Article: Loren Anthony from Fit Pregnancy
Image: Baba & Kleuter

Here's the ultimate need-to-know guide on what to expect.

Step 1: the birth plan
Dare to dream. You can have the birth you want. Draw up a detailed birth plan and then get to work researching.

Step 2: the B-team
This is an empowering yet vulnerable time for you. You need to choose a supportive team that will lavish care on you throughout your pregnancy and labour. Word-of-mouth and recommendations usually point you to the right professional, but make sure there's a "click", a nice connection, with your chosen caregiver. On labour day, you want someone who will actively listen to you and honour your needs – not their own schedule.

Option 1: Obstetrician/gynaecologist
What you'll get Regular consultations and sonars of about five to 15 minutes throughout pregnancy. Your obs-gyn will deliver the baby, but the labour-ward staff will attend to you during labour. You will get postnatal visits each day of your hospital stay and at six weeks.

Option 2: Doula
What you'll get Assistance throughout labour. A doula acts as a labour coach, offering emotional but not medical support.

Option 3: Midwife (private)
What you'll get Regular pre- and postnatal consultations for as long as you need her. But you will still need three visits to a regular obs-gyn at 12, 20 and 36 weeks. Prenatal check-ups take 30–45 minutes, where you'll get a full medical plus the chance to discuss your fears and concerns. Two midwives assist with labour and birth. One will assist throughout labour, and the second will deliver your baby.

Option 4: Midwife (hospital/ABU)
What you'll get No pre- or postnatal care. One to two midwives will assist with labour, but gynae delivers your baby. Shifts change every 12 hours.

Step 3: your birth day
It's your birth and you'll cry if you want to. Remember, this is an important rite of passage and you need to decide how you want it to unfold. Discuss your birth plan with your midwives or gynae. Don't be bullied or pressured out of your dream birth. But be flexible – things don't always go as you planned.

Focus on the positives: you are strong and naturally primed for this, and you have excellent healthcare on hand, should an emergency arise.

Choose from: Elective Caesar
What you'll get You are able to plan around a given date. You're going in for abdominal surgery, so prepare yourself for this. You will be given a spinal anaesthetic (general is rarely given, unless you request it), so you'll be fully conscious during the procedure. You might feel a little whacked and dissociated afterwards, so get your partner to be very hands-on at this stage. Just because you're post-op doesn't mean you have to miss out on critical bonding time! You'll experience post-op pain and will not be allowed to drive for 2–3 weeks.

Choose from: Emergency Caesar
What you'll get A true emergency C-section will be performed if your or your baby's health is in danger. Unfortunately, this is not always the case and a C-section is often performed when there is no immediate danger. The word "emergency" tends to feed into our fears. Try not to feel panicked, though you may feel you have lost control of your birth. Visualise your baby in a lovely white light. Breathe deeply. Let your partner do the negotiations. You may feel disappointed, but focus on your baby's safety and wellbeing.

Choose from: Normal vaginal delivery (hospital)
What you'll get You can chose between an Active Birthing Unit, where you'll have greater privacy and control, or an open labour ward. There may be pressure to birth in a given time frame (usually you will be expected to dilate by 1cm per hour), so bring something comforting along to make you feel at home – candles help soften the atmosphere. Get to know the hospital midwives before B-day: check who will be on duty and start making friends. At some hospitals you may be routinely shaved, given an enema and hooked up to a drip, but you can decline these dubious pleasures. (Discuss this with your gynae beforehand, as some do have a strict protocol on this.)

In an ABU, you'll have a low bed, bath and couch to birth on. In the open ward, you'll give birth on a hospital trolley. Try to move around as much as possible during labour, and avoid being forced to lie down. Get gravity to work for you. Pethidine (injection), entonox (gas) and epidurals (spinal injection) are available. You may be induced if your labour does not progress fast enough. (This is done by rupturing membranes or chemically, using a drip.) This may lead to increased frequency in contractions. Be prepared for this. And breathe! After birth, baby will be whisked away for a check-up. You can request no separation after birth.

Choose from: Natural birth (home delivery)
What you'll get A great option if you're having an uncomplicated, low-risk pregnancy. Your midwife will guide you and provide emergency equipment. Labouring at home is empowering because your mindset is so positive. There are no threatening drugs down the corridor, so you just get on with it. Two midwives should be on hand. Have a back-up plan that includes a hospital and a gynae or paediatrician, and do a dummy run to the nearest hospital a week before due date. Your midwife will do a home visit a few weeks before due date to familiarise herself with your home. Your midwife will provide oxygen, though pethidene and entonox are not usually provided. She'll bring waterproof bedding so you don't have to worry about your St Leger & Viney's. You’ll get a comprehensive list of must-haves from your midwife before the birth. Your partner and midwives will assist labour by massaging and coaching you.

There is huge partner involvement with a home birth. And after the birth, your baby won't be whisked away for a check-up but will be placed on your chest. Should he wish to, your partner may cut the cord.

Choose from: Water birth
What you'll get Birthing pools are available for hire, so you can choose to birth in an ABU or at home. An experienced midwife or gynae will be able to assist you. The benefits of a water birth are well documented and it tends to be a very relaxing, reassuring option. But be flexible: on the day, you may feel too tired and may be asked to leave the bath.

During a water birth, heated water (36–37ºC) and water jets may be used for pain relief. Baby is delivered into the water and gently placed on your chest. Your baby won't start breathing underwater – so she won't breathe with her lungs underwater – she'll use the cord, as she did in the womb. Clever thing! The cord will be cut once baby's out the water.

A water birth is not a messy option. The water remains clear until the placenta is delivered – and by then you're out of the water and tucked up with baby.

choose from: Normal vaginal delivery (hospital) with private midwife what you’ll get This is an option most women don’t realise they have. A private midwife (with whom you’ve built up a relationship) can deliver your baby in a hospital setting. You get a home birth experience in a hospital setting. Not all hospitals accommodate this, so check first.

For thousands of years, we’ve managed, rather nicely, to overpopulate the planet. We’ve done this because childbirth is not a medical condition or an abnormal state, but a perfectly natural function of our bodies. We’re absolutely wired to succeed at childbirth. So try to eliminate the fear factor, no matter what your birthing option. And don’t be pressured into doing anything that doesn’t feel right for you. Think of the thousands of women in the past who have had babies – in fields, in the back seat of a car, at a small rural clinic, in the heart of the metropolis – and know that you absolutely can do this.

Speak to: Heather Pieterse (private midwife): 082-8295309 or 012-3611836 Devorah Gruss (private midwife): 021-5525872 or 083-4638114 The Sister Lilian Centre: 012-8044418.