BREAKING NEWS!!!

“Partner’s Touch Reduces Pain For Laboring Woman”

receiving-hands-1920865_1920In a recent study published in Nature, it was discovered that a partner’s touch resulted in something the researchers termed, “physiological coupling.” The same study also found that empathetic touch from the partner contributed to an analgesic effect via the woman’s autonomic nervous system.

In other words, when a partner held the hand of the woman they cared for and a pain stimulus was activated, the couple would begin to synchronize their breathing and heart rate patterns, otherwise known as physiological coupling. In addition, the woman would report that her pain lessened while holding hands with her partner. If they were sitting next to one another, but not holding hands, her pain level would not be affected.

Obviously, this has implications for the families I teach, which is why I joke about this study being big news and something I didn’t already know about. But it’s important to share this news far and wide, because even though I’ve been preaching it for close to 20 years – “Everything you do for your partner while she’s in labor makes a difference! Even if all you do is hold her hand!” – partners still don’t seem to believe it!

Labor is not just something that a birthing woman experiences. Her partner experiences labor too, just in a very different way. For far too long, we’ve either diminished or ignored the partner’s experience of labor – to everyone’s detriment.

I’ve mentioned many times before that I have a soft spot in my heart for the partner’s experience. I realize that it makes sense to pay close attention to how a woman experiences and moves through her pregnancy, labor and birth. But if we’re not paying equal attention to her partner’s experience, we’re not setting this new family up for success. In fact, we might be doing the exact opposite.

I spend a lot of time discussing the second stage of labor (pushing and delivery of the baby) using my uterus and baby doll props to share what to expect and what it will look like from the partner’s perspective. At this point, the nurses and provider have their attention focused on the laboring woman and baby – with good reason. They need to be aware of any changes in the heart rate as the baby moves through the birth canal, and they need to remain alert as the baby’s shoulders make their way through the woman’s pelvis.

But not enough attention is being paid to what the partner experiences during this critical time. Partners need to know what a newborn baby really looks like and what the process entails so that the moment their baby enters the world it’s a moment full of joy for the whole family! When we forget about the partner’s experience, and they have no idea what to expect, that moment can result in a partner frozen with fear and in a state of shock at what they’re seeing and what’s happening – and this can negatively impact their transition as a new parent in a significant way.

Likewise, if partners don’t realize the importance their words, actions and touch can have on the laboring woman’s experience, many partners will freeze up and feel helpless as they witness the power and intensity of labor and birth. They may end up feeling as if their efforts and suggestions for comfort measures are without any effect. But this couldn’t be farther from the truth!

Sometimes I use a marathon analogy to discuss how important the efforts of the partner can be in helping a woman through labor and birth.

Imagine you’re running your first marathon. You’ve heard from friends and family how challenging it can be, but you’ve also heard about all of the “extras” along the race route that will help you make it across the finish line: the excitement and camaraderie of other runners, the music blaring at checkpoints, the mileage post signs marking your progress, the water stations providing hydration, snacking on energy-packed gummies, reading signs of encouragement from strangers, and awaiting you at the finish line, cheering crowds and some of the best peanut butter sandwiches and chocolate milk you’ve ever tasted! Now, these “extras” might not seem very important – until we take them all away.

What if I painted a very different picture of your marathon experience?

You’re told to stand at the starting line alone and when the gun goes off, run for 26.2 miles toward the finish line with nothing to help you along the way – no water stations, no music, no snacks, no encouraging crowds, no one waiting for you at the finish line… nothing.

The difference between the first scenario and the second is stark. Without all of those “extras” even the experienced marathon veteran would have a hard time completing the race. Let alone, crossing the finish line with even a hint of a smile.

So it is that every little thing a partner does to make the laboring woman more comfortable matters, and it matters immensely. Every sip of water offered, every new position suggested, every word of encouragement, every reminder to breathe, every single touch, provides comfort to the laboring woman. And partners need to know this and believe in the power that their undivided attention and connection can bring to the laboring woman.

I’m reminded of this when I think back to being in labor with my first, some seventeen+ years ago…

I had two doulas – one for me, and one for my husband! I came prepared with a full team of support for this birth. They all worked so hard to support me in what ended up being a long labor that began, as most labors do, in the wee hours of the morning. I wasn’t the only one exhausted some 20 hours into the experience – my husband had been awake and working hard just as long as I’d been. And he was getting tired.

I remember hearing my two doulas talking in a stage whisper with my husband: “Go ahead and lie down. Try to get a quick nap in now before the really intense labor begins. We’re both here – we can take care of her.”

