The truth about labour

If you ask some people (like your grandkid-crazy mum) giving birth is a breeze. All it takes to pop out a sprog is a few well-timed puffs as you sit tidily on a bed of crisp white sheets. On the other side, you’ve got that mate who had a 56-hour labour from hell.

IT’S GOING TO HURT LIKE HELL, ISN’T IT?

In a word: yes.

“Some women genuinely don’t feel much pain,” says Tasmanian obstetrician and spokesperson for the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, Dr Kristine Barnden. “But for the majority it is incredibly painful. However, the perception of pain is amplified by negative emotional states, such as fear.”

Women's Health health expert and GP Dr Ginni Mansberg agrees: “Anxiety and pain are linked,” she says. “Stop listening to horror stories. A lot [of women] find it’s not as bad as they thought – unlike other pain, labour pain has an end purpose. Every contraction is bringing your baby closer.”

IS AN EPIDURAL THE BEST FORM OF PAIN RELIEF?

“It depends on the woman,” Dr Barnden says. “Some want a totally drug-free birth.” Massage and hypnosis are two popular drug-free options – find a hypnobirthing practitioner in Australia or New Zealand.

Drug-wise, the most common choices are epidural, nitrous oxide gas and narcotic drugs.

“In theory, a lot can go wrong with an epidural,” Dr Mansberg says. “But in reality, we don’t see many problems. The main issue is it’s given by an anaesthetist, which means it’s expensive!”

With gas, “You might feel a little high, or not so ‘present’, but there’s almost no risk,” Dr Mansberg says.

Pethidine is the most widely used narcotic, but Dr Barnden advises caution. “There’s growing awareness of difficulties associated with side effects, so there’s a move away from its use,” she says. “Many obstetricians will encourage an epidural instead of pethidine.”

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OBSTETRICIAN OR MIDWIFE?

“Obstetricians are trained in the management and care of all pregnancies,” says Dr Barnden. “But we do tend to work more with complicated pregnancies – identifying and dealing with problems.”

Midwives, however, play more of a supporting role. “We guide where needed, and step in where needed,” says Dr Hannah Dahlen, spokesperson for the Australian College of Midwives. “The outcome we aim for is a woman being able to say ‘I did it all myself’. We don’t even like to say we ‘deliver’ the baby. It’s the woman who delivers the baby – we just catch them.”

Of course, you can always opt for both. “Look for midwives and OBs that are willing to collaborate and respect each other,” says Dr Barnden.

DO I HAVE TO GIVE BIRTH IN HOSPITAL?

Public and private insurance aside, your options are open. “This is particularly true with the recent maternity reforms that allow midwives to become eligible Medicare providers and access professional indemnity insurance,” Dr Dahlen says.

Most women choose to give birth in hospital, but a growing number are now choosing birth centres – maternity units run alongside hospitals. A small percentage of women choose to give birth at home.

“Most pregnancies are straightforward physiological events,” says Dr Barnden. “But no matter how healthy you and your baby are, there is the chance something can go wrong. It’s best you’re in an environment that can provide timely, successful treatment.”

RELATED: When should I start to plan for a baby?

DO I NEED ANTENATAL CLASSES AND A BIRTH PLAN?

“Antenatal classes are great for meeting other women, or if you have absolutely no idea what to expect,” Dr Mansberg says.

The important thing is to be prepared for anything – birth rarely happens the way you want it to. By having a rigid birth plan, you set yourself up for disappointment.

“You can practise breathing and bean bag positions in classes, but on the day they might just annoy you,” Dr Mansberg says. “You might want to throw the bean bag out the window and just stand under a hot shower.”

AM I GOING TO POO IN FRONT OF EVERYONE?

“It’s very common,” Dr Barnden admits. “Luckily, by then you will most likely either not notice or not care, and the midwives and doctors have seen it all before, anyway. So don’t worry.” Oh, OK then.

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