit down. I was having strong back pain, and I knew sitting would put an unwelcome amount of pressure on my pelvis and would be excruciating...I wasn't wrong.

That 30-minute trip to the hospital was awful. I tried to lay on my sides as much as possible to take pressure off of my lower back and pelvis, but I could never find a comfortable position. I withered in pain during each contraction (2 minutes apart at this point) and the pain in my back was unbelievable. Josh was my rock though. He kept calling out landmarks as we were driving so that I'd know how close we were getting. As soon as we got to the hospital I was out of that car as fast as I could be.

While checking in I had several more contractions. I would sit in the chair to rest while talking and answering questions to the woman behind the counter, and during each contraction I would have to stand up and lean over the counter and moan, this didn't seem to faze the woman at all. Once I had a bracelet on my wrist, I was in the waiting room and had to lean on chairs. My mom applied counter pressure on my back while Josh parked the car.

At this point in time my contractions were fierce and almost frightening in their intensity. I was finding it harder and harder to keep my composure. I kept thinking that I didn't want to do this and that I wanted an epidural. I even voiced those thoughts to my mom who told me I could have whatever I wanted - sweet words that helped me calm down. Soon after those thoughts popped in my head, our doula arrived (Josh called her at some point to let her know we were going to the hospital) and was helping me with positions while we waited to be called back, and my thoughts of giving up on a natural birth went away.

I was the only one in the waiting room, and was taken to be assessed fairly quickly. They checked my blood pressure (which was up) and temp (which was normal). They then took me straight back to a room - although I hadn't been admitted yet. It took some time to get to the room. I didn't want to sit in a wheelchair, so I walked. And, during each contraction I would stop and lean on Josh in the hallway.

I had three nurses that seemed to be moving and buzzing all around me. Soon after getting into the room a nurse asked me to undress from the waist down so that she could check me. I dreaded getting on my back, but I managed it. I was so worried that they were going to tell me that I was only 3 cm and that I needed to go back home. However, I was relieved to find out that I was at 8 cm dilated and 90% effaced! No wonder I'd been having thoughts on giving up - I was in transition!! I remember looking at Josh and smiling, at that point we knew it wouldn't be long before we got to meet our baby!

For the next little while, I was standing next to the bed, with my head on Josh's chest, eyes closed, belly hanging down between us and moaning through contractions while a nurse hooked up the belts to my belly. I had another that was putting an IV in my arm for my GBS, and another that was entering information into the computer. All through this, my midwife still wasn't at the hospital, and was on her way. In all of our haste, we forgot to call her. The nurses were texting her telling her to hurry.

I remember a nurse saying that my IV was placed at 2:45. We had planned all along for this to be a water birth, and I was excited for it! I was more than ready to get in that warm water. However, I was told that I couldn't get in the birthing pool until my midwife got there because of paperwork. And, because my midwife wasn't there, my doula couldn't even fill up the tub! To cut the tension that information caused, Josh tried to distract everyone by taking a poll about the baby's gender. Apparently, there had been a streak of girls born at the hospital and all the nurses thought the baby would be a girl.

All this time going by, I was still standing next to the bed with my head on Josh's chest and eyes closed. Being in labor is the wildest feeling. I was conscious, and aware of everything that was going on, but I was also totally in my own head, my brain thinking and whirring the whole time but unable or unwilling to voice most of it. I was just concentrating on the contractions, trying to remain relaxed and loose, and to rest as much as possible between them.

The nurses must have pushed my IV fairly quickly, almost as soon as it was placed it was taken out. They left a heparin lock in, and taped a rubber glove over my arm so that I could get in the tub when the time came.

I'm fuzzy on the times, but I was told that my midwife got to the hospital around 3:10, and it's at that point that I was finally admitted to the hospital. I found out later that she had her shirt on inside out because she was in such a hurry to get there. As soon as she came in she got the paperwork going for the birthing tub to be set up, and then she turned to me and wanted to check me. I was so over being checked, and I didn't want to get on my back because of the back labor I was having. I didn't want to move, I just wanted to stay exactly as I was, but I finally consented.

I waited until I had just finished a contraction, and got on the bed. She checked me fairly quickly and told me that I was now at 9 cm! But, she then kept me on my back to break my water. I was irritated at this, because she never asked if she could break it, and I didn't know it was happening until it was too late to do anything about it. As my doula was setting up the tub, she didn't know it was happening until after. And, then of course I had another contraction while on my back, which caused me to whither and cry out in pain, derailing me from my focus. Back labor is just awful....

In retrospect, I wish I had declined that final check, but labor is a funky thing. With both of my births I have found that when someone tells me to do something, I've found that I generally just do it without thinking, despite all the plans I had made previously.

I remember looking at the bed after my water had been broken and saw my mucus plug and bloody show on the pad. Who would have thought that at 9 cm dilated that those two things would still be firmly in place? My water was clear, so thankfully I'd be allowed to get in the pool. I was told that if my water had meconium in it I wouldn't be allowed to labor or deliver in the pool. I had one contraction after my water was broken, and man they don't lie when they say that contractions are more intense after your water breaks.

After all of that, the pool was finally ready and I was chomping at the bit to get in it. The warm water felt amazing, and really helped to take the edge off the contractions. Almost as soon as I was in the water, my body started to push on its own. I was kneeling in the pool, hanging over the edge and pushing, and pushing and pushing.....and getting nowhere. After a while, my midwife checked me while I was in the pool and discovered that I had an anterior lip of cervix caught between my pubic bone and the baby's head which was now swollen. So, my midwife had me flip over on my back to push for a few contractions while she tried to move the lip of my cervix out of the way. #1. it hurt like hell to be on my back again, #2. it hurt even more when she was messing with my cervix. I believe I was screaming in pain.

