Childbirth is a powerful rite of passage. One of my favorite resources, The Pink Kit, has some great reflections on this rite of passage and the words we use to describe the powerful, indescribable act of giving birth:
Whatever the culture, when a woman surrenders to the process, accepts the intense sensations, works through each contraction, and digs deep within herself to achieve the end goal–giving birth–she is touched by the Unknown and Unknowable. Many traditional cultures send their young men into initiation rites where they, too, can learn to understand humbleness and achieve the self-control that women learn in childbirth.
All cultures believe that women become better and more generous through the process of giving birth. That is why some cultures use words such as ‘sacrifice,’ ‘suffering’ and ‘labour.’ These terms can seem overwhelming and to be avoided’ however, seen from a different viewpoint, childbirth helps us to become strong, resourceful and determined.
In a modern world, ‘getting through’ labour without numbing or dumbing the process can be a very powerful experience for a woman, and very challenging.
I like the concept of “digging deeper.” This how The Pink Kit explains it:
You might avoid the pain in labour by moving into a position which is comfortable for you (i.e. reduces the sensations), but it slows labour down and then you stay there for hours. Doing that will increase the likelihood of medical intervention because you will become tired, bored, or frightened, and labour doesn’t progress. Instead, consider remaining in positions that keep you open and the labour progressing, while using your skills to manage the sensations. This is ‘digging deeper’.
I have noticed an emphasis in other natural birth preparation books and explanations about finding positions that are “comfortable.” I very much like the concept of finding positions that help you feel “open”—these positions may certainly also comfortable (and that is great!), but if you remain mindful of “staying open,” it may lead you “dig deeper” and find positions that really help move the baby. In my classes, I encourage women to welcome labor “getting bigger” (not more “painful” or “difficult,” but make it “bigger” and be excited by that change!). I think this idea goes hand in hand with digging deeper.
When 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:
Powerful, authoritative, and wise energies assist in releasing the baby from the womb. Go with them.
Many women experience the work of pushing and the sensations of the internal movement of the baby as it moves and rotates through the birth canal as intensely gratifying. But some women feel the sensation as painful. They may get exhausted or discouraged and need lots of encouragement. Many women need to move around and change positions. Some women roar and discover a power within they have never encountered before.
With my first baby, I found the pushing stage to be very intense and overwhelming. I had been fairly calm and focused during my labor, but pushing felt scary to me and I said, “I’m scared” quite a few times. I also said, “pushing is supposed to feel GOOD,” because that is what so many people had told me (that pushing felt good/satisfying/rewarding). It didn’t feel good to me! With my second baby, pushing was more like an uncontrollable wave that moved through me and was natural and spontaneous. It didn’t feel “good” really to me, but it was not scary.
I have a pile of things to blog about about and one of them was this quote from the book Fathers at Birth:
“Labor is like stairsteps. There is an incline, then a plateau. Another challenging incline, and another plateau. The inclines get steeper and more intense as labor progresses. The plateaus get shorter. However, in deep labor, the incline can go straight up, off the charts, without a plateau. Sometimes women are very close to pushing when this happens and do not know it.”
As a father-to-be, if you notice inclines with no, or very short plateaus, you will know that your baby is very close to being born. Reassure your partner about the wonderful job she doing, how great everything is working, and that she is getting closer and closer to meeting the baby!
Some time ago I wrote a post about the commonly used “three P’s” of birth. The P’s most often referred to are the Powers (contractions), the Passage (pelvis and soft tissues), and the Passenger (the baby). In my post The Three P’s I came up with some different P’s that could be used instead–both P’s that help and P’s that hinder birth. In reading The Big Book of Birth recently, I came across another section about the three P’s. She uses: Patience, Practitioner, and Partner as the three things we need in labor:
“Everyone involved in labor needs a lot of patience….Partners need to stay focused on the laboring woman and often need just as much assurance that things are going well…Practitioners need patience because every woman’s body does this ever so slightly differently…”
She goes on to explore the role of the Practitioner and how while the primary role is clinical care for mother and baby, women “also need respect and reassuring language for their body and their experience. This has a profound impact on how we experience labor. If we feel undermined, ignored, violated, discouraged, condescended to, or made to feel stupid or as if we have not been acting in the interest of our baby…this tends to skew our entire perception of the day our child is born.”
Similar to posts I have made before about the role of fathers at birth, she emphasizes that the role of the Partner is important primarily because “our partners…[who] know us so well, are often the most valuable person in the room when it comes to ‘being there’ for us.”
A topic that frequently arises in birth classes is about the fear of “losing control” in labor. Losing control, “losing it,” or “freaking out” are concerns expressed by women preparing to give birth. It is important to acknowledge that this is a common fear. I also like to ask parents to think about what “freaking out” or “losing it” would mean to them? I ask them to consider what benefits there may be to losing control. I also say, “What if you do freak out? Maybe, so what?! Maybe it is okay. Maybe it is good. Maybe it is helpful.” (This doesn’t come across in print quite the way it does in real life!) Surrendering to the flow and power of birthing can be of tremendous benefit. Losing it can mean letting go and letting the power BE. Letting the energy be. Letting birth carry you with it, instead of wrestling for control of it. (When discussing this topic, it is important to remain mindful that for mothers-to-be who are survivors of abuse, language about “surrender” and “letting go” can be very threatening and unhelpful.)
