If you are showing the positive signs of labor (progressive contractions, water breaking, etc.), then a baby is working on making his/her way into this world! At this point in time, you may be feeling a couple of different emotions:
The Realities of Labor and Birth
Do you know what a laboring woman truly looks like? It’s okay if you don’t. Actually, I don’t know if there are a lot of people out there that really do. They may have never witnessed a live birth, or they have only been exposed to birth in the media (SO unrealistic). Before I became a doula, I was very naïve. I was unaware of the impact of medical interventions on birth. I didn’t know there were moms out there that were opting for natural birth, let alone giving birth in their homes. I had no idea labors could last +24 hours. I didn’t even know doulas existed. I wasn’t aware that when your water breaks, you don’t have to rush to the hospital. And you definitely don’t have to labor in bed or push while lying on your back. If you already knew these things, how powerful was that moment when you were presented with the realities of birth? Going to my first births as a doula was so eye opening and educational. From my experiences, I wanted to share some general information and tips that can help you better understand and navigate through this process:
Childbirth is physiological.
There are so many hormones that come into play during labor and birth. If mom is feeling anxious or tense, adrenaline is released. This hormone can hamper labor progress, causing it to stall or stop all together. Laboring mamas need to feel supported—which will cause a release of oxytocin, the “love hormone.” Partners and support people: be in tune with mom’s emotions. Matching her mood and simply being present will positively affect labor progress. You can read more about the role of hormones in labor here.
Early labor can last a while and feel mellow or chill.
In early labor, distraction is KEY! Engage in regular, everyday activities until you can no longer distract yourself. Do you have a lunch date with girlfriends planned for today but are hesitant because you're in labor? Go ahead out and grab a bite. As one childbirth educator in our community says, you can get pretty fast service if you tell your waiter you’re in labor! ;) But really...take the dog for a walk, call your mom to chat, watch a movie or play some card games with your partner. Do whatever helps to pass the time. Remember that this is the longest stage of labor. If you can manage it, try resting or napping for a period of time. You want to reserve as much energy as possible for the more intense parts of labor. With that being said, eat light foods and keep up your fluid intake. Nourishing your body in the early stages of labor will prevent you from running on empty when you’re pushing your baby out.
Call your doula and let her know you are in labor. She may not meet with you at that very moment, but it’s nice to give her a heads up. By the time you are ready for her to join you and your partner, she will have all of her ducks in a row.
If you’re planning a hospital birth, try laboring at home for as long as possible.
This will help decrease the chance of interventions. If you are feeling lonely or unsure, this would be a good time to invite your doula over. She can provide reassurance, perspective, and suggestions.
If mom and baby are both healthy, there is no need for continuous electronic fetal monitoring (EFM).
When mom arrives at the hospital, the nurse will want to hook her up to the EFM for about 20-30 minutes. This is just to make sure mom and baby are doing well. Once she assesses mom and baby’s well-being, and everything looks okay, mom will be taken off of the EFM. Typically, the nurse will come in about every hour or so to get a quick reading (subsequent readings are much shorter than the one upon arrival). If labor is moving at a fast pace, the nurse will come in more often. EFM is usually considered necessary when other interventions are introduced, such as Pitocin or an epidural. At prenatal appointments with your care provider, ask for his/her opinion on routine practices and interventions. This may give you a good idea of what to expect once you go into labor. If you find that you are unhappy with the way your care provider handles things prenatally, try switching care providers! Unless you are nearing your due date, it is most likely not too late to switch.
Eat to hunger and drink to thirst.
I know I mentioned this up above, but it is just so important to note once again! Most hospitals offer clear foods for laboring women. These include: jello, gummy bears, ice chips, popsicles, broth, etc. I encourage expectant mamas to pack light snacks in their hospital bags. Consider brings crackers, granola bars, fruits and veggies, etc. Not nourishing your body in labor can have adverse effects on the laboring process.
Movement and breathing are powerful coping mechanisms in labor.
