THE LABOUR & BIRTH GUIDE

THE LABOUR & BIRTH GUIDE

Childbirth is unpredictable, but knowledge is power.

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Navigating the complexities of childbirth well requires informed decisions and an understanding of the options available to you. To do that, you need some direction. Dive into our comprehensive guide to gain insights into birth locations, pain relief methods, creating a birth plan, and deciphering medical jargon. Whether you're anticipating the arrival of your baby or merely seeking knowledge, these articles aim to empower and reassure you on this transformative journey.

Choosing where to give birth

 Hospital private, public or at home

This decision where to birth your baby (or babies) is personal and one that requires you to be very honest with yourself. Where will you feel most safe, most comfortable and most positive? For now however, a summary of ‘top line’ considerations regarding the choice between Private, Public and Home births is below.

Private Hospital

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A private hospital may be the best option for you if;

  • You’d prefer your baby to be delivered by an obstetrician rather than a midwife. 
  • You’d prefer continuity of care (i.e. you’d prefer to see the same person (obstetrician/midwife) at each antenatal appointment. You’d also like this person to deliver your baby.) 
  • You feel more comfortable opting for an elective caesarean.
  • You’d like the option to stay in the hospital for a period of time following the birth.
  • You feel comfortable within your chosen hospital. You feel positive about their staff and you’re aware of the statistics around their vaginal delivery rates versus their caesarean rates, induction rates and their pain relief options.
  • You have private health cover*

*Prior to choosing a private hospital, it is very important to check that Pregnancy & Birth is covered within your package. It’s also important to understand exactly what is covered, how much you’re likely to be out of pocket and if there are any lead times to consider. For example most health providers have a 12 month lead time before you gain access to the cover. If you fall pregnant before you add Pregnancy & Birth to your insurance, or if you add it during your pregnancy, your options will be compromised.

Public Hospital

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A public hospital may be the best option for you if;

  • You’d prefer midwifery care (which, pending your chosen hospital, can still include continuity of care. If you would like continuity of care, make sure to tell your GP as soon as you can so they can put you on a list). 
  • You’d like to aim for an intervention-free vaginal birth. Please note, pending your pregnancy and the circumstances during birth, intervention (forceps, ventouse, an emergency caesarean) may still be the safest way to deliver. 
  • Assuming there are no complications, you’re happy to return home quite soon after the birth. In some cases women who give birth in the public sector are approved to go home between 4 and 24hrs. Shorter hospital stays such as these, however, usually only apply to vaginal deliveries. If you do require a caesarean, it’s very likely you’ll remain in hospital for a few extra nights. 
  • You don’t have Pregnancy & Birth cover within your private health cover, which is very common in most private health funds. Be sure to add this on asap (up to 3 months before conception is ideal) if you’re hoping for private care.  
  • You’re comfortable within your chosen hospital, you feel positive about their staff and you’re aware of the statistics around their vaginal delivery rates, caesarean rate, induction rates and their pain relief options.

Home Birth

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A home birth may be an option for you if;

  • You have arranged a midwife who is adequately qualified and experienced with home births. 
  • Your chosen midwife has a highly organised plan in place for both your birth, and for transferring you to the safest and appropriate hospital with absolute efficiency, should any issues arise. This contingency plan is paramount.

  • If you are 100% sure you feel comfortable to give birth at home, knowing that there are more risks of complications as you’re further away from more medical staff and medical equipment. And you understand you do not have immediate access to resources if an emergency was to arise. 
  • If you are safe in your own home and you feel able to voice your needs and wants, and have them actioned asap.

Get prepared. Have your hospital bag by the door.

Your hospital bag list

Vaginal Birth

Roughly 2 in 3 women give birth vaginally in Australia. Vaginal childbirth involves minimal to no medical intervention. Instead, intervention can include use of forceps or the ventouse.

Benefits

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A vaginal delivery means bypassing major surgery. Generally speaking, the recovery time following a vaginal delivery will be shorter and less challenging on the body. With the exception of women who experience a 3rd or 4th degree tear or other complications during birth, you should be able to go home sooner than if you were to have a caesarean (i.e. after 1-2 days, as opposed to 3-6).

Another benefit of a vaginal delivery, is that when the baby is squeezed down the birth canal, most of the fluid in their lungs will be squeezed out via their mouth, making them more comfortable after birth.

Babies born via caesarean need help ridding this fluid and are therefore at a higher risk of transient tachypnea (TTN).

Lastly, when it comes to breastfeeding, your milk may arrive a little sooner that what it would after a caesarean, and feeding may feel slightly less painful as you won't have a wound in your abdomen.

