YOU’RE NOT IN LABOUR

425pregnant.jpgYOU’RE NOT IN LABOUR

These are difficult words for birth attendants to say; I would say they are right up there with “I’m sorry, I’ve made a mistake.” They are, also, difficult for the birthing woman to hear. I’ve been on the receiving and giving ends of those words.

RECEIVING END
During my first home birth (second baby, 12 years after my first birth), I “laboured” all day (5 minute apart sensations that I thought “really hurt”) and at 8 p.m., my mw did a pelvic and said “you’re only 3 cms., you’re not in labour. I suggest you send all these people home, stop entertaining, go to bed, get some rest and I have to go help some other midwives at another birth.” I remember (a) wanting to kill her  (b) knowing somewhere inside that she was right but not liking it and (c) going into the bathroom and crying my heart out. I did as she told me, went to bed and about midnight it swung into a whole different level of intensity. I could see what she meant that I hadn’t been actively having a baby during the day. I gave birth to my baby at 2 a.m. after about 4 hours of very high gear birth sensations.

What did my midwife do for me by “giving it to me straight”?

1. She gave me the benefit of her experience which was what I paid for.
2. She respected me enough to know that I could deal with the truth and she didn’t have to candy coat it for me.
3. She opened up the possibility that, yes, things could get harder but I could manage it.
4. She provided a model for me to give to other women.

At the time, I didn’t know that I would be attending births in my future but many of the things I learned from that birth now benefit the women I attend and those I teach.

At times, it’s tricky to know the woman who is “not in labour”. (I actually don’t use the term “labour”; I would use the term “not in the birth process” so I’ll change to that language now.)

A PRIMIP CASE

I was looking at a film this weekend of a 3 day marathon birth process. The birthing woman was having strong back to back sensations, feeling hot, in immense pain. She had a very good doula attending her plus her male partner. After three days of tiring birth process, she went to see her midwife at the birth centre and she was only 1 cm dilated. As I watched it (granted you can’t tell anything from a short film clip), I wondered if she might have scarring on the cervix from previous laser surgery. The other possibility is that she was scared to death and couldn’t dilate (it was a planned hospital birth centre birth with CNMs). At 1 cm she was given an epidural to get some rest and, the next day, “some manual help to get dilation going” (breaking up scar tissue, perhaps?) and she went on to birth her baby vaginally.

ANOTHER PRIMIP SITUATION

I was asked to help out at a birth for a midwife’s daughter. The grandmother thought the birth was imminent and wanted me to come over and provide support, camera operation, and rested after care person. When I arrived, sure enough, the daughter was in high gear and I proceeded to boil up the instruments and get things ready for the birth. Between the highly intense sensations, the birthing woman said to me, “Gloria, I like your running shoes.” At that moment, I realized that she wasn’t really in the birth process. (If a woman is really having a baby, I could be naked and she wouldn’t notice). I think this birthing mother had seen so many birth videos in her childhood that she was acting out the whole scenario rather than experiencing it. Needless to say, it was another 48 hours before that baby was born. Telling my friend who is a very experienced midwife that her daughter wasn’t even close to having a baby was not easy but it had to be done. With our own family members it’s often difficult to be objective.