My midwife couldn't get my cervix to move out of the way while I was in the pool, so she then wanted me to get out of the pool and onto the bed. The move out of the pool took an immense amount of strength for me. I did not want to move. I was in pain, out of focus and just wanted to be left alone. I remember that I was thinking that I just wanted this to be over, and I wanted a break. I even had thoughts of wanting a C-section so I could be done. I never voiced those thoughts, and eventually I did make it onto the bed. I believe Josh and the nurses had to almost physically haul me out of the tub.

And, once again I was put on my back while my midwife tried to move my cervix out of the way. It was more painful than it sounds. I remember yelling quite fiercely while she was moving it, and begging for her to stop. She kept telling me that I wouldn't like her during this, but I would like her afterward, and she was right. Eventually she got the lip out of the way. She had me then get on my knees and push on the bed for two contractions, to get the baby's head below the lip. That time it worked, and I could get back in the pool. However, I didn't want to move. I remember telling everyone to leave me alone, that I just wanted to relax and have some downtime. My contractions had spaced out and weren't as hard as the transition contractions, and I just breathed through them without bearing down, giving myself a little rest. I was tired, and my energy was draining, and I really just wanted a nap. My doula was strongly encouraging me to get back in the water before I had the baby on the bed, and eventually I summoned the strength to move again.

As soon as I started pushing in the pool, I could feel the baby moving down. And, fairly soon the head was right there, ready to come out. That feeling, freaked me the hell out. It burned oh so badly. I felt like I was stretched to the max and was about to tear from stem to stern. But, Josh, my mom, my midwife and doula helped me get refocused. Seriously, Josh was amazing the whole time. He really was my rock and kept me focused and determined. He was repeating the mantra I'd been saying to myself my whole pregnancy: I can do anything for one minute. That helped snap me out of my freakout. I also remember my midwife telling me that I was fine, and that I wasn't going to tear apart, which was reassuring. They then helped me widen my knees and when I was pushing I would sit back, almost in a child's pose, or as close to child's pose as a pregnant, laboring woman can get. Seriously, my face was in the water as I was pushing. After a few more times pushing like that, and out the baby came. I believe the baby came out in one push. One of the nurses later told me that the baby ended up doing a flip in the water as he came out.

The next thing I heard was Josh announcing that the baby was a boy! It took some fancy maneuvering since he came out so fast behind me, but I was able to stand up, step over the cord, sit back down in the water and then he was handed to me. For the next while I was holding our son to my belly (the cord was too short to reach to my chest) skin to skin in the water and just marveling him. I just kept thinking how beautiful he was. He was squishy and plump and perfect in every way. He cried a few times, and then was just alert and calm, snuggling with me. Josh was leaning over the pool and I could hear in his voice that he was tearing up. It was a very beautiful moment.

Soon enough the cord stopped pulsating and Josh cut the cord. Not long after, I handed Josh the baby to do skin to skin with while I got out of the tub. I got up on the bed and I was covered with warm blankets, and then the baby was handed back to me. He nestled right on my chest, and was just beautiful. It's at that point that we decided to name him Benjamin.

I definitely remember still having contractions after Ben was born, which I still had to breathe through, but I didn't care about them. Instead, I was irritated at the umbilical cord, because it just kept seeming to get in the way and rub places that it did not feel good to rub against. Thankfully, not long after getting up on the bed I delivered the placenta, which didn't hurt at all. I had a tear (no idea on the degree, I never asked), which required stitches (I have no idea how many). My midwife gave me a few shots to numb the area, which stung, and then I could feel her stitching me up, feel the thread pulling through skin, but oddly it didn't hurt. All while that was happening the nurses were assessing Ben on my chest. Ben's APGAR scores were 9 and 9.

We got over an hour of skin to skin time before Ben was taken to be weighed. It seemed no one in the room could agree on how much they thought he'd weigh. The nurses all suspected that he'd be around 7 lbs, but we were all surprised when he was 8 lbs, 6 oz. He was 20.5 inches long, with a head circumference of 14 inches.

After everything was all said and done, and we had been moved from Labor and Delivery to the Mother/Baby suite, things settled down and I was finally able to really connect with my son. I've read account after account of women getting that natural oxytocin rush immediately after delivery, but that overwhelming feeling of love, comfort and peace didn't come to me until about 3+ hours after Ben was born. I believe because those first two hours are so busy, with so many people working on you and assessing the baby, even while you're holding him, that it's hard to just sit and relax and bond. But, once it was just me and my husband alone with Benjamin, that overwhelming feeling of love started to flow. Even now, over 6 months later, I still get that feeling whenever I look at my boys.

Benjamin was born at 4:23 in the morning on June 19, 2016 - Father's Day. I think that he was the best Father's Day gift that we could have asked for!
Story and photographs submitted by Amanda C.

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To tell you about the birth of my second child, I have to tell you about the birth of my first child. With my first pregnancy I had Gestational Diabetes, and Gestational Hypertension and due to mounting concerns from my midwives from my rising blood pressure and heart rate, I was induced at 39 weeks.

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Good birth stories are powerful. Hearing a mother's experience - how she felt, what helped her feel strong, the way they were loved and listened to - it's more than comfort. It's a model to copy.

Learning from first-hand experience gifts you confidence for your birth. And when you also have a story to share, you can pay that forward in turn.

For nine years, tell me a good birth story has been building a big chain of beautiful birth stories. The link gets longer all the time, so if you'd like to add to it, please get in touch. Whether waterbirth or caesarean, induction or a breech birth at home, if you want to contribute your experience as a way to support new parents, contact us using the SHARE YOUR STORY page.