Thinking about “losing control” makes me think about the things that you can have over control of when it comes to your birth experience (I’ve also been reading The Big Book of Birth and it addresses this):
1. You can control who who choose as your doctor or midwife (and can choose to switch at any point in pregnancy if the match is not a good one).
2. You can control where you give birth.
3. You can control who you ask to attend your birth as support–your partner, your best friend, your mother, your sister, a doula. (Anyone who attends should be there for YOU, not because they want to “see a birth” or because you feel obligated to have them.)
4. You can control how you prepare yourself for birth and the education you seek to help you explore your options.
5. You can control the type of books you read and the information you seek about birth.
6. You can control how you care for yourself during pregnancy.
7. If you are having your baby in the hospital, you can control when you go to the hospital.
Hypnobabies rephrases the usual concept of “transition” in labor as “transformation.” This is the time in labor in which many women fear “losing control.” Women may also pass through another transformation point as they move from early labor into active labor–this is sort of a “moment of reckoning” in which it becomes clear that it is really time to DO this! Erica Lyon, who wrote The Big Book of Birth referenced above, addressed this subject really well:
“…as a mother shifts from early labor to active labor, she begins to have an awareness that the labor is getting bigger, strong, more powerful. This often translates into a feeling or idea that you are going to ‘lose it’ or ‘lose control.’ This is a temporary, transient feeling that tells you labor is progressing. It does not mean you will go running naked and screaming down the hallway of your birth facility. What is really happening is a momentary emotional state that reflects your ‘social self’ beginning to fold inward. Labor is not a rational process, it is a body function that is experienced as a gradually intensifying event. You do not think your way through it. You do it. “
Essentially, this is a point in labor when you stop fighting with the “birth power” and begin to BE it. The process of birthing becomes your entire focus. I remind and encourage people to welcome the increasing intensity of labor–and suggest taking a “make it bigger!” approach to greeting and welcoming contractions, rather than trying to avoid or minimize them.
I have already written about eating during labor. One of my suggestions is honey sticks–but why honey sticks and where to buy them? Honey sticks, also called honey straws, are plastic tubes of honey similar in size to a drinking straw. During labor, honey sticks can provide an instant energy boost for a laboring mother. They are especially good to pack along if you are going to be laboring in a birth setting with restrictions on food or drink intake (read more here about why withholding food and drink from laboring women is not a good idea!). They are also handy if a mother is very tired and needs some quick energy, but is not interested in eating anything more substantial. Dads who are feeling a little tired or woozy in the birth room may also find honey sticks a quick boost for themselves as well! The sticks hold about a teaspoon of honey and you can easily pop the end open with your teeth and suck the honey out.
A while ago I posted about needing more words for pain. I got a book for my birthday called Labor Pain (I wanted it in hopes it would have more good coping ideas for me to share with couples in birth classes). In it, she discusses the results of a study about how women feel labor pain. The most frequently used description was “sharp” (62%) followed by camping, aching, stabbing hot, shooting, and heavy. Tiring was another word used (49%), exhausting (36%, intesne (52%), and tight (44%). Other words and descriptions used were burning, grinding, stony, overwhelming, terrific, bruising, knifelike, invaded, baby in charge, powerful, relentless, crampy, like period pain, like thunderbolts, excruciating, frightening, and purposeful. Only 25% of first time mothers and 11% of mothers with other children described pain associated with labor as “horrible” or “excruciating” (the top of the pain-scale range).
My previous post about a good experience and a healthy baby as well as reading a relevant section in the wonderful new Our Bodies, Ourselves: Pregnancy & Birth book I’m reviewing made me want to post about this topic. There are a multitude of common procedures that are overused in hospitals and that when used routinely actually harm mothers and babies. I also thought about the multitude of evidence based, helpful procedures that are underused in many birth environments despite research indicating that they contribute to better outcomes for both mother and baby. (The use of the terms “overused” and “underused” and the examples below are taken from the OBOS book.)
Overused Procedures–these techniques are often used routinely (instead of appropriately based on true level of need in which case they can be truly helpful and sometimes even save lives) despite clear evidence that overuse is harmful:
Induction of labor
Underused Procedures that have been shown to improve birth outcomes as well as to improve women’s satisfaction with their birth experiences include:
Continuous one-on-one support from a skilled caregiver during labor (a doula is a professional labor support provider who offers this one-to-one support).
Changing positions during labor (especially positions using gravity).
Laboring out of bed.
Walking during labor.
Comfort measures such as water, massage, and birth balls.
To increase your likelihood of satisfaction with your birth experience and of having a normal birth as well as a healthy mother and baby, choose a birth setting and care provider that supports and USES these underused procedures and only rarely, and appropriately, uses the overused procedures listed above.