You are here: Home / Birth / Labor

How Do You Know When it’s Time to Go?

March 20, 2013 By Cara Terreri 2 Comments

When you’re nearing the end of your third trimester, the biggest question next to “when will I go into labor?” is “how will I know when it’s time to go to the hospital/birth center?” Most care providers use the tried & true formula: call when your contractions are consistently 5 minutes apart, lasting for 30 seconds to 1 minute each, and have been going on for a couple of hours. When you are genuinely in early labor, your contractions will grow longer, stronger and closer together. But for moms who are experiencing labor for the first time, the question still remains about how that will feel — “how will I know what I’m feeling is labor?”

While it’s impossible to generalize the feeling and experience of labor for everyone, there are some common similarities for most women. Contractions feel different depending on what stage of labor you’re in. When your contractions make you feel like you cannot talk or answer a question reasonably, you’re most likely at the end of early labor and headed into active labor. And yes, it’s probably time for you to go to your chosen place of birth. Having experienced three of my own births, I can look back and say that for my first, I went to the hospital in very early labor and could have benefited from staying home longer. My early contractions made me pause and concentrate, but I was still able to answer questions, talk, and remain lucid. With my most recent birth, I waited until contractions made me stop in my tracks, drop to the ground and find a position and rhythm for comfort. When my husband called our doula, I was not able to talk to her on the phone. When we drove to the hospital, I was not looking out the window, thinking about the scenery. In fact, apart from stopping at a (really long) traffic light, I remember very little of the ride!

Of course, there are stories of women who say they felt barely more than menstrual cramps up until the point of birth, but those stories are the exception. And then, there are well-meaning folks who say “you’ll just know when it’s time.” Which is nice, but not helpful!

So, Giving Birth with Confidence wants to know, so we can share with our readers (some of who may be wondering, “is today the day?”): How did you know when it was time to go? Share your thoughts in the comments!

Filed Under Birth, Featured Story, Labor

Stages of Labor

March 18, 2013 By admin Leave a Comment

By Judith Lothian, RN, PhD, LCCE, FACCE

Think of this as your “childbirth manual,” a step-by-step guide to prepare you for what lies ahead. We’ve divided the process into stages to describe the typical changes that occur as labor progresses. The first stage encompasses the very beginning of labor, when contractions begin, all the way through active labor, when your cervix is almost fully dilated. The second stage covers transition, when your body shifts from dilating to pushing, and the movement of your baby through the birth canal and into the world. Finally, there’s the third stage, when all of your hard work is done and your body begins to recover. Although every labor and childbirth is unique—yours will unfold in its own way—the process is remarkably constant.

 

STAGE ONE

Prodomal LaborProdomal Labor

What’s Happening

  • The cervix begins to soften, thin and move forward, and it may begin to open. The baby settles into the pelvis.
  • At this point of childbirth, contractions may be noticeable as an achy sensation or as pressure in the lower abdomen or back. Contractions in this phase are usually irregular—starting and stopping; sometimes strong, sometimes mild. This is your body’s natural way of gearing up.
  • This phase can last from a few hours to a few days.

What Helps

  • Don’t worry whether or not this is really labor. For the vast majority, labor eventually makes itself very clear.
  • Try to be patient and feel confident that your body knows what it’s doing.
  • Take good care of yourself. Eat, drink plenty of fluids, and rest or take a walk.
  • Surround yourself with people that help you feel comfortable and safe. Your support team can keep you company and provide reassurance.

Early Labor (Latent Phase)

What’s Happening

  • The cervix continues to thin out and open, dilating to 3 or 4 centimeters.
  • Labor is meant to be gradual, so this phase may take quite a while—usually about two-thirds of the total labor time. Over a period of several hours, contractions will become longer, stronger and more regular (about 5 minutes apart, each one lasting 25 to 45 seconds — but these times can vary).
  • A pinkish vaginal discharge (called “show”) usually increases as labor progresses.

What Helps

  • It can be hard to believe that this is it. Take time to settle down and work with the labor — change positions and go with what feels best.
  • Once again, the best thing to do is to take care of yourself. Alternate rest and activity (for instance, take a nice walk followed by a relaxing shower), eat easily digested foods and drink plenty of fluids.
  • Many women find that the best place to be during this phase of childbirth is at home, where you can move about and do things for yourself.
  • When contractions become so strong that you can no longer talk yourself through them, try using relaxation and breathing strategies. Your support people should be nearby, helping you to stay calm and confident.
  • Keep the environment pleasant—perhaps listen to music, ask your partner for a shoulder massage or prepare the baby’s room.

