Body

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Your body is amazing. Just think, right now you are growing a little human inside of you. Your body is doing everything it needs to nurture and develop your baby. You don't consciously need to think about any of it, your body does this all naturally and instinctively. And in the same way that your body knows exactly what to do during your pregnancy, your body also knows instinctively how to give birth.

Every labour is slightly different, so I can't tell you exactly what will happen for the birth of your baby. In this module we will look at some of the things that happen to your body during labour and give you some idea of what you can expect.

How will I know that I am going into labour?

These are some of the key signs to look out for which will signify that labour is imminent. You may experience all of these things, or just a few, and they can happen in any order. For example, most people associate going into labour with the waters breaking, usually in a large gush. This is the case for some women. Other women just experience a small trickle when their waters break, and some women will be well into their labour before their waters break. In rare cases, the waters never break and the baby is born en-caul (with the amniotic sac still intact). This is a guideline and definitely not a ticklist!

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What does a contraction feel like?

Again, there is no definitive answer I can give you. The way each women experiences a uterine contraction can be completely different to another. Some women experience the contraction around their bump, others feel it in their lower back, some women even experience the sensation in their thighs.

The sensation can vary due to many influencing factors - different pain thresholds, the environment, emotional state and support given. We've already looked at the very negative impact that fear and tension can have on a birthing women and how any tension can cause painful contractions. We'll look at the importance of creating the right environment for your birth and how your partner can support you effectively in later modules.

Essentially your uterus is a large bag of muscles, the largest in the female body, and so when it contracts you will feel it as a strong sensation. It consists of circular and longitudinal muscles - longitudinal muscles which flex and pull the circular muscles open. A bit like pulling a polo neck jumper over your head.

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The more relaxed the circular muscles are, the more effective each pull from the longitudinal muscles is at helping the circular muscles to open. So the more relaxed you are, the more relaxed the rest of your body is, the more effective each contraction is.

Hormones

Our bodies are designed to give birth and during labour a series of clever little things happen which help us cope with what is happening in our body. Contractions generally start off quite mild and gradually increase in intensity, allowing us time to acclimatise and get used to the sensations as they get stronger. The body also releases a cocktail of useful hormones which act as a form of natural pain relief, in particular 'oxytocin' and 'endorphins'.

Endorphins

Endorphins act as a natural pain relief (some respected scientists believe endorphins to be as powerful as morphine).

Endorphins are usually released as the body’s response to physical exertion, through meditation or controlled breathing, or as a response to stress or pain. The brain produces these neurotransmitters to take the edge off and generally make you feel amazing.

Oxytocin

Oxytocin, also known as the ‘love hormone’, is present throughout the whole sexual and reproductive cycle, and is strongly linked with bonding and attachment, feelings of wellbeing and love. The lovely feeling that you get when you have a nice long hug with someone you care about is down to your body releasing oxytocin.

The first contraction, as labour begins, is triggered by a huge rush of oxytocin. Both Mum and baby experience a huge oxytocin rush as baby comes into the world, cleverly enforcing the natural bonding process and feelings of love for each other. It is the oxytocin present in the body which stimulates milk production and helps breastfeeding flow naturally.

Feeling safe and loved can help the production of oxytocin, along with gentle loving touches, hugs and massage. This is why massage and touch can be so beneficial during labour, as well as helping to keep Mum feeling calm and relaxed. You can find out more about different types of massage in module 6.

Avoiding Adrenaline

When the body is allowed to do it's job, undisturbed, these hormones play a really important role in helping birth to flow easily and naturally.

Adrenalin (which the body releases when scared or tense) can have a negative impact on these good hormones, stopping the bodies ability to produce the hormones and therefore making birth more difficult. It's really important to understand this and to reduce all causes of adrenaline production throughout labour, where possible. Any feelings of fear, anxiety, tension, feeling exposed etc. should be avoided at all cost (remember the Fear-Pain-Tension cycle that we looked at in module 2). Remember to create the right birth environment to help reduce any adrenaline and, should you feel scared or anxious at any point, use some of the breathing techniques from module 5 to help you regain calm.

Using artificial pain relief or induction methods also prevents the body from naturally producing these birthing hormones. You can read more about the pros and cons of the different pain relief options available to you in module 1.

The Emotional Phases of Birth

Every labour is different and there is no set rule for what will happen to your body or how long it will take. The clearest way to bench mark labour and how you're progressing is to look at the emotional phases that most women go through and how to deal with each stage.

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Excitement 

The first stage of birth is excitement. The day has arrived, it's finally happening, your contractions have started and very soon you are going to meet your baby! 

Your contractions may start very gently and it may be a while before things really get going. Many women find that they are able to carry on with their day, doing gentle activities about the house, maybe going for a walk in the very early stages.

Let your birth partner know what's happening. They may not need to rush back immediately but it's a good idea to keep them in the loop incase things start to speed up. You can make plans now so that you know how long journeys are likely to take - your partner's commute back from work, your journey to the hospital, how different times of the day can effect the timings. This can help you work out when to leave on the day and avoid any anxious feelings - 'will we make it to the hospital?!'. Don't forget to allow for any extreme weather conditions.

Stay at home as long as you can. Remember how important it is that you feel relaxed, safe and secure in your surroundings. Your home is familiar, safe and has everything that you need to stay calm and relaxed.

