*This is part two of a two-part series. You can read the first part on my advice before you reach labor here. Again, this is not meant to be a pros/cons list, rather a list of some of the things I found most helpful during labor. Please read the first two paragraphs of my first post to hear my heart on this sensitive issue.
1. Stay at home as long as you [safely] can. My first OB, when I told her I wanted to labor without drugs, told me to stay home as long as I could handle it. She told me to come in when I “couldn’t take it anymore.” There are of course instances when this is not a good idea, and you need to be on the same page as your healthcare provider, but if everything looks good and there aren’t any reasons to be at the hospital right away, then by all means, labor at home. More often than not, you’ll get to the hospital earlier in your labor than you think. Once you’re in the hospital, you will be hooked up to monitors, IV drips, and the clock. Some hospitals give you plenty of time to labor, but if you’re not in one of those hospitals, you might be pressured to progress your labor faster than necessary. During my first labor I agreed to breaking my water and doubling the pitocin drip within the same half hour. OH MY DEAR GOODNESS do I regret that decision. There was no medical reason to either of those procedures (everything was going smoothly and it was only two hours into my induction), but in my naivety of it being the first time, I agreed. Here’s my advice: If you are experiencing a normal and healthy pregnancy/labor, go to the hospital when you really have to work through contractions and the rest of the world has ceased to exist.
2. Move it. I wanted to kill the triage nurse when she prescribed two hours (turned to three) of walking before they would admit me. But it really is the best thing you can do to get all those centimeters accounted for. If you are experiencing back labor (I’m sorry), wiggle those hips like a hula dancer. You’ll feel completely weird (or I did at least), but it does wonders for getting that baby in the proper position. When walking gets hard and you have to stop every few steps for a contraction, take a breather for a contraction or two and then get moving again. I have a friend who did dance moves during her less than five hour labor. Movement really works!!
3. Relax as if your life depends on it. Read that sentence again. This is the line from the book Natural Childbirth the Bradley Way that is literally the best advice I’ve heard. When I first felt a true contraction, I cringed through the entire thing. It was my natural reaction, but it’s the last thing our body needs during labor. Fighting the pain will only make the pain worse and labor longer. In order to relax fully, you and your partner will want to find relaxation exercises that work for you. I found it best to mentally search my body and release any tension I was carrying (often in my shoulders and toes). Make your body go limp while that faithful uterus does its thing.
My favorite relaxing techniques:
– Music. I found worship music to be incredibly helpful during labor. I focused on the lyrics and not the pain while I endured minute + long contractions. It was also helpful to know that the contraction wouldn’t last as long as the song. Our bodies give incredible rest during labor. Use music to look forward to that rest.
– jacuzzi tub. A nurse once described the hot tub as “nature’s epidural.” And to that I say Amen. It can be tricky though, because our bodies are super sensitive during labor. I wasn’t able to use the tub with El, and labor slowed down when I used it with Claire, but with Melia? Magic. I was only in there for about 20 minutes before completely dilating. Give it a try, but it’s not your only option.
– birthing ball. AKA medicine ball. Something about sitting on a giant rubber ball… If I wasn’t in the tub, I wanted to be sitting on that ball, leaned over with my hands around JD’s neck.
– standing up in a ‘slow dance’ pose. With all three labors, labor sped up when I was standing, so it was helpful to stand up with my head in JD’s chest, arms wrapped around his neck. During contractions I literally melted into him while we swayed to get baby in better position.
4. Know the emotional signposts of labor. We learned in our birthing classes (and has been confirmed by nurses) that our emotions can be a better indicator of where we are in labor than actual dilation. For instance, I was emotionally very serious and concentrated when we went to the hospital with Melia. I was only 3 cms. dilated and 60% effaced at the time, but less than five hours later, she was out. The Bradley method focuses a ton of attention on the emotional signposts of labor as a guide for the birthing coach. I recommend their handbook for more accurate descriptions. In a nutshell, here they are:
– Early first stage labor: “putsy putsy” You’re excited! Yay! Baby’s on the way, FINALLY! (this stage sometimes gets repeated, depending on just how many false alarms your body accomplishes before that baby is actually on the way). Toward the end of this stage, you’ll start working through contractions while steam cleaning the carpet… three times.
– Late first stage labor: You’re now working through contractions and feeling serious about labor. This is it, it’s hard work, and you’re determined to get it done. You may or may not snap at somebody. This is when the Bradley method recommends getting to the hospital.
– Transition: Your contractions are coming strong and steady and close together. This is where self doubt usually kicks in and you feel completely done. Many women ask for drugs when they’re in transition (myself included), but try to hold off if you can, because chances are, you’re only twenty to thirty minutes away from pushing out a baby. And in labor time – that’s nothing. My advice during transition: take it one contraction at a time and remember that your next contraction could be your last. It will soon be over. Relax and let your body do its thing for just a short while longer! Transition is tough but it’s also short.
