1. Be well informed: Gather as much information about pregnancy and birth as you can, and try and attend childbirth education classes. We are fortunate in Bermuda to now have a wide choice of classes. The hospital’s own midwives are now offering classes ( 239-2055, ext. 1682), the Maternal Health and Family Planning department also (278-6441), Rita Stevens runs Lamaze classes through the Nurse’s Practice (232-0264), Lisa Blyden runs classes using the Bradley Method (337-2019) and Sophia Cannonier and I run Birth Matters Workshops (292-3261). Going to classes should help give you the up-to-date information to make informed choices about your birth, pain relief and other options that are available to you. The chances are that as a result, you are more likely to feel better able to cope with the prospect of labour and birth. It’s also a great way to meet people who are in the same situation and make new friends.

2. Make a birth plan: Using the information you have learned from the classes and other sources you will be able to put together a plan for your birth. Flexibility is essential but it will help you to focus on what you want and help your obstetrician and the midwives caring for you to know what you are hoping for. A word of warning: the birthing situation here is different from the US or the UK so it is pointless to print out a pro forma birth plan from the many baby and pregnancy websites that offer such things. Once again, through your childbirth education classes and discussion with your obstetrician, you should be able to discover what is important to you and what is relevant to the Bermudian situation, and this can be put in your own words on your plan>

3. Get good support:<$> A supportive birth companion (aside from your midwife) is one of the most effective forms of care a woman can receive in childbirth. Research shows that it has far more influence on the way you feel about the birth afterwards than even the pain relief you opt for. Although most fathers want to be at the birth, it’s not right for every man and is something that must be discussed before labour begins! If you feel close and very comfortable around your partner, able to do your own thing without feeling inhibited, then going through birth together may work well and be a very special experience for you both. Other options might be a mother, sister or close friend. You might also choose to have a doula who can relieve the pressure from the father and facilitate his participation at his own comfort level.

4. Help your baby into the best position: There is no doubt that your labour will be easier if your baby is in the optimum position for birth — head down with the back of her head towards your front.

There are various things you can do that may encourage the baby into the best position — try kneeling on all fours or leaning over a exercise ball while you are watching TV, or leaning forwards slightly when you are standing (supporting your upper body on a shelf or your partner (!) and gently swaying your hips in a circular motion). Ask your obstetrician, midwife or childbirth education teacher for more detailB>

5. Recognise the latent phase of labour:<$> This is a very important part of labour and is often the longest. Women often report ‘niggling’ contractions for days, or the contractions can stop and start which is exhausting and frustrating.

If you can stay relaxed and try and get as much rest as you can during this phase and recognise you are not yet in established labour, it’ll mean you are more ready when labour really ‘kicks in’!

6. Rela<$> Relaxation is the key to an easier birth. It is unrealistic to think you’ll be able to do this in labour with no preparation so your childbirth education classes should cover it.

7. Communicate: Talk to your obstetrician and midwives. They are there to offer you support and advice during your pregnancy, labour and birth. Discuss with them your hopes and fears, find out what your options are if you go overdue, your waters break before you go into labour, different positions for the birth, what you can do if your labour slows down, choices for third stage (delivery of the placenta) and so.

8. Don’t rush to the hospital:<$> It might be tempting as you’re so excited that your labour has finally started, but many women get to the hospital before they are in established labour (ie, their cervix is 3-4cm dilated), which can mean either returning home or spending the majority of your labour in the hospital.

Contractions should be strong (lasting around 60 seconds), regular and about five minutes apart. There are obvious exceptions to this: if you are GBS positive or your waters go before your labour starts. It is a good idea to discuss with your obstetrician what their preference is for when you should go in and if in doubt, ring the hospital and speak to a midwife who will be able to advise you as to the best thing to do!

9. Keep on the e:<$> Changing position during labour is of great benefit, both in helping you deal with the contractions and in encouraging the baby through the pelvis in the best position.

Women who walk around in labour or who remain upright are less likely to need pain relief and more likely to have a straightforward birth. When you first arrive at the hospital you will usually need to be monitored on the bed for ten to 20 minutes to check that all is well with the baby, but once the midwife is happy with the results then you are free to get off the bed and mobilise as you want to ... walking, leaning over onto the bed, using a birthing ball, sitting on the toilet etc. If your labour is long and you are tired you can lie on your left side on the bed or be propped up leaning over the head of the bed. Ask your midwife for some more ideas if you need some inspiration and encouragement!

10. Be posve:<$> Arming yourself with information, getting to know your body and staying active can all help towards you achieving the birth you want.

Although some women definitely need interventions for the safety of their baby or for themselves, many more women can give birth safely without them.

Fiona Dill is the mother of five children, a nurse (BSc (Hons) in Nursing Studies), a childbirth educator (Diploma in Antenatal Education), a doula and a parenting course facilitator. Her column usually appears every other week in Saturday’s Weekender section. Contact: fionadill[AT]logic.bm