Active Labor

What’s Happening

  • Contractions continue to become longer and stronger, until they’re eventually about 3 minutes apart and last for about a minute or more (again, times may vary).
  • During this phase, which on average takes from 2 to 6 hours, the cervix effaces and dilates to about 8 centimeters.
  • Women in active labor usually get very focused as the hard work begins.

What Helps

  • Now labor has real momentum. Listen to your body and develop a rhythm to work with it instead of fighting against or tensing up with contractions.
  • Do something active during the contractions, such as breathing in a pattern or moving around, and rest between contractions.
  • As the strength of the contractions increases, so does your need for support. All present should focus their attention on you.
  • Changing positions frequently not only helps you stay more comfortable, but also enhances progress.
  • The environment can influence your labor. Make it peaceful and personalize it
    with music and dim lights.

Transition

Transition

What’s Happening

  • The cervix finishes dilating and effacing.
  • Contractions are now powerful and efficient, so this phase is usually quite short (less than an hour).
  • Some women feel nauseous, shaky, restless or irritable during this phase of childbirth.

What Helps

  • To keep from feeling overwhelmed, focus on one contraction at a time.
  • Continue with breathing, vocalization (if it helps) and rhythmic movement.
  • Even though rest periods are short, they allow you to relax deeply and restore yourself.
  • Those providing labor support should offer close undivided attention, unwavering encouragement and praise. If you’re using a breathing pattern, your team should try “conducting” to help you focus or moving with you in rhythm to your breathing.

Birth

What’s Happening

  • Your body shifts from dilating to pushing.
  • The baby makes his way down through the pelvis and birth canalBirth.
  • This phase can last from 15 minutes to several hours.
  • Although it may take several contractions after full dilation to be noticeable, most women get an urge to bear down. Your body is giving you clear instructions on what to do. The urge to push usually gets stronger as the baby descends.
  • Many women feel more clearheaded and have a renewed sense of optimism when pushing begins.
  • Just before the baby is born, you may feel a burning, stinging, stretching sensation at the vaginal opening: A sure sign that you’re almost there!
  • As the baby’s head emerges, it turns to one side to allow the shoulders to align and then the rest of his body slips outs.

What Helps

  • The urge to push usually feels strongest at the peak of the contractions and then fades toward the end. Just follow along and do what feels right. For most women, this means taking normal breaths as the contractions build and then pushing when it becomes irresistible.
  • It may help to make sounds (much like athletes do) in response to what you’re feeling.
  • Labor supporters should provide quiet, reassuring encouragement. There’s no need for yelling.
  • If progress is slow, change positions. Squatting, all-fours and side-lying are all good options.
  • Let go of any tension in your perineum. Asking your care provider to apply warm compresses there may help you push.
  • Rest deeply between contractions.

Recovery
What’s Happening

  • What a mix of feelings—excitement, joy, awe, and relief!
  • Your baby is placed on your abdomen and you can both take in each other as you begin skin-to-skin care.
  • The baby’s cord is cut, optimally when it is done pulsing with rich blood from your placenta.
  • The placenta is delivered, usually within the first 10 minutes.
  • Your health-care provider will make sure you are comfortable. Cold compresses are often applied to the perineum to ease discomfort and reduce swelling.
  • Many women get after-pains (uterine cramps) and “the shakes” after childbirth.

What Helps

  • Touch, caress and cuddle your baby without time constraints. Keep him skin-to-skin with you from the moment of birth.
  • This is a good time for your first breastfeeding, which tightens the uterus and decreases bleeding.
  • All routine infant procedures can be done without removing the baby from your side. Request that measuring, weighing and applying eye medication be delayed for a few hours.
Filed Under Birth, Featured Story, Labor

Power Positions for Labor

January 22, 2013 By FitPregnancy Leave a Comment

Giving Birth with Confidence is pleased to once again provide articles from FitPregnancy through our resource-sharing partnership. 

Women all over the world give birth squatting, leaning or even standing. We lie down. What do they know that we don’t?

By Nancy Gottesman, a health writer for FitPregnancy

If your car stalled at the bottom of a hill, you certainly wouldn’t try to push it uphill. So why does it make sense to fight gravity by lying down during labor? This is just one reason why the standard hospital labor position—semi- or fully reclining—is not ideal. For one thing, when you’re lying on your back, your uterus compresses major blood vessels, potentially depriving the baby of oxygen and making you feel dizzy or queasy. “Most women feel better when they are not lying on their back during labor,” says certified nurse-midwife Katy Dawley, Ph.D., C.N.M., director of the Institute of Midwifery at Philadelphia University in Pennsylvania. In addition, when you’re reclining, the baby’s head puts pressure on pelvic nerves in your sacrum, increasing pain during contractions. Remaining upright and leaning forward reduces this pressure while allowing the baby’s head to constantly bear down on your cervix. As a result, dilation tends to occur more quickly.