– Second stage: This is when you push a kid out. And it’s pretty awesome. Depending on how long you push, you might experience the above emotions all over again in the same order, just before your baby comes. My pushing advice: get ‘er done. When baby’s head is crowning (you’ll know by the ring of fire), pause briefly and then complete the transaction. I finally figured this out by the third one. Realistically though, pushing can take anywhere from 5 minutes to 3 hours.
5. Find your zone. There came a point in all three of my labors where I was completely closed off to the rest of the world and focused on what my body was doing. In each case, I had a picture, word, or phrase that I concentrated on in my mind during contractions. I didn’t plan ahead what they might be, they just came to me in labor. Images of floating on a wave, sitting on a rocking chair, counting to 8 over and over again (no clue why I did that), or repeating words were all coping mechanisms when I was in the hardest part of labor. I think your zone comes only when you are super relaxed. And that, my friends, is hard work.
6. Go to sleep. If you’re having a hard time relaxing, then just go to sleep. Cozy up on the birthing ball, lie in a comfortable position on the bed, sit in a chair – whatever feels the most comfortable to you – and close those eyes. By this point in labor, you might be exhausted. Take advantage of those nice breaks between contractions and sleep in between. Your body will be much more relaxed through the tough stuff if you are able to sleep during rests. I know this sounds crazy, but there came a point in each of my labors where I JUST wanted to sleep. So I did! Those precious moments of sleep gave me lots of centimeters toward completion.
7. Keep an open mind. Labor is unpredictable. Don’t be married to your birth plan. Labor and Delivery nurses joke that the woman who comes in with a birthing ball and extensive birth plan is destined for an emergency C. In two of my three births I had to surrender parts of my birth plan and it was fine. I still had a natural birth. Don’t let issues like fetal monitoring and an IV make or break your experience. If you’re really against those things, you’ll need to find a hospital that will accommodate your wishes or give birth at home.
8. Know your options. This comes with research done before labor begins, but even when you’re in labor, think carefully about your options when they’re given to you. Is there a medical reason to break your water or increase your pitocin? Sometimes there really is and those things are necessary. Sometimes, not. The more you are able to birth without intervention, the easier it will be to birth without medication.
9. Use a birth coach. Whether this is your husband, a friend, a certified doula , or all three- it is incredibly
helpful necessary to have help and support during labor. Others can see things you can’t, and it’s always good to have an advocate in your corner.
A Word on Induction and Back Labor
I come to you having experienced a pitocin induction as well as back labor. Both situations make having an unmedicated birth hard, but not impossible. I joke that if I ever have to be induced again, I’ll ask for an epidural with my pitocin. Although, quite honestly, I probably wouldn’t have an induction like I did with my firstborn, simply knowing what I know now about labor. Here are my thoughts and advice in each situation:
Induction: Ask first if they will induce you by breaking your water and then giving you time for contractions to start. In situations where you need to get that baby out fast, this might not work, but if you have time on your hands – do it. If you are having a pitocin induction, ask for it to start out with a low dose. The less you have to deal with that stuff, the better. Some women only need a little kickstart to get their labor going and a low dose of pitocin will do the trick. Unless there is a medical reason for doing so, it is preferable not to have your pitocin doubled within the same time period as having your water broken. This happened with my first baby and I went from small cramping to late stage hard labor in minutes. The only way I was able to avoid the epidural was because my L & D nurse relaxed me while we were waiting for the anesthesiologist and when he came to the door, I sent him away. Here’s a hint: if your nurse knows you really want to give birth without drugs and you ask for her help, chances are she’ll be your champion.
Back Labor: First – I’m sorry. Second – MOVE girl. Wiggle those hips, get on all fours (or child’s pose in the tub – I swear by it), make the birthing ball your best friend. Do everything you can to spin that baby around. If your hospital has a rebozo, use it (you can reference my third birth story here – lots of fun back labor)!! Third – get that hott man of yours (or a doula, nurse, your mom – whoever!) to use counter pressure on your lower back. Back labor feels like knives sticking in your back and the counter pressure feels great. Finally – wait as long as possible before getting drugs. It will be tempting – I promise. But if you are able to get that baby turned around during labor, pushing will be much easier (and most likely hours shorter). Once you have an epidural, you can’t move… that being said, much much sympathy to you if you’ve tried all those things and that sweet baby is still posterior. A nice cocktail of drugs might be just what you need (yes, I said it.).
While this list is long, it’s certainly not complete. There are many ways women respond to pain in labor, and something that worked for me might not work for you. Every birth is different. In fact, what worked for me during one labor didn’t always work during another. There’s no way to tell what your labor will look like – just like there’s no way to tell when labor will start. One of my dear friends just went into labor because she was throwing up with the stomach flu! Guaranteed she didn’t have the labor she expected (love you Karyn). What it ultimately boils down to: you get a baby in your arms soon, regardless how he/she comes out. Focus on the end result, trust your body, work with what you have, and enjoy what you can. And know this: your identity and strength as a women is not measured in how your baby is born. Got it? Good. Now I have to post this immediately before my nephew is born any second.