As for how to use this site.....head over to our library and dive in. A scroll's ok. But better still, get yourself a cup of tea and have a proper 'meeting' with the people sharing their stories there. In amongst the tales you'll find some tips from me - pearls and pointers about what all women need, wherever their birth journey takes them.

For further encouragement, my book is packed with practical guidance, and will help provide a clear path to you having a positive birth experience yourself.

Buy a copy, for yourself or a friend, and you'll be supporting our site and helping our community to grow.

'Absolutely loved this book. Very informative and full of no-nonsense, real and realistic advice about giving birth. A fantastic resource for preparing for a positive birth experience, whatever kind of birth you have. On top of that, it is a beautiful book with gorgeous imagery. A joy to read.' Noobug, Amazon Customer

'Natalie is all your mothers, your sisters, your aunties and your friends arriving bearing the gifts of their experience and wisdom. Nothing this book shares with us is useless; every page holds a nugget that could make birth or parenting easier or more beautiful. Reading the section on labour I felt I could hear Natalie's warm, kind voice, holding my hand as she passed on the deep, intuitive knowledge that can only come from years spent accompanying parents through labour and birth.' AIMS ( Association for the Improvement of Maternity Services )

'I adored this book and can't stop recommending it to people. I read it when pregnant with my second child and learnt so much, despite having giving birth before. It made so much sense! I learnt about all the stages of labour and was so much better prepared for my second birth. I loved the suggestions of lavender and hot water bottles, and other tips. It made me feel nurtured and excited about the birth. A very special book!' Jo

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Good birth stories are powerful. Hearing a mother's experience - how she felt, what helped her feel strong, the way they were loved and listened to - it's more than comfort. It's a model to copy. Learning from first-hand experience gifts you confidence for your birth.

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Water injections

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Sterile water injections used for labouring women describes the injection of minute amounts of sterile water into the skin. The injections are fairly new to be used during labour but have shown such wonderful results, so we interviewed the amazing Carolyn Hastie, who previously managed Belmont Birthing Service and was NSW Midwife of the Year, to find out more.

Are Sterile Water Injections Really Just Injections With Water In Them?

Yes, it is really just water!

How Did It All Come About To Use Water In This Way?

From my understanding, the water injections being used for labouring women came from their usage with people with renal colic/kidney stones. They are very effective for that condition.

The concept behind the development of sterile water injections for pain is 'gate control theory'. The skin has thousands of receptor sites and nerve cell endings which scan for pain, pressure, touch etc., and transmit that information to the brain very, very quickly. The sensations shoot up the nerves and spinal cord to the brain. The sensations (which are chemical and electrical signals) go through little traffic control stations.

The signal boxes in the nerve pathways are 'manned' by chemical signalers which let pain, pressure, touch etc., signals through to the brain. The signal boxes in the nerve pathways are called 'gates'. They are called gates because they choose which signal to let through. When the brain receives the signals, it decides what action to take.

The traffic controllers (chemicals) which man the 'gates' preference skin signals over internal signals because the skin is monitoring the outside environment and lets the brain know when there is immediate danger. When a woman has back pain in labour, the pain signals are slow, internally generated signals. Some back pain is normal when the baby's head is decending in the pelvis, it presses on the sacrum, pushing it out as the head turns on its way down. That is nature's signal to the mother than the birth of her baby is imminent. When a woman has intractable back pain, because of the baby being in the posterior position, then the water injections may be useful. If a woman has the water injections into her skin, it stings for about thirty seconds. That sting switches on the fast fibres. The fast fibre signals from the skin come racing up to the gate, the traffic controlling chemicals recognise an immediate threat, close the gate to the slow pain messages and let the quick skin related message through. The internal pain signal is stopped in its tracks and the woman no longer feels that internal sensation. That effect lasts for about 90 minutes.

How Effective Are Sterile Water Injections?

They are very effective for the majority of women. The pain level of the back pain has to be a high enough level so that the wasp like sting is worth it. On a 0-10 score, with 10 being the worst pain imaginable, the pain level has to be about an 8 or above.

How Many Women Have You Witnessed Having The Injections?

I've seen lots of women have the injections and only one has said it wasn't worth it. Her pain scale was not high enough when the midwives administered the injections.

How Quickly Does It Work and How Much Pain Does It Take Away?

It works immediately and takes away the internal pain.

Do Sterile Water Injections Work For Everyone?

Even the woman who said it wasn't worth it pushed her baby out very quickly after the injections when she was not pushing effectively before the injections, because of the pain in her back.

When Is The Best Time To Have Sterile Water Injections During Labour?

They are best used when the woman's backache is 8 out of 10 and she can't manage it.

What Would You Suggest To A Woman Who Is Interested In Having Sterile Water Injections In Labour?

Women could certainly ask their local service (hospital/midwives) about the use of these injections for back pain. Janice deoCampo from Colac teaches how to do these injections and has run workshops on using them. Janice brought the idea to Australia after her daughter used them in labour in Sweden. Janice ran a workshop for us at Belmont Birthing Service and our midwives use them when necessary. These injections are also being used at John Hunter Hospital. We wrote a policy and put the process through the Clinical Governance Unit for approval.

What Do You Think About Sterile Water Injections?

These injections are fantastic. Quick, easy and safe. Women are able to stay mobile and there are no other effects from them. Obviously, infection could be a risk, if sensible normal procedures were not followed. We have actually used them for suprapubic pain (referred sensation from the cervix opening, felt just above the pubic bone). This pain is another one of those indicators from nature telling the woman that labour is progressing, but for an occasional woman, she is not able to bear it. We have found the sterile water injections work well there too - the system works all over the body because of the 'gates'.