A statement that was completely true! One of my doulas was an L&D nurse (soon-to-be-midwife) and the other was my best friend who knew my husband and me almost as well as we knew ourselves! They were more than capable of helping me through contractions, which up to this point I’d been handling really well.

Upon their urging, my husband walked about three feet away and lay down on the daybed in the labor and delivery room. And then strangest thing happened – I completely lost my rhythm and my ability to breathe through contractions! It was as though I’d lost my way, somehow. The next handful of contractions felt incredibly painful to me. So much so, that I cried out in anguish which woke my husband up and he hurried to my side and held my hand once more. And then, just as quickly, I found my rhythm, my breathing returned, and I was able to continue and handle my contractions, until I gave birth several hours later.

I know from talking with my husband and other partners about their own experiences how challenging it is to watch the person you love go through labor and birth. It pulls strongly on the heartstrings and can leave partners feeling incredibly helpless to do anything that will be effective in increasing their partner’s comfort level.

But here’s why I think the findings from this latest study are so important: it’s the feeling of shared empathy between the laboring woman and her partner that causes the physiological coupling and analgesic effect that help a woman when she’s experiencing pain.

That’s why I’ve always told the partners in my classes that even if they hired an army of the world’s greatest labor doulas, if the partner provides the laboring woman with their unwavering, focused and empathetic attention during the labor, she will tell everyone that she could not have made it through without her partner – even if all they did was hold her hand!

I love it when someone else does the research and publishes findings that support what I’ve been teaching my families for the past twenty years!

Because, let’s face it… Some partners in my classes may think that I’m just trying to make them feel better or elevate their role in the birth experience. (Which is exactly what I’m trying to do, by the way!)

But I’ve also known forever that empathetic touch – combined with all of the other wonderful comfort measures partners learn in our time together – really can help a laboring woman when she needs it the most.

And now, I have the science to prove it.

Can you relate to this post as a laboring woman? Did your partner’s touch (among other things) actually make labor and birth easier for you? What about partners – have you felt helpless in labor? Does this information about how your words, actions and touch really helped her through labor and birth make you feel any better? Let me know your thoughts. I love hearing from you!

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Thank You!

Thank You

Let’s get real for a minute… Parenting is hard. Really hard.

And here’s where I need to give a sincere shout-out to all of you who are doing this work solo. You deserve a standing ovation. Seriously. Single parenting is double, triple and on some days I’d imagine, quadruple harder than when you have a partner to help share the load. One of the main reasons I think it’s so hard, is that there might not be someone there in the everydayness of parenting who appreciates all that you’re doing to raise the next generation.

And I’m not just talking about wiping their butts, cleaning their snot-encrusted faces, making them all their meals (no one ever tells you how much or how often they will need to eat!) or driving them from one end of the universe to the other!

I’m talking about sharing with them our most precious gift: our time.

The time it takes to sit down and feed your newborn, the time you allow for your three year old to “Do! It! MYSELF!!!”, the time you spend reading that book you have committed to memory because you read it approximately 2,000 times a day, the sleep you surrender every time you wake up in the middle of the night to soothe the hacking cough, or run in with a bowl just a moment too late when your kiddo’s sick, the time you listen – really listen – to descriptions of the Pokemon characters you’ll never be interested in (just being honest!), the concerns of starting Middle School somewhere new, the feelings of overwhelm at wanting to be really good at dance, soccer, acting, music, while still maintaining good grades and a successful social life.

If you’re doing this all by yourself, I hope you have a solid group of family and friends who are giving you the acknowledgment that you so deserve. And if they aren’t? Go find yourself some new, and better, family and friends! Because this parenting gig is challenging and we need all the encouragement and validation we can get.

But now I want to turn attention to those who do have of a partner to share in the parenting. Are you giving each other the appreciation that you deserve? Because even if you’re parenting with a partner, feeling under-appreciated makes parenting exponentially harder than it has to be.

Why? Because the little people we have committed our lives to don’t really get it. They don’t really know how to express appreciation for all that we do for them. That’s why it’s so important for your partner to acknowledge everything that you’re doing to keep the family going. Especially, if you’re the primary caregiver either working mostly or completely in the home.

In our society, we put so much emphasis on how much money a person makes, that any work done in which there’s no exchange of funds, is automatically considered less important. When, in fact, it certainly has greater importance and impact on the lives of the next generation than what vacations they get to take, or what kind of sneakers they can afford to wear.

I’m not trying to slam the parent that works outside of the home. This is a very important role that allows the other parent (when financially feasible) to even consider working part-time, or staying home entirely to raise the children. But when that decision is made, it’s important to not make assumptions about what goes on during that day at home. At least not negative assumptions.

