After that last post, I thought it might be good to do a follow up post on early labor.
I have had quite a few friends who have had some hard experiences with long prelabors. These are labors where you are feeling contractions, they are regular and strong, but they aren't progressing very quickly and often come and go. An example is someone who has been contracting regularly for 5-6 hours and they are about 4-10m apart and feel like they are getting stronger. This goes on throughout the night and the next day they are gone. They then reappear a day later and start the same pattern. Or you have been contracting for a few days, but at the hospital they send you home because your cervix isn't changing.
This can be tricky for both the mom and the medical provider to deal with. What is difficult, is that our model of labor today is based off of the Freidman's curve, which many providers feel like it is very outdated. The model basically states that if you get to 3-4 cm and have regular painful contractions, your cervix should dilate about 1cm/hour. I think this idea has led to some labors which are not supported very well, both emotionally and physically, and have led to unnecessary interventions and possibly c-sections.
If you take a look at the references I provided, you can see that a lot of research is suggesting that the active phase of labor should really not be started at 3cm(one even suggests it should start at 5cm or later in women who haven't had any children before), and that labor actually progresses a lot slower, particularly in women who have had no previous children. So what does this mean? It means the medical community is just as confused as we are about when labor starts and what to do about it. And if it doesn't fit their definition a woman is either sent home with no support or help, or put on pitocin when it may not be appropriate or needed.
So, what can you do to help during this time? Here's a few suggestions I've come up with to help you work through the early phase of labor. Much of this is based of off my discussion on Maslow's Hierarchy of Needs.
First off, you want to take care of yourself physically. Your going to need lots of energy when you go into more active labor. So the three things I suggest first is to make sure you are rested, drink and eat. Sometimes, these things may slow down labor, but you will be grateful for the renewed energy when you are having to do more work. If your basic physiological process are not taken care of, it makes labor that much harder.
Then you need to think about what you need to do to feel safe and protected. This is very variable among women. Some women don't want anyone else around, or feel uncomfortable with others watching. Some need to know exactly what is going in with their bodies and want to know how far dilated they are. Others could care less and just want to be left alone. Some want to know that their baby is ok. In any case, it is perfectly acceptable to stay at home if you feel safe and comfortable there. If you feel like you need more info, though, you may want to go in "just to see". If you go in early though, chances are you may have more interventions done. It's just something you need to understand about the medical philosophy. If you come in, it means you want something done to you:)
Pain control would also go under this need to feel safe, I think. So if you are dealing well with contractions at home, then your good to stay. If on the other hand, you aren't, and are comfortable with pain medications you can go to the hospital to get some, even if you are not in active labor. Some comfort measure you can take at home...movement, rocking on hands and knees, a bath or shower...check out my section on essential oils. Try and find something that can distract you, like a movie or a book. Once that no longer works, you can work on some of those other things mentioned. Also, a doula can help a lot during this time, even if you are not in active labor. Try finding ways to help you relax. You can use music or relaxation exercises. Just make sure that you are still focusing on you physiological needs at this time too. If you are tired, sleep. Hungry, eat. You really don't know how long you may be doing this:)
Pay attention to how you feel with others around you. If you are feeling distracted or uptight by the people around you, you need to let them know you love them, but need them to be elsewhere:) This may include your kids. Even if you are not in active labor, it is beneficial to find someone to watch your kids, if they are making your nervous or tense. On the other hand, kids can be a good distraction. Also make sure that you have the people there that you need. Part of this includes people who help you to make choices and respect those choices.
The hardest part for most people is the waiting and wondering if this is it. For those that have long early labors, it really is a test in patience. But, just so you know, the medical profession has no clue either:) Some medical reasons to consider...if you are just exhausted-you have not been able to eat or sleep, and your body needs a rest. You are not coping well with contractions or you just want some medical pain relief. Something just doesn't feel right or the baby isn't moving much. So if you feel like you should go in...well you would know more than me:) I usually advise to go to the hospital when you are having to concentrate through your contractions and you can no longer talk through them, but that's not really a hard fast rule either.