“Lying on your side, standing, sitting, walking, rocking—anything that keeps you active can help decrease pain and speed up labor,” says Dawley. Just be aware that a prenatal visit is the time to discuss with your doctor or midwife the different positions you think you’d like to try. “In the throes of labor, you’re not going to be able to advocate for yourself,” she explains.

Seven soothing labor positions

Here’s another reason to be open to the possibilities: Fetal heart monitoring during labor can help determine which positions you can sustain without impairing circulation to the baby, so it’s best to have a repertoire available. Some options:

1. Get on all fours. This position eases back pain and helps the baby rotate into the optimal position for delivery—facedown. (When the baby is faceup, the result is the dreaded “back labor.”)

2. Lean forward. This can help make uterine contractions more effective in bringing the baby down. Drape your chest over a table, bed, countertop, pillow or exercise ball (see “Get on the [Birthing] Ball,”).

3. Lie on your left side. This may increase blood flow to your baby and can help reduce back pain. Support your belly and legs with pillows.

4. Lunge. Place one foot on a sturdy chair or footstool and lean into that foot during contractions.

5. Rock. Sit on an exercise ball, the edge of the bed or a chair and gently rock back and forth.

6. Sit and lean. Sitting in a chair, prop up one foot and lean forward into it during contractions.

7. Sway. Put your arms around your partner’s neck and sway back and forth; pretend you’re slow dancing.

Ready, set, push! While the position may be less convenient for hospital personnel, squatting is especially effective when you’re ready to push. In fact, squatting is sometimes called the “midwife’s forceps” because of its ability to work with, not against, gravity, enlarge the pelvic opening and speed the pushing phase of labor.

One study found that first-time mothers who squatted while pushing had labors that were 23 minutes shorter on average than women who labored semi-reclining. They also required significantly less oxytocin (Pitocin) to stimulate contractions. What’s more, they had less back pressure, fewer forceps or vacuum deliveries, and fewer and less-severe perineal tears and episiotomies.

Don’t want to squat in the middle of your hospital room? Use the squatting bar on your hospital bed for support. The correct form: knees wide, feet flat on the floor. Warning: Don’t try squatting unsupported unless you’re sure you can hold the position and keep your balance. In fact, you should get in shape by practicing squats during your pregnancy: You don’t want to find out at the crucial moment that your leg and thigh muscles aren’t up to the task. (But don’t worry if you’re approaching labor and you haven’t practiced squats — you’ll be surprised at what your body is capable of.)

Other options for delivery include sitting on a birthing stool, kneeling or crouching on your hands and knees. No problem if you’re having a midwife deliver your baby at home or in a birthing center. Otherwise, make sure in advance that your doctor and hospital policies give you the green light.

Get on the (birthing) ball

Using an exercise ball could help you get through labor. The ideal size for most women is about 65 centimeters in diameter. When you sit on it, your knees should be bent 90 degrees. Here are various ways to use one:

Place the ball on a bed or sturdy chair, stand facing it and lean forward so that your upper body rests on the ball. This will enable you to stand up longer without overtaxing your muscles.

Kneel in front of the ball and drape your body over it. This will encourage a baby who’s faceup to rotate into the proper position for delivery (facedown) and relieve the pain of back labor.

Sit upright on the ball. This relieves pain and pressure on your back and perineum (the area between the vagina and rectum).

Tips from a labor nurse

If you’re spending even part of your labor in bed, here are suggestions from Fit Pregnancy’s “Ask the Labor Nurse” blogger Jeanne Faulkner, R.N.:

Angle the head of the bed 45 degrees and put a pillow or rolled-up towel under one hip; this will help “tip” the uterus off of your large blood vessels, improving circulation to the baby and your brain.

If the baby is faceup and this is causing back labor, lie as far on one side as possible, then rest your top leg on the mattress in front of your belly. This encourages the baby to rotate into the ideal (facedown) position for birth.

Changing positions every 10 contractions while you’re pushing can help “corkscrew” the baby out. Start lying on one side, go onto your back, turn to the other side, then get on your hands and knees.

Filed Under Birth, Featured Story, Labor Tagged With labor and birth positions

Questions to Ask During Labor and Birth

November 19, 2012 By admin 1 Comment

Labor and birth can be unpredictable. It’s smart to be prepared with questions to ask to decide if what your provider is recommending is needed and right for you. Keep the following questions in mind, especially when you hear words like “induction,” “fetal monitoring,” “episiotomy” and “C-section.” Also keep in mind that it can be helpful to have a support person with you who can help you navigate the important choices and decisions you will be making.