Considerations and Risks

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Delivering vaginally can include pelvic floor damage such as prolapse and incontinence. To prevent these outcomes it’s highly advised to work with a women’s health physio in the lead up to the birth. They’ll be able to walk you through some exercises and provide direct feedback as to areas you may need to work on.

Other risks include but are not limited to postpartum haemorrhage (drastic loss of blood), vaginal tears (tears in the perineum tissue which rests your vagina and anus), and postpartum preeclampsia (excessively high blood pressure).

If within the first 6 weeks post delivery you’re dizzy, lightheaded, nauseated or you’re seeing spots or flashing lights, make contact with your health practitioner asap for urgent treatment.

To mitigate risk during your delivery, make sure you remain open and honest with your midwife, obstetrician or GP throughout your pregnancy. While not everything can be controlled or predicted, keeping a close eye on your pregnancy can help to prevent unforeseen issues during labour.

So... What Actually Happens

A vaginal birth is a natural and primal experience. On your back, your side or on all fours, your body will know what to do - trust us. Here are some things to know.

Contractions

Contractions occur when the uterine muscles tighten and relax in a continuous motion as your body prepares to birth your baby. In the earlier stages of labour, contractions are likely to be irregularly timed, short and sharp. They can be anywhere from 45 minutes (or less) to hours apart, each lasting around 20-30 seconds.

Generally speaking, when your contractions become strong, painful to the point you may be unable to speak, 45-60 seconds each and they've occurred five minutes apart for around an hour, it's a good sign to make contact with your birth team. Grab your hospital bag as it's likely to be 'go time'! Like everything else, if you're in doubt or confused whether to stay at home or go into hospital - always call your team to be safe.

Dilation

Whether in the movies or in pregnancy books, we've all heard about the phrase '10cm dilated!" Dilation refers to the size of the cervix opening, where your baby will come out. Your cervix is continuously checked during the early stages of labour by your midwife via a vaginal examination (with your consent). The reason being; the size of the cervix opening is a good indication of the progression of your labour.

The time it takes to dilate will differ for all women. You might arrive at the birth ward all excited and ready to go at 6cm, only to find that it takes hours and hours to get to 10cm. You will get there! Deep breaths.

Bring in pain relief

Aside from the pain relief offered by your birthing team (for example the gas, epidural, spinal block etc), you may like to consider bringing in some other pain relief options from home. These may include;

- A heat pack for your lower back

- A TENS machine. A TENS machine is attached to your back with sticky pads and its job is to send electrical impulses to certain parts of the body to block pain signals.

- Soothing music for distraction

- Magnesium oil to rub into your lower back, helping any strained muscles to relax

- Your partner or doula for massage

- Pushing or bearing down

As your labour progresses and your baby's head lowers, this will place pressure on your lower pelvis. At this point, many women feel a very strong urge to push or poo. The latter is totally normal, it's a common sign of birth approaching! Despite your body's instinctive response (to push), it's important to communicate with your birthing team before doing so.

The reason for this is that you might not actually be 10cm dilated yet and as your body is still contracting, there are certain times when pushing is optimal and certain times when pushing is not. Follow the guidance from your birth team to help you find a nice rhythm while also lowering the risk of tearing or other pelvic floor damage.

Bring in assistance

Forceps and a ventouse are instruments that protectively hold or suck onto the baby’s head, allowing the birth team to gently (and safely) pull and assist your baby through the birth canal and then through the vagina.

Examples of when your birth team may opt to use either of these tools for assistance include (but are not limited to);

- If after a certain duration of pushing, the baby is having trouble coming through the birth canal

- If there are concerns for the baby's heart rate or if the baby is showing signs of fatigue or distress

- If the baby has wriggled or turned into an 'awkward' potion making it harder for you to push them out

- If you are showing signs of fatigue or;

- If you have pre-existing medical conditions that have to be considered (i.e. previous heart issues)

Labour Aids

Elle TENS Plus

Elle TENS Plus

Elle TENS

Elle TENS Plus

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Clary Sage Roller 10ml

Clary Sage Roller 10ml

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Clary Sage Roller 10ml

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Hydramama - Blackcurrant
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Birth Comb

Birth Comb

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Birth Comb

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Caesarean Birth

In Australia more than 1 in 3 babies are born via caesarean section. Of those, 2 in 5 are unplanned.