If the labour is a long one, the woman may need a couple of 'doses', but for many women, the relief of the internal pain enables her to relax, the pelvic muscles relax, the baby turns, the cervix dilates and out it comes! In second stage it can be amazingly fast. In first stage it depends on how open the cervix already is when the injections are given as to how fast it goes.

Comments About Sterile Water Injections From Other Midwives

"I have only used this once with rather miraculous results, so not really qualified to comment. Went from back pain scale 9&1/2 to zero in 2 contractions!" - Di

"I have used water injections for back pain in labour for the last 3 years in 2 different hospitals, always with amazing results. Very few women say it didn't help at all." - Sally

Pointers For Midwives/Doctors Interested In Doing Sterile Water Injections For Labouring Women

a) Use fine needles 25gauge
b) Use 0.1mL of sterile water (yes, that's all)
c) Get the woman to point to where the pain is worst, inject her there
d) Two midwives administer the water at the same time - the sting may stop the woman from having the other side done if only one midwife does it.
e) Have the partner hold the woman's hands and talk her through the injections as she can automatically swipe at you when you give the injections
f) Administer the water injections into the skin, it's intra - dermal, not sub cutaneous, not under the skin, the idea is to raise a little bleb which stretches the skin and sets off the receptors
g) Leave the area alone! the sting is the thing, if you rub it, it will lose its effectiveness.
h) The Swedish midwives give four injections, either as four in a row across the back, or on the four points of an inverted trapezpoid shape on the woman's sacrum.

Further Information

Read this PDF on a sterile water project with contact details for Janice HERE. Midwives if your hospital does not provide this service, let your workplace know so you can organise some training!
http://www.radmid.demon.co.uk/waterjab.htm

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Sterile Water Injections - Taking the Pain Out of Back Labour | BellyBelly

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Sterile water injections used for labouring women describes the injection of minute amounts of sterile water into the skin. The injections are fairly new to be used during labour but have shown such wonderful results, so we interviewed the amazing Carolyn Hastie, who previously managed Belmont Birthing Service and was NSW Midwife of the Year, to find out more.

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NHS overview

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Your pain relief options

Labour can be painful - it can help to learn about all the ways you can relieve the pain.

It's also helpful for whoever is going to be with you during your labour to know about the different options, as well as how they can support you.

Ask your midwife or doctor to explain what's available so you can decide what's best for you.

Write down your wishes in your birth plan, but remember you need to keep an open mind. You may find you want more pain relief than you'd planned, or your doctor or midwife may suggest more effective pain relief to help the delivery.

Self-help in labour

You're likely to feel more relaxed in labour and better placed to cope with the pain if you:

learn about labour - this can make you feel more in control and less frightened about what's going to happen; talk to your midwife or doctor, ask them questions, and go to antenatal classes

learn how to relax, stay calm and breathe deeply

keep moving - your position can make a difference, so try kneeling, walking around, or rocking backwards and forwards

bring a partner, friend or relative to support you during labour, but do not worry if you do not have a partner - your midwife will give you all the support you need

ask your partner to massage you - although you may find you do not want to be touched

have a bath

Gas and air (Entonox) for labour

This is a mixture of oxygen and nitrous oxide gas. Gas and air will not remove all the pain, but it can help reduce it and make it more bearable. Many women like it because it's easy to use and they control it themselves.

You breathe in the gas and air through a mask or mouthpiece, which you hold yourself. The gas takes about 15-20 seconds to work, so you breathe it in just as a contraction begins. It works best if you take slow, deep breaths.

Side effects

there are no harmful side effects for you or the baby

it can make you feel lightheaded

some women find that it makes them feel sick, sleepy or unable to concentrate - if this happens, you can stop using it

If gas and air does not give you enough pain relief, you can ask for a painkilling injection as well.

Pethidine injections in labour

This is an injection of a medicine called pethidine into your thigh or buttock to relieve pain. It can also help you to relax. Sometimes, less commonly, a medicine called diamorphine is used.

It takes about 20 minutes to work after the injection. The effects last between 2 and 4 hours, so would not be recommended if you're getting close to the pushing (second) stage of labour.

Side effects

There are some side effects to be aware of:

it can make some women feel woozy, sick and forgetful

if pethidine or diamorphine are given too close to the time of delivery, they may affect the baby's breathing - if this happens, another medicine to reverse the effect will be given

these medicines can interfere with the baby's first feed

Epidural

An epidural is a type of local anaesthetic. It numbs the nerves that carry the pain impulses from the birth canal to the brain. It should not make you sick or drowsy.

For most women, an epidural gives complete pain relief. It can be helpful for women who are having a long or particularly painful labour.

An anaesthetist is the only person who can give an epidural, so it will not be available at home. If you think you might want one, check whether anaesthetists are always available at your hospital.

How much you can move your legs after an epidural depends on the local anaesthetic used. Some hospitals offer "mobile" epidurals, which means you can walk around.

However, this also requires the baby's heart rate to be monitored remotely (by telemetry) and many hospitals do not have the equipment to do this. Ask your midwife if mobile epidural is available in your local hospital.

An epidural can provide very good pain relief, but it's not always 100% effective in labour. The Obstetric Anaesthetists Association estimates that 1 in 10 women who have an epidural during labour need to use other methods of pain relief.

How does an epidural work?