  1. Is my baby in any danger? Am I in any danger?
    Asking about the safety and health of you and your baby can steer you to the safest, healthiest outcome. If the answer is “no” to both questions, it’s more than likely that the intervention your provider is recommending is not needed.
  2. What happens if I go through with this intervention? What are the risks and benefits?
    Most health care providers want a laboring woman to feel comfortable, so there’s a tendency to answer questions like this with, “It’s really safe,” or “I don’t usually see a problem with this.” But, all interventions have pros and cons. If you know what they are, you can weigh your options and make the best, most informed choices.
  3. What does the research say?
    Not all medical practices are based on the best research. In fact, the majority of interventions are shown to be overused and often unnecessary. As your care provider, he or she should know whether the intervention is backed by science.
  4. Is there another alternative?
    There are plenty of alternatives to common interventions. For example, epidurals are not the only option for pain management; movement during labor, pressure points and breathing exercises are natural ways to help with pain relief. Consider the alternatives first, so you can get the care that’s right for you and your baby. Lamaze childbirth education classes can help you identify very practical, effective alternatives to ease the pain.
Filed Under Birth, Birth plans, Featured Story, Labor

Lamaze Care Practices: What They Are & How They Can Help

October 17, 2012 By Cara Terreri 2 Comments

Common sense tells us and research confirms that the Six Lamaze Healthy Birth Practices featured in these video clips and print materials are tried-and-true ways to make birth as safe and healthy as possible. But don’t take our word for it — click through to watch each of the short clips to learn more about safe & healthy birth and how best to achieve it, no matter where you give birth.

Introduction: Safe and Healthy Birth Practice - Download PDF

#1: Let Labor Begin on Its Own - Download PDF

#2: Walk, Move & Change Positions - Download PDF

#3: Have Continuous Support - Download PDF

#4: Avoid Unnecessary Interventions - Download PDF

#5: Get Upright & Follow Urges to Push - Download PDF

#6: Keep Your Baby With You - Download PDF

Download the complete booklet here.

Lamaze International partnered with InJoy Productions and their new Mother’s Advocate program to provide you with this free, evidence-based educational material.

Filed Under Birth, Coping with pain, Dads, Featured Story, Healthy Birth Practice, Hospital Birth, Labor, Parenting, Skin-to-Skin, Support Tagged With Healthy Birth Practices

Tips for Finding a Doula

October 8, 2012 By Cara Terreri 4 Comments

This and many more valuable articles and resources can be found on Lamaze.org, the Lamaze site dedicated to families.

 

History, common wisdom, and research tell us that women who have continuous support in labor have a higher chance of giving birth vaginally, use less pain medication in labor, and are more likely to remember their births as positive experiences. These tips will help you build the right team to support you in labor so that you can have a satisfying birth.

Doulas: Professional Labor Support

Research says that having a doula (a trained labor support professional) as part of your labor support team provides the most benefits. But how do you find someone who is a good fit to be part of your labor support team? Here are some tips:

  1. If you have a friend who has used a doula, ask her to share her story and have her introduce you to her doula. Keep in mind that each woman and her birth are unique. While this doula may have been perfect for your friend, you must decide if this doula is a good match for you.
  2. Ask your midwife or doctor for recommendations. Some hospitals and birth centers provide doula services or referrals. Some providers regularly work with doulas. But remember that a doula works for you, not for your doctor or midwife. If you don’t click with the person your provider recommends, keep searching.
  3. Ask your childbirth educator for a referral. They have heard many birth stories and may know the local doulas who have helped other women, or may work as a doula too. By spending time together in your classes, you’ll get to know each other before your birth.
  4. Contact your local Birth Network if available, or attend a La Leche League meeting or a local moms group. You’ll meet women who have used doulas at their births and may meet doulas there, too.
  5. Check the Web sites of the organizations that certify and train doulas, such as DONA International. Most of these sites will let you search by location for a doula near you.
  6. Interview several doulas if possible before choosing one. When getting ready for your interview, think about what you want your doula to do for you. How will she fit in with the rest of your labor support team? Think about the ways you deal with challenges and how you like to be treated when you need support. What helps you to relax? Do you like lots of massage or do you prefer the distraction of a conversation? How does your partner want to support you? Does he or she want to participate in the physical support or just to be there emotionally for you? Ask the doula how she sees her role at your birth.
  7. If your insurance doesn’t cover doulas and you can’t afford the doula’s fees, look for a doula-in-training. She may not have as much experience with birth as someone who is certified, but she may attend your birth for little or no fee in order to earn her certification. Some communities have volunteer doula services for women in need. Some doulas will write a contract for women to pay over time or even trade for another service that you can offer to her.