Instead, let’s assume that the parent who is at home is working, too – doing a million different things all at once to make sure that the offspring are: clean, well-fed, not stuck in front of a screen for too long, intellectually stimulated, chauffeured to and from activities, and all the while, happy and well-adjusted.

So, maybe there are a few extra dishes in the sink at the end of the day. The floors could be a little cleaner. The laundry is starting to pile up a little bit. And if these things bother you, less-at-home-parent, then by all means do what you need to do to change this situation: 1) Pitch in and clean up the dishes, laundry, floors or whatever else is causing you stress or 2) Hire somebody else to do it.

But don’t under-appreciate all that your partner is doing to keep everything – everything that actually matters – going.

I’ve talked about my parents very happy union before – they are closing in on 60 years, and I spoke about my Dad’s musings on thoughtfulness here. But I can remember as a child, several occasions when we’d all settled down for dinner and he would stop the evening chatter to make this announcement: “Look at your beautiful mother. I want all of you to know that this family would fall apart if it weren’t for all of the work that she does to keep our family life running smoothly.”

What a wonderful model he provided for all of us! She worked as full-time parent and homemaker and didn’t get paid a dime for raising six (!) children. My Dad understood exactly what her worth was as his partner and the mother of his children, and he made sure that we all understood it too.

Take your most precious commodity of time to appreciate what one another is doing in the role of parent to your children. It’s all too easy to assume that you’re carrying an unequal load when it comes to parenting no matter who is working full-time, outside of the home. Once there, it’s even easier to begin to resent one another. This one-upping, and keeping score is ugly and negative – and it can poison your relationship.

Instead of looking for what your partner is not doing and criticizing their efforts (or lack thereof), shift your focus on finding the ways your partner is working for your family and recognize their contributions to the family you’ve created together. How and where can you pause to say thank you?

The work of parenting one or several children is not for the faint of heart. And I’m sorry to say, it doesn’t get any easier down the road. This is a lifelong commitment and you need some level of positive acknowledgement and validation from your partner that what you are doing as a parent matters.

Because, my friends, it matters so much more than you know! So appreciate one another for all that you’re doing – in and outside of the home – to make your family thrive.

Does this resonate with you? Have you been feeling under-appreciated lately in your role as a parent? We’re unlikely to get the encouragement and validation we need from the outside world, so we need to make sure we say “Thank You” early and often. Here’s a little inspiration from Sam and Dave to get you in the mood.

What Do I Do Right?

Do Right

I’m taking part in Elly Taylor’s, Becoming Us Facilitator Training, and it’s fantastic! This training is based on her book, Becoming Us: 8 Steps to Grow a Family That Thrives. I love this book as it aims to prepare couples by presenting them with normal, realistic expectations for the transition to parenthood. Through this training, I’m learning how to “plant seeds” for my expectant couples so their transition to new parenthood goes as smoothly as possible.

This work is not necessarily new to me and the way I teach, but going through this training has allowed me to look in-depth at the incredible transition that women and their partners go through as they become parents to a newborn. This is a life-changing event, after all, and we need to do better in preparing our families for all of the changes that will be happening to them as individuals and as a couple. This is why I’m taking part in this advanced training. I’m weaving Elly’s work into my current curriculum to better prepare my families with realistic expectations that go far beyond the birth itself.

The module that I’ve most enjoyed so far is learning more about the challenges new parents have in grappling with their lowered sense of identity and self-esteem as they move into their new roles. We’ve definitely moved away from the idea of parents receiving a boost to their self-esteem by other members of the larger culture when they start a family. The idea of ushering in the next generation as a role of honor, just isn’t a part of our cultural identity any longer.

In a society that elevates the material world and success is measured in how much money you make, the work parents do to raise their children doesn’t even rate in our collective consciousness. It’s barely recognized, let alone given any extrinsic value. When we look at parenting through this cultural lens, it starts to become obvious why the identities and self-esteem levels of new parents, both men and women, take a hit.

To address this issue, I’ll sometimes talk about parenting in a way that resonates with my student’s experience up to this point: Parenting is a job. But it’s not just any job, it’s the job – the one you’ve been focused on getting for the past year at least, maybe even longer and finally, you land that job.

And it ends up being the hardest freaking job you’ve ever had.

The hours suck. There’s no pay, no vacation time. Your mentors aren’t that helpful because they were trained about 25-30 years ago, and things have changed – a lot. There are so many different manuals with conflicting information about every aspect of this job, that you just stop reading them.

If you’re lucky, you have partner to help you in this new job – but guess what? They were hired the exact same day you were and they don’t seem to know any more than you do about the right way to get this job done. Plus, they’re as sleep-deprived and resentful of the “No-Pay Policy” as you are, so morale in the office is really, really, low.