A VBAC BIRTH THAT FOOLED ME

One of my VBAC clients called me to say she was having regular sensations. She seemed to be in the early stages of birth so I settled in to just wait it out. About 10 p.m. at night, things picked up dramatically so I decided to do a dilation check (this was 20 years ago). To my surprise and delight, she was 7 cms dilated. (that should have been a clue that I was making a mistake. When the external world doesn’t match the internal exam, check more carefully). I held her and massaged her all night long while the others slept. By morning, everything had petered out and I couldn’t figure out why she wasn’t actively pushing by that time. She had been snoozing between her sensations through the night but I’d had her on the toilet, walking around, in the shower, etc. I did another exam only to realize, at that point, that I had completely blown it, she was only 2 cms dilated and wasn’t even in the birth process yet. That was one of those awful moments when you have to say BOTH of the top two difficult things at once. I said “Theresa, I’m sorry I’ve made a mistake. Last night when I checked you it wasn’t accurate. Right now, you are 2 cms dilated and you’re not in the birth process yet. I shouldn’t have been encouraging you all night that you’d be having the baby soon. Right now, the only way that this will work is if you’re willing to begin anew. Cancel everything we’ve done so far and get back to the very beginning. You need to eat, get some sleep, downplay this early stuff, relax. Everything is normal and healthy but I have made a huge blunder and I’m sorry.” The worst thing I could have done in this situation is to lie to this woman and tell her that she had gone backwards in her dilation—yes, many practitioners do this. It’s so unfair to a woman who already thinks her body might fail her. Not only that, but I think somewhere in the woman’s own “knowing” place, she realizes that she has not really been in the birth process.

This amazing woman did begin anew. She and her husband forgave me for my mistake, rested, ate, relaxed, summoned their patience and had a home VBAC for their baby. I will be grateful to them forever.

MULTIPS CAN HAVE THIS, TOO

Even though a woman has given birth before, each birth is different. We got a call from a woman who lives out in the country that she was in the birth process. Usually one attendant goes first to scope things out and the other gets called when the birth is close. In this case, I picked up my trusty partner, Mary, because it was a second baby and the drive was long. When we arrived, the mother seemed to be having a lot of pain and I went into “we’re going to have a baby mode” getting the pool inflated and supplies ready. On one of my sprints through the kitchen, I noticed that Mary was sitting at the table reading. I said “What are you doing?, the baby’s coming.” Mary looked up and said “She’s not in labour, Gloria, you’d better check her before you get too excited.” Ewwwwww! I hated hearing that, but, of course, she was right and I knew it even without checking. Her membranes were intact, so I suggested checking dilation and the woman was more than willing (another sign it’s very early). Sure enough, no dilation at all.

We reassured the birthing woman that things would get more intense and she definitely would have her baby. To give her and her husband some privacy, we went over to the local mall and told her to call us when the sensations picked up. She never called us so, after we’d spent all our money at the mall (only time I ever shop is when I’m waiting on babies), we drove home. She called back two weeks later and, this time, she was really in the birth process and pushed her baby out two hours after we arrived!

Added December 2014. Quote from Gail Hart, Midwife in Oregon.

We all need to remember that Prodromal Labor is NOT LABOR.. Prodromal is symptoms which occur BEFORE LABOR BEGINS and are similar to the condition of PreMenstrual Syndrome.
We should help women recognize this is normal. It is not labor. it is not a sign in anyway of anything being wrong. It is not a symptom of malposition. It is normal.

She just is not ready to be in labor — the hormones are not quite there. These women can be ‘not yet in labor’ for days, sometimes weeks. They should understand this as normal ‘discomforts of late pregnancy’ and use remedies if they need it — baths, distractions, sleep aids etc.

The contractions they are having are preparatory — preparing for labor — and women with a lot of PreLabor SYmptoms frequently have easier labors because their uterus is nicely primed for labor when it does begin.
It is not relevant to know how frequently they contract — but the length and strength of the contractions will tell us (and mom) whe she is finally tipping into Labor. Contractions which are less than a minute long are not likely to be true labor.

Added December 10, 2016: From Gloria Lemay: Many women do things to “get their birth going”. This can range from a 4 hour brisk hike, to acupuncture, to eating spicy food, castor oil, etc etc etc. When the body isn’t ready to give birth, all these things do is just drag out a ‘pretend’ birth process.
Another big pitfall, wasting the early period of the birth process by staying awake, chatting, texting, and socializing. In modern times, we don’t seem to have the older, wiser women to tell the younger women to “chill out” and ignore the early phase. When the woman stays up all night in early birthing, she basically works a graveyard shift. Then, her circadian rhythms are thrown off. No other mammal does this. Electric lights are no friend to a birthing woman. So, don’t blame the woman’s body or the baby’s size when a birth is not moving along. Look to the powers i.e. the strength of the uterus. There are things that the woman can do to get the birth off to a good start beginning with waiting till the baby is really ready. Then, guarding her privacy and being in the dark will help her pituitary to work effectively in producing birth hormones.