Just as you have an inner wisdom that guides you in birth, you have this same intuitive knowledge that will tell you which doula should be with you when you give birth. Trust yourself!

Friends and Family: Another Source of Support

You may already have a “doula” among your family and friends. A doula is a woman experienced in birth who provides continuous emotional and physical support. Finding someone within your own circle of friends and family is often special because she already knows you and will continue to be a part your family’s life. Here are some tips for building a support team from within your friends and family.

  1. Remember that women have helped each other in birth and afterward for thousands of years – long before there were organizations with training and certification programs. Family members and friends can be wonderful doulas. But, be sure to choose someone who shares your philosophy of birth, makes you feel confident and safe, and will follow your wishes at your birth.
  2. Don’t assume that a friend or family member with medical experience will offer the best labor support. Studies have shown that continuous support from people without medical training may actually provide more benefits than support from people who are nurses or doctors.
  3. Involve your labor support companion in your birth planning. Invite her to a prenatal appointment and your childbirth classes. Take a tour together of the place you will give birth. Do a “labor rehearsal” where you practice comfort measures. If you write a birth plan, share it with your labor support companions and make sure they have a chance to talk about it with you and ask questions.
  4. If there are several people providing you support (such as your husband or partner and a family member or friend) make sure that the members of your “team” communicate well with each other and that each person is clear about what his or her role will be. Building team communication will ensure that everyone – including you – can stay focused on your labor, instead of worrying about how to work together.
  5. Share your favorite books or Web sites about birth with your labor support team. Suggest some books that are especially for people who will support laboring women, such as “The Birth Partner,” “The Doula Book,” or “The Labor Progress Handbook.”

Web Resources:

Books for Labor Support Companions:

  • The Official Lamaze Guide: Giving Birth with Confidence (2010) by Judith Lothian & Charlotte DeVries
  • The Birth Partner, Second Edition (2001) by Penny Simkin
  • The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth (2002) by Marshall H. Klaus, John H. Kennell, & Phyllis H. Klaus
  • The Labor Progress Handbook (2005) by Penny Simkin & Ruth S. Ancheta
Filed Under Birth, Featured Story, Labor, Support, Working with a doula Tagged With doula

Lamaze Breathing: What You Need To Know

September 24, 2012 By Cara Terreri 1 Comment

Once upon a time, the hallmark of Lamaze chidbirth education was “breathing” (hee, hoo, hee, hoo). Over the years, Lamaze has evolved into a comprehensive approach to childbirth, part of which are comfort measures for labor; breathing is one of the suggested comfort measures. So what does it mean to “breathe?” Here’s a little on what you should know (excerpted from The Official Lamaze Guide: Giving Birth with Confidence by Judith A. Lothian and Charlotte DeVries):

 

Breathing in Pregnancy:  A Daily Check-in
Finding the time, energy, and peace to face your fears—or do anything that requires mental focus—is a challenge in our culture. One pregnant woman shared that after years of working at her office, she’d tuned out the sounds of phones ringing and computers clicking. She didn’t even notice how noisy her office was until an older coworker looked at her across the bank of desks and said, “You’re bringing this child into a world of sounds my babies never heard.”

It’s true: In just a decade or two, technology has changed the world dramatically. From cell phones to ATMs, from microwave ovens to Facebook friends, from high-definition DVDs to iPods, technology fills our days with vivid images and messages. It’s a noisy, busy world that can crowd out the peace we need to connect with ourselves.

Connecting with yourself is an important task during your pregnancy.  It’s a big job to pay attention to all the physical, emotional, and spiritual changes you’re experiencing. It takes concentration to envision a future that includes a new role and a new person. Finding a place of stillness for a few moments each day can help you do this crucial work.

Even if your space and your schedule are crowded, you can find a place and time to keep a daily appointment with yourself. Perhaps you can retreat to the corner of your bedroom, the bathroom, a closet, or an empty room at your workplace. Perhaps you can sneak a moment before others wake up, after they’ve gone to bed, before you get in the shower, or during your lunch break. You might want to “check in” at the same time each day so you treat this appointment with yourself as the important time it is.