References:
http://www.ncbi.nlm.nih.gov/pubmed/20629924
http://www.ncbi.nlm.nih.gov/pubmed/12388957
http://www.ncbi.nlm.nih.gov/pubmed/20308828
http://www.ncbi.nlm.nih.gov/pubmed/8598954
I have had quite a few friends who have had some hard experiences with long prelabors. These are labors where you are feeling contractions, they are regular and strong, but they aren't progressing very quickly and often come and go. An example is someone who has been contracting regularly for 5-6 hours and they are about 4-10m apart and feel like they are getting stronger. This goes on throughout the night and the next day they are gone. They then reappear a day later and start the same pattern. Or you have been contracting for a few days, but at the hospital they send you home because your cervix isn't changing.
This can be tricky for both the mom and the medical provider to deal with. What is difficult, is that our model of labor today is based off of the Freidman's curve, which many providers feel like it is very outdated. The model basically states that if you get to 3-4 cm and have regular painful contractions, your cervix should dilate about 1cm/hour. I think this idea has led to some labors which are not supported very well, both emotionally and physically, and have led to unnecessary interventions and possibly c-sections.
If you take a look at the references I provided, you can see that a lot of research is suggesting that the active phase of labor should really not be started at 3cm(one even suggests it should start at 5cm or later in women who haven't had any children before), and that labor actually progresses a lot slower, particularly in women who have had no previous children. So what does this mean? It means the medical community is just as confused as we are about when labor starts and what to do about it. And if it doesn't fit their definition a woman is either sent home with no support or help, or put on pitocin when it may not be appropriate or needed.
So, what can you do to help during this time? Here's a few suggestions I've come up with to help you work through the early phase of labor. Much of this is based of off my discussion on Maslow's Hierarchy of Needs.
First off, you want to take care of yourself physically. Your going to need lots of energy when you go into more active labor. So the three things I suggest first is to make sure you are rested, drink and eat. Sometimes, these things may slow down labor, but you will be grateful for the renewed energy when you are having to do more work. If your basic physiological process are not taken care of, it makes labor that much harder.
Then you need to think about what you need to do to feel safe and protected. This is very variable among women. Some women don't want anyone else around, or feel uncomfortable with others watching. Some need to know exactly what is going in with their bodies and want to know how far dilated they are. Others could care less and just want to be left alone. Some want to know that their baby is ok. In any case, it is perfectly acceptable to stay at home if you feel safe and comfortable there. If you feel like you need more info, though, you may want to go in "just to see". If you go in early though, chances are you may have more interventions done. It's just something you need to understand about the medical philosophy. If you come in, it means you want something done to you:)
Pain control would also go under this need to feel safe, I think. So if you are dealing well with contractions at home, then your good to stay. If on the other hand, you aren't, and are comfortable with pain medications you can go to the hospital to get some, even if you are not in active labor. Some comfort measure you can take at home...movement, rocking on hands and knees, a bath or shower...check out my section on essential oils. Try and find something that can distract you, like a movie or a book. Once that no longer works, you can work on some of those other things mentioned. Also, a doula can help a lot during this time, even if you are not in active labor. Try finding ways to help you relax. You can use music or relaxation exercises. Just make sure that you are still focusing on you physiological needs at this time too. If you are tired, sleep. Hungry, eat. You really don't know how long you may be doing this:)
Pay attention to how you feel with others around you. If you are feeling distracted or uptight by the people around you, you need to let them know you love them, but need them to be elsewhere:) This may include your kids. Even if you are not in active labor, it is beneficial to find someone to watch your kids, if they are making your nervous or tense. On the other hand, kids can be a good distraction. Also make sure that you have the people there that you need. Part of this includes people who help you to make choices and respect those choices.
The hardest part for most people is the waiting and wondering if this is it. For those that have long early labors, it really is a test in patience. But, just so you know, the medical profession has no clue either:) Some medical reasons to consider...if you are just exhausted-you have not been able to eat or sleep, and your body needs a rest. You are not coping well with contractions or you just want some medical pain relief. Something just doesn't feel right or the baby isn't moving much. So if you feel like you should go in...well you would know more than me:) I usually advise to go to the hospital when you are having to concentrate through your contractions and you can no longer talk through them, but that's not really a hard fast rule either.
References:
http://www.ncbi.nlm.nih.gov/pubmed/20629924
http://www.ncbi.nlm.nih.gov/pubmed/12388957
http://www.ncbi.nlm.nih.gov/pubmed/20308828
http://www.ncbi.nlm.nih.gov/pubmed/8598954
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