To have an epidural:

a drip will run fluid through a needle into a vein in your arm

while you lie on your side or sit up in a curled position, an anaesthetist will clean your back with antiseptic, numb a small area with some local anaesthetic, and then introduce a needle into your back

a very thin tube will be passed through the needle into your back near the nerves that carry pain impulses from the uterus. Drugs (usually a mixture of local anaesthetic and opioid) are administered through this tube. It takes about 10 minutes to set up the epidural, and another 10-15 minutes for it to work. It does not always work perfectly at first and may need adjusting

the epidural can be topped up by your midwife, or you may be able to top up the epidural yourself through a machine

your contractions and the baby's heart rate will need to be continuously monitored. This means having a belt around your abdomen and possibly a clip attached to the baby's head

Side effects of epidurals in labour

There are some side effects to be aware of.

An epidural may make your legs feel heavy, depending on the local anaesthetic used.

Your blood pressure can drop (hypotension), but this is rare because the fluid given through the drip in your arm helps to maintain good blood pressure.

Epidurals can prolong the second stage of labour. If you can no longer feel your contractions, the midwife will have to tell you when to push. This means that forceps or a ventouse may be needed to help deliver the baby (instrumental delivery).

When you have an epidural, your midwife or doctor will wait longer for the baby's head to come down (before you start pushing), as long as the baby is showing no signs of distress. This reduces the chance you'll need an instrumental delivery. Sometimes less anaesthetic is given towards the end, so the effect wears off and you can feel to push the baby out naturally.

You may find it difficult to pee as a result of the epidural. If so, a small tube called a catheter may be put into your bladder to help you.

About 1 in 100 women gets a headache after an epidural. If this happens, it can be treated.

Your back might be a bit sore for a day or two, but epidurals do not cause long-term backache.

About 1 in 2,000 women feels tingles or pins and needles down one leg after having a baby. This is more likely to be the result of childbirth itself rather than the epidural. You'll be advised by the doctor or midwife when you can get out of bed.

Read more about the pros and cons of epidurals.

Using water in labour (water birth)

Being in water can help you relax and make the contractions seem less painful. Ask if you can have a bath or use a birth pool. The water will be kept at a comfortable temperature, but not above 37.5C, and your temperature will be monitored.

The National Childbirth Trust has information on using water during labour and birth.

TENS machines

This stands for transcutaneous electrical nerve stimulation. Some hospitals have TENS machines. If not, you can hire your own machine.

TENS has not been shown to be effective during the active phase of labour, when contractions get longer, stronger and more frequent. It's probably most effective during the early stages, when many women experience lower back pain.

TENS may also be useful while you're at home in the early stages of labour or if you plan to give birth at home. If you're interested in TENS, learn how to use it in the later months of your pregnancy. Ask your midwife to show you how it works.

How TENS machines work

Electrodes are taped on to your back and connected by wires to a small battery-powered stimulator. Holding this, you give yourself small, safe amounts of current through the electrodes. You can move around while you use TENS.

TENS is believed to work by stimulating the body to produce more of its own natural painkillers, called endorphins. It also reduces the number of pain signals sent to the brain by the spinal cord.

Side effects of TENS machines

There are no known side effects for either you or the baby.

Read more about TENS.

Alternative methods of labour pain relief

Some women may choose alternative treatments such as acupuncture, aromatherapy, homeopathy, hypnosis, massage and reflexology. Most of these techniques are not proven to provide effective pain relief.

If you'd like to use any of these methods, it's important to discuss them with your midwife or doctor and let the hospital know beforehand. Most hospitals do not offer them for pain relief during labour.

If you want to try any of these techniques, make sure the practitioner is properly trained and experienced. Learn more about complementary and alternative medicines and how they're regulated.

Find maternity services near you.

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Labour can be painful - it can help to learn about all the ways you can relieve the pain. It's also helpful for whoever is going to be with you during your labour to know about the different options, as well as how they can support you.

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Water birth

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Opiates

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Epidural

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Entonox

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Coping skills for labour from baby centre

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Coping skills for labour from baby centre

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by , Senior midwife and team leader June 2021

iStock.com / Prostock-Studio

In this article

If you've looked into pain management for labour and you're not sure about having pethidine or an epidural, you may want to use some tried and tested natural methods of pain relief first. Natural methods like massage and breathing work by releasing pain relief and feel-good hormones, and don't have unwanted side effects. They can help you during labour and birthing. You can include any natural pain relief options you want to try in your birth plan so your hospital or birth centre can support your choices. You might also be able to practise some of the methods at your antenatal classes.

Can using warmth ease labour pain?

Applying warmth is a tried-and-tested way of relaxing aching, tense muscles. So it's no surprise that it can help provide relief from labour pain.

A warm water bottle is perfect for warming your back, tummy or groin if you're in hospital or at home. Use a hot water bottle filled with warm (not boiling) water. Take care to wrap the bottle in a towel or soft cover before you use it.

A wheat bag can also be used if you're planning a home birth. This is a bag that's been filled with wheat husks and can be heated for just a few minutes in the microwave. It shapes itself to your body and should stay warm for an hour or so. Some wheat bags are even scented with lavender, which may also help you feel calm and relaxed.

Unfortunately, hospitals, especially NHS ones, don't have the facilities to heat wheat bags, so this is only an option if you're having a home birth. Maximum heating times and instructions for use will be stated on the packet, so always be sure to follow them carefully.

A warm flannel or compress placed on the area between the back of your vaginal opening and your back passage (perineum) can be used once your baby's head emerges. It may reduce your risk of having a severe tear, and can make you feel more comfortable.

How does a birth pool relieve labour pain?

Labouring in warm water can relax you and make contractions more bearable, just as having a regular bath helps to ease tummy ache or backache. The birthing pool is kept at a warm temperature which will relax you and help you to store up energy for what's to follow.