Your daily check-in may be a few moments of silence, meditation, or prayer. You can use this time to get in touch with not only your feelings, but also your body and the little one who is taking up more and more of it. Close your eyes for a moment and listen to your breathing, then take an inventory of yourself: Are there any tense areas in your body—neck, shoulders, throat, hands, back? Is anything nagging at your mind? Doing a full-body and -mind check will help you identify what needs to be released, relaxed, or dealt with.

 

Breathing Benefits from Yoga Practice
Yoga, an ancient form of exercise that includes breath control, meditation, and body postures, has become popular among pregnant women. It’s easy to understand why: Many yoga exercises include movements that open the pelvis. Yoga also teaches rhythmic breathing, concentration, stamina building, and relaxation. Some women who do yoga report improved physical coordination and more balanced emotions.

 

Lamaze Classes and Breathing
Lamaze classes prepare women for a safe, healthy birth by providing the most current, evidence-based information about birth, simplifying birth, and helping women navigate the maze of modern obstetrics. Be wary of “Lamaze” classes that spend a lot of time practicing relaxation and breathing and little or no time building your confidence or discussing how to keep things simple and how to have the safe, healthy birth you want in the birth setting you have chosen.


Breathing: Finding Comfort in Labor
When allowed and encouraged to, a woman will naturally move, moan, sway, change her breathing pattern, and rock to cope with contractions, eventually finding the right rhythm for her unique needs. Such active comfort-seeking helps her baby rotate and descend and helps prevent her labor from stalling. As her contractions get stronger, her body releases endorphins—nature’s narcotic—to ease her pain.

Conscious Breathing
Conscious breathing (especially slow breathing) reduces heart rate, anxiety, and pain perception. It works in part because when breathing becomes a focus, other sensations (such as labor pain) move to the edge of your awareness.

Conscious breathing is an especially useful labor tool because it not only keeps you and your baby well oxygenated, it’s also easy to learn and use. It’s naturally rhythmic and easy to incorporate into a ritual. And best of all, breathing is the one coping strategy that can’t be taken away from you—even if you’re stuck in bed attached to an electronic fetal monitor and intravenous fluids.

Conscious (or patterned) breathing used to be the hallmark of Lamaze childbirth education. For many women, it’s still an important way to stay relaxed and stay on top of their contractions. It’s true that conscious breathing can help you relax and feel less pain during contractions.  There’s no “right” way to breathe in labor, despite what others may tell you. Slow, deep breathing helps most women manage the pain of contractions. But the right way for you to breathe is whatever feels right to you. Issues like your number of breaths per minute, breathing through your nose or your mouth, or making sounds (like hee-hee) with your breaths are only important if they make a difference for you.

It may help you to have a visual focus to accompany your conscious breathing. You can recall an image with your eyes closed, focus on a picture or special object from home, keep your eyes on your partner, or simply stare at a spot on the wall. You may also find that as labor progresses, faster, shallower breathing—like a dog gently panting—feels better. You’ll figure out what works best for you. And what works best will probably change as you move through labor.

Many women “practice” breathing during pregnancy by using conscious breathing when everyday life presents stressful situations, like being caught in traffic, running late for an important meeting, or worrying about any number of things.

Find Your Rhythm
At some point in labor, you’ll “find your rhythm” or “get in a groove,” much like a marathon runner does. You’ll be living in the moment, doing without thinking.  To others you’ll appear to be in another world. Your movements will be rhythmic; you’ll relax between contractions; you’ll respond to contractions in the same way over and over again, perhaps shaking your arms, rolling your head, breathing slowly, chanting, or praying.

You’ll be totally focused, but you won’t necessarily look comfortable. You’ll look like you’re working very, very hard—which you are. When this happens, you’ll know endorphins are working their magic—dulling your pain and helping you ride your contractions intuitively. You’ll be doing exactly what you need to do. You won’t need to be rescued; in fact, the worst thing that could happen to you at this point is to be disturbed or interrupted. A healthy dose of encouragement, support, and respect are all you’ll need from your support team.

Do you have experience with conscious/patterned breathing during labor? How did it affect your birth experience?

Filed Under Birth, Breathing, Coping with pain, Featured Story, Health and well-being, Labor, Pregnancy Tagged With Lamaze breathing

All About Pushing During Labor

February 22, 2012 By Cara Terreri 1 Comment

Despite what the media likes to depict, pushing while lying flat on your back during labor may not the most comfortable, helpful or efficient way to birth a baby. According to the Lamaze Healthy Birth Practices, “Upright positions—such as standing, kneeling, or squatting—take advantage of gravity to help your baby move down into the pelvis. Squatting increases the size of the pelvis, providing more room for the baby to move down (N. Johnson, V. Johnson, & Gupta, 1991; Simkin & Ancheta, 2005).”

