Twenty things I wish I’d known about having a baby

Despite progress, plans and strategies, it will be some time before we have a maternity service that gives all pregnant women the choices, care and facilities they deserve.

Many of those necessary changes were already being promised 16 years ago when I was awaiting the birth of my first baby. Lucky enough to access the National Maternity Hospital’s community midwife domino scheme, I was given the antenatal care, labour and birth I didn’t know I wanted. Another birth, and a collaboration on a pregnancy guide with a midwife under my belt, and I’d learned how fortunate I had been.

So what would I tell a younger self now if I was preparing for birth?

Choose a maternity carer wisely and early

Geography, economics and your own health may limit options. However, where and with whom you give birth will have a huge impact on how you give birth. What suited your best friend may not suit you.

Whether you choose a private obstetrician, midwife team, public hospital team or independent midwife for a home birth, research their policies and practices, and make sure your personal hopes and concerns for the pregnancy and birth can be accommodated. For example, will you need the reassurance of regular ultrasounds and other antenatal screening tests? Or will your hopes for an active birth without routine interventions be facilitated?

Educate yourself

Back away from Google. Some discerning reading and antenatal classes can help decide what kind of birth you would like, and understand why it might be possible.

You are the expert on you

Pregnancy brings lots of new, but normal, symptoms. However, if something is bothering you or doesn’t feel right (including your baby’s movements), keep telling your doctor or midwife.

Learn hypnobirthing or gentle birth techniques

These could be your greatest birthing aids.

Get tested for Group B Strep

While it does not affect women, Group B Streptococcus, a common transient bacteria, can pass to your baby during birth, causing life-threatening illnesses. Check if you will be screened, as this is one test not routine for all pregnant women in Ireland (so is a 20-week anomaly ultrasound). If you test positive, antibiotics are given during labour.

Contractions don’t necessarily mean you are in labour

It can take hours (or even days) of short irregular contractions – “pre-labour” – to prepare the cervix before it starts to dilate. Full labour contractions will gradually increase in regularity and strength. You won’t be talking through them.

Your waters may not break until moments before you give birth

Tell your maternity unit if you do not want them broken.

Some hospital bag essentials:

Heat pads for pain relief
Drinks and snacks. If food and drink is restricted during labour, suck glucose sweets
Flip-flops, because shared showers can be very messy
Earplugs and an eye-mask to help you sleep on busy wards

Arriving at hospital, you should also bring:

A dilated cervix: Or they'll send you home! Contractions should be about four to five minutes apart.

An empty bowel: If you thought constipation was uncomfortable during pregnancy, imagine how it's going to feel as a baby pushes out against your large intestine.

An open mind: You cannot predict how your labour will go. On the day, your plans to demand an anaesthetist during admission could evaporate as you realise you are coping fine; or your hopes for an active birth could be overtaken by the need for the intervention of a skilled obstetrician.

A voice to be your voice: Enlist whomever will be accompanying you at the birth to represent your wishes and concerns, and to ensure you are treated with the respect you deserve.

Build a nest

Ask for the delivery room lights to be dimmed. Block out the world around you by putting on headphones and listening to music (if it isn’t an irritant) or your hypnobirthing tapes.

Keep moving and use birthing aids

Walking, swaying and changing position regularly can help you cope. Use birthing balls and other aids for support and relief. Water works – you may be lucky to have access to a birthing pool. If not, use your bath or shower while at home.

Just when you think you can’t go on . . . it’s almost over. An intense feeling of panic, restlessness and overwhelming emotions probably means it’s time to give birth.

Don’t give birth on your back. If you are not restricted by an epidural, use an upright or all-fours position to birth your baby.

And after birth?

Request delayed cord clamping and immediate skin-to-skin contact: Some units will even facilitate skin-to-skin after a C-section.

Remember that newborns look odd: In real life babies can be purple, slimy and have funny-shaped heads.

After the birth, there's the after-birth: If, like me, you weren't paying attention at the antenatal class, the discomfort of delivering the placenta can be a shock.

You may not bond immediately: An instant rush of love for your baby is not guaranteed. It's also normal to be underwhelmed.

Don't expect to be fed: If your baby is born in the evening or night you may get only tea and a biscuit afterwards. This is where the stash in your bag becomes essential.

You will still look pregnant: Your bump and any swelling will be around for a while longer.

You will bleed a lot, and for a long time: Your new (temporary) best friends will be massive maternity pads and dark pyjama bottoms.

Take all the painkillers you are offered: Regardless of how you gave birth, you will be sore. The only reason you may not want those painkillers is because the last ones haven't worn off yet.

After-birth pains are a thing: As your womb contracts you will experience cramping. They will be strongest while breastfeeding. They really kick in on your second child.

Breastfeeding is not easy – at first: Don't let difficulties in the first few days put you off breastfeeding. Investigate "laid- back" feeding as a possible easy introduction for you both.

Consider a visitor ban: Do you want your boss, or even your sister-in-law, watching you get to grips with breastfeeding or sobbing through the third-day blues?

Going home with your baby will be terrifying: But the terror eases. It will all worth it.

Louise Ní Chríodáin is co-author of Bump to Birth to Baby, an ebook guide. See bumptobirthtobaby.com