Labor & Birth

The process of birth not only brings forth a baby, it also transforms the woman into a mother.  Birth can be an intensely powerful, emotional, empowering, and even spiritual experience.  Unfortunately, in our society, instead of feeling empowered, the laboring woman often ends up feeling intimidated, out of control and afraid.  I challenge you to be an informed and active participant in the birth of your child.  It is something you will remember for the rest of your life . . . do all you can to ensure that it is a gratifying memory. 

The moment you have been anticipating for nine long months has finally arrived!  Here are some suggestions to help you have an easier, more satisfying labor and birth.

Be Realistic                                                                         BACK TO TOP

Be prepared for the fact that labor is hard work.  Expect there to be moments during your labor (usually during transition) when you doubt your ability to cope.  Know that this is normal, and that YOU CAN DO IT. Surround yourself with loving, nurturing people who believe in your ability to give birth.

Early Labor                                                                          BACK TO TOP

Try to spend as much of your early labor as possible in your own environment doing activities that are appropriate for the time of day.  Regardless of what time you go into labor, try to rest as much as possible (hard as this may be); you’ll need your strength and stamina later.  Plan a “labor project” that takes a while to complete, such as baking bread, addressing birth announcements, writing a letter to the baby about the last day of your pregnancy, etc.  If you will be birthing outside of your home, talk to your birth attendant regarding the point at which she would like for you to leave for the hospital or birth center.  As a general rule, if you are still able to comfortably walk and carry on a conversation during contractions, then it is probably too early to go.  Arriving at your chosen birth facility too early in labor will not make things happen any faster.  On the contrary, being in an unfamiliar environment can actually slow labor down and decrease the effectiveness of your coping skills.

When to Call Your Doula                                                 BACK TO TOP

Notify your doula as soon as you think you are in labor.  By keeping your doula updated, she, along with your birth attendant, can help you determine the best time to leave for your chosen birth facility. 

When to Call Friends and Relatives                             BACK TO TOP

Be cautious about calling all of your friends and relatives to tell them that you are in labor.  If it turns out that you have a long, hard labor, you will probably not appreciate all of the “have you had the baby yet?” calls. 

Who Should Attend the Birth                                         BACK TO TOP

Think carefully about who you would like to be present for the labor and birth of your child.  It can be a great help to have supportive family and friends with you, however, it is not productive to labor if you feel as if you are “in the spotlight” and everyone is just watching and waiting.  Usually, the presence of your birth attendant, your partner, the baby's siblings, your doula, and possibly another support person is sufficient.  As the laboring woman, you will be concentrating and working very hard.  You need to feel free to move around, vocalize, and do whatever it is that is going to help you to cope.  Be sure that those who will be present will not inhibit this process. As a general rule, no one should be at the birth whom you would not feel comfortable using the bathroom in front of.

When to Use Coping Mechanisms                               BACK TO TOP

Try not to use all of your coping techniques before you really need them - believe me, you will reconize when you need them.  Once you have reached the difficult point of transition, relaxation and breathing exercises will likely have little use if you have been doing them since you were in early labor! In fact, try to ignore the contractions and go about your usual business for as long as possible.

Using Gravity                                                                      BACK TO TOP

Rest  when you can, but when you are not resting, try to stay upright and moving.  Let gravity work for you. Do the "hula", rotate and rock your hips, dance...have fun!

Changing Positions                                                          BACK TO TOP

Make sure to change positions often (about every half-hour to every hour).  This will help your labor to be more efficient and can help decrease discomfort. Helpful Hint: The first couple of contractions in a new position are often more uncomfortable.

Keep Your Bladder Empty                                              BACK TO TOP

Be sure to empty your bladder at least every hour.  A full bladder makes contractions more uncomfortable and less effective.  Helpful Hint:  You can make it your partner’s “job” to remind you to go to the bathroom. Also, try to have one or two contractions on the tiolet each time you go to the bathroom. This helps move the baby into the best position for birth.

