Five ways to improve your birth experience

Want to know what’s more important than pain relief in the quest for a stress-free labour? We’ve got the answers…

What makes a good birth? Well, it’s got to be over quickly. Pain-free would be nice. And ideally, you’d want to get through it without a hair out of place, let alone any stitches. Oh, and you definitely, definitely don’t want to poo in front of the midwife…

In reality, though, a good birth experience depends on more than just the length of labour, how much it hurts and whether you escape with your dignity intact. ‘The women who cope best are those whose goal is a healthy baby, delivered in the safest way possible,’ says Gabrielle Downey, consultant obstetrician and gynaecologist based at Birmingham Nuffield hospital.

But why do some mums look back on their three-day-long marathon with misty-eyed fondness, while others can emerge after a seemingly easy six-hour labour vowing never to do it again? We look at the five factors which really make for a good birth.

1. Keeping an open mind

According to midwife Sue Jacob, a good birth experience has a lot to do with your attitude and personality. ‘The majority of women fall into one of two groups,’ she explains.

‘Some are “regulators” – they like to be in control and don’t deal with the unexpected very well. Other women are “facilitators”. They go with the flow, and deal with situations as they arise.’

A facilitator, faced with a difficult labour, will say, “Well, it’s not what I imagined, but I’ll go with it”, says Sue. ‘A regulator, however, likes to know exactly what’s going to happen. If things don’t go to plan, she’s thrown.’

Great news if you’re a facilitator, but what if you’re a regulator? It may go against your nature, but an open mind is essential for labour. Okay, so you thought you could manage with gas and air, but if it’s more painful than you anticipated, why not have that epidural?

It’s also helpful to take each stage of labour as it comes. Rather than thinking, ‘I can’t cope with another 12 hours of this,’ tell yourself, ‘That’s one less contraction to go!’. Trust us, positive thinking really does work – it’ll make the pain easier to bear and you’ll feel happier with your birth experience in the long run.

2. No pain, no gain

If you burst into tears over a paper cut, you’re probably not looking forward to giving birth. At all. Women with a high tolerance to pain tend to cope better with labour, but no one knows exactly what determines our pain threshold – it’s likely to be a mixture of genetic, emotional and hormonal factors.

Regardless of your pain threshold, labour hurts. ‘Be realistic,’ advises Gabrielle. ‘If you believe that labour is like lying on the beach, letting the waves flow over you, at the first real contraction, you’ll think you’re dying!’

Although sensitivity to pain is partly genetic, you can boost our pain threshold by being relaxed. Try this simple hypnobirthing technique – breathe in through your nose, imagining your body filling with calming, golden air.

As you inhale, count down slowly, saying, ‘Three… two… one… relax’. Then breathe out through your mouth, imagining all the tension leaving your body.

Your environment also affects your sensitivity to pain, which is why it’s best to stay at home as long as possible. You’ll cope better in your own surroundings than on a busy ward echoing with the screams of other labouring women.

There are no medals for having a high pain threshold, so if you suspect you’re going to struggle, you might want to write ‘epidural’ in capital letters on your birth plan. But labour is a completely different pain from anything you’ve experienced before.

‘I have a low pain threshold, so I rushed to hospital, begging for an epidural,’ says Taz Chowdhury, 33, from London, mum to Kayan, six months. ‘But the midwife suggested trying the birth pool, and Kayan was born in the water with no pain relief at all.’ You never know, you might just surprise yourself.

3. The right company

For many women, their choice of birth companion is a no-brainer – they want their husband or partner. But given that a good birth partner can shorten labour by up to two hours, halve the chance of a caesarean and reduce your need for pain relief, is he the right person? Possibly not, if watching Holby City makes him feel faint…

‘A good birth partner is someone who’ll support you, but who also has realistic expectations,’ says Gabrielle. So, if you chose to have your partner by your side, he should be able to meet your physical needs (massaging your back, fetching drinks), speak up for you and help you make decisions.

But he also needs to realise that your plans might change – it’s no good if you’re begging for pain relief but he’s telling the midwife you want a natural birth. Neither do you want to be worried about him during labour.

‘My husband was such a nervous wreck that the midwives were more concerned about him than me,’ says Jude MacIntyre, 30, from Edinburgh, mum to Elspeth, seven months.

‘It’s okay to be critical about your choice of birth partner,’ says Sue Jacob. ‘Ask yourself if your husband or partner is the best person.

If not, have someone else there instead or as well.’ Research shows that women make the best companions, so a trusted friend, your sister or mum would be a good choice. Make sure, though, that she’ll be supportive, rather than interfering.

If all else fails and you’re facing labour on your own, don’t panic. From around £300, you can hire a trained birth companion called a doula – research shows you’re more likely to have a positive experience, with less pain relief and fewer interventions. Call 0871 433 3103 or visit doula.org.uk.


4. Do your homework

As every Girl Guide knows, it pays to be prepared. But how do you get ready for the biggest challenge of your life?

