Tag Archive | birth education

How do I know I’m really in labor?

Mollyblessingway 042When I was in early labor with my first son, I spent quite some time upstairs in our computer room googling, “how to know you’re really in labor” or, “signs of true labor,” or “the difference between false labor and real labor,” or, “how do I know I’m in labor,” or, “how to know I’m in labor.” I would do this between contractions and then when I had a contraction I would think, “Wow! This is definitely it!” Then, it would ease, and I’d start googling again, certain I must just really be experiencing “false labor.” One of my biggest fears was arriving at the birth center and only being two centimeters dilated (or possibly not in labor at all!). So, in honor of my former self, I offer a list of some ways to to gauge whether you are experiencing true labor.

It is true labor if/when:

  • Your contractions fall into a regular pattern. And, that pattern involves contractions that are lasting longer, feeling stronger, and occurring closer together.
  • If when you walk around or otherwise increase your activity, the contractions also increase.
  • And if changing positions and drinking plenty of fluids also do not cause the contractions to ease…
  • The sensation begins in your lower back and spreads like a band around your belly causing a peak of tightness and discomfort in the front and then fades away again.
  • You have been feeling some gastrointestinal upset and may be experiencing diarrhea also.
  • You have pinkish or blood streaked, mucousy discharge.
  • Your membranes have ruptured (keep in mind that labor only begins in this way for roughly 10% of women. So, if your waters have not released, do not be discouraged thinking that you must not be in “real labor.” Many women do not experience their waters breaking until they are pushing or are starting to feel like pushing).
  • Truly, I think that the best sign that you are in labor is if you really feel like you are in labor. This is one of those things that doesn’t feel that helpful to a first-time mom—“yes, but how will I know?! What if I’m in labor and don’t know it until the baby is coming out?!” I promise that for the wide majority of you, at a certain point, you will just know that you are in labor and there will be no more questions about whether this is “really it”—that is the best sign, when you stop wondering “is this really it?” My observation is that this point comes along when you enter active labor and enter your “birth brain” instead of your analytical, logical brain.

Is this really it?

If you are still wondering, “is this really it?” my best piece of advice is to ignore it! Pretend like nothing is happening. Go about your normal day and your normal routine. If you would normally be sleeping, sleep. If you would normally be eating, eat. Go for a walk, water the plants, feed the dog, bake something, go to the store, etc. When your contractions need your full attention, they will ask for it 🙂

Symptoms of pre-labor (“false labor”)

Some “symptoms” that what you are experiencing is instead practice labor, pre-labor, or “false labor” (I do not usually use the phrase “false labor” because I think it is dismissive of women’s experiences. All contractions are doing something and so I refer to them as “practice” rather than “false.” Another good phrase to use is “pre-labor” contractions. My midwife with my second baby referred to them as “toning contractions”):

  • The contractions are irregular (no pattern) and are not increasing in frequency or intensity.
  • If you change positions or drink two large glasses of juice, water, or tea, the contractions subside.
  • The contractions center in your lower abdomen and do not involve your back.
  • The contractions go away if you take a walk, take a shower, or lie down.

This is also a popular question in birth classes. Because labor is a new event for you, it can be hard to know what to expect until it actually happens! There is  pdf handout here with some additional signs and information. There is also a helpful handout with a sort of flowchart of signs/symptoms here.

Oh, and by the way, when I did finally go to the birth center, I was 10 centimeters dilated and started pushing about 30 minutes later!


What about induction?!

On a closely related topic, why bother with all this guessing about whether or not you’re in labor? Why not be induced instead? Good questions! There are numerous reasons why you should let labor begin on it’s own—labor that begins on its own is usually safer and healthier for both mother and baby. Also, it is less painful than a labor that is induced with medications such as Pitocin. For more information about letting labor begin on its own, check out Lamaze’s Healthy Birth Practice #1, or this video clip from Mother’s Advocate:

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Awakening Your Birth Power


“If you have heard enough birth ‘war stories,’ advice, and medical information…

If you are beginning to doubt yourself and to feel confused and worried about giving birth…

It is time to focus on something simple, positive and inspirational.

It is time to come back to center and listen to your own inner wisdom.

It is time to Awaken your Birth Power.”

I recently received a copy of the book and CD set 25 Ways to Awaken Your Birth Power, by Danette Watson and Stephanie Corkhill Hyles. The book is a collection of 25 short breathing meditations each accompanied by a beautiful (and sort of whimsical) drawing. The enclosed CD has 3 tracks–the first is called “awaken your birth power for pregnancy” and consists of the relevant meditations from the book read aloud. The woman reading has a pleasant, soothing voice with a slight Australian (?) accent. The second track on the CD is “awaken your birth power for labour and birth” and consists of 48 minutes of the relevant meditations from the book read aloud. The third track is an abbreviated almost 8-minute guided meditation. This CD would be perfect to listen to while in labor. The book and its gentle illustrations is a nurturing, confidence-inspiring, birth-power-enhancing, reflective, time-out for use during pregnancy or birth.