Additionally, the outdated holding-your-breath-and-count-to-10-and-PUSH! method of pushing is not ideal. Also known as “purple pushing” (because your face turns purple when you hold you breath!), this style of pushing is often used in many hospital labor rooms, but it can deprive your body of oxygen, add undue stress to you and your baby, and increase your risk for perineal tears and further weaken your pelvic floor muscles after birth. A healthier way to push is to follow your body’s instincts and cues to push, taking breaks when needed and bearing down when you feel the urge.

Want to learn more by seeing examples? Watch this helpful video, created by Lamaze, which shows women birthing in hospitals– with and without epidurals — using different positions for pushing.

 

Filed Under Birth, Featured Story, Healthy Birth Practice, Labor Tagged With pushing

Labor Day: Your Step-by-Step Guide to Birth

August 26, 2011 By judith lothian 4 Comments

Think of this as your “childbirth manual,” a step-by-step guide to prepare you for what lies ahead. We’ve divided the process into stages to describe the typical changes that occur as labor progresses. The first stage encompasses the very beginning of labor, when contractions begin, all the way through active labor, when your cervix is almost fully dilated. The second stage covers transition, when your body shifts from dilating to pushing, and the movement of your baby through the birth canal and into the world. Finally, there’s the third stage, when all of your hard work is done and your body begins to recover. You will most likely move from one stage to another fairly seamlessly. Although every labor and childbirth is unique—yours will unfold in its own way—the process is remarkably constant. Trust that your body will know just what to do.

 

STAGE ONE

Prodomal LaborProdomal Labor

What’s Happening

  • The cervix begins to soften, thin and move forward, and it may begin to open. The baby settles into the pelvis.
  • At this point of childbirth, contractions may be noticeable as an achy sensation or as pressure in the lower abdomen or back. Contractions in this phase are usually irregular—starting and stopping; sometimes strong, sometimes mild. This is your body’s natural way of gearing up.
  • This phase can last from a few hours to a few days.

What Helps

  • Don’t worry whether or not this is really labor. For the vast majority, labor eventually makes itself very clear.
  • Try to be patient and have confidence that your body is doing exactly what it needs to do.
  • Take good care of yourself. Eat, drink plenty of fluids, and rest or take a walk.
  • Surround yourself with people that help you feel comfortable and safe. Your support team can keep you company and provide reassurance.

Early Labor (Latent Phase)

What’s Happening

  • The cervix continues to thin out and open, dilating to 3 or 4 centimeters.
  • Labor is meant to be gradual, so this phase may take quite a while—usually about two-thirds of the total labor time. Over a period of several hours, contractions will become longer, stronger and more regular (about 5 minutes apart, each one lasting 25 to 45 seconds).
  • A pinkish vaginal discharge (called “show”) usually increases as labor progresses.

What Helps

  • It can be hard to believe that this is it. Take time to settle down and work with the labor.
  • Once again, the best thing to do is to take care of yourself. Alternate rest and activity (for instance, take a nice walk followed by a relaxing shower), eat easily digested foods and drink plenty of fluids.
  • Many women find that the best place to be during this phase of childbirth is at home, where you can move about and do things for yourself.
  • When contractions become so strong that you can no longer talk yourself through them, try using relaxation and breathing strategies. Your support people should be nearby, helping you to stay calm and confident.
  • Keep the environment pleasant—perhaps listen to music, ask your partner for a shoulder massage or prepare the baby’s room.

Active Labor

What’s Happening

  • Contractions continue to become longer and stronger, until they’re eventually about 3 minutes apart and last for about a minute or more.
  • During this phase, which generally takes from 2 to 6 hours, the cervix effaces and dilates to about 8 centimeters.
  • Women in active labor usually get very focused as the hard work begins.

What Helps

  • Now labor has real momentum. Listen to your body and develop a rhythm with it.
  • Do something active during the contractions, such as breathing in a pattern or moving around, and rest between contractions.
  • As the strength of the contractions increases, so does your need for support. All present should focus their attention on you.
  • Changing positions frequently not only helps you stay more comfortable, but also enhances progress.
  • The environment can influence your labor. Make it peaceful and personalize it
    with music and dim lights.

Transition

Transition

What’s Happening

  • The cervix finishes dilating and effacing.
  • Contractions are now powerful and efficient, so this phase is usually quite short (less than an hour).
  • Some women feel nauseous, shaky, restless or irritable during this phase of childbirth.