44 thoughts on “YOU’RE NOT IN LABOUR

  1. I enjoyed this post but I have a thought. I always “labor” for weeks before I suddenly have a baby. After doing this three times, I thought I recognized the difference between what I think of as early labor and active, imminent labor. Except with my 3rd, I was so *relaxed* while laboring along with him, I honestly couldn’t tell the difference…at all. Until his *head* was on the perenium and had to hold him in to get to my friend’s house, where he was supposed to be born (his story’s on my website if you’re interested in details).

    I only bring this up because I think our perception of “real labor” vs “not real labor” is strictly a definition of convenience for the caregivers and Mom. The reality is that labor starts out very, very slowly for some of us and sort of picks up speed and intensity as the birth becomes imminent. With my first, I had regular contractions, all day, every day, for three solid weeks before my baby was born. The same was true for my second so I guess it’s understandable that when this started with my 3rd I just ignored it. The only difference for me between early labor and “baby coming out now” labor was the intensity of the contractions as I neared transition. My cervix changed by degrees, my babies engaged, all that. It just took forever and a day to get to around 6ish or so cntmtrs dilated and THEN it was like wham bam THANK YOU MA’AM, BABY!”. My longest “active labor” was only 7hrs long. But if you start with contractions=cervical changes….you get a much different picture.

    I think this is important. If anyone had told me I wasn’t in labor with my 2nd, I might have scratched their eyes out. Birthing is a process that begins with conception. There are no hard lines to be drawn, especially when one figures that each woman’s body and unique baby within her dance their own dance.

    At the same time, I can certainly see having some distinction or the sake of the people who need or want to be there for the birth. It’s not really practical to hang out for days or weeks as Mom n baby work towards those final moments or hours of their birth-dance, is it?

    • Good points. I feel that it is all work that gets the baby born eventually. Hard to get out of our heads and clock time and let go into birth time. We are not used to being with our body sensations and tuning in to see what they are telling us.
      I think most of my moms catch on after all the times I say during prenatals- it depends, let’s just see what happens, for some women it is like this and for others like this or what do YOU feel/think? LOL
      My favorite analogy for labor is weather. Some storms seem to come out of nowhere and some you get a little sprinkle everyday and wonder when is it going to really pour? and all the variations in between.

  2. Thanks for this, Rebekah. Such a good reminder that women are ornery critters who don’t like to do things by the (text) book. I had an apprentice at one time who was a very experienced and smart labour/delivery nurse. All I could teach her was that out of hospital birth doesn’t go according to any graph and is not pathological when it’s unpredictable.

  3. While I see the wisdom in what you’re saying, being a victim of “you’re not in labor”, I have a slightly different take on it. My primip story ended with the midwife, who did not want to be bothered with me just then, ramming her finger into my cervix so hard that I bled for days. Naturally, labor not only stopped, but it did not restart again…until that midwife went off rotation and another came on.

    Headgames happen on both sides.

    • Thanks, Laureen, sounds like she stripped your membranes rather than assessing your cervix. We live in a culture that is nuts when it comes to birth so, as you say, both women and practitioners are affected.

      • Actually, no. She literally rammed her finger up there, full speed. There was a huge scrape across my cervix (I checked). Jason almost punched her, it was so completely brutal.

        She’s not practicing any more, thank God.

        • Holy, Laureen, that’s unreal! Some pretty insensitive women dare to don the word “midwife”. I was only treated with love and respect by my midwives and that’s what the title denotes for me.

          I’m so sorry that happened to you.