Staying Hydrated                                                               BACK TO TOP

If your health care provider permits it, drink plenty of fluids during labor.  You may or may not feel like having light snacks during labor.  Your body will be expending an enormous amount of energy during labor, and food and drink can help you to keep up your stamina.

Internal Examinations                                                      BACK TO TOP   

Try not to place too much emphasis on the results of internal cervical checks.  It can be frustrating if you are experiencing strong, intense contractions and then find out that you are only three centimeters dilated.  This inevitably leads to the “how much longer?" question.  You could move very quickly through active labor and be completely dilated in an hour or two.  By the same token, you could be led to believe that you are “almost there” because you are seven centimeters, and you may still have many more hours of work to do.  My point is that it is impossible to know how long your labor will take.  Cervical exams merely give you an indication of what your cervix has done thus far.  It is often much more help to you, both mentally and physically, if internal exams are kept to a minimum.

Hydrotherapy                                                                      BACK TO TOP

Use water to aid in relaxation.  The simple act of getting into a warm tub or shower during labor can provide almost magical relief.  A note of caution:  Avoid getting in the tub before you are in active labor (4 centimeters dilated and experiencing regular, intense contractions), because labor may actually slow or stop. If your membranes have ruptured, contact your health care provider before getting into a bath.

Emotional Changes of Labor                                         BACK TO TOP

You and your partner should both be aware of the emotional changes that often take place towards the end of labor during transition(7-10 cm dialtated).  At this time, it is not uncommon for the laboring woman to begin seriously doubting her ability to continue.  You may find yourself feeling shaky, nauseous and very uncomfortable.  You may begin saying things like “I can’t do it anymore” and “give me something for the pain”.  This is the HARDEST part of labor, but it is also the SHORTEST.  Transition usually only lasts 30 minutes to an hour.  At this point, you may need someone literally “in your face” breathing with you and talking you through each contraction.  You will get through it! Have people with you who recognize this and can help and support you.

Trusting Your Body                                                          BACK TO TOP

Believe in yourself!  Women have been doing this since the beginning of time.  Even if you feel that you do not know what you are doing, or how to do it, your body does know.  Trust in the process of birth and stay focused on the end result – meeting your beautiful baby.

Spontaneous Bearing Down                                          BACK TO TOP

Once you are fully dilated (ten centimeters), wait until you have the unmistakable urge to bear down before pushing (unless you have an epidural, in which case you may not be able to feel that urge).  For some women, the urge occurs immediately after full dilation, if not before.  For others, this powerful sensation does not occur until twenty or thirty minutes later.  Listen to your body, and be grateful for the reprieve!

Positions for Pushing                                                      BACK TO TOP   

Encourage your birth attendant to allow you to push in the position you find most comfortable.  The positions in which women give birth are many and varied.  These positions include semi-sitting, squatting, side-lying and hands-and-knees.  Many women find it helpful to push while sitting on the toilet, as this is a good position for the pelvis, and decreases their fear of having a bowel movement on the bed or floor.  Avoid the supine/back lying [(lithotomy) position for birthing, as this requires the baby to move against gravity and increases your chances of tearing.  If you have been pushing for a long while without much progress, try a squatting position.  Squatting increases the size of the pelvic outlet by a third.

Decision-making                                                                BACK TO TOP

You and your partner should plan on being active participants in the birth of your child.  Anytime a suggestion, decision, or change in your birth plan is made, make sure that you ask questions and feel comfortable with the decision.  Your chosen birth attendant is there to help you, but remember that this is YOUR body and YOUR baby . . . be a well-informed partner in the decision-making process.

My Own Philosophy                                                         BACK TO TOP

My personal philosophy on coping with labor:  The uterus is a large muscle.  The more you can TOTALLY RELAX the rest of your body, the more effective the uterine contractions will be.  Any energy spent tensing other muscles in the body detracts from the energy (and oxygen) going to the uterus.  When you have a strong contraction, your first instinct will probably be to tense up.  Fight this instinct!  If you can coax the rest of your body into a state of limp relaxation, the uterus will be able to do its job better, faster, and with less discomfort to you.

Birth is Powerful !

Copyright 2006 A Better Childbirth, Inc.