Moms will find what works for them in labor, but I always find that breathing techniques and position changes really do the trick. There is no one right way to breathe, but as labor becomes more intense, mom may find that her breathing style changes. Just like transitioning from walking to jogging to running, heart rate and breathing patterns will pick up. Changing positions often will also help with labor progress and baby’s descent. What works in early labor may not work in active labor, and that’s okay! Women typically rely on more than one comfort measure and position to cope with labor pain.
Active labor, especially while in the transition phase, is intense!
This is the part of labor that media loves to play off of. I always think of Alison screaming, “GET OUT” when giving birth in the movie, “Knocked Up.” Yes, the moments leading up to full dilation can be very intense, but mom may also turn inward. She may be very to herself, very quiet and focused on each contraction. Don’t be alarmed if she is very primal in her labor. She may be moaning, chanting, keeping a rhythm of some sort (Check out Penny Simkin’s write up on "The 3 R’s in Childbirth Preparation" to get a better idea of coping rituals). In this phase of labor, support people often hear mom say, “I can’t do this anymore.” Mom may feel defeated and ready to throw in the towel, especially if she is exhausted. She may ask for pain medications or say, “If I could just go to sleep and wake up tomorrow, I could do this.” This irrationality is totally normal. Offer encouragement and remind her of your birth plan. Often times, laboring mamas get so caught up that they cannot see the light at the end of the tunnel. Remind her that you both are getting a baby out of this! It can be hard to keep that in perspective.
There is a resting phase.
Before mom enters the 2nd stage of labor, the pushing stage, she may doze off. Support people may be surprised at her ability to relax after such intense and frequent contractions. At this point in time, mom’s uterus is playing catch up and will give her a “break” before she feels the urge to push. Know that this is completely normal, and if mom experiences this lull, encourage her to shut her eyes and rest for a moment. Typically, moms will get a second wind when it’s time to push, but any bit of rest until then will help!
Visit the bathroom frequently.
This may sound like a "Duh!" statement, but a full bladder can cause labor to stall. If you feel like you have to pee, go sit on the toilet. If you don't, that's cool. But try out some contractions while you're sitting there. As humans, we have this natural instinct to let go when we sit on the toilet. Really opening up and relaxing may be just what you need to dilate fully. You never know!
Mom can use spontaneous pushing to get her baby out.
When mom is fully dilated, she will be encouraged to push. Remind her to wait for that natural urge. Like I stated above, she may not feel that urge right away, and that’s okay. I think it’s said best in “Our Bodies, Ourselves: Pregnancy and Birth:”
“Pushing your baby out works best when you do just what your body wants,
without external direction. Bear down when you feel the urge. Your pushing
efforts will be more effective and powerful if you push when your urge is the
strongest. If you have an epidural and cannot feel the contractions well, your
care provider and support people can help you identify when to push down.”
To get a better idea of spontaneous pushing, check out this video created by Mother’s Advocate.
Last, but definitely not least, I wanted to briefly touch on the topic of informed decision making. Understand that I offer these suggestions and details to help you decide what is best for you and your family, not to tell you the correct way of handling these events. Giving birth entails so much more than "having a healthy baby," and sometimes the people around a laboring/ new mom do not get that. My goal as a doula is to help moms and partners achieve satisfying birth experiences--whatever that looks like to them.** When moms and partners are involved in the decision-making process, they feel more informed and empowered than those that do not. Giving birth is something that women do, not something that happens to them! Mamas, please remember that this is your body, your baby, and your birth!
**There is a lot to cover when it comes to talking about the process of labor and birth, and I know I didn't cover all of the details in this blog post. If you're reading this post-birth, what kinds of support did you benefit from during your experience? Were there specific comfort measures, positions, or mantras that got you through? Looking back, is there something you would have done differently? I truly appreciate you taking the time to share your personal stories.
Podcast: Birth on TV and the movies
WombEcology by Michel Odent
Our Bodies, Ourselves: Fetal Monitoring
Restricting Oral Fluid and Food Intake in Labor
The 3 R's in Childbirth Preparation
Get Upright and Follow Urges to Push (video)
Childbirth Connection: Informed Decision Making