What Helps

  • To keep from feeling overwhelmed, focus on one contraction at a time.
  • Continue with breathing, vocalization (if it helps) and rhythmic movement.
  • Even though rest periods are short, they allow you to relax deeply and restore yourself.
  • Those providing labor support should offer close undivided attention, unwavering encouragement and praise. If you’re using a breathing pattern, your team should try “conducting” to help you focus or moving with you in rhythm to your breathing.

Birth

What’s Happening

  • Your body shifts from dilating to pushing.
  • The baby makes his way down through the pelvis and birth canalBirth.
  • This phase can last from 15 minutes to several hours.
  • Although it may take several contractions after full dilation to be noticeable, most women get an urge to bear down. Your body is giving you clear instructions on what to do. The urge to push usually gets stronger as the baby descends.
  • Many women feel more clearheaded and have a renewed sense of optimism when pushing begins.
  • Just before the baby is born, you may feel a burning, stinging, stretching sensation at the vaginal opening: A sure sign that you’re almost there!
  • As the baby’s head emerges, it turns to one side to allow the shoulders to align and then the rest of his body slips outs.

What Helps

  • The urge to push usually feels strongest at the peak of the contractions and then fades toward the end. Just follow along and do what feels right. For most women, this means taking normal breaths as the contractions build and then pushing when it becomes irresistible.
  • It may help to make sounds (much like athletes do) in response to what you’re feeling.
  • Labor supporters should provide quiet, reassuring encouragement. There’s no need for yelling.
  • If progress is slow, change positions. Squatting, all-fours and side-lying are all good options.
  • Let go of any tension in your perineum. Applying warm compresses there may help you push.
  • Rest deeply between contractions.

Recovery
What’s Happening

  • The cord is cut, and your baby is quickly dried and placed on your abdomen.
  • What a mix of feelings—excitement, joy, awe, and relief!
  • The placenta is delivered, usually within the first 10 minutes.
  • Your health-care provider will make sure you are comfortable. Cold compresses are often applied to the perineum to ease discomfort and reduce swelling.
  • Many women get after-pains or “the shakes” after childbirth.

What Helps

  • Touch, caress and cuddle your baby without time constraints. Keep him skin-to-skin with you from the moment of birth.
  • This is a good time for your first breastfeeding, which tightens the uterus and decreases bleeding.
  • All routine infant procedures can be done without removing the baby from your side. Request that measuring, weighing and applying eye medication be delayed for a few hours.
Filed Under All Recent Articles, Birth, Labor Tagged With Birth, early labor, Labor, prodomal labor, stages of labor, transition

A Birth Partner Cheat Sheet

April 25, 2011 By Cara Terreri Leave a Comment

Uncertain about your role as a birth partner? Follow these nine easy guidelines.

1. Support is a key element to a woman having a positive birth and postpartum experience. As a birth partner, identify the resources you have for informational, emotional and physical backup early on. This could include childbirth classes, the mother’s care provider, a doula, or a trusted friend or family member.

2. As you learn more about the process of birth, you will discover your strengths in offering support, and you can decide how you want to contribute to the birth of this child. Will you be the primary support, work more with the other team members or be by the mother’s side with your full love and support while others do the hands-on work? A birth partner can serve in any manner that helps the laboring woman, so be comfortable, even joyful, in whatever role you both agree upon.

3. Whether you decide to actively work with the mother or just shower her with love, simply being present makes a difference. The birth partner is usually the one member of the team who best knows her desires and can interpret her cues and express her wishes to others. Your personal history with the laboring woman is something the rest of the team doesn’t have.

4. In order to care for a mother in labor, you must also care for yourself. Eating and drinking during labor will give you the energy you need. Wear comfortable clothes and let the doula or nurse care for your partner while you take an occasional break.

5. Ask questions. Unless you are birthing at home, you are in an unfamiliar setting surrounded by unfamiliar people. A doula can help you get the attention of the health-care provider so that you are heard.

6. Be prepared to experience some strong emotions. Often, a birth partner is so absorbed in supporting the mother and remaining strong that he or she is surprised by the powerful feelings of love and awe that accompany seeing this incredible woman go through birth.

7. You and the mother may have the most familiar voices to the infant. When you talk to the baby, he experiences a feeling of calmness that has a positive effect on his transition to the outside world. Stroking him will also reduce stress hormones and improve his breathing and temperature regulation.

8. Understand that the postpartum period is a mix of joyous and difficult moments. The unpredictability of each day and getting to know your baby can sometimes make for a challenging situation.

9. After the excitement of birth dies down a bit, enjoy quiet time with the mother and baby, and delight in the miracle of birth and the part you played.

Filed Under All Recent Articles, Birth, Dads, Labor, Postpartum, Support, Working with a doula
« Older Posts