  4. I too appreciate your wisdom. I was only a midwife briefly before deciding I should focus my energy on raising my children instead. But I wonder if your use of words could be more sensitive. You can certainly get the same point across in other ways without belittling all of the work the woman is or has been doing. Telling a woman that she is not in the birth process makes her feel as if everything she is doing is for nothing, and it might also put a lot of fear into her (“if this isn’t labor, I don’t know if I will be able to handle what actually is). Any time she is having regular contractions, any time she is effacing and certainly any time she is dilating, she is in labor, no? Could you not say that she is in early labor and that it is extremely important to lay the groundwork for active labor?

    My other thought was that with my first birth (an only birth to date, although I am pregnant now), I was talking between contractions right until the very end, even after transition. Even cracking a joke here and there. I know that isn’t common, but I don’t know that you can tell a woman’s progress by her demeanor (although I know this was not your only observation that lead you to your conclusion). I never really went to “laborland”.

    I do appreciate your posting though.

    • Whitney, I was talking and joking in between contractions right up until the very end too with my second! Then the midwife told me to turn to my side to help the baby come down, and then she came down so fast and the midwife and nurse came running back into the room when I said, “It’s burning!” They didn’t think I was so close by my demeanor!
      With my third birth a month ago, I was already in laborland by 5cm, even though we thought I was almost done, but after mw broke my water at 5, I had the baby only 20 min later!

  5. I am a midwife…and actually can’t imagine telling a woman that she is or is not in labor, especially based on a cervical exam. I especially wouldn’t presume to tell that woman what she is experiencing based on that cervical exam.

    With my first homebirth…I was in pain, working hard, contractions every 4 minutes. When my midwife checked me I was found to be 1cm dilated! Inside I panicked and looked her in her eyes and said, “I am in active labor!” She smiled and said the BEST thing she could have: “I believe you…so lets just have a baby!” And I did…I labored through the day, progressed steadily, and delivered my baby in my bathtub into daddy’s hands.

    My last homebirth my husband called “the team” in because of how quickly the contractions were coming (every 3-4 minutes) even though I was barely needing to breathe through them. When they arrived I was laughing, and chatting…offering people snacks or something to drink and showing off my tank top I had bought specifically for the birth that said, “She’s coming” (I was having a girl). Midwife checked me and said I had an anterior lip – baby was born 20 minutes later.

    I can absolutely say that 1cm with the first homebirth was worse than 9cm with my last one. If my midwife had tried to tell me that I wasn’t “in the process” with the first one, my birth would have gone very differently – and for sure, not in a good way!

    I refuse to tell a woman whether she is in labor or not…that’s her call, not mine! I will tell her if her cervix is or is not changing if she wants me to…but can’t imagine telling someone that she’s not in labor. I just can’t agree with that…

    • I’m with you sister! We need to be careful about interpreting a woman’s labor and birth experience. I went from 1 cm to crowning in a very short time with my second baby (after 11 hours of increasingly intense labor). If someone had said I wasn’t really in labor (or the birth process) he/she might have turned out to be right. Midwives know that this kind of discouragement can be enough to stall precious oxytocin production. We have to be careful about the realities we invite/create with our interventions and interpretations!

  6. It drives me nuts when women brag about how long they were in labour for when they’re referring to early labour, or what you say is not labour! Not that it should be about comparing but if you’re going to compare – do it like with like i.e. compare lengths of active, imminent labour.

  7. Thank you for this article, I agree on most points but I too was talking coherently and never went into labourland as such with my second and his birth completely took the midwife by surprise. I used HypnoBirthing and so was completely relaxed.

    It’s on youtube and you can watch it for yourself 🙂

  8. my interpretation of this piece is simply that there are times when a midwife has arrived, the woman and her partner believe labor is underway…the midwife hangs around a few hours and realizes that her presence is not yet needed. it can be hard to tell a family that you should leave, that it isn’t time for delivery yet…it’s not about telling a woman that the process is not *real*, just that it’s not eminent.

