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BLOG: Episode 5 - The work of labour

Blog by Gill Houghton, Consultant Midwife For Normality, 19th April 2016

Tonight's One Born gives us a fabulous insight into the different attitudes we have when preparing to give birth. We are all individuals with our own beliefs and ideas about what "the best birth possible" looks like, and this differs much more than you might imagine.

Some viewers will be as amazed as Carlotta and Havier were when "in this day and age" midwife Vicky doesn't immediately run to get the epidural and instead suggests a massage and a hot water bottle! 

 

 
Just to dispel any rumours, we midwives love the fact that epidurals are available to women, as they provide excellent pain relief and can be a God send. It may therefore be surprising that relatively small number women choose epidural as their first choice of pain relief and that the majority use other strategies to manage any labour pain they experience.

 

This is because many women are now aware that epidural pain relief also removes some other important sensations associated with giving birth. These sensations are important and experiencing them can actually help the birthing process to go well.  In "epiduralised" birth, women may not feel all the important cues they need that tell them when and how to move positions to help the baby move through the birth canal. Many women are also unable to remain upright and active after an epidural or cannot feel the sensation to "bear down" or "push" as the baby comes closer to being born. This can cause labour to slow down, for some women an epidural given at an early stage of labour can even stop labour in its tracks. We know from research that women who have epidural pain relief experience longer labours and increased more medical assistance with the birth its self through the use of forceps or a ventouse (suction cap applied to the baby's head ), when compared to when other methods of pain relief.

Many women therefore prefer to "work with the pain" of labour rather than get rid of it altogether. And if your aim for labour is to get the baby born as quickly and as naturally as possible, this can be an effective strategy.

Of course, in theory, this sounds like a good plan, at the time however this works out well for some and not so great for others. Carlotta does everything midwife Vicky suggests to help manage the long early part or "latent phase” of labour she experiences. She is very relieved when her expectations for a modern-day birth are realised and an epidural is given.

Kirstine has a different approach to her labour, she walks across the car park pausing only briefly to breathe through her contractions. We see how she is listening to her body's clues and this helps her to instinctively know what to do to help the birth along. She chats and laughs with Phil then as a contraction builds she leans forward and rocks.

 

 

 
Phil looks on and admits he is worried. This is common; it can be unbelievably difficult to watch someone you love in pain. On top of this many women and partners find the uncertainty and unexpected nature of childbirth quite difficult to deal with. A useful technique can be to recognise these feelings are normal, once you accept the uncertainty it can be a little easier to let go and just "go with the flow" as the birth unfolds in its own time. 

 

Congratulations to all the parents featured in tonight's show. You really give us a fabulous snapshot into just how varied individuals expectations and experiences of birth can be. Every woman births their baby in their own unique way. I like to think we midwives can and do help, but I admit that mostly we merely wait and watch in amazement as women work with their bodies to become mothers.

by Liverpool Women's

Liverpool Women's

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