Reading it got me thinking about ways in which women awaken their birth power during pregnancy? How did you awaken yours? I’d love to hear about it and to write more about this topic!

I reflected on the ways in which I awakened my own birth power and my sense of confidence in my own inner wisdom. Here are the ways that I came up with when considering my own pregnancies and births:

+I read like a maniac 🙂 During my second pregnancy, I read a lot of literature about unassisted birth–though I didn’t have an unassisted birth (my midwife was there for 5 minutes of my son’s birth), I found the philosophies of unassisted birthers to be very inspiring.

+I maintained a daily yoga practice that included affirmations about my ability to give birth.

+I had specific dreams that reinforced my confidence.

+I journaled daily.

+I created birth art–needle felted birth goddess sculptures during my first pregnancy. Later, I drew womb labyrinth drawings–the labyrinth is a powerful metaphor for birth and I really connect with it. There are pictures of both of these on a very neglected other blog of mine.

+I talked extensively with my very birth positive friends–no horror stories from them!

+I formed my personal philosophy about birth and its role as a sacred rite of passage.

+My mother had a blessing way ceremony for me (with both my pregnancies) that made feel special and also confident and secure.

+The materials and philosophy on the Trust Birth website. I love their “what we believe” statement. It gives me chills!

+The book Birthing from Within–one of my all-time favorite birth books and a great birth power resource.

Nothing really worried me about my second birth or my ability to do so. I feel like I had a deep and true  and physical sense of confidence and trust in birth. During my second pregnancy, it became a *knowing* for me that I was a capable birth giver. I had complete trust in my body and my baby. With my first pregnancy, I remembering feeling like I was studying for the biggest test of my life–I did not yet have the deep and true sense that developed during my second pregnancy (actually, I think  developed as I read voraciously during the interim between my pregnancies). I also earned my certification as a childbirth educator during the interim between births and that also increased my confidence.

I attended a performance of Birth, the play, in St. Louis last weekend. While there, I picked up one of ICAN‘s flyers called “ICAN Birth” (sponsored by Hypnobabies). I think the flyer is an excellent resource for awakening your birth power, particularly the back panel with a list of things that, “if you were my sister, I’d tell you…” I’m going to order a bunch to give away in my class packets.

How do you awaken your birth power?

Comfort Measures Illustrations

We spend a lot of time in my classes talking about different comfort measures for birth. In fact, one of my most popular classes is my “Labor Support and Comfort Measures” single session class in which we practice all kinds of different skills that may be of use for birthing.

I enjoy Childbirth Connection’s free pdf booklet “Comfort in Labor” and use this as a class resource. Very recently, they added a new section to their website  with lots of helpful, line drawing illustrations for Comfort Measures During Labor.  The illustrations are the same as in the booklet, but presented on one page without a lot of accompanying text—great for visual learners!

As I’ve referenced before, the Transition to Parenthood website also has a helpful section of comfort measures illustrations available to birth educators.

Even if it might feel silly, I encourage people to print out the images and physically practice the techniques illustrated a couple of times—this helps develop a “body memory” so that when you are actually in labor different labor-beneficial positions feel comfortable and familiar. Also, it helps for the birth partner to have a body memory as well to help reinforce healthy positions or suggest fresh ideas.

kneeling with head on chair

Childbirth Education Mnemonic Devices

Thanks to the word “tulip,” used by my Western Civilization professor in 1996, I will never forget the 5 basic beliefs of Calvinism. This is an example of a mnemonic device that was (to me) apparently unforgettable. In March of this year, I took the ICEA childbirth educator certification exam. I studied compulsively for the exam and came up with a couple of mnemonic devices (word tricks that help you remember things) for several birth-related anatomy terms that I was otherwise having trouble remembering.

1. “What do you want for Isthmus [Christmas]?”  “A lower uterine segment!”

2. “Brady’s always been a little slow…” (said with a sort of sympathetic grimace. This helped me remember the difference between bradycardia [too slow FHT] and tachycardia [too fast]).

3. “I schitt on my tuberosities” (not pronounced quite as bad as it looks, draw out the “sch.” This helps me remember that the ischial tuberosities are the “sitting bones” at the bottom of the pelvis–I was getting them confused with the iliac bones and perhaps with the ischial spines).

4. And less interesting and more classic, that arteries carry blood *away* from something (both start with A) and veins carry blood to it.

5. I remember the three layers of the uterus by using the start of the word to remind me of its location. Endometrium is on the INside (end–>in). Perimetrium is on the perimeter (the outside. Words both start with “peri”). And, myometrium is in the middle–both start with “m.”

