LABOUR. The mere mention of the word conjures up feelings of trepidation in most mothers-to-be.
But how might you feel if you were a midwife preparing to give birth for the first time?
No matter how many patients a midwife may have helped go through the process, labour is an intensely personal experience for every woman. It’s an experience that has been made more complicated by the Covid-19 pandemic.
Phil Ní Sheaghdha, general secretary of the Irish Nurses and Midwives Organisation, says that the visiting restrictions in most maternity units mean that midwives have to be even more supportive of new mothers and they are using IT to improve communication with family.
Phil has two children and, while both of her birth experiences were very different, each time she was attended by pupil midwives. “I couldn’t have got through the experience without them.”
She adds that “there’s a lot of focus on the labour itself but in reality, it’s a bigger experience and an experience that takes in the pre-natal period and the post-natal period”.
According to the Nursing and Midwifery Board of Ireland, there are 10,661 registered midwives in this country, of whom approximately 3,500 are currently practising.
Three of these midwives share their stories of giving birth for the first time.
Nadia Arthurs was pregnant with her first child when a colleague told her that she had made a bad decision marrying her husband. Her colleague, an obstetrician, was speaking professionally. Nadia is 5ft 1in and her husband is 6ft 5in and weighed 12lb as a newborn, but she wanted a natural birth for their child.
Nadia had been working as a midwife in a large maternity hospital for several years by then. A 32-week scan revealed that her daughter’s estimated weight was six pounds, which had been Nadia’s own birth weight.
To prepare herself, she listened to hypnobirthing tracks. “A lot of hypnobirthers would say that labour is not painful,” says Nadia. “And I was very fortunate that I was one of those people. I would not describe it as a pain. It was intense and it was powerful.
It was hard bloody work, it wasn’t easy by any means, but it was very doable and very manageable, and it was an amazing experience.
Her nursing background helped. From 37 weeks, Nadia was regularly having pre-labour contractions.
“I was asking myself if I rang the emergency room now, what would I tell myself? The answer was always if they got stronger or closer together, come into the hospital. But in any one night, they never did.”
Then on August 29, 2012, she woke up at 3.30am, and she says “it was intense from the get-go”.
She used her TENS machine, bounced on her ball and had a bath. “I didn’t want to be a drama queen, going in too early.”
But then her waters broke. They were green, which is a sign that the baby is in distress so the couple immediately set off for the hospital where Nadia worked.
“I was on all fours in the back of the car, and we had a long drive,” she says. “It was the hardest part of the labour.
“We got to the hospital and I knew the midwife who was there. I just wanted to hear a heartbeat and she knew that, so she put on a trace on baby’s heart and it was fine so I could relax. She gave me gas. I started laughing when I had it first — I was just a bit high on it.”
Alannah was born at 11.34am and she weighed 9lb 7oz. “I remember thinking afterward, God, I can’t wait to do that again. The whole birth was pretty amazing.
“The journey in the car was tough, so that was why on my second, I had a home birth to avoid that.”
Her third pregnancy was high risk so she gave birth in the hospital which describes as “a home away from home”.
Although Nadia doesn’t think that her experience was particularly unusual, for Gemma Owens, labour first time round was very different.
“I didn’t expect it to be as painful as it was,” says Gemma. “I thought I had a relatively normal pain threshold but it just took my breath away. When you got into established labour, that was a killer.”
After working in the labour ward for two years, she trained as a sonographer and now works as a midwife specialist doing scans. Gemma had her first child three years ago, and says “I thought, of course, I was prepared for it”.
Her waters broke unexpectedly at 35 weeks, “but the midwife in me knew that he was going to be fine. Still it was a shock and then when labour did start, it came fast and furious and I don’t think anything can prepare you for that. Even with all of my background and my experience in the labour ward and the training that I had done, the number of babies I had delivered over the years, I was not prepared for that.”
She gave birth to Seb in the hospital where she works. “From when I did my training there, I’d trust them with my life. I wouldn’t want to have my babies anywhere else.”
She had her second baby, Alex, in May this year and says that it was a more stressful pregnancy due to Covid-19. This time, she was 38 weeks pregnant when her waters broke and it was 24 hours before labour began.
“The pain was still pretty horrific. When they examined me in the labour ward, I was only 2cms and I thought ‘oh my God, you’re joking’.”
Gemma thinks that her experience has had a real impact on how she does her job. “I used to hate when midwives who had children would say ‘you don’t understand, you don’t have kids yet’. But now that I’m on the other side, I totally understand where they’re coming from. It definitely makes you more empathetic.”
This feeling is echoed by midwife Cara McNally.
You learn all about labour, you learn about the process of labour and how the baby comes out but until you go through it you don’t actually fully get the experience of what a contraction feels like.
During her training, Cara went to Holland which has a very high rate of home births. “I thought it was the most amazing thing. I knew that if I ever had a baby, that was what I was going to do.”
When she got pregnant, she booked a place in the hospital but also booked an independent midwife and went on to have her son Jack at home.
“I looked forward to labour because, after nine months, you’re dying to meet the baby,” says Cara.
“It’s the event you’ve been waiting for since the day you did your pregnancy test. One day out of nine months is nothing.”
She remembers ringing her midwife on a Saturday, thinking she was in labour. But she was just 1cm dilated. Jack was born weighing 9lb 8oz on the Monday afternoon and Cara reckons she had probably been in active labour since the previous evening. “It was long, but that’s normal for your first baby. It didn’t go through my head once that I needed pain relief. I used the bath and by Sunday evening, I was using my midwife head thinking what do I need to do to get this to hurry up? I actually did enjoy every minute of it and I felt so empowered. It was painful, but I didn’t feel I couldn’t cope.”
Although Cara had planned a home birth for her second child Eoin, she had to go to hospital because she was 14 days overdue. Crucially, she says that she felt very much in control of what was happening, and again she enjoyed the experience.
Her third son, Finn, was born at home as the sun was rising. “I had a playlist on and he was born to that song ‘Here Comes The Sun’. I actually enjoyed having the contractions because I knew the baby was coming. I know that sounds bizarre, but you have to feel in control. If you’re full of fear, it takes over your mind and it affects how you are able to control what is happening to you.”
The key to labour is relaxation, says Nadia. “If a woman is really stressed, then labour doesn’t progress, and things slow down, particularly on first babies. Labour for your first baby tends to be the longest one and women get tired.
“Whatever it is that makes you tap into relaxation normally, that’s what you need to do for labour and birth.”