A midwife's guide: What women need to know about giving birth

A midwife has revealed how she encounters women “every day” who are surprised by the realities of childbirth.

Between the wailing women on TV and the idyllic image of a glowing mother holding a baby swaddled in a blanket in her arms, the in-between-part can seem a bit of a mystery thanks to the taboos which surround childbirth.

Rachel Fitz-Desorgher is a midwife, infant feeding consultant, active birth teacher and parenting consultant Henley Birthcare. She has been working with pregnant women for 31 years, and knows a thing or 10 about childbirth. She says that she encounters women "every day" who are shocked about what their bodies go through when giving birth.

“Preparation for childbirth tends to be geared more towards meeting other mums and dads and rather less on really helping couples to understand what to expect, and more importantly, what to do during labour,” she says.

These are the stages of childbirth that Fitz-Desorgher believes women are not aware of but should be.

The “warm-up phase” of labour can last up to three days and nights and feels like very strong period pains but isn't considered to be part of “proper labour”, she says. This is when the cervix softens and stretches, and the body positions the baby so it is ready to be born. It is essential women rest properly during this time to prevent themselves becoming exhausted before labour has begun.

“Women feel vindicated tractions and think they are in labour. So they head up to hospital and hang around getting tired and fed up. Stay at home!” says Fitz-Desorgher.

When the warm-up ends, the body enters “active” labour when the cervix is dialated by 4cm. Hormones flood the body, which can feel like a dimmer switch being turned on in the head. Women describe the sensation as like being on a different emotional plane which she labels “planet labour”.

The sensation of period cramps will make way for the feeling of muscles gradually tensing and becoming solid like a rock which will become longer, stronger and closer together. This is where breathing exercises, and focusing on every part of the body except the womb, comes into play.

“Don't expect to have your baby soon just because you have gone into hospital. Midwives can't make your baby come any faster. It's a waiting game. Women labour more quickly at home so stay home for as long as possible," she stresses.

Gas and air are used to “ride” the contractions and makes a woman feel slightly drunk, but can make some women vomit.

During the warm-up stage, diamorphine is used to make a woman drowsy and sleep better. But it doesn’t do much for the pain and can also make women sick and babies sleepy meaning they are slow start to feeding.

Epidurals, which makes the lower body numb, means a catheter is put in place and a woman must be monitored for longer.

“Having an epidural put in takes a little while and can be quite tough, until it starts working, because you have to curl up tight to make it easy for the anaesthetist to get the needle into your back. Curling up tight during a strong contraction is very hard. Sometimes an epidural doesn't work properly and so women can then still feel the contractions."

The water doesn’t usually break until a woman is ready to push the baby out. “They can make such a loud “pop” that other people in the room hear!” says Fitz-Desorgher. The water breaking feels warm and slippery to help the baby pass out the body more easily.

As the cervix dilates, the urge to push builds – which is similar to the need to sneeze.

“Pushing feels good because it is a reflex and so you can't fight it. You really won't need anyone to tell you how, unless you have had a epidural and can't feel the sensations. After all, nobody ever taught you how to sneeze and you’re probably perfectly good at that!” says Fitz-Desorgher.

Women can be worried they will pass faeces during childbirth. "Your pelvis will be so full of baby that there will be hardly any space for poo to pass, so stop worrying: women don't poo more than a teeny weeny bit (if at all) during birth," says Fitz-Desorgher. "The more you push into your vagina, the less you are likely to pass any poo. So, when your midwife says 'push into your bottom', she means your 'front bottom'."

“Almost all women worry that they will be cut to get the baby out. Such a cut is called an episiotomy and it is only done in urgent situations. They really are not common. If you do need one, a local anaesthetic is used to ensure the snip is painless.”

"Overall," she adds "try to remember that your body is beautifully evolved to carry and birth your baby. Although things do sometimes become difficult, most women have straightforward labours and births.

"So don't worry about labour: focus, breathe and take it one moment at a time."