  9. I didnt go into “labourland” with my first baby, and it was the most horrifically painful thing ever! I didnt even make it to 6 cm before I let them push an epidural on me. with my subsequent two unmedicated births, I let my brain turn off and just let my body do it’s thing. each birth was less painful than the last.

    I dont think it’s anything to boast about if you went through labour chatting and serving coffee! if somebody was making it necessary for you to talk or do anything besides BE IN LABOUR while you were in your birth process, you maybe should rethink inviting that person to your next birth, man.

    • I enjoy visiting and celebrating while I’m in labor. Remember that each labor will be felt differently, and different women need different things to make their labor a good experience. some want privacy, others like a celebration. Some want quiet and not to be touched…others want to be talked to throughout their contractions and want to be massaged and loved on. every body and every labor is different….and my last birth (where I was laughing at jokes and offering snacks at 9cm) was, IMO, perfect and beautiful and everything I could have prayed for!

  10. I took red raspberry leaf tea for my first home birth, and it really works to hurry labor! First birth, 7 1/2 hours and no false labor. Our second home birth, I took red raspberry leaf tea and also took Lady’s mantle as well, and that helped a lot for the comfort level and speed. I didn’t even think I was in labor! This labor it was only 4 hours from start to finish! Transition was like 4 pushes, that was it.

    Using the birth pool and hypnobabies as well as an improved diet (raw milk helped, as did raw milk yogurt for the morning sickness), really made this birth very easy this time. I also took magnesium for improved blood flow, and witch hazel leaf tea (post partum) to help control the bleeding which worked. My first baby I lost a lot of blood and was still wiped out 2 weeks afterwards. I made sure to try and guard against a posterior position by not leaning back and not sitting back in bucket seats.

    • I also took RRL tea at the end of my pregnancy, and I don’t know if it helped speed labor up, but I know that I’m going to do the same thing next time! I didn’t really think that I was in labor until transition hit about 3.5 hours in. If we didn’t have to go to the hospital my daughter probably would have been born 30 mins earlier 🙂

  11. Gloria, I am very curious how this process (breaking up scar tissue) might be done and why it would be necessary?
    Thanks!

    quote:
    “I wondered if she might have scarring on the cervix from previous laser surgery. The other possibility is that she was scared to death and couldn’t dilate (it was a planned hospital birth centre birth with CNMs). At 1 cm she was given an epidural to get some rest and, the next day, “some manual help to get dilation going” (breaking up scar tissue, perhaps?) and she went on to birth her baby vaginally.”

  12. A couple things: thank you, Gloria, for this post. I appreciate the heart in it. And, as a woman who can relate to Rebekah’s birthing experience, I am encouraged to see your response to her.

    I also appreciate several of the comments here. I can relate to Stephanie’s perspective. Women labor differently. What one of us considers an ideal labor scenario may be off-putting to another. For me, the goal is to enjoy the labor/birth. This may be many women’s goals, but what that looks like can be very different. Also, for women who labor prodromally, “retreating” and “focusing” while laboring can seem like a luxury. It doesn’t exactly work to do so for weeks at a time, so some of us do so only when we know “this labor’s gonna deliver.”

    I also like the examples that show how not all women exhibit the textbook emotional/behavioural signposts at the “appropriate” times. Some women get super serious from the get-go. Other’s seem to not get to a very serious point until near the end (if at all). I believe this is more a reflection of the woman than it is of her labor. As one who has been known to smile and converse near the end, it can be discouraging for it to be assumed: a) I labor wrongly or b) my labors are easy. Labor is labor. It’s hard work.

  13. What a fabulous thread! I also tend to talk quite a lot in labor. I do have times when I get quiet and times when I’m joking. When my son was being born, I would be chatting and laughing, have a contraction while talking about it (well, grunting, really, as I was pretty much pushing when I walked in the door) and well, I like it that way. I like my births to be like a party. That’s fine with me. But I know women who can’t STAND that much attention in labor. I’ve met women who literally found the darkest, quietest place where they could just totally be alone, not even their husbands, to birth their babies.