Using a birth pool can help you cope better with the pain of labour and make you feel more in control. Research has found that spending some time labouring in water means you're less likely to need an epidural or spinal painkiller than if you spend your entire labour out of water. Using a birth pool may also shorten the first stage of your labour.

How can breathing help with contractions?

Focusing on your breathing is a really helpful way of getting through each contraction. Follow these tips to help make the most of your breathing:

As you breathe, think of the word "relax" in two stages. Take a deep breath at the beginning of the contraction and think "re-", then as you breathe out, think "-lax" and let go of any tension.

Continue by breathing in through your nose and out through your mouth, keeping your mouth soft and slightly open.

Concentrate as hard as you can on breathing in as the contraction builds up, and out as it fades away.

Keep a good rhythm going. Don't worry about how deeply you're breathing, or for how long. Just try not to let the in-breath become longer than the out-breath.

When the contraction is over, try to relax as much as possible.

This rhythmic breathing will conserve your energy and help to ease your pain, too.
Will resting help with labour pain?

In early labour you can prepare yourself for coping with pain. Make yourself as comfortable as possible in bed or on a chair. Tuck pillows all around yourself. Have a hot, sweet drink and relax. Put the television on or play some of your favourite music, and rest!

Later on, you'll find it much easier to cope with painful contractions if you haven't been rushing around during early labour.

Should I change position during labour to ease pain?

Yes, keeping mobile will help you cope as your labour progresses. There's good evidence that staying in upright positions or walking around can help to shorten your labour by over an hour.

Unless you're really tired, try not to lie on your back once you're in active labour. Doing so can make your contractions slower and more painful.

Walking around and using upright positions means you're less likely to need an epidural or a caesarean. It's good for your baby too, as it reduces the likelihood that they'll need special care.

Your midwife can guide and support you to try different positions. Some are designed to help you cope in the first stage of labour. Other positions may help your baby to descend in the second stage.

As labour progresses, lying on your side may help you to rest and keep your pelvis free and open.

Try out different positions to see what's most comfortable. You could:

Stand up and lean on the bed or your partner.

Kneel down on a mat or pillow and lean on the seat of a chair or birth ball.

Kneel with one leg raised to make lots of room in your pelvis for your baby to come out.

Get on your hands and knees. You may find this makes things easier if your baby is in the back-to-back position.

Sit for a while in a chair or on a birth ball, then get up and walk around.

Rock your hips to help your baby to move down.

Saving energy in early labour is important, but sometimes a short, gentle walk can ease pain and speed up your contractions. That's because it encourages your baby down your birth canal and put pressure on your cervix to help it dilate. Just try not to overdo it, as you'll need plenty of energy later on.
How does massage help with labour pain?

Massage may help you to keep calm and cope with labour pain.

Massage, particularly having someone rub your back, will warm your skin and stimulate your body to release its own natural painkillers. If you're using essential oils, check with an accredited aromatherapist that they are safe to use during pregnancy.

Tell your birth partner or midwife where you'd like to be massaged. You may prefer it at the very base of your back to help with lower back pain during contractions. Or you may like your shoulders massaged between contractions to help you relax. Let them know what works for you, so you get the best out of it.

A massage that starts slowly is best. Frantic rubbing will make you feel panicky rather than relaxed! Firm pressure will help stimulate your body to release feel-good hormones (endorphins), which help to reduce pain and relax you.

Can having a supportive birth partner help me cope with pain?

If you have someone supportive to comfort and stay with you during labour, you're more likely to give birth more quickly and easily. You're also likely to use less pain relief than someone without continuous support. Overall, you're also more likely to be more satisfied with your birth experience.

Who you choose as your birth partner may make a difference too. You may want your partner, a good friend or family member to be your birth partner. But you can also choose someone who you trust but don't have a personal relationship with, and is just there to provide continuous support during your labour. For example, this could be a doula or a woman who's given birth before herself. In fact, you may find that someone outside your normal circle may be better able to offer the support you need. Don't worry if this doesn't appeal to you, though. A good friend, family member or your partner will also be able to provide excellent support as a birth partner.

Think carefully about who you want to have with you during your labour and birth. You'll need someone who won't panic, is positive, and is confident enough to talk to health professionals on your behalf.

You may like to choose two birth partners. Keep in mind that some hospitals dislike having two extra people in the birth room at the same time, due to lack of space. Your hospital may allow you to have one of your two birth partners in the room at a time, though.

Discuss this with your midwife and ask for your requests to be put in your notes well before your due date. Your preference is what matters.

How will my midwife help?

Your midwife will keep you informed about what's happening when you're in labour and listen to you to make sure you have the birth experience you choose. If you want to use natural pain relief to cope with contractions, your midwife will help you. And if you choose an epidural or other medical pain relief, they'll support you.

Some midwives are trained in complementary therapies, such as aromatherapy and shiatsu massage. It's worth asking if any of the midwives in your clinic or hospital have these extra skills.

Doulas aren't regulated in the same way. So if you employ a doula who's offering complementary therapies, it's worth checking what training they have had had to give you peace of mind.

