8 Facts to ease your labour fears

It’s normal for you, as a new mom, to feel afraid as you find yourself hurtling towards the inevitability of birth and motherhood. But don’t panic… arm yourself with these facts instead. By Françoise Gallet

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1. I’m worried I won’t make it to the hospital in time

This was particularly true for Angela de Sousa (26), mom to a baby girl born in July, who was terrified she’d ‘miss’ her labour and wouldn’t get to the hospital in time.

“In the last few days of pregnancy, I kept confusing Braxton Hicks contractions with labour. So I was concerned that I might misread the real cues. In retrospect, it seems crazy to think that I would ‘miss’ my labour. Contractions can stop you in your tracks.”

A first labour can last anywhere from 12 to 15 hours,” counsels midwife Sue Cohen, who assures first-time labouring mothers that it’s highly unlikely that they’ll struggle to get to the hospital in time.
When your labour is established, you’ll be able to clearly recognise and time your contractions. When they’re five minutes apart, then you’ll be ready for your trip to the hospital, she advises.

2. What if I have a bowel movement during labour?

As baby’s head passes through the birth canal, which is sandwiched between the bladder and the rectum – the pressure thereof can push a stool out. “Sometimes this happens, and sometimes it doesn’t,” counsels Cohen.

In the days preceding labour, your body produces hormones that help you have softer, more regular stools – it’s your body’s way of bypassing a bowel movement during labour, explains midwife Glynnis Garrod, who also emphatically reassures women that your gynaecologist or midwife has seen too many stools to be fazed.

Likewise, Cohen counsels women that, when in labour, you’re unlikely to care if you produce a stool. “Most mothers don’t even notice, and we don’t tell them.”

Furthermore, routine enemas are no longer recommended because it’s easier for your caregiver to quickly dispose of formed stools than clean up diarrhoea, Garrod explains.

And cleaning up quickly, with little fuss, is exactly what the doctor or midwife will do. Thereafter, the delight at your baby’s birth will help you forget the moment, reassures Garrod.

3. What if I tear or need an episiotomy?

“I didn’t want to be cut. I’d read horror stories about women saying that they had pain when going to the loo forever afterwards,” shares Angela of her episiotomy fears.

Obstetrician and gynaecologist, Mark van der Griendt, confirms that damage to the perineum, as a result of tearing or an episiotomy, is a common fear among women, with tearing occurring with about 50% of labouring mothers.

Nonetheless, an episiotomy, although not routinely done anymore, may indeed be the preferred option should your birth-care provider anticipate the risk of tearing into the anal sphincter. This is called a third- or fourth-degree tear and it damages the anal sphincter muscle, says Van der Griendt.
Although a tear of this nature only occurs in about 4% percent of women who deliver vaginally, it’s a complication that obstetricians aim to avoid, as it can have long-term implications, including the risk of anal incontinence.

An episiotomy might also be considered necessary to expedite labour if the baby develops foetal distress at the end of labour, explains Garrod. She offers reassurance, though, that your perineum will be infiltrated with local anaesthetic prior to any cutting, so you’re unlikely to feel the incision.
Furthermore, should you tear or have an episiotomy, you will be given more local anaesthetic after the baby is born, and the wound usually heals very quickly.

Meanwhile, midwife Ntombi Mchunu suggests that women listen very carefully to their caregiver’s instructions as their baby’s head crowns.

“You will be asked not to push, and to pant with your breath. This avoids the head shooting out with pressure – which can tear your perineum,” she says.

Both Garrod and Van der Griendt confirm that most women do not have any long-term effects from sutures to the perineum.

4. I’m terrified of the pain of labour

“The pain of labour is experienced by women individually and in a unique way. The reality, though, is that, in varying degrees, it is indeed painful,” shares Garrod.

During labour, your body does however produce a mix of hormones that are designed to help you cope with the pain, and many midwives incorporate natural methods of pain relief – from movement, massage, breathing techniques and warm water, to lots of encouragement. But, Garrod urges, training your ‘headspace’, similar to what you might do if you were to prepare for a marathon, is invaluable in decreasing fear.

There are also various methods of medicated pain relief available in hospital, as follows:

  • Entonox (or gas and air) can be effective in taking the edge off the pain.
  • Pethidine: If a mom is struggling with a long early stage of labour, administering Pethidine can allow enough relaxation for the body to progress to effective active labour.
  • An epidural is the most effective pain-relief method and can make labour pain-free.

5. I desperately want to avoid a C-section

Your best way to avoid an unnecessary Caesarean is to choose a caregiver who respects your wish to have a vaginal birth, suggests Garrod.

“If you have a low-risk pregnancy, there are very few reasons why a C-section should be proposed before labour. But if complications have arisen regarding your medical health or if it becomes apparent that your baby’s health is compromised pre-labour or during labour, a C-section may be a medical necessity.”

6. I’m worried there’ll be complications – what if my baby needs resuscitation!

Most normal, healthy pregnancies result in a normal vaginal delivery and a healthy baby, explains Mchunu. However it’s important to go for your regular check-ups and to do the appropriate scans – the most important being between at 9 to 12 weeks, at 20 weeks and at 34 weeks, counsels Cohen.
She also advises being conscious of baby’s movement throughout your pregnancy.

“From about 20 weeks, you’ll begin to feel baby move; and you should feel him move at least six to 10 times in a 24-hour period.”

If you are worried that your baby is not moving, contact your healthcare provider, she urges. During labour, your midwife will check your baby’s heartbeat every half-hour in the first stage of labour to after every contraction in the second stage of labour. But birth asphyxia – where baby comes out with a low Apgar rating – is something that can happen.

If a baby needs resuscitation, midwives are trained to deal with all emergencies around childbirth, and a paediatrician may also be present if a difficult birth is expected, assures Mchunu.

7. I’m terrified of dying during labour

Maternal death is most significant women don’t have access to healthcare. Mortality in labour for women with access to healthcare, is very rare, reassures Van der Griendt.

“Ensure that your caregiver is skilled and experienced and has access to technology and medication,” counsels Garrod.

Also, attend your scheduled antenatal appointments so that your health and that of your foetus, can be monitored for any complications.

8. I’m scared of paralysis or that the epidural won’t work!

Epidurals are given by experienced anaesthetists, safely and regularly. For the overwhelming majority, it provides effective analgesia, reassures Mchunu.

“The anaesthetist will usually talk you through the procedure to allay your fears. Let him know if you feel a contraction coming on and listen carefully to his instructions.”

Speaking with the anaesthetist certainly helped quell Angela’s anxiety. “Once I understood the procedure, I felt more comfortable,” she says.

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