Physical fitness is crucial to give you strength and stamina. Go for gentle workouts like swimming and walking – do 20 minutes a day, so you’re slightly out of breath but still able to chat. Or check out pregnancy courses like antenatal yoga and Pilates. Ask your midwife, or visit www.birthlight.co.uk.

Many midwives recommend massaging your perineum (the skin between your vagina and anus) from around 32 weeks. Use pure wheatgerm or olive oil, then insert both thumbs into your vagina and sweep them down and out towards your bottom. Studies have shown that perineal massage reduces the risk of tearing or needing an episiotomy (a cut to widen the vaginal opening), especially if you’re over 30 – and that’s got to be worth a try.

You need to get your mind into gear, too. For a tell-it-like-it-is guide to giving birth, go to antenatal classes, run either by midwives or the National Childbirth Trust (0870 990 8040, nctpregnancyandbabycare.com). You’ll learn what labour is really like, and will also get to find out about that all-important pain relief.

It will help you to write a birth plan to explain your wishes to your midwife. It will also provide some continuity if the shift changes halfway through, and give your birth partner a guide to what you want. But don’t be too rigid. As Gabrielle says, ‘By all means have a birth plan, but be flexible. Your plans may have to change if circumstances dictate.’


5. Call in the professionals

We all dread having a midwife who makes Nurse Ratched look like Florence Nightingale. A positive vibe between you and your midwife will help you relax, reducing anxiety and pain.

But what makes a ‘good midwife’ is subjective. Maybe you want someone who’ll mop your brow and lavish praise on you. Perhaps you’d prefer her to tell you to get a grip. You might want her to encourage you to manage without pain relief, or to call the anaesthetist as soon as you walk in.

Whatever your preference, you have the right to a certain standard of care, says Sue Jacob. ‘Women have needs and choices,’ she explains. ‘They’re our customers – whatever makes labour a good experience for them, we should help them to achieve, within the bounds of safety.’

But what if it’s labour bags at dawn between you and your midwife? ‘There’s nothing wrong with politely explaining that you don’t think you’re going to get on, and asking if you can have someone else,’ says Sue.

‘Most midwives will happily swap with a colleague. If that doesn’t work, ask to see the ward manager or the senior midwife, and explain the problem. Don’t feel guilty – none of us want bad chemistry in the delivery room.’

Good birth, bad birth…

Lucy Dimbylow, 27, from Watford, is mum to Thomas, five months

‘I was hoping for a natural labour without pain relief – I didn’t want Pethidine, as it can cross the placenta and affect the baby, and I knew that if I had an epidural, my plans for an active birth would go out of the window.

I prepared by listening to a hypnobirthing CD every evening. I have a high pain threshold anyway, but the hypnobirthing techniques made me feel positive about my ability to cope. I never once felt scared about giving birth.

‘But after 48 hours of labour, I was only 3cm dilated. The midwife broke my waters, and suggested a Syntocinon drip to accelerate labour. My first thought was, ‘No way!’ – I wanted to do things naturally, at my own pace.

‘An hour later, though, I still wasn’t dilating. I agreed to the drip, on the grounds that I still didn’t want an epidural. My midwife was brilliant, massaging my back through every contraction. With her support, gas and air and my hypnobirthing techniques, the pain, while intense, never felt unmanageable.

‘I got to 9cm, but Thomas’s heart rate was dropping, so the doctor decided to use the ventouse. It was incredibly painful – I had an episiotomy and tore as well – but I was focused on getting my baby out safely. He was born after 56 hours of labour, weighing 6lb 14oz.

‘Although my labour was long, managed and far from the natural birth I wanted, it was still a good experience. For me, the main goal – apart from a healthy baby – was to avoid a caesarean.

I’m proud that I coped with just gas and air, and that Thomas was delivered vaginally, even if I did need some help (and a lot of stitches!).’

Alison Smith, 26, from Salisbury, is mum to Lewis, six months

‘My midwives said I had a good labour – 12 hours from start to finish, with no stitches. But it was a frightening and lonely experience.

‘I had some Pethidine, but then Lewis’s heart rate started to drop. I assumed they’d keep monitoring me, but the midwife said I could go in the bath, then went off to do a handover. My partner and I were left alone, and neither of us knew what we should be doing.

‘The midwife told me to buzz if there were any changes, but when the pain got worse, I didn’t know whether it was normal or if I needed to call for help. When a new midwife finally came to get me out of the bath, I was already pushing.

She got me onto the bed and put me on a monitor, but then disappeared again, even though I needed to push and Lewis’s heart rate was dropping. When she finally came back, she told me the cord was wrapped round his neck twice. I was scared stiff.

‘Luckily, Lewis was born safely, weighing 6lb 5oz. But even though it was over quite quickly for a first labour, it was a scary experience. I didn’t know what to expect – I’d have coped better if I’d had more support.’