Most common mistakes in labor and childbirth (part 2 - active labor)

ACTIVE LABOR:

“Do these 3 things and you won’t feel a thing!” “Don’t do this and you’ll be done in exactly X hours!”

Most of us women would be happy to try almost anything that promised to make birth easier or at least shorten the process. But as nature has it, every one of us is as unique as the children we grow in our bodies and bring to earth with our unconditional love and courage.

Is there a right way and wrong way to birth? If only it was that clear…

For this reason, we decided that instead of the word ‘mistakes’, the words ‘misjudgements’ or ‘miscalculations’ are more compassionate. Let’s face it, labor is no joke.

Early labor may be bearable enough for some to continue with light daily activities. We discussed why this is recommended, along with other suggestions in the article on Common Mistakes: Early Labor. But at some point, the intensity of those sensations changes.

You might be in Active labor when... your contractions feel stronger and harder to bear.

So, unlike before, the distractions may not be working as well anymore. You are finding that you have to stop what you’re doing each time. These are major cues that your body and baby are getting really serious about this birth thing.

How exciting!

NOW WHAT, DEAR DOULA?

That’s your cue!

Start timing the contractions again.

What you are looking for is length and duration.

Longer, Closer, Stronger

Assuming you had told your OB/ Midwife when you went into labor and depending on whether you chose to have your Doula join you in early labor, let your birthing team know about this new development.

The onset of Active labor is when a woman feels the strong need to do something about the contractions. This in a natural urge designed by our bodies to help baby along. 

So let’s talk about some tempting misjudgments that might go against the natural progression of labor.

Doing nothing

This is a go-to whenever we are are in pain or discomfort. Sitting still in a way that feels more comfortable or the good old fashioned bed-rest.  Even though this offers a sense of relief, it could contribute to a longer labor and increase back pain due to pressure on the spine.

If for some reason the mother chooses to or has to stay in bed, it is encouraged to change positions or to lay side to side. Even the smallest change for just a few contractions is helpful.

Moving in rhythm with contractions and changing positions also makes it easier for the baby to navigate the pelvis.

Gravity is a laboring woman’s best friend.

(After a Doula, that is.)

If you would rather hang out in your room for privacy or other reasons, a Doula has got a mind full of positions to ease discomfort and aid the progression. We also bring a ‘bag of tricks’ full of labor equipment you can use.

If you feel up to it, grab your partner or a family member and take a slow walk down the hall. Feel free to pace back and forth in the room. If you are having a home birth, stroll around your house. You are likely to find that you have to stop at each contraction. Having someone by your side is priceless as you can use them for physical support. You are going to appreciate all the encouragement you can get. Enjoy the company of someone willing to walk the walk with you.

Doing Everything

Ah, you can’t win can you? Yes you can, I promise!

There is the complete opposite staying in one place: trying every single position and comfort measure you learned because that is what you are ‘supposed to do’.

It’s great to change positions and techniques during labor, but how do you know when to do what?

The amazing thing about our bodies is that, if you are focused enough, you can pick up on the natural cues on what to do.

Try positions and techniques in response to cues from your body; not just "try everything." Once you find a good position or technique, continue through several contractions until you feel your body needs a change.

One of the most humbling lessons as a Doula is to learn to ‘lead by following’. This is one way we honor a woman’s natural wisdom. We may make suggestions and help along the way, but above all we trust that women are capable. Forcing changes during labor can be distracting and can pull mental and physical energy away.

*Wait, I thought distractions were good for labor?

Stick around dear mom, there is a time for everything.

Distractions

We established that distractions are great in Early labor. Focusing too much on bodily sensations too soon can cause unnecessary stress and get the mother tired way before she needs all her energy. Active labor is a whole different ball game though...

Active labor feels more intense physically and so it takes a lot of mental energy to go through. At this point, too many distractions can cause the mother to lose her focus.

Having someone beside you to talk to during labor can be calming and reassuring. The down side of this is that, the mother might feel obliged to respond and be an active part of conversation in the room.

It is not easy to be there for someone and give them space at the same time.

This is a balancing act that a good Doula practices.

There is a lot of benefit in being mentally present at the labor. It is easy to miss out on your body’s cues or become irritated or anxious based on what is happening in your environment. This can trigger stress hormones, which do not interact well with birth hormones, leading to a stalled or longer labor.

Relaxation at this stage of labor is a priority. Calming or inspiring music is one way to set the mood for the mother.

If the TV is on in the birthing room, let it be by the mother’s choice and that she has the say on what should be on. Preferably, something pleasant that she does not have to pay too much attention to or to follow.

Sometimes visitors or other staff in the room get carried away talking about topics not relevant to the mother. It is ok to give a polite reminder to keep such conversations out of the room.

As Doulas, we respect the 'birthing space' as a mother’s own NEST.

We allow the mother to set the tone and the pace.

So, imagine you've made it this far but there is still a way to go...

*They say the next stage of labor, TRANSITION is the hardest and that it is when women are most likely to ask for an epidural.

Next time we discuss how true (or false) this is.

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