    To me, it’s all “right”. Every human being is special and unique. Why should their births be any different?

  14. I so much appreciate this site, found while researching whether reduced amniotic fluid really increases risk. Because of past uterine surgery I do not qualify for home birth. I am approximately 32weeks with my fourth living child. So much of me identifies with the idea of being in the beginning stages of labor for weeks ahead of time. Both my first and third baby were born so fast once clinical standards for active labor were achieved that if I had not already been hospitalized for reduced amniotic fluid, I am convinced that I would never have made it to the hospital. We are approximately 1 hour away. My third child was born less than one hour after a hard contraction caused a pop and small gush of water. (Yes, gush, even though I was diagnosed to have low amniotic fluid) After that gush I needed physical support from my birth team to change position- even in bed. Before that pop the contractions were weaker and farther apart than I had experienced consistently every night for the previous two weeks.

    It is the pure grace of God that I have had such wonderful labor experiences. Hospital policies and procedures are not ideal for promoting healthy natural experiences, but my husband and I always ask “why?”, “why not?”. We insist on comfortable positions and movements for me when they ask what I will be using for pain medication, and we have avoided intervention several times because of how busy our Drs. have been with other more needy patients. The majority of staff have been respectful and even helpful, when approached with politeness, confidence, and at times stubbornness. I think that I will discuss with my husband as well as provider the possibility of refusing the late term ultrasound, but who knows? My babies are always extremely active up until the day before birth day(resting up for the big event maybe?), when they have slept through their ultrasounds and been low enough on fluid to scare the Ultrasound tech and OB. The truth is, they are not really as scared of a bad outcome, as the litigation that could end their careers after a bad outcome if they haven’t covered every base and followed every policy every time. They told me never to come to a U/S appointment without having a really good meal and a large cold sweetened drink, as that will affect the test more than anything. I really don’t want unnecessary intervention, but overnight hospitalization may be the only thing standing between me and a Fire dept delivery. We are kind of playing their game, helping them check off their safety boxes and then somehow managing to do it our own way anyhow. Please pray for us and offer any suggestions

  15. I nearly had an unassisted birth with my daughter, much to my surprise! I didn’t beleive I was in labor until it was almost too late to get to the hospital, mainly because I trusted books more than I trusted my own intuition. (Books that said that labor would last 10+ hours for a new mother- mine was less than 5 hours!) That being said, I was grateful to be able to labor on my own and avoid cervical checks.

    I had discussed this with a friend of mine who recently had a baby- but could tell that she didn’t really trust that she would know when labor had started, and she listened to the doctor when he told her to go to the hospital after her water had broken. They examined her, told her that she was 3 cm and IN LABOR (although she had NO CONTRACTIONS) and started augmentation (induction, really). The story ends 8 hours later with a c-section. I wish that her doctor had just told her that she wasn’t in labor. I feel like she was lied to, and because of it she doesn’t feel that her pelvis was big enough for her 7 ob 13 oz baby, all because of the provider’s impatience. *sigh*

  16. This reminds me of my last birth. I was so anxious for labor that I imagined it was starting all the time. But of course it wasn’t. My wise midwives said, “You’ll know when it’s really labor.” When I was having the 3-5 minute apart contractions for hours on end I knew that wasn’t really labor, anyway. My wise midwife told me to stop counting. Don’t write down another contraction time. I would know when it was really labor, and I would come in to the birth center to give birth. And once it really began, I knew it. It was so different. And I gave birth almost immediately after arriving at the birth center! I’m grateful for midwives like you who don’t sugar coat it.

