This post originally appeared in VICE UK
Midwives are facilitators of life. They are the conduit between a baby's uterine world and our world. But how many of us know what the delivery person actually sees, smells and get soaked in up to four times a day? And, if you're about to give birth, how do you know that what they're going to see between your legs won't shock them?
We spoke to a young London midwife who works in a busy central London hospital to find out what work at the coalface of colostrum and cervixes actually looks like, and what knowledge they can pass on to new or expecting parents. And to reassure you that, honestly, from catching shits in sanitary towels to getting amniotic facials, they've seen it all before.
Women should not be embarrassed about shitting in front of their midwife. "We literally don't give a toss—it doesn't faze us," my midwife friend says, smiling. "You just deal with it. You get a sanny pad out, catch it, and get rid of it. It's absolutely fine, and a good sign." You see, when the baby's coming down, it presses against the rectum and that may force a shit out.
Also, don't be surprised to be on all fours, with the midwife staring deep into your butthole. They're looking for signs of full dilatation of the cervix, which can include dilation of the anus. And if you do a shit, the midwives may well start saying things like "It's great!" because it means that things are moving on well.
The urge to shit will come quite late on in the labour, once the baby is fully engaged. Once you're fully dilated the second stage can take up to two hours, but is normally quicker with a second baby.
Women are sometimes sick when the contractions get really intense, and a bit of diarrhea in early labour is perfectly normal—like a much stronger version of when you have such bad period pains you have to vomit.
Your body is, effectively, chucking out any excess ballast—clearing the way for one of the most complicated, most exhausting and most remarkable things it will ever do. Don't worry that you're ill, or that the midwife will be grossed out. These people are impossible to shock.
THE MUCUS PLUG
"Your cervix is a long channel," explains the midwife. "Inside that canal is a mucus-y plug. It's a good sign of early labour when that mucus plug comes out. It might be bloodstained, which is fine, but if there's fresh blood then we'd worry more."
If you've never seen a mucus plug before then you can—and I say this from experience—find lots of photos online. It's basically like a little mucus tampon, like the product of a particularly heavy sneeze. And, as she says, it's not remotely disgusting; merely a good sign that things are getting under way.
AIR TRAFFIC CONTROL
Your midwife may tell you not to push at the very end. Although naturally you'll have a massive urge to push, the stinging sensation when the head is getting lower is actually a sign to slow down. If the head comes slower—when you just give little pushes—you're less likely to tear. So it's the midwife's job to time it, to guide you, like an air traffic controller.
Some midwives have even been known to take a spare pair of pants with them to work, because they regularly go home completely covered in piss, blood and amniotic fluid. Again, like a lifeguard, plumber or Irish farmer, getting soaked right down to your underwear is simply another part of the job for midwives. They don't resent it.
When the baby's born there's often a lot of amniotic fluid built up behind it. If the head is really tight, you'll only get a trickle when the waters break, but it'll all come out afterwards. "So you're kneeling down on all fours and it'll come shooting out all over you."
Of course, the fluids don't stop once the baby has been born. Babies will frequently piss all down the person who delivered them, while there may be blood and, of course, the odd nappy to sit on during home visits. All of which calls for a change in trousers.
PULLING OUT A PLACENTA
After the baby is born, there's still the niggling little matter of the placenta to be addressed. "When you breastfeed, the same hormone that causes milk let down will also cause the uterus to contract," my midwife friend explains. It's a very clever feedback loop: As the uterus contracts, the placenta will come out. Or you can get an injection, which will cause the same thing. With an injection, the midwife will guard the uterus—with their hands—and pull the placenta out.
The placenta—the thing that has kept the baby connected to the uterine wall and given it all of its nutrients for the last nine months—does contain a lot of minerals and other things of nutritional value. Some women choose to have their placenta capsulated or, at the risk of spending a fairly large sum of money on something that is very likely to get thrown up a few minutes later, turned into a smoothie, with fruit juice and berries.
"Advising a woman on hand-expressing can sound quite funny," says our midwife. "If the baby's not feeding very well, you may not get as good a supply." Because, like capitalism, breastfeeding is a case of supply and demand. You have to keep stimulating the breast to keep the milk flowing. Also, there is a theory that the smell or taste of colostrum can make the baby want to feed.
So, don't be afraid to knead your tits like soft white rolls. Your body knows exactly what it's doing and just needs a little encouragement. Any midwife will be happy to give you pointers either over the phone or during one of your home visits.
Don't be surprised to be on all fours with the midwife staring deep into your butthole.
The pain doesn't stop after you've given birth. Any tears may need to be sewn up but don't worry, says our midwife, "it heals very well." Of course it does, otherwise nobody would ever have more than one baby.
You may also experience after pain, often when you're breastfeeding, because the uterus has to carry on contracting into the pelvis. But don't worry, any discomfort or anything you're concerned about can be discussed totally frankly with a midwife. It's what they're there for.
OTHER THINGS YOU MAY NOT BE AWARE OF
The danger of booze. Any amount of alcohol during pregnancy could cause problems; visible disabilities, heart problems, ADHD. The more you drink the higher the risk. The less you drink, the lower the risk. And if you don't drink at all for nine months then you've not put your baby at any unnecessary risk. It could be 40 years of care, against nine months of not drinking, says our midwife, which is quite a persuasive bit of math.
BLEEDING AFTER SEX
You may bleed after sex when you're pregnant because your cervix is vascular, i.e., it carries blood. So, if you're prodding it with a healthy bit of horizontal rugby, it may bleed. However, any bleeding during pregnancy should always be reviewed by a doctor—never assume it's normal just because it happened after sex.
There are male midwives. Just like there are male obstetricians. And male gynecologists. And male most things, really. They may not have vaginas or ever experience a dilated cervix first hand, but they will have studied for a long time to understand it.
IF YOUR PARTNER IS MAKING YOU ANXIOUS, TELL THEM TO SOD OFF
Fear, anxiety and stress can all stop your labor progressing. So it's important that your birth partner is someone who will help you feel calm and relaxed. That might be your mum or it might be your boyfriend or girlfriend. And, of course, it might be neither. So, fuck personal politics—pick someone who is going to keep you feeling as relaxed as possible. After all, you've got quite the task ahead of you.
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