Have some tasks or activities in mind to help occupy the time. The last thing you want to be doing is clock watching - baby will come when baby is ready. Have a boxset ready to watch, or a collection of your favourite films. Or think of a practical job like cleaning or batch cooking some meals to put in the freezer, so that you don't have to worry about either for a while after baby arrives. Or maybe something creative is more up your street - start a video diary for your baby, or knit them something. Whatever you choose to do it needs to be something that will distract you and keep your attention for an indefinite amount of time (could be hours).

Serious

As labour progresses you will find that your mood changes and that you have a natural need to focus. This is the serious phase, when sensations are getting more intense and your body means business. You might feel less like you want to talk or laugh and want things to be quieter so that you can concentrate on what is happening to your body and keeping yourself nicely calm and relaxed.

Birth partners, this is a time to match her mood. If she seems quiet and focussed support her, be there quietly in the background, gently encouraging her with words or touch. Now is not a good time to try and distract her or 'cheer her up' with some of your best jokes! If she is still upbeat and chatty that's fine but behave in a way that supports and reflects her mood. You can find details of how best to support your partner in module 7.

Now is the time to start thinking about getting to hospital if you're planning a hospital or birth centre birth. As a guideline, once contractions are lasting 45-60 seconds and 3-5 minutes apart is a good time to make your way there (obviously allow for your journey - if you have a long way to travel you may want to leave before this). There are some great apps that you can download onto your phone that time contractions for you. I'd recommend having a look now and having one downloaded ready.

Self Doubt

Self doubt is a stage that many women seem to be experience during labour. It's a reaction to all of the hormones flowing around their body and the intense physical activity that the body is doing. It varies hugely how a woman will experience this. Some find that it's very mild, or they are not really aware of it, maybe a slight feeling of doubt or tiredness which quickly passes. Other women will experience self doubt in a more intense or emotional way and really feel that they are not coping or can't do it. They might get quite upset, want it all to stop, or start demanding any and every form of pain relief possible (all at once!).

Many athletes experience similar when they are doing some form of extreme exertion, running a marathon for example. They just seem to hit a wall and feel like they can no longer go on, they just can't do it, can't go on any further. There may be no obvious reason for this to hit them when it does - they may have been doing just fine the whole way along and all of a sudden felt this huge wave of doubt in themselves and that they can't continue.

It may seem that nothing really changes in how Mum is physically coping, it's an emotional reaction and it usually happens at 10cm dilated which means it's actually a sign that baby is nearly here! Try and focus on this (it's nearly all over and you'll soon be meeting your baby!). 

Birth partner, this is a time when your support is really needed. Remind her how well she's doing, reassure her that it's all going to be ok and she's just showing signs of 'self doubt' which means that your baby will soon be born. If she asks for pain relief at this point (but has previously not wanted any or wanted to keep things as natural as possible) then suggest that you wait 20 minutes or so and see how she feels then. If she is experiencing self doubt then it usually passes fairly quickly and she may no longer want any pain relif once that time has passed. 

Please be aware that, if your partner is distressed and asking for pain relief early on in labour (i.e. at 4cm rather than 10cm) then you should listen to her as this is not self doubt and may be a sign of something else (for example that baby is back to back). You can still try reassurance and waiting for a while but ultimately there's no prize for refusing pain relief, if that's what is needed.

Preparing Your Body

As part of the preparation for the birth of your baby there are some physical exercises that may want to try. Some women enjoy pregnancy yoga or pilates and find that it helps them practise releaxed breathing as well as building up muscle strength.

Pelvic Floor

The pelvic floor muscles are the muscles located between your legs, running from your pubic bone down to the base of your spine. they are the muscles that keep all of your pelvic organs in place - uterus, vagina, bowel & bladder. 

During pregnancy these muscles can become very weak, due to the large amount of pressure on them from the weight of the bump, baby and all the amniotic fluid.

It's not something that many women openly talk about but, if these muscles weaken too much then it's likely that you'll experince some form of incontinence after you've had your baby. It may just be a little leak here and there with a cough or a sneeze, but for some women it can be more serious. It's not a very appealing thought and it's definitely one of the least glamourous aspects of becoming a Mum, but it can be prevented (or at least minimised) by practising some simple exercises during pregnancy known as 'pelvic floor exrcises' or 'kegel exercises'.

Click on the button below to find out more about pelvic floor exercises and how to do them.

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Perineal Massage

The perinium is the area between the opening of the vagina and the rectum. It's an area that softens and stretches out during labour and can also sometimes tear. Some women find that they, understandably, get quite anxious about the prospect of tearing. due to the amount of pressure on this area of your body during labour it actually becomes very numb and you are unlikely to actual feel it if you do tear.

Research studies have shown that if you use perineal massage during your first pregnancy from approx the 34th week, that it can help reduce tearing. Click on the button below to find out more about perineal massage and how it should be done.

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Homework

Make time to try out your pelvic floor exercises and the perineal massage too (the perineal massage is optional but pelvic floor is a definite must do!). Once you are confident, make the exercises part of your daily routine. To remind yourself you can set a timer throughout the day (or there are some great phone apps available that give you reminders throughout the day) or use specific tasks that you do regularly (watching tv, washing up or catching the bus or train to work) and practise them every time you do that task.

 

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