One thing that all my experience has taught me is that every single woman is unique and experiences birth differently to the woman next to her. Yes, the physicality is broadly the same but your feelings, emotions and perceptions of pain are very unique to you and your situation.
Not long after I had qualified as a midwife, a woman turned up unannounced on the delivery suite saying that she knew that she would be going into labour in a few hours. This was an odd thing for a start for someone to say. Usually women would come in reporting having had irregular contractions or their waters breaking or some other symptom that might herald the start of labour.
This woman was from a family of travellers who had just arrived in the area and she was having her fourth child. She wasn’t distressed or appear to be in pain but I led her into a delivery room anyway because I just felt that she would have benefitted from some privacy. Her partner had left her at the door and she did not want him with her at this stage.
In the room, I introduced myself to her and asked her consent to carry out all the usual routine observations for a woman coming into the delivery suite in labour. She gave her consent but then looked me straight in the eye and said very firmly but politely:
“Yes, but I would like to tell you how I would like things to be –
First of all, I am not in labour yet so you don’t need to examine me internally to find out – in fact you won’t need to do that at all because I can tell you when I am going to birth my baby. I would like to go for a walk when you have checked me and the babies heart beat and then I will come back when I know that I am going to give birth. On asking her what she would like for pain relief, she laughed and said ‘nothing – I have a yellow flannel that I will put over my face and that will be enough’. And when I have given birth, I want you to wash me and the baby straight away and put us in clean clothes, tidy the room so there’s no blood or mess and clean sheets on the bed. Then you can get my husband to come in to see me”.
I must admit to feeling a little anxious about this because usually, when a woman is in labour and having her fourth baby, it is not wise to let them go too far away in case they birth their baby in the car park or in the road. However, I reasoned that Mrs A was not in labour, her waters hadn’t broken and all was well with her so I could see no reason to keep her in a delivery room waiting for labour to commence. I felt instinctively that she was a woman who knew her own body extremely well, having had three previous births all without complication. Also, we used to encourage women to go home and await events as it was far better for reducing their anxiety levels to be in their own environment.
It’s a known well researched fact, that women labour better where they feel safest and that coming into a hospital environment increases their anxiety levels which are already increased due to the release of adrenaline in response to the pain of the contractions. The body is finely tuned however, so that endorphins are released in response to pain which helps ease it and oxytocinon which brings on labour and continues to stimulate the womb until birth and after with the bonding and attachment process. There is a great web site explaining this:
She promised that she would not go far only around the hospital grounds and to the local shops and that she would come back as soon as she knew that she was going to give birth.
Two hours later, she did indeed come back looking a little flushed but calm. The first thing that she did on going into the delivery room was produce the yellow flannel which I put cold water on. She sat on the bed, put the flannel over her face and told me that she was going to give birth. Which she did – fortunately I did have time to prepare the room for a birth and managed to put on a pair of gloves.
The birth was effortless with no fuss and she produced a healthy baby within 15 minutes of being back in the room. I carried out no internal examination to confirm that the cervix was fully dilated but I did manage to listen to the baby’s heart beat which was normal. After the birth of the placenta she and the baby were washed and dressed as instructed. The room tidied, a clean sheet put on the bed, cup of tea supplied. Her husband came back into the room to find his wife looking like the queen, propped up against clean pillows and clean sheets.
He was so proud of her and so grateful to me and my care it made me feel very humble, especially as he had bought me a small box of chocolates which they could probably ill afford.
For me, this birth demonstrates how important that element of self-belief is in ourselves and the enormous trust that is placed in a relationship between woman and midwife.