Ask the Midwife- 10 Common Questions
Chloe Hunt has been a practising midwife since 2014 after training at UWE Bristol. She currently works in an Acute Maternity Hospital in Bath which has a birth rate of around 6,500 births per year.
“My role as a midwife is never the same day to day and is full of the unexpected, it can be a very emotionally and physically demanding job but ultimately it really is the best most rewarding job in the world. I get to care for new mothers and families at such an intimate time in their lives and help to bring their new baby into the world. Even over 300 births later, each one is still just as special”.
In this blog, Chloe answers 10 questions she is commonly asked as a midwife...
1.Is it going to hurt?
Yes! Labour/childbirth is hard work – but different for every woman, and even pregnancy to pregnancy. During labour, contractions and shortening of the muscle fibres in the uterus and the dilation of the cervix can be felt as strong waves of menstrual cramps for some women and for others intense pressure – usually felt in the abdomen, back, vagina, bladder/bowel. It is important to reiterate that ‘pain’ doesn’t necessarily mean something is wrong. Midwives who are experts in physiological birth know that most of the time women can absolutely manage the pain, but when needed work with women to support them in managing labour with various relaxation techniques or appropriate pain relief.
2. I’m worried I’ll tear when I have my baby.
This is a common fear women have when giving birth. During birth the ‘perineum’ – the skin between your vagina and anus needs to stretch for baby to be born. We know around 90% of women tear to some degree during childbirth, which occurs when the perineum is unable to stretch enough to accommodate baby’s birth. The most superficial tears involve only the skin of the perineum or labial tears where as some tears can go deeper into the vagina or pelvic floor muscles; a small percentage of women may endure a more serious tear which involves the rectum and anal sphincter muscles. If you have a tear it is more than likely you’ll require stiches which dissolve and gently heal over a few weeks. Most tears are repaired under local anaesthetic in your birth room, more extensive tears repaired in theatre. In some births an episiotomy (a cut performed by a Doctor or Midwife) to the perineum can help to prevent a severe tear or expedite delivery if baby needs to be born quickly.
There is less chance of tearing if you avoid giving birth lying/sitting down, if the birth of the baby's head is slow and controlled. Research also suggests that perineal massage in the last 4-6 weeks of pregnancy can help to reduce the risk of tearing or needing an episiotomy.
3. What do I really need to pack in my hospital bag?
You’ve probably spent the last few months dreaming of the day you finally get to pack your hospital bag. So, what do you really need...
For you
•Birth notes
•Any current medication you are taking
•Comfy clothes, pyjamas and dressing gown
•Slippers/Flip Flops
•Nightdress/top/swimwear for labour and birth
•Toiletries - (toothbrush, toothpaste, face wash, deodorant, moisturiser, any makeup, hairbrush, shampoo, conditioner, lip balm)
•Hairbands
•Flannel - to use as a cold compress
•Maternity bras
•BIG pants
•BIG sanitary pads & breast pads
•Nipple cream if breastfeeding
•Ear plugs/eye mask
For baby
•3 x Bodysuits/Vests
•3 x Sleepsuits
•Scratch mittens
•Hat
•Nappies
•Cotton wool/wet wipes
•Bibs/Muslins
•Going home pram suit/cardigan
•Blanket
•Bottles and formula if bottle feeding
•Car seat
For your birth partner
•Change of clothes
•Toothbrush
•Drinks and snacks - for the both of you
•Camera
•Phone charger
4. I’m worried I’ll poo when giving birth
It’s extremely common for the body to naturally clear itself out prior to, or in the early stages of labour. So, you may experience frequent trips to the toilet before ‘the pushing stage’ and birth of your baby. Don't panic if you do poo a little bit, midwives are very good at being discreet and clearing away so you are none the wiser.
5. How long will the labour and birth take?
The length of your labour and birth is dependent on many factors, such as: which number baby, method of your labour (spontaneous/induction), position of your baby, strength and frequency of contractions and how calm and relaxed you are. It’s tempting to time your labour from the first contraction - however the first stages of labour can be unpredictable. Established labour is from 4cm dilated and from when the duration of your labour will be counted It is then expected for the cervix to dilate on average 0.5cm-1cm every hour. The second stage of labour is when you’re ‘fully dilated’ or 10cm, for first time mums it can then take on average 1-2 hours to push baby out.
6. How common are caesareans?
Caesarean sections account for around 25% of births across the UK. Emergency caesareans are a last resort method and the decision to perform one is always made in the best interest of mum and baby; for example - ante natal haemorrhage or fetal distress. In most cases caesareans can be performed under a spinal anaesthetic meaning you’ll be kept awake and your birth partner can be with you in theatre for the birth of your baby.
7. When will I be able to go home after giving birth?
Following an uncomplicated birth you can go home just a few hours after delivery. If you are breastfeeding it is important to feed your baby and feel confident with doing so before being discharged. However, in some cases, if you’ve had an assisted birth using ventouse or forceps, a caesarean or complications following birth such as raised blood pressure, haemorrhage or have an infection requiring close observation and antibiotics you’re likely to stay 1-3 days.
8. Will I get supported with breastfeeding my baby?
Yes. Unless there are any complications you shouldn’t be separated from skin to skin with your baby for at least the first hour following birth as this will encourage baby to start breastfeeding. Your midwife or maternity care assistant will support you to breastfeed, help you to achieve and recognise good positioning and attachment for effective breastfeeding and also show you how to hand express. Following discharge from hospital your midwife or health visitor will check in and will be on hand to assist or answer any questions you may have when at home. You should also be able to find details of local breastfeeding support groups in your discharge letter or babies child health record (the red book).
9. Will I bond with my baby as soon as he/she is born?
You may do, some parents have an overwhelming feeling of attachment soon after birth, for others bonding may take a little while longer to develop. You may feel exhausted or unwell following labour, have experienced a difficult birth or in some cases have been separated from your baby if they needed to go to special care. In either case parents should try and have skin to skin with baby as soon as it’s possible to do so following birth to strengthen the feelings of attachment and bonding. Bonding should naturally develop at your own pace through everyday care of your baby and responding to their daily needs. However, it may be that after a few weeks you don’t feel any more attached to your baby in comparison to the day they were born; if this is the case talk to your GP or health visitor. It is important to be honest and open about your feelings of bonding and attachment in order to get the help and support you and your baby may need.
10. What’s the difference between baby blues and post-natal depression (PND)?
Despite how much you were looking forward to having a baby or the overwhelming feeling of love you have for your new baby, many women experience at least some feeling of ‘baby blues’. Baby blues, caused by sudden changes in hormone levels post birth and the combination of sleep deprivation and the overwhelming feeling of new responsibility for your baby cause you to feel emotional, tearful (sometimes without reason), irritable or anxious. These feelings associated with baby blues usually pass following the first two weeks post birth.
If your symptoms last longer or start later and you have persistent feelings of sadness, lack of energy, manic behaviour, difficulty bonding with your baby or frightening/overwhelming thoughts of harming yourself or your baby you could have post-natal depression (PND). It is extremely important to speak to your GP or health visitor as soon as possible to seek support.
iCandy is delighted to be collaborating with Chloe on this mini series of midwifery blog posts, so whether you're expecting a baby or making plans for the future keep an eye out on the iCandy Life Blog.