But maybe the worst part of this job? You don’t get to have regular job reviews with a supervisor that can sit you down, talk with you about what a great job you’re doing, provide helpful feedback with some of the challenges you’re facing, and ultimately encourage you to keep going. No one is there to remind you that this job is important, it matters, it has meaning, and even if the payoff is hard to see right now, it’s completely worth it.

When we come from a world where we get regular pats on the back for a job well done, being thrown into the job of being responsible for your newborn’s life without any of that regular feedback can be really hard. And in some ways, it’s harder on men who become fathers than it is for women who become mothers. Men today, who really want to be much more involved, might not have a strong role model in their own father. They might end up feeling like they’re playing catch-up to their partner who may have been encouraged in her role as mother since she was a young girl through (stereotypical) ideas of nurturance, play, and babysitting.

But studies show that identity and self-esteem of both men and women are lower after they become parents. They’re often floored by how much they don’t know about parenting, how much “on-the-job-training” comes with having a baby, and often feel like they have to defend their parenting choices, or be ready to criticize other parenting choices as a way to lessen their own feelings of vulnerability in this new role.

I think waiting for our culture to provide parents with a pat on the back for a job well done will be an exercise in futility. I’m not sure it’s worth waiting for. Depending on the relationship, we may or may not get any positive feedback even from our own parents. Which is harsh to say, but true. Still, this issue needs to be addressed as it has long-term implications for new parents as individuals, as well as their couple relationship. 

I think the obvious person we need to look to in this situation, is our partner.

Our partner is the only person that understands the level of sacrifice, the long hours, the hard work, and the immense love that we have for our children. They’re the only ones that can provide us with feedback as to how we’re doing in this new job. And studies show that what our partner says about our parenting has the greatest impact on our feelings of identity and self-esteem.

Take the time to let your partner know that you think they’re doing a great job as a parent in this shared “work project.” Try to focus on the positive – remember that this job will become exponentially harder on both of you, if you end up doing it by yourself from two different job sites. Instead of telling your partner what they could do better, focus on what it is they’re already doing really well.

We need to know that the person who is intimately connected with the work that we’re doing day in and day out, respects us and the tireless work we do to parent our newborn, toddler, tween, teenager and young adult. Because it never ends, this parenting gig. And to have a committed partner in parenting makes this job so much more enjoyable and rewarding.

Tell your partner one thing that you love about how they parent – today. It will give their parenting identity and self-esteem a very much needed boost!

This whole blog post was prompted today by this song  by Jimmie’s Chicken Shack I heard on the way to school drop-off this morning. And because everything somehow connects to the worlds of pregnancy, birth and parenting, I give you this as a reminder of how it can start to feel if we forget to tell each other what we do right as parents.

Were you surprised by a lowered sense of identity and self-esteem after you became a parent? How do you and your partner acknowledge one another in your role as parents? Isn’t every day as a parent Mother’s Day and Father’s Day?

Boys (And Some Girls?) Don’t Cry

BoysDontCry

My six-year old son stood in front of me with tears streaming down his face and his lips in a full downward pout – so different from his usual dimpled, teeth-just-coming-in, goofy grin. He was crying because he’s feeling anxious about starting up swim lessons again. In January.

I knelt down to make eye contact and said, “It’s okay you’re feeling anxious – but buddy, January is far away and there’s so much life to live between now and then. When it’s January 9th, we can revisit how you’re feeling, okay?” He asked, “Have you ever felt this way?” I answered immediately, “Of course! Lots of times!” And that’s when he said, “Yeah, but I’ll bet you’ve never cried about it before. You never cry about anything.

Ugh. He’s right. I don’t hardly ever cry about anything. For real. I’ve been this way my whole life. It’s not that I don’t have feelings – I feel very deeply – it’s just that my feelings rarely ever bubble up to the surface and spill out of my eyes. That’s all.

But – I cried at each and every one of my births. Big, loud, wracking sobs with tears easily flowing down my cheeks. No checking in with myself about how I was feeling or what I was feeling or if these feelings actually merited tears or not, just wet saltiness streaming down my face as I locked eyes with my baby in that inexplicable moment between before and after.

Before you were a dream, an imagined little person floating around inside of me as our hearts beat as one, connected in the way only a mother and her unborn baby can be. After you are here, now, and we are meeting face to face for the first time. You are the living definition of miracle.

I wish that my children could remember me crying at our first meeting because it would mean all that much more to them knowing me as I am in their everyday life: strong, resilient, able to handle anything that’s thrown my way, and as my 13 year old son likes to tease, having “more testosterone than most men.”