These are the ones that have come to mind right now. Does anyone else have any devices to add that they use for terms like this?

I’d like to find one for the 7 cardinal movements!

Active Birth Video

Lamaze and Injoy videos have teamed up on a nice new website called Mother’s Advocate. The site has a variety of handouts and a booklet to download based on “6 Healthy Birth Practices” (which, in and of themselves form a nice little birth plan for a normal, healthy birth!). I especially enjoyed their video on active birth: “get upright and follow urges to push.” The video urges upright birthing positions and avoidance of directed/forceful pushing (the kind with counting that you see so often on tv!).

Skipping Birth Class?

Yesterday, I watched a short clip on why people don’t take birth classes. The comment that I found most interesting from the expert interviewed was: “The instructors in a lot of these classes –are a little bit doctrinaire about their point of view. They made an issue out of saying  ‘You’re not a real woman if you need drugs. She should go through labor and childbirth on her own with help from your spouse with breathing techniques. They made it a kind of a contest. A lot of mothers today don’t want it — they want to go in and have their baby with a pain free a time as possible.” I find this perspective about “a contest” sad and disheartening and inaccurate. It is also slightly amusing–seriously, I know NO ONE who would say to someone else “you’re not a real woman if you need drugs” least of all a professional person teaching a birth class! I think this might be an example of what someone says being different than what someone else hears: i.e. the instructor says, “all medications have an impact on the baby. Additionally, many women find a very satisfying sense of personal mastery from giving birth without medication.” The person hears, “you’re not a real woman if you need drugs.”

This reminds me of an excellent section I’m re-reading in the book Mother’s Intention: How Belief Shapes Birth about judgment and bias. The author also address how the word “balanced” is misused in childbirth education–as in, “I’m taking a class at the hospital because it will be more balanced.” Balance means “to make two parts equal”–what if the two parts aren’t equal though? What is the value of information that appears balanced, but is not factually accurate? Pointing out inequalities and giving evidence-based information does not make an educator “biased” or judgmental–it makes her honest! (though honesty can be “heard” as judgment when it does not reflect one’s own opinions or experiences). She says, “Every person has a lens. Every opinion is biased, including the ones you hold. The question is, what created the perception leading to a particular bias?…When it comes to childbirth and parenting, when someone dismissed information as ‘biased,’ what it actually means is the information does not fit their already held biases. It is our insecurities that bring up defensiveness in the face of judgment, or perceived judgment, as the case may be…You may never even have a thought in your head that the other person could have or should have done anything differently, but they are seeing your actions through their own lens and making assumptions.” (i.e. if a mother had a homebirth it may be assumed she hates doctors and hospitals). I think this is exactly what was happening in the video clip–because a birth educator shares the benefits of natural birth, the assumption is that she “hates epidurals” and thinks you’re “not a real woman” if you have one!

As far as the “contest” idea goes, I’ve mentioned this before–just because someone runs a marathon, for example, doesn’t make the person who opted out of the marathon bad or “less than” 🙂

The expert in the video clip referenced above also emphasized several times that the time investment in classes is just too much and parents just “don’t want to invest.” So, now perhaps this IS “doctrinaire” or unpleasant of me, but I also find it a little frustrating that people are apparently unwilling to invest the time in preparing for their children’s births–most people watch more than 8 hours of TV a WEEK, but 8 or 10 hours of birth classes total is too much to invest? I hope my classes are exciting and informative and useful to the parents that come to them. I also realize that week after week CAN feel like a lot, which is why I designed my single session classes. I get a lot of interest in the single session classes and I’m glad I came up with them, because I think it allows me to better meet more people’s unique needs! In fact, so far this year, I’ve done only mix-and-match classes (from 1-4 weeks), no full six-week-series’ (perhaps they are a thing of the past?). I find I get clients who are very well-informed and interested and that these classes “hightlight” the things they are most interested in learning about, though they often tell me at the end that they wish they had signed up for more classes!

Fear & Birth

I was interested to read a short segment in the book Labor Pain about studies on fear about birth. A Swedish study indicated that it was not pain that caused women the most anxiety about labor (44% of women had fear of pain). It also wasn’t fear of death of the mother or baby (55% worried about this). It wasn’t fear of their physical or mental capacity to give birth (65% feared this), but it was “lack of trust of obstetric staff during delivery” (73%).

This is tremendously significant! As I mentioned in the post, can I really expect to have a great birth, it is important to choose your birth care giver and place of birth carefully–to ask questions before your chile is roasted! Considering that the Listening to Mothers reports by Childbirth Connection and the Millbank Report on Evidence-Based Maternity Care reveal that many doctors do not utilize evidence-based practices, it seems that women’s top fear is very warranted.