Blooming Birth: How to get the pregnancy and birth you want. Lucy Atkins

us think about – or many midwives are asked to do – but this strategy, laid out in your birth plan and reinforced during labour by your birth partner, can be immensely helpful. A great many experienced doulas encourage their clients to do this. Your midwife may be taken aback when you ask her to do this, but explain your reasoning to her and she should respect your wishes.

       EIGHT TIPS FOR A NUMBERS-FREE LABOUR

      1 Do not assume your labour – or any stage of it – will last for any particular length of time. (A favourite doula adage: ‘Prepare for a long labour, hope for a short one’.)

      2 Cover the clocks (literally) – at home and in the hospital room.

      3 Ask people not to discuss time with you during labour – how long you’ve been at it, how long you may have to go on for.

      4 Eat, drink, pee, sleep when you want – your body knows best.

      5 Do not accept medical intervention to speed things up unless there is a good clinical (or personal) reason to do so.

      6 Negotiate about your hospital’s imposed time restraints on the stages of labour unless there is a good clinical reason to stick to them.

      7 Ask the midwife to do as few vaginal exams as possible: they can be distracting and uncomfortable.

      8 Ask the midwife not to tell you how dilated you are unless there is a good medical reason to do so.

      Vaginal exam coping tip:

      No one tells you, but vaginal exams done by the midwife when you are in labour can be painful. If it’s a routine check of your progress ask her to wait until you are ready and can catch your breath. Then prepare as if for a big contraction – use whatever was just working for you. Arching your back slightly might relieve the pressure you feel from her fingers, but the best defence is to breathe and get through it. Most midwives will be gentle and as quick as possible.

      Now that’s what I call real labour

      When labour hots up you’ll become very serious about your contractions which will probably be longer and more regular than before. This kind of contraction can feel overpowering. Women talk of ‘sledgehammer’ contractions, ‘fierce’ ones, feeling pain around their middle, in their back and sometimes up and down their thighs. This sounds scary, but when it is happening, if all is well and you feel safe, your body will somehow be coping. You will soon be unable to talk through this kind of contraction and you’ll have to focus on breathing and making noises. Remember, too, that each contraction lasts less than a minute and there are breaks between them for you to ‘regroup’ mentally. By this time, if you’re having a hospital birth, you are either in your delivery room or on your way there. Your partner may be baffled if you were cracking jokes before, and have now gone silent, concentrated or snappy. (Partners should remember to follow your lead – if you’ve gone all introverted and they’re still jesting, they’re not going to be helping you much.)

      Another progress tip:

      Regular contractions don’t happen in every birth, so try not to attach yourself to timing them rigidly. The Signs of Progress list (below) is also a good way to tell how you are doing.

       SOME GOOD SIGNS THAT YOUR LABOUR IS PROGRESSING

       Frequent contractions

       Backache

       Deep pelvic pain

       Waters breaking

       More bloody show

       Breathing changes

       Tender belly or back

       Curling toes

       Making animalistic noises

       Perspiration, shaking legs, chattering teeth

       Thirst

       Loss of appetite, nausea, vomiting

       Hiccups/burping

       Intense concentration on contractions

       Not wanting to be touched

       Not wanting to be left alone

       Tiredness

       Asking for medication/help

       Emotional signs:

       Anger/frustration/demoralisation

       Confusion or apprehension

       Surprising lack of modesty

       Obsession with ritual

       General irritability

       Amnesia between contractions

       Restlessness

      ‘Hard’ labour is usually shorter than early labour, thank goodness. If you don’t have drugs or clocks you may not have any idea of how long it lasts. You may get into a trance-like state, needing weird rituals or objects. This is when you really rely on your birth partner(s) and midwife: they’ll help you with positions, find ways with you to keep the labour progressing, and will keep you confident and calm. You might sound odd at this point. During the hardest part of Ted’s birth my husband John says I sounded like an old drunkard. I’d be moaning ‘Penny, is ‘e ok?’ and Penny (my midwife) would say ‘Yes, he’s doing very well. He’s fine.’ And two minutes later I’d slur, ‘Is ’e ok Penny?’ Lucky midwives are so patient.

      Your waters might break (if they haven’t already) during this phase. This can help your labour to progress. This is why sometimes your midwife might want to break your waters for you – ‘artificial rupture of membranes’ – to help the birth along. You may become irritable or even angry between contractions. ‘Many of my clients are totally bitchy here,’ says Julia ‘and I’m usually relieved – it’s a sign that they are moving to the next part of labour. Most also tear at their clothes and become naked as this part of labour goes on.’ If you’re shy about nudity, wear a sports bra. Do not let incidental worries like baring your boobs stand in the way of this birth.

      Many women begin to lose touch with what is going on around them during hard labour. This sounds scary for the control freaks among us, but it can be strangely liberating. With Sam, I was extremely concerned not to go to the hospital too soon (as I did in my first labour). It took John nearly two hours to get me from the bathroom in our house to the hospital car park (a five minute car ride away). Julia watched through the hospital window as it took me another 20 minutes to get from the car to the door of the hospital. I arrived on the labour ward in the lift on hands and knees, baying like a cow. If you find this disturbing remember: the midwives, doctors and nurses (and, presumably your husband) have seen it all before. They do not care what parts of your anatomy are showing or what noises you are making.

      Hard labour tip:

      ‘Labour hurts,’ says Chari, 30, mother of two. ‘Why don’t women speak realistically about that? My mother said it felt like menstrual cramps – but if that’s what her cramps felt like, she should have had a hysterectomy. I had trouble catching my breath; they started with BAM! one on top of the other, and all my natural childbirth plans flew out the window. Labour hurts but it doesn’t have to be scary, that’s what I tell my friends.’

       TEN WAYS TO COPE WITH HARD LABOUR

      1 Move around and change positions often. You can walk around then stop and lean against someone when the next contraction comes.

      2 Don’t lie on your back. This can slow things up and lead to other interventions.

      3 See each contraction as