I find that curious, really. The fact that I don’t cry is seen as such a masculine trait. How sad for all the boys and men out there who happen to cry easily! They’re seen as too sensitive and encouraged from far too young to “Stop that crying!” All too often on the receiving end of that stupid phrase that gets thrown at them when their tears start to flow, “Man up!” Men are taught from such a young age that to be a real man, they need to act a certain way.

I’m uncertain if that’s where my own challenges with crying comes from. I’m a girl and I’ve always identified as being female. But I was a huge “tom-boy” as a child. You could count on finding me in the middle of the field, captain of the pick-up football team, long before I’d be caught dead playing with dolls on the sidelines. Maybe I, too, picked up on the social cues that were handed down by the dominant culture to my friends – most of whom were either boys or other “tom-boys” like myself. Maybe I adopted that same code and misidentified being strong with being able to hold back tears.

But, the gorgeous thing about being fully present during birth is that there’s no way to stay completely hidden or protected from feelings of vulnerability and surrender. If you are fully present the wonder, the crazy intensity, the recognition of the part you are playing in the birth of this miracle just plows into you – and you are transformed.

I’ve seen it happen to many couples over the years. She might find a strength that she didn’t even know she had. And he might find a softness that had always been there but had been locked away for far too long.

I’ve witnessed this (only in reverse) four times for me and my wonderfully already sensitive and easier-to-cry-than-me husband. He’s stepped up and provided me with exactly the strength and confidence I’ve needed so I can let go and rediscover my softness and vulnerability that stays hidden most of the time. Allowing yourself to let go of any pretense, any plan of how things should look, sound or feel and instead just be in the moment is where the real power of birth happens.

A few years back, I was invited to meet a baby not even a day old by the new parents who’d been students in my class. As the new Momma was getting some key points on lactation from her nurse, I turned to her proud partner and asked him to tell me about the birth from his perspective.

This very masculine, business-minded, Ironman tri-athlete looked at me and said something I’ve never forgotten, “Watching her give birth and seeing the baby come into this world just broke me wide open.” I could feel the shivers of recognition run down my spine. “Yes!” I felt the exact same way in all of my births. Broken. Wide. Open.

These words might intimidate the uninitiated. It might even scare the hell out of you. But I encourage you to embrace those feelings so you might experience that same level of transformation. It’s nothing short of breathtaking.

You might even find yourself crying from the miracle of it all.

If you do cry easily, were you amazed to find that despite any tears that were shed, how strong you felt after giving birth? If you are not an easy crier, were you surprised by how easily your tears fell at the moment you first saw your baby? I’d love to hear your responses below in the comments.

And for your listening and viewing pleasure, you knew this was coming, right?

Rethinking Early Labor Series: PART III

Re-Think IIIn my last two posts, I discussed how laboring women and their partners are being encouraged to stay at home and away from the hospital for most, if not all, of their early labor. But the definition of early labor has changed. It is now believed that a woman is still in early labor until she reaches about 6 cm dilation. This means most women will be at home working for longer periods of time through the early phase of labor. It’s not enough to encourage women to stay home. We also need to provide some ideas about how to stay home and continue to cope with contractions of early labor without anxiety settling in. This is the final post in my three-part series, “Top 10 Things to Consider in Early Labor.” Here are the last 5 ideas from that list.

6) Clear your day. If either of you had been planning on being at work the morning that labor begins, call in and let one trusted person know that you might be in early labor. Ask them please to not tell the entire office your news as it might prove to be super early labor, or maybe just a good bout of practice labor  – and you don’t want to have to field a ton of phone calls, emails or texts from your excited co-workers.

7) Plan a date. This is the one thing that I get the most heat for encouraging people to consider, but I swear it helps you get your mind in the right place for the start of your labor experience. Most first-time Mommas have loads of time between when labor begins and when they reach active labor. And if you have something to look forward to as labor begins, you’re more likely to enter into early labor with a more positive attitude. This can definitely impact how well you’re able to handle your early labor. This labor day date doesn’t have to be anything special, but there should be some actual direction to it, a potential theme. I’m not sure it’s enough to say, “We’re going to watch a bunch of movies” or “We’re going to play board games.” Which movies do you want to watch? (Make sure they’re pretty emotionally charged – those that are can help boost your oxytocin levels by up to 47%!) Get out the board games and lay down a challenge. Card games that can go on forever are really great because they can be left hanging if your labor should pick up speed. If the weather is nice, plan a picnic lunch. If it’s not, picnic on your living room floor. Go for a walk – just make sure that you pass by your car every 1/4 mile or so in case labor changes dramatically. You don’t want to have to walk 5 miles back to your car with really challenging contractions if labor moves from early into the active phase while you’re out and about. This date should be focused on distraction and enjoyment. This is the last time you’ll be able to go out as a twosome without the baby or without paying for a babysitter. Don’t waste this opportunity. 