  17. I can relate to Stephanie’s experience. I am chatty and happy when I’m in labor. With my 4th, my midwife told me that I was too happy to be in active labor (this was over the phone). I assured her that I WAS in active labor and she came anyway. DS was born 1 1/2 hrs later. With my 5th, my midwife arrived 45 minutes before DS was born. After she arrived, she started setting things up, we were talking and joking and I even got out the Nosefrida (Snotsucker) to show her. This went on for about 30 minutes and then I got in the pool because I knew if I waited any longer it would be too late. DH told her that he knew it would be soon. After the birth, she told me that she couldn’t figure out why DH thought that, how he could tell, because I certainly wasn’t acting like I was that far into labor. What I’m saying is, I would have noticed my midwife’s shoes (she took hers off at the door, so there weren’t any to notice) and would have absolutely noticed if she was naked! If someone would have told me that I wasn’t in labor at that point because of how I was acting, I would have laughed and said, “please stay, you’ll see!” Yes, labor is hard work, but for me, it is a celebration, something to be happy about! I appreciate the idea behind this post, but not all women labor the same way and applying stereotypes to laboring women only leads to trouble.

  18. I birthed my child this last Monday. It may not be correct to say that mothers who are in the birthing process are not able to make observations if they are actually in “labour”. I was actually quite light and making jokes while 8-10 cm dialated. I think that it had to do with the positive atmosphere and the calmness that I felt at this time. As Mac stated earlier, I agree, not all women labor the same way. None the less, a wonderful post.

  19. As an L&D nurse, I cared for women who seemed to “know themselves” and others who relied on others (the system) to tell them what was happening to their bodies. I trusted the former to tell me “s/he’s coming” and used cervical exams for the latter.

    For my first birth, I woke up at 430 am, and kept waking up every 5 minutes before I realized I must be having ctx. That afternoon, I went to the doctor’s office. I knew I wasn’t really active, but figured since it was Friday, better to check in with him during office hours. “Closed, thick, & high. You’re not having this baby any time soon.” At 11 pm, things had changed. I was uncomfortable to the max! Went to the hospital. I was only 2 cm, and they wanted to send me home, but called the MD first to give an update. He said to keep me, as this was a significant change since 5 pm. (Glad he did – the L&D ward had been empty for 2 weeks, and they had 13 births in 11 hours that night. Many women labored in the hallway with curtains pulled around stretchers. I got the last labor room.) I gave birth 3 hours later.

    In my last birth (#7), I was giving birth for another couple, who had never seen a birth before, and until they met me, were unfamilar with the concepts of natural birth. They were initially frightened of the prospect of an out-of-hospital birth for their baby. My contractions were 10-12 minutes apart when I woke up because my watch was too tight and was irritating me. I removed the watch and tossed it away. It landed in a pitcher of orange juice on the coffee table. I remember being really embarrased. “If this is how I’m acting in early labor, what am I going to be like when it’s ‘real’?” 5 minutes later, I felt the urge to push. My water broke on the way to the birth center, (“Don’t worry it’s a rental car!”) and the midwives made it to the parking lot where I gave birth standing up holding onto the car (imagine a scene from Cops) in a driveway shared with Wendy’s drive thru.

    It’s difficult to say based on ctx timing, dilation, or mother’s behavior. Sometimes, it’s best to trust intuition and instinct.

    • Oh – and that couple is now an enthusiastic supporter of natural birth, midwives, and out-of-hospital birth centers!

  20. Sometimes I wonder if even the act of checking for dilation ought to be postponed as long as possible and to simply encourage rest, hydration and carbohydrates. I mean it comes when it comes, and rather than focussing on the linear aspects of time and measurement, it may help the woman to be encouraged to accept the processes of transition as a way of being in and of itself with no definitive end, or beginning… once you put a number to the birthing process ie: 7cm dilated, you set up an expectation and take the woman out of her process to assimilate the information with the part of her brain that is at odds with the birthing process. everyBODY is different and a measurement is only as good as the physiological process behind it… and yes a woman’s body CAN stop labouring if she is around people and situations she does not feel safe… the best way is to just encourage the woman to present and relaxed and put the expectation on the back burner, forget the measurement of the cervix altogether.

