whatsoever, with either of my babies. This panicked me the first time. I had to be ‘coached’ by my midwife the whole way through the second stage.’ Fay’s experience is quite common. ‘Mostly women who have had a vaginal birth before don’t need to be told how to push – they do it automatically,’ says midwife Jenny Smith. ‘But first time mothers often need lots of support and encouragement that they are doing well, and upright positions are essential.’
Pushing can feel like the greatest feat of physical endurance you’ll ever encounter. I remember using every single ounce of strength in my entire being to push Sam out. I was aware that I’d never done anything remotely strenuous before this point in my life. Getting a mirror and actually looking at your baby’s head appearing as you push may sound like something from a 1970s feminist workshop, but many women say it’s surprisingly helpful. It can seem unfeasible to you that your gargantuan efforts will actually make a baby emerge. And it is easy to lose heart if your baby does not pop out straight away. Seeing (or touching) a tuft of wet hair can be a shocking experience – one that helps you realise you’re really producing a baby. And – yes – it’s genuinely going to come out that way – soon.
This is what pushing may look like if you see it in a mirror: your vulva gently opens with each push and fluids trickle out. Your pubic hair blends in with the hair of your baby. (Many husbands need to have this pointed out to them. They then become very moved to see their baby’s hair coming out and disappearing in what can be a hide and seek game.) The smells may be very strong now – acrid and pungent. In a hospital the smells of birth combine with clean, medicinal smells as well.
Pushing tip:
‘Ask to use the birth stool if there is one, or sit on the loo at the beginning, when you are learning how to push properly – particularly in a first birth,’ says midwife Jenny Smith. ‘This helps you to feel the urge to push in the correct place, and can reduce the length of the pushing phase. You can come off the loo once you’ve got the hang of pushing so there’s no worry about your baby being born into it!’
OH, WHAT AN ATMOSPHERE | The room may feel busy as the midwife prepares to ‘catch’ and care for your baby. If there are any concerns for you or the baby another midwife, or a doctor, will be called in. The bustle can make you lose focus. Many of us, seeing all this action, get scared that something is wrong. In fact, activity, at this point, is normal, and a doctor can be called in as an extra safeguard. Touching your baby’s head can help you focus in again. It will feel a bit spongy and slimy.
YOUR PARTNER AND PUSHING | He can see his baby, along with a certain amount of blood and fluid, if he peers down there. If he has read Chapter 8 he should, at this point, not crash to the floor (he’ll be hydrated, fed and mentally prepared). You might have planned to video or photograph the actual birth. If your partner is overwhelmed (and he will be) he’ll probably forget about things like cameras. If you have another birth partner with you, arrange in advance that it’ll be her job to take a photo or two.
A WORD ABOUT THE ‘RING OF FIRE’ | When Julia asks clients to break down the fear they have about labour, about 40 per cent of the time they point to this – the moment when the baby’s head comes out (crowns) and the perineum is stretched to its limit. Just thinking about this moment could bring a non-pregnant woman to her knees. But most of us cope perfectly because it brings the baby. It’s not always bad. Julia has an amazing photo of a client laughing as the baby crowns. Having said this, when I gave birth to Sam I do not remember crowning as being particularly amusing: in fact, it was exquisite agony – but it was fleeting and was instantly outclassed by the big baby boy who shot out. This, I have to say, is one of the greatest miracles of motherhood: our ability to forgive and forget. Julia’s water birth experience was very different: ‘I did not feel the ring of fire at all,’ she says. ‘I gave birth under the water, which is known to significantly lessen the pain of this stretching.’
YOUR PARTNER AND YOUR PERINEUM | Sometimes men find the moment at which the next generation appears through their loved one’s holied vagina utterly mind-blowing. If your man removes himself from the room, sits down or sobs, it really is not a sign that he won’t be a good father, or that he’s abandoning you. Frankly he could be swinging from the rafters in a tutu as your baby crowns and you probably wouldn’t bat an eyelid. He’s better off outside, gathering his emotions for fatherhood, than he would be screaming, fainting or openly panicking next to you. Men can also become uncharacteristically emotional when their baby emerges. Julia’s husband Buckley sobbed so much at their second child’s birth that before the cord was cut Kim, the midwife, roused Julia to see if he was OK. ‘It’s all the emotions of life, in just a few seconds,’ says Buckley. ‘It all rushed out of me in sobs of joy and relief.’
BABY!
Actually producing a real baby can be totally surreal. You’ve been planning and obsessing about this for months, and here it is. And it was inside you. You grew it. Seeing this large, slippery, funny coloured, funny smelling, actual baby – before it has even taken a breath – can feel overwhelmingly weird.
WHAT IS GOING ON | ‘There is a moment, after a birth, when the room may be silent or loud, but the energy shifts,’ says Julia. ‘All that fear and anticipation is released and is hanging there in the seconds before the baby cries.’ Julia has had so many clients (men especially) tell her that they thought something was badly wrong at this point. When I watched Julia give birth, I certainly wasn’t prepared for this moment. The time before Larson cried – it must have been 30 seconds or less – felt like infinity. ‘The whole thing is a disaster,’ I thought lucidly. ‘They will never recover from this.’ Larson yowled loudly a moment later: he was fine. Julia remembers this moment differently – the midwife rubbing her son, her sharp voice as she asked her assistant for the bulb to suction the mucous from his nose and mouth. She remembers a fleeting moment of concern, then her baby’s voice. At this point, the trance-like hormones of labour can be a real advantage.
Fathers don’t have these hormones. Victor, a first time dad, was calm throughout the birth but when his daughter Elizabeth emerged, he became certain something was wrong: ‘My heart was pounding out of my body. I looked at the midwife, the nurse and then the doula – and saw they were all calm, though excited. I tried to stay calm too. None of the women in the room were even aware of the time before Elizabeth took her first breath but for me it felt like forever.’
Most babies just need a rub from a towel. They aren’t hung upside down, or smacked on the bottom, like they once were (thank God). Some babies may need oxygen, or occasionally have the mucous suctioned from their nose and mouth with a bulb syringe. Your baby may be taken off to a different part of the room, after the cord has stopped pulsing and is cut (no, you cannot feel this) so that the midwife can check her over. Some men ask to cut the cord themselves (it feels, apparently, like cutting a piece of chicken and it has no nerves, so don’t worry). Even after the birth the placenta gives your baby healthy blood and oxygen for up to 20 minutes – this is why many women decide to ask the midwife not to cut the cord until it has ‘stopped pulsing’. Your baby’s vital signs will then be checked and she’ll be given something called an ‘APGAR’ score (see below).
BABY CHECK-UPS
1 The midwife checks your baby at the birth and he is given an APGAR score out of ten (ten being the optimal number), based on the following:Activity/muscle tone (limp/no response to active/taut arms and legs)Pulse/heart rate (absent to >100bpm)Grimace (first breath response none to sneeze or cough)Appearance (colour – white/blue/gray to pink all over)Respiration (absent to good/cry at one, five, and sometimes ten minutes)
2 Usually, your baby will also be thoroughly checked by a paediatrician the day after the birth (before you leave the hospital). This check will include:Head and chest circumferenceLength and weightGeneral appearance (activity, tone, cry)SkinHead and neckEyesEar, nose and throatAbdomenHeartGenitalsReflexesSpine and anusLungsHips