8) Consider hiring a doula. (This actually could have been #1 on my list of things to consider if I were rating them, but I wrote this list more chronologically in terms of what to consider as labor progresses.) Having a doula who is yours and yours alone ready to take your phone calls or texts in early labor or even stop by your house to check in with you can really make a difference in your continued ability to progress in early labor at home and away from the hospital. A doula’s expertise about what labor looks, sounds and feels like for most women will mean that she can normalize what you’re experiencing. She can also suggest comfort measures that can help you continue to cope and remain comfortable in your home for longer. When I’ve asked new parents from my classes what advice they would offer to expectant couples, they usually say, “Tell them to stay at home for as long as possible!” Having a doula to check in with might allow you to do just that. And doulas only get better as labor progresses! If a doula is not possible for any reason, who else can you check in with during this long and sometimes frustrating early phase of labor? What does your provider have to say about contacting them in early labor? If you contact the hospital looking for guidance they will often either refer you back to your individual provider – or tell you to come in to be checked. This defeats the entire purpose of trying to stay home in early labor. An unnecessary trip into the hospital is a real bummer and can start you down a path you might be trying to avoid. Do you have a friend or family member that’s given birth before that you might be able to touch base with for reassurance that you’re moving in the right direction even if it feels long and slow-going? Enlist their help to be that touchstone for either you or your partner during this early part of labor. Remember, reassurance is key during this early phase.

9) Use those comfort and coping techniques that you learned about in an evidence-based childbirth preparation class.  Initially, you might find that focused and intentional breathing are all that you need to get through the peaks of contractions. But don’t forget to think about using different positions, sitting on the birth ball, getting into the shower, vocalizing, looking at a focal point, enjoying lots of massages, using rhythmic movements and getting plenty of encouragement from your birth team members as ways to help you continue to move through your early phase of labor and into the more active phase. Understand that you will need to do some of the hard work of labor before any medication will be a realistic option for you. Pay attention to this section during your classes, even if you are “planning on the epidural.” You’ll need to use some of these techniques at the end of early labor while you’re still at home, for sure while you’re making your way into the hospital and definitely when you first arrive as you move into active labor.

10) Wait until your contraction pattern gets to at least 5-1-1, maybe even 4-1-1, before you head into the hospital. What does this mean? You want to wait until you have a labor pattern where contractions are 5 or 4 minutes apart when measured from the beginning of one contraction to the beginning of the next contraction, each individual contraction is 1 minute long, and this has been happening for at least 1 hour. In addition to this, your contractions should be strong enough that during the peak of each one, you are unable to walk, talk or smile. You are all business and your full concentration is on getting through each contraction. When this is the case, you’ll be working hard and that means that you’re moving through early labor and into active labor. This is the perfect time to come to the hospital or birthing center as any distractions there will have less power to negatively impact your labor progress.

How long will all of this take – this early labor? For most women, it will be the bulk of their labor overall. If you had a 24 hour labor, you could expect  maybe16 hours of it to be in early labor! For the majority of women, they should expect to be laboring at home for about 2/3 of their overall labor. (This is, of course, based on averages of labor and your situation would be contingent on so many different things that makes this just an example. You could be at home shorter or longer than this and all would be in the realm of “normal.”)

I feel very strongly that it’s not enough to encourage women to “stay at home as long as possible” without providing some real tools about how to do just that. We have been fed a cultural construct about birth that makes it seem impossible that we could be in early labor walking around the neighborhood, going out for a bite to eat – passing the time of these short and do-able contractions without it being a huge, dramatic experience. Women need to have more confidence in their bodies and their ability to judge for themselves whether or not they are in labor. Too often they feel they need to have someone else tell them they’re in early labor for it to be “official.”

Coming to the hospital and being told to go home can be devastating for a woman, not just because it’s an unnecessary and uncomfortable car ride, but because it makes her second guess her ability to make the call and determine what “real labor” looks like. Providing women with the “Top 10 Things To Consider In Early Labor” is my contribution to helping women feel like they can cope with early labor and feel prepared to stay home as long as possible to progress in their labor and reduce their risk for unnecessary interventions, medications and Cesarean Birth.

I’ve never had a woman come through my class saying, “I can’t wait for all those interventions – bring ‘em on!” Most are wanting to avoid all of them if possible. Waiting through the early phase of labor before coming to the hospital or birthing center is an great way to start their individual birth story.