Definitions

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A caesarean is the surgical delivery of a baby through an incision in the mother's abdominal wall and their uterus. When your baby is gently pulled out by the obstetrician, the umbilical cord will be clamped and cut. Your baby will then be checked over by a paediatrician, before hopefully coming to you to start skin-to-skin on your chest. We suggest having a conversation with your obstetrician in the lead up to your birth, to let them know you want to start skin to skin as soon as possible, after birthing your baby.

While you’re enjoying this special moment, the obstetrician will remove your placenta (through the same incision) and stitch you up. As a caesarean is a major surgery, you will experience some pain and discomfort for a period of time, as the wound heals. For this reason, your hospital stay post birth may be up around 5 days.

Benefits

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If you’re a planner, in the case of an elected caesarean, what an advantage to know exactly when your baby will greet you!. On a more serious note, the benefits of a caesarean include less trauma endured by the vagina and reduced risk of postpartum incontinence and/or pelvic floor damage such as prolapse.

If you’re planning an elected caesarean, like all births there are some elements to consider. Some of the reasons a caesarean may be a good birth option for you include:

  • For personal reasons, you feel more comfortable scheduling in your birth date, rather than waiting to go into spontaneous labour.
  • You’ve previously birthed via caesarean (elected or non elected).
  • There is a concern for your baby’s wellbeing. They may be showing signs of distress in which case a vaginal delivery holds the risk of exacerbating the issue/s.
  • The size of your baby poses a risk to your health (and their own).
  • Your baby hasn’t ‘turned’ and they’re either breech (bottom or feet down rather than head) or transverse (on their side).
  • You’re experiencing major placenta praevia, a condition where the position of the placenta is blocking the birth canal and therefore interrupting the option to birth vaginally.

Considerations and Risks

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A caesarean is the surgical delivery of a baby through an incision in the mother's abdominal wall and their uterus. Like all things in life, there are both pros and cons to having a caesarean, but it is major surgery and as such, carries certain risks. These should be spoken about with your obstetrician as they will vary with every woman and every pregnancy.

Risks to consider include (but are not limited to); pain, the risk of an infection in the uterus lining or at the incision site, greater loss of blood, the development of blood clots (hence the compression socks you’ll be asked to wear), a longer recovery time (both in hospital and potentially when you return home) and a reaction to the anaesthetic. Talk to your medical practitioner to learn more.

Emergency Caesarean

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Unlike an elected caesarean, an emergency caesarean is not scheduled but required as a matter of urgency due to reasons including (but not limited to);

  • You have started to labour however your cervix is slow (or unable) to dilate, which increases the stress on your baby. In this instance, immediate intervention is required.
  • Monitoring of your baby's heart rate is indicating that they are not receiving enough oxygen.
  • The placenta has separated from the uterine wall too soon. This is known as placental abruption. If this is not treated immediately, there can be haemorrhage and blood clotting complications for the mother and baby.
  • In some instances the umbilical cord may enter the birth canal before the baby, which is known as an umbilical cord prolapse.

So... What Actually Happens?

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Keep in mind that while a caesarean is a common method of delivery, it is also a major abdominal surgery meaning you’ll be in an operating theatre rather than a birth suite. It may feel and look a lot more clinical, however rest assured you’re in safe hands.

So how will it all unfold?

  • After you’re wheeled into the operating theatre on your bed, you’ll have monitor screens placed around you. These will track your heart rate, your oxygen levels and your blood pressure.
  • An anaesthetist will administer an epidural or a spinal block (or sometimes a combination of both). Following this, the lower half of your body will be without feeling, however you will remain awake.
  • You’ll have a catheter inserted into your bladder through your urethra as you won’t be able to stand and walk to the bathroom to wee. Rest assured, you should be numb at this point, so you won’t feel a thing.
  • A privacy screen will be erected near your belly, blocking you from the actual procedure. Your birth partner will sit in a chair as guided by your anaesthetist. If you would like to witness your baby being born, just make this known by your obstetrician.
  • Your belly will be washed with an antiseptic solution and the procedure will begin. The obstetrician will make the incision (roughly 10cm) and moments later, you’ll meet your baby.
  • Due to the epidural and/or the spinal block you won’t feel any pain. You will however feel a range of sensations as the baby is being born. Some women describe it as a ‘tugging’ or a pulling/pushing sensation.
  • If the baby is healthy after a check over by the medical team in the room, the umbilical cord will be cut and it’s time for skin-to-skin.
  • The obstetrician will now remove your placenta, from the same incision point and stitch you up.
  • The steps listed above will usually take between 30 and 60 minutes.

Everything else you need to know

For every twist, turn, question wondered or asked, we’ve got the answer to help you feel good.

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