Archive for the ‘labor progress’ Category

So You’re In Early Labor. Now What?

Monday, April 24th, 2017

 

One night, you are awakened from slumber at the beck and call of your compressed bladder. No, wait. That’s not it. There’s a crampy tightness that feels familiar. Where have you felt that before?

Menstrual cramps! It feels crampy. Weird. You decide to get up and move to the bathroom. After a few minutes, you get back and bed and feel more cramps. Hm. Weird.

Could this be it? It could be! This is it! You’re finally in early labor!

You know this because the contractions are coming, no matter what you do. You’ve had a big glass of water. You’ve gotten up to pee. You’ve had a snack. You’re content to let the rest of your house rest while you anticipate the birth day to come.

So you’re in early labor. Now what?

You think back to what your midwife told you, and you remember that she gave you several things to do during this slow building time.

  1. Let Your Midwife Know. As soon as you know you’re definitely in labor, she’ll want to know. She or her assistant might swing by to check on you and baby, or just triage you over the phone, depending on what’s happening and your needs.
  2. Rest. This is not the time to try and “get things moving” by taking a long walk, doing nipple stim, or anything else that is supposed to speed things along. This is the time to conserve energy. If you can talk through your contractions, you can sleep through them.
  3. Eat & Drink. Whatever time your labor starts, eat normally. One good meal is often enough to sustain you through the work to come. No food is off-limits, though it’s wise to keep in mind that you may throw up, so avoiding choking hazards or harsh foods might be a good idea. Comfort foods are wholesome, nourishing, and encourage happy hormones. Also, keep drinking. Water, juices, herbal teas that you enjoy, smoothies, and broth are all great candidates. Whatever sounds good.
  4. Do Life. There is no reason to put off that quick trip to the store to get milk and bread, or going to the movies. There is no reason to go out if you didn’t plan to, but just going about your day, doing your best to ignore what’s happening. At this point, it’s really no big deal, and it helps your progress if you can be content, happy, and moving.
  5. Distract Yourself. Sometimes, especially when it’s your first baby, it’s so hard to keep your mind off your contractions. But the rule of thumb is that you must ignore them until they demand all of your attention, whether you like it or not. Conserving energy in early labor is paramount! Don’t use breathing or coping techniques from your classes yet either. They contribute to the sense of time, and can make you far more tired than you need to be. Instead, watch funny movies, go to the park, go out on a date with your partner, bake a birthday cake, start a slow cooker meal for after the birth, or call a friend to chat.

I like to tell people to “be in denial” about their labor until their labor gets all up in their face! Just take care of yourself, pretend like everything is normal, that nothing is going on, and let your body keep the secret just a little while longer. You will be shouting to the world in your own way soon enough, so save your breath. Smile. 

“To move into active labor, a woman must give up ideas of how she thought labor might be; in other words, she must surrender.” ~Elizabeth Davis in Heart & Hands

Open up to the path your labor has chosen, and surrender time.

Grace & Peace,
Tiff

Could this be labor?

Wednesday, September 21st, 2011

For first time mamas, previously induced mamas or those who have loads of prodromal labor, getting a handle on the nuances of when labor is going to start or if it is lasting labor can be really confusing. There is no way to know exactly when labor is going to start, but there are many things to look out for that can give clues and signs that onset of  labor is sooner rather than later.

Here are my favorite categories to look at and simple ways to decipher what is going on with your body at the end of pregnancy.

Remember to take a look at the whole puzzle picture not just one piece.

  • Vaginal Discharge:
    • Loss of mucous plug (after 38 weeks);
    • Steady mucousy output;
    • Thin and watery mucous;
    • Blood tinged – similar to the beginning or very end of a menstrual period. This means there is effacement and ripening of the cervix going on and even a bit of dilation happening.
  • Contraction Characteristics:
    • Longer and more intense contractions that most often find a pattern;
    • They do not stop or even increase with activity change;
    • Sudden increase or onset of regular Braxton-Hicks;
    • Low period crampiness, pelvic heaviness, off and on backache, thigh achiness.
  • Other symptoms
    • Increased nesting;
    • Insomnia or excessive tiredness;
    •  Flu-like symptoms;
    • Intuition/Instinct;
    • Loose bowels;
    • Weight Loss in the last week.
  • Testing out contractions for possible labor:
    • Change activity level – if resting get up and move, if moving sit down and rest;
    • Drink a large glass of water;
    •  Eat a snack, preferably higher protein;
    • Take a bath or shower.

After doing these things if contractions continue and increase in intensity over another hour or so likely labor is becoming established. Congratulation! As always, contact your care provider at the agreed upon time.

Preparing For Birth – Labor Length and Progress

Monday, October 19th, 2009

There are always questions on what is the normal length for labor and what is not.  Women in labor are not static.  Though there may be averages, falling outside of those may not be reason to manage labor by augmentation or cesarean.   Patience and individualized care tend to be the biggest keys to better labor outcomes.   Of course, maternal emotions, fetal positioning, maternal movement in labor or lack thereof, use of epidural or other pain management, provider or staff attitudes, over use of vaginal exams, continuous monitoring without risk association, and other can influence the normal course of labor.  There is no one-size fits all time-line to put on a mom and baby.

Generally as long as a progressing labor doesn’t all of a sudden stall out, become unorganized, or stop without a reason (see above), dystocia may not be present at all.

Below is a compilation list of information relating to progression of labor and dystocia.

Dytocia Defined First time Mothers AAFP

diagnostics – reassessing the labor curve.pages

Varney’s Midwifery Book

http://emedicine.medscape.com/article/260036-overview

Spontaneous Vaginal Delivery – AAFP

Labor Progress Handbook excerpt.

http://www.guideline.gov/algorithm/5587/NGC-5587_6.html

Helpful hints for keeping labor progressing:

  • If at all possible (lacking medical necessity),  do not arrive at the hospital or birth center prior to well established labor (contractions as close as 3 minutes apart and a minute or more long).
  • Eschew labor induction for any reason other than medical.   http://prepforbirth.com/?s=labor+induction
  • Decline pain management if at all possible.
  • Labor in the water.
  • Continue to eat and drink in labor.
  • Hire a labor doula.
  • Attend evidence-based childbirth classes – not good patient classes.
  • Attend meetings in your community who promote natural, healthy birth practices: ICAN, Birth Network, local doula organization, etc.
  • Read variety of books – http://prepforbirth.com/products-page/books-videos-and-more/
  • Surround yourself with those who believe in you.
  • Be confident that you can birth!

Remember, a mother and baby are a unique pairing.  Some labors are short and some are long. Progress is defined by much more than cervical dilation. There is a huge spectrum of normal. No mother and baby will fit into a box.

Lastly, prior to labor also make sure you understand what your provider’s expectations are and how dystocia is defined.  That alone can determine whether or not you will have a successful vaginal birth.