How can we, as Childbirth Educators and new parents get the word out about rethinking early labor? What other practical ideas do you think should be added to my “Top 10 Things to Consider in Early Labor?” I’d love to offer as many tips as possible for my expectant families, please feel free to share your own ideas in the comments.

Rethinking Early Labor Series: PART II

 Re-Think III

In my last post, I identified that laboring women and their partners are being encouraged to stay at home and away from the hospital in early labor. But the definition of early labor has changed. It’s now widely believed that a laboring woman needs to get to about 6 cm dilation before active labor has begun. With this change in definition comes a longer amount of time working through contractions at home in early labor. In my opinion, it’s not enough to just encourage women to stay at home for longer periods of time. They need some concrete ideas on how to normalize early labor and pass the time together without added anxiety. To that end, I offer my “Top 10 Things to Consider in Early Labor.” For this post, I’ve listed the first 5 things to consider.

1) If labor contractions wake you from sleep, stay in bed. If these contractions are real-deal, then you won’t really be able to sleep through them, maybe more like rest. But once you realize that you can comfortably have a contraction while lying down, then you should do just that. The bigger question is, do you wake your sleeping partner yet? Some women will say, “Absolutely!” and others will say,”No way!” Check in with your partner to make sure that if they’re wanting to be awakened at the first sign of labor that you honor those wishes. Just make sure that they’re on board with the “stay in bed” regimen first. No need to get up and bust a move until your body requires you to do so.

2) Get busy. Yep, that’s exactly what I’m talking about. A little nipple stimulation, or better yet, great sex can have fantastic results in helping your body continue to move forward in labor. I say great sex, because it’s the combined efforts of prostaglandins found in semen acting to ripen your cervix plus the release of oxytocin when you orgasm that can contribute positively to getting the party started. As long as your water hasn’t broken, there should be no concern in using this technique to help move things along. What a great, connected way to begin labor together! Plus – it might be a while on the other side of baby’s arrival before you’ll be ready to go there again, so you should definitely take advantage while you can!

3) Once you’ve gotten out of bed, drink a big glass of water and go pee. These three things – changing position, drinking a big glass of water and peeing – will give you needed information about whether or not this is the start of early labor or just your irritable uterus talking. Real-deal contractions will continue no matter what position you’re in and if you change the status of your bladder (which, so conveniently sits beneath your uterus) it can help you figure out whether or not this is the start of early labor. If after changing position, drinking a big glass of water and peeing you’re still having contractions that seem fairly regular, you could choose to check in with your provider and let them know you think you might be in the early phase of labor. You could always wait to check in too, but sometimes touching base with your provider helps calm any nerves you might have as labor is just beginning.

4) Eat something. I don’t care what it is and, really, neither should you. At this point in your labor, eat whatever sounds good to you and something that you wouldn’t mind seeing again later in labor (if you get my meaning). Nothing super heavy or spicy or greasy – but other than that, fuel your body. It will be doing a lot of hard work today and you want to make sure it has what it needs to help you get through. Eating in labor should never be denied to you, but it’s important to note that many hospitals have a clear liquids only policy when a woman is laboring in the hospital. One more reason to stay at home when things are just getting started. It’s super challenging to try and give birth to a baby when you’re starving! Eat at home until your body tells you, “No more food, thank you – I’m all done.” This usually won’t happen until you’re farther along in active labor.

5) Take a shower and get ready for the day. Most of us would like to head in to this experience of giving birth looking and feeling as good as possible. So at the very least, a shower is a great way to start. Some women will go into this experience au natural, and others will want to have their hair and makeup done before the harder work of labor begins. I’ve even known some women who’ve had their partners give them a little mani-pedi to help pass the time (often with hilarious results!) There’s no right or wrong to this one. It’s most important that you feel good about yourself as labor is just beginning. Also, any amount of time a you take to get yourself together while contractions are still manageable allows time to pass more quickly – always a plus.

These are only the first 5 on my list of “Top 10 Things to Consider in Early Labor.”

As you can see, they focus on the practical.

I believe much of the rush into the hospital happens as a result of what women are fed about birth from seeing it portrayed on TV and movies from when they were just little girls. It’s hard to get your head wrapped around the idea that birth is normal. That for most women, it starts out slow and stays at a slow and steady pace for a good, long while. It’s hard for a pregnant woman to imagine that she might actually maintain normal activities for most of her early labor. It’s hard for her partner to let go of the idea that they won’t be racing into the hospital at break-neck speed!