More on natural pain relief in labour

References

Aasheim V, Nilsen A.B.V, Reiner LM et al. 2017. Perineal techniques during the second stage of labour for reducing perineal trauma. Cochrane Database of Systematic Reviews (6): CD006672 www.cochranelibrary.com [Accessed January 2021]

Bohren MA, Hofmeyr GJ, Sakala C et al. 2017. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews (7): CD003766. www.cochranelibrary.com [Accessed January 2021]

Cluett ER, Burns E, Cuthbert A. 2018. Immersion in water in labour and birth. Cochrane Database of Systematic Reviews (8): CD000111 www.cochranelibrary.com [Accessed January 2021]

Gotter A. 2019. Treating pain with heat and cold. Healthline. www.healthline.com [Accessed January 2021]

Gupta JK, Sood A, Hofmeyr GJ, et al. 2017. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database of Systematic Reviews (5): CD002006. www.cochranelibrary.com [Accessed January 2021]

Guittier MJ, Othenin-Girard V, de Gasquet B, et al. 2016. Maternal positioning to correct occiput posterior fetal position during the first stage of labour: a randomised controlled trial. BJOG 123(13): 2199-2207

Harding M. 2016. Complementary and alternative medicine. patient.info [Accessed January 2021]

JMWH. 2020. Second stage of labor: pushing your baby out. Journal of Midwifery & Women's Health 65(3):439-440. onlinelibrary.wiley.com [Accessed January 2021]

Lawrence A, Lewis L, Hofmeyr GJ, et al. 2013. Maternal positions and mobility during first stage labour. Cochrane Database of Systematic Reviews (10):CD003934. www.cochranelibrary.com [Accessed January 2021]

NCCWCH. 2017. Intrapartum care: care of healthy women and their babies during childbirth. National Collaborating Centre for Women's and Children's Health, Clinical guideline, 190. www.nice.org.uk [Accessed January 2021]

OAA. nd. FAQs pain relief. Obstetric Anaesthetists Association. LabourPains.com. [Accessed January 2021]

Smith CA, Levett KM, Collins CT, et al. 2018. Massage, reflexology and other manual methods for pain management in labour. Cochrane Database of Systematic Reviews (3): CD009290. www.cochranelibrary.com [Accessed January 2021]

Uvnäs-Moberg K, Handlin L, Petersson M. 2014. Self-soothing behaviors with particular reference to oxytocin release induced by non-noxious sensory stimulation. Frontiers in psychology 5, 1529.

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From massage, essential oils and applying warmth, to birth pools, birthing balls and birth partners, check out these natural ways of reducing labour pain. - BabyCentre UK

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An overview

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First stage of labour: a definition

As labour can be a long, complex process, it's handily referred to as happening in three stages (NICE, 2017).

"The first stage of labour is made up of contractions that will get longer, stronger and more frequent."

These contractions will help to push your baby down and your cervix to open (dilate) so that your baby can come into the world. When your cervix has dilated to about 4cm, you're in 'established labour' (NICE, 2017).

If this is your first baby, the first stage of established labour usually lasts between eight and 18 hours. If it's not, it's more likely to be around five to 12 hours (NICE, 2017).

What do contractions feel like?

Ah, the big question. Trouble is, contractions can feel completely different from woman to woman and even in different pregnancies. So the way your friend describes hers may be a world away from your own experience.

Some ways you might describe the feeling are:

discomfort or a dull ache in your back or lower stomach

pressure in the pelvis

stomach becoming hard, then soft again

wave-like motion from the top of the uterus to the bottom

similar to period pain.

If you're wondering what early labour feels like, watch our video where new mums talk about what it felt like for them.

The good news is that contractions will come and go so - if you can - try and relax in between them (WebMD, 2018).

Contractions versus Braxton Hicks contractions

The contractions you'll experience during established labour are different from the Braxton Hicks contractions (false contractions) that you probably felt while you were pregnant. Unlike Braxton Hicks, they don't go away when you change your position or relax.

Early labour pain management and calling your midwife

Your midwife will know how far on you are and whether you need to be in hospital or at your birthing centre yet. So before you head off anywhere, give them a call.

Your midwife will then ask questions and assess you based on your:

movements

breathing

ability to hold a conversation

emotional state.

Call your midwife or a doctor straight away if:

you have a heavy 'show'

your waters break

your baby's moving less than usual

you're less than 37 weeks pregnant.

(NHS Choices, 2017)

First stage of labour: managing pain at home

In the early part of labour, you're likely to be at home. Try the following if you can:

walk or move around

drink a lot of fluids and healthy snacks

have a warm bath

do some relaxation or breathing exercises

ask your birth partner to rub your back

manage the pain with paracetamol (if needed)

stay in an upright position.

When your contractions start coming every five minutes and last at least 60 seconds, give your midwife a call (NHS Choices, 2017).

Early labour and your birth partner

Having a supportive birth partner can give you a sense of control, comfort and competence and make complications less likely (Hodnett et al, 2013). So (no pressure), choose carefully...

Things your birth partner can do to help you are:

Speaking to midwives or doctors if you're not able to.

Encouraging you (especially through contractions...) and reassuring you.

Massaging your back (if you can bear it... some women can't).

Getting you those crucial energy-boosting drinks and snacks.

Speaking to you about pain-relief options.

Helping you with relaxation and breathing techniques.

Supporting you while you try different positions.

First stage of labour: how it will progress

When you meet your midwife, they will:

Ask you about the length, strength and how often your contractions are coming.

Possibly conduct a vaginal examination and record your pulse, blood pressure and temperature.

Ask about your baby's movement in the last 24 hours.

Examine your stomach.

Monitor your baby's heart rate.

(NICE, 2017; Which?, 2018)

First stage of labour: what happens at the end

Toward the end of the first stage of labour, your cervix will be about 7cm to 8cm dilated.

A lot of women find this the hardest, most painful part of giving birth and you might feel like you are out of control. If this happens to you, don't worry: it's totally normal.

If you want to give birth without pain relief, this might also be the part when you find it the trickiest to stick to your plan. It's absolutely fine, of course, if you do change your mind but if you do want to still avoid pain relief, it is possible to use self-help methods like hypnobirthing instead.

