New Beginnings Doula Training

New Beginnings Doula Training
Courses for doulas and online childbirth education

Sunday, August 14, 2011

Normal physiological labor-assessing progress during labor

Before I go further with this, I think I should define what normal physiological labor is and why I choose to use this term. First off, our bodies were made to birth. Just like they were made to digest or pump blood. There is a system involved that allows a mother to nurture a growing child and then birth that child. I will state here, that yes sometimes things go wrong, just like any other system we have. That said, I want to focus here on what happens during birth with everything functioning well.

I wanted to talk about this topic as I have just discussed how many medical personal never see what a birth without interference looks like, and how they need much more education in this respect. One of the best examples is with labor progress and vaginal checks.

Because most patients in labor get epidurals, cervical checks are an easy way to assess progress. Unfortunately there are a few problems with this method. The first being that with increasing vaginal checks, there is an increase in infection. It stands to reason that this would be better to avoid. It is also very uncomfortable for a laboring woman. For many practitioners, though, this is the only way that they have learned to assess progress because they have not seen enough births without medication to know what else to look for.

Those who have labored with women know that there are certain things to look for in a laboring woman that signals where she is at. A lot has to do with how she is laboring. For instance, the other night at the hospital a woman came in labor. During her contractions she was moaning and at the end of her contractions there was a small, hardly noticeable catch in her breathe. I looked at who I was with and told her...she's going to be delivering soon.

We found out that she had been 6 cm dilated at admission, but delivered 10m later. In this case, if you just paid attention to her dilation, you might think she has a little bit longer or not. The dilation at this point did not tell you much. What did tell me something was her behavior.

If you watch a woman over time you can watch how a woman's behavior changes and progresses and understand what that means. This is something impossible to gain experience in unless you do numerous unmediated births. But it is valuable because you avoid needing to introduce more bacteria that may cause infection or cause unnecessary pain.

I'm also not saying that a vaginal check is not useful sometimes, but what I am saying is that by paying attention to how our body would normally act or behave, we can do without a lot of routine vaginal checks.

Check out this page for other ways to assess dilation during labor:

No comments:

Birth is a Journey: Does it have to be life changing?

  • One woman might have to climb on an overfilled boat, risking her life and nearly dying as she escapes over the ocean to come to this land. This experience could certainly be life altering. It may very well color the rest of her life, positively or negatively. (I overcame this amazing struggle and here I am triumphant! OR Holy crap, that was SO hard I don’t know if I can go on! By the way, neither response is “right”. No one would judge the woman with the 2nd response.)
  • One woman may buy an airplane ticket, sit on a comfortable 747 and fly to America with a nice smooth flight and landing. She is happy to be in America. Those welcoming her are glad she is here safe and sound. She may only travel by plane 2-4 times in her life, so it is pretty memorable. But the journey itself probably wouldn’t be life changing; it would simply be a journey.
  • One woman may learn to fly an ultra-light plane to lead a flock of geese into America teaching them to migrate. This experience could certainly be empowering and life altering.