But there are real reasons to encourage laboring Mommas to stay at home for as long as possible in early labor: they’ll feel more comfortable in their own homes, wearing their own clothes, eating their own food, stepping in and out of their own shower… If we can normalize and recreate a picture of early labor as something do-able for most women and provide some thoughts on how to help pass the time of early labor at home with as little anxiety as possible, then she can move through early labor feeling confident. Confident in her ability to recognize when she should be heading into the hospital, and confident in knowing that she’s lowered her risk of unnecessary interventions, medications and Cesarean Birth.

My next post will be about the remaining 5 on my list of “Top 10 things to Consider in Early Labor.”

Rethinking Early Labor Series: PART I

Re-Think I

In doing some research for my book, just recently I read an article entitled, “What is women’s experience of being at home in early labour?” This article cites that there were four main reasons women came into the hospital “too soon” despite knowing that there was no need to arrive before active labor was well established: Reassurance, Uncertainty, Pressure from Others, and Permission. This article made me want to write a blog post (which has now ended up being a 3-part series!) about re-thinking early labor. I’m interested in how we, as Childbirth Educators, can do a better job at preparing our couples for the realities of early labor. Later in the series I offer concrete things to consider in helping women and their partners pass the time of early labor and stay at home longer. This is one of the most effective ways to avoid unnecessary interventions, medications and Cesarean Birth. 

First, a definition: Early labor, also known as the “latent phase” is so named because you’re not yet in active labor. This phase is most commonly the longest part of a woman’s labor experience and can easily take up 2/3 of the entire process over all. For over 60 years, we used Friedman’s Curve to describe early labor as moving from 0 cm dilation to 4 cm dilation. In very recent history, this curve has been under increased scrutiny and it’s now more widely believed that active labor does not really begin until a woman has reached 6 cm dilation.

This distinction between onset of active labor changing from 4 cm to 6 cm dilation is important. What this small shift in definition implies for today’s providers is that they should be willing to wait awhile before making the proclamation that a laboring woman who is taking longer to dilate has “failure to progress.” Hopefully this will translate to a more “wait and see” approach rather than moving too quickly to medications, interventions or surgery for the delivery of her baby.

But the implications for today’s laboring Mommas is also significant because this means that she will likely be working longer and harder at home in the early phase of labor before coming into the hospital.

As a Childbirth Educator, I have the specific challenge of encouraging the students in my classes to stay at home for potentially much longer periods of time when they (or their partners) might have great anxiety about doing this. How do we help a woman increase her chances of avoiding unnecessary interventions, medication and Cesarean Birth, but also address the level of anxiety that she (or her partner) might feel about continuing to cope through early labor at home?

First, reassuring every woman that her body is amazing and completely capable of giving birth to her baby should be a top priority. Too many of today’s pregnant women lack that celebration of their bodies and instead of feeling beautiful, strong and capable – they often feel insecure, disconnected and unsure of themselves. First time Mommas especially tend to feel like everything that happens to their bodies while pregnant is so foreign and strange that it’s hard to believe that any of it is normal. Any amount of information we can provide a woman about her body that reinforces how she is exquisitely made for the process of giving birth should be addressed early on in our classes.

The normal progression of labor should be presented in a way that boosts a woman’s confidence. Great care should be taken to explain what early labor really looks, sounds and feels like for the majority of women so they can begin to release the cultural construct that says labor is unbearable from start to finish. Women need help realizing that the depiction of birth they see repeated over and over again in movies and TV shows is done purely for dramatic or comedic effect. In reality, most first time Mommas can expect a slow and steady marathon pace of labor rather than a mad dash to the finish line. This information can help them realize that when early labor begins (after their initial moment of freak-out) they should settle in for what will most likely be a long wait until it’s time to come to the hospital or birth center.

Okay – so, maybe they’ve bought into this idea of waiting until their contractions get to a pattern of 5-1-1, or even 4-1-1, before making the move toward the hospital or birth center. They’ve read the articles that tell them that their chances of having unnecessary interventions and medications go up if they come to the hospital too soon. They don’t want to come in only to be sent home again. They get it.

But how do they manage to stay at home when labor drags on and on? If their water hasn’t broken yet (and for the majority of women this will be the case. Their water won’t break until they’re in active labor or actually pushing their baby out), how will a woman know definitively that she’s in labor and then feel like she has what she needs to pass the time of early labor at home? How can she do this in a way that progresses her labor and doesn’t make her crazy with anxiety? 

That’s where Childbirth Educators come in – we have to convince Mommas, and their partners, that it makes sense for them to stay at home for all, or at least, the majority of their early phase of labor. But – we have to provide them with real and concrete ways to do this.

In my next post, I will share with you the first five ways we can do that from my “Top 10 Things to Consider in Early Labor”.