Then you'll be on to the second stage of labour, which will last until you have your baby, normally for two to three hours at the most. (NICE, 2017)

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth and life with a new baby.

You will also find useful information on NHS Choices in a guide to labour.

More information on stages of labour can be found in NICE guidelines.

Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. (2013) Continuous support for women during childbirth. Cochrane Database Syst Rev.(7):CD003766. Available from: http://cochranelibrary-wiley.com/doi/10.1002/14651858.CD003766.pub5/pdf [Accessed 3rd August 2018].

NHS Choices. (2017) Signs that labour has begun. Available from: https://www.nhs.uk/conditions/pregnancy-and-baby/labour-signs-what-happens/ [Accessed 3rd August 2018].

NICE. (2017) Intrapartum care for healthy women and babies. Available from: https://www.nice.org.uk/guidance/cg190/ifp/chapter/what-happens-during-labour [Accessed 3rd August 2018].

RCM. (2012) Evidence based guidelines for midwifery-led care in labour: assessing progress in labour. Available from: https://www.rcm.org.uk/sites/default/files/Assessing%20Progress%20in%20Labour.pdf [Accessed 3rd August 2018].

WebMD. (2018) Pregnancy and signs of labor. Available from: https://www.webmd.com/baby/labor-signs#1 [Accessed 3rd August 2018].

Which? (2018) Stages of labour. Available from: https://www.which.co.uk/birth-choice/getting-ready-to-give-birth/stages-of-labour [Accessed 3rd August 2018].

WHO. (2013) Counselling for maternal and newborn health care: a handbook for building skills. Available from : https://www.ncbi.nlm.nih.gov/books/NBK304186/ends [Accessed 3rd August 2018].

Further reading

Lawrence A, Lewis L, Hofmeyr GJ, Dowswell T, Styles C. (2013) Maternal position and mobility during first stage labour. Cochrance Database Syst Rev.(8):CD003934. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164173/ [Accessed 3rd August 2018].

Which? (2018b) Choosing your birth partner. Available from: https://www.which.co.uk/birth-choice/getting-ready-to-give-birth/choosing-your-birth-partner [Accessed 3rd August 2018].

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First stage of labour: signs, coping and when to go to hospital

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As labour can be a long, complex process, it's handily referred to as happening in three stages (NICE, 2017). "The first stage of labour is made up of contractions that will get longer, stronger and more frequent." These contractions will help to push your baby down and your cervix to open (dilate) so that your baby can come into the world.

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An article about the benefits of staying at home for as long as possible

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For several years, I ran Recipes for Normal Birth workshops and spend a lot of time analysing the research on what helps keep birth normal. Yes, I know that the word 'normal' is very loaded and needs debating. For today. I'm going to focus on another aspect of the discussion. Because, as I've looked at the research on what helps facilitate straightforward birth, there's one tip in particular that I would like to share with women.
Stay at home as long as possible in labour.
That is, in my humble but - if I may say so myself - reasonably informed and evidence-based opinion, one of the most important things that a woman can do in order to help give herself the best chance of a straightforward normal birth with as little intervention as possible. Because time and time again, research shows us that, the sooner a labouring woman who is planning a hospital birth enters the hospital, the more likely she is to end up with lots of intervention which may lead down the road to a more medicalised operative or instrumental birth.

Here's some data...

One recent study which illustrates this really well was conducted by Wood et al (2015). They analysed data from 2033 women who went into spontaneous labour at term with a single baby, focusing on the relationship between how dilated their cervix was on admission to hospital and the likelihood that the woman would have a caesarean section.

The results were really clear. Women who went to hospital earlier were more likely to have a caesarean section compared with those who went later. If you want the numbers, then the cut-off point was 6cm, although please bear in mind the two important caveats here. One, midwives have long been stressing that dilation is only one element of labour progress, so I don't want to emphasise the measurement element of this more than is appropriate. Particularly because, two, most women can't or don't wish to do vaginal examinations themselves, so they can't possibly know whether their cervixes are 1cm, 5cm or 7cm dilated. The numbers aren't the important bit in the translation of this into our conversations with women.

The important bit is the message that staying at home for as long as she is comfortable doing so is one of the most important things a woman can do if she wants to maximise her chances of having a straightforward, normal birth.

What needs to happen?

There are a number of things that those of us who work with women can do to help this, and I am acutely aware that simply telling this to women may not make a difference. For a start, women receive mixed messages about when to come into hospital. Not to mention years of undermining about who is the expert on their body and baby. There is also a good bit of work to be done in the area of making time before labour to consider what needs to happen to make sure that everybody is comfortable with staying at home. By everybody, I mean the woman herself, her partner, any other relatives or birth partners and birth attendants.

Partners and families are key. If the woman can't relax because her partner can't relax, then she's not likely to get to 6cm in a reasonable timespan, and she may end up transferring in for partner's distress. But yes, birth attendants' comfort levels are another important element. Sadly, some women transfer for caregiver's distress as well, and that's something which needs to be addressed. But these are not insurmountable, and helping women and their partners and families to develop strategies for staying at home as long as possible, even if they are planning a hospital birth, is a really simple way in which we can help reduce the caesarean section rate.

Wood AM, Frey HA, Tuuli MG et al (2015). Optimal Admission Cervical Dilation in Spontaneously Laboring Women.Amer J Perinatol. DOI: 10.1055/s-0035-1563711

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The most important thing women can do for themselves in the quest for a normal birth? - Dr Sara Wickham

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For several years, I ran Recipes for Normal Birth workshops and spend a lot of time analysing the research on what helps keep birth normal. Yes, I know that the word 'normal' is very loaded and needs debating. For today. I'm going to focus on another aspect of the discussion.

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When to call the midwife