  21. I totally get what you’re referring to here, but I also think it’s good to listen to the mom too. I had a lot of prodromal labor and if I hadn’t known better maybe I would have thought I was in labor, but I did know when it went from same old contractions to actual early labor. I definitely felt the switch to active labor too, yet I saw my midwife in active labor and she said I wasn’t (no cervix check or anything) I was contracting every 6 minutes and couldn’t talk through them! I went home, contractions got 4 minutes apart, shortly after my water broke, and I hit transition! I think if anything, her saying I wasn’t in labor delayed me from really giving in and letting the contractions take over and progress. I wished she had just agreed that something was happening, because I wasn’t at the point where I wanted her there at all, but I was definitely not able to just relax and have some wine by that point like she suggested! Even once she arrived at my birth she thought my contractions were 15 minutes apart, but I was having them on top of each other and not speaking at all because of it, which they took to mean I wasn’t having a contraction. Not all woman make noise I guess 😉

  22. These comments have been so encouraging to read. I was in prodromal labor the entire time… I too didn’t feel much of a difference from the beginning until the end, I didn’t feel very different when I went into transition. I was exhausted after 5 days of laboring, not sleeping and having no significant changes. I planned on having a birth center birth without any assistance, and I ended up going to the hospital at this point, had an epidural at 8 cm and tried to sleep throughout the day. After hearing I was 8 cm and my labor was stalling..again..I was given help to move the labor forward and 12 hours later I had a beautiful little girl. We are all so different, our bodies are so different. I remember the midwife telling me I wasn’t in labor in the middle of the night for the 2nd time and thinking this is impossible…

    Hearing other people’s stories, and makes me feel a little less crazy…I really appreciate it.

  23. Hi, Fascinating stories. While every woman is different, and every baby has its own ideas, there can be no strict definition of labour. Many of the long drawn out sets of contractions are due to baby trying to find the position most useful for him/her.Some are ready early, and some leave it till the last minute. Once the baby is sorted, the uterus will change shape with each contraction, and the mother will feel the difference. If we listen carefully to the mother, there is seldom any need for vaginal exams—except to keep the records tidy.
    Jean Sutton

  24. Ahhh. Stumbling across these words as I await a young Mommy’s turning the corner and moving on into the end of her birth process…tough, tough
    Words to convey. She is truly entertaining her host of family members and has been doing so for days. Of course the grandma to be called with worries and I could hear the mom quietly increase her breathing every few minutes and doing so for 3-4 minutes at a time. Sleep is not the word that any of them want to hear. Yet mommy to be is only wishing that her pains are true active labor. I’ve been saying sleep for three days now but at midnight they all want her (and she wants) to begin nipple stimulation. Everyone in the house has been on fire for this labor to be done. I feel that mommy to be is trying to please her helpers and wish her contractions into something much bigger than they really are. Sigh. I don’t sleep well under these circumstances either.

  25. I’ve heard those words, and they turned out to be inaccurate. My son fell out exactly 3 hours after the hospital sent me home because I was not supposed to be in labor. I labored at home with my husband until I was pushing because I thought I wasn’t in labor and the people who were supposed to know told me so. My son was very nearly born in the car because it didn’t occur to me to question the L&D staff until I was pushing. According to my chart, I labored for 3 hours, though I had been having surges all day before then; I was in labor much longer, regardless of what their parameters would say.

    Not all women labor the same and though wisdom can be helpful in these situations, some of us don’t start feeling intensity or pain until transition and some of us never go to laborland. As a homebirth midwife, I would hope you would recognize that there are many of us outside of the box, and that though it might not have looked like labor to the L&D staff, it most certainly was. I realize my experience is mere anecdote, but there are many anecdotal stories that go along with mine. Even if my experience is only 2% of birthing women, that is significant enough to be considered normal. A variation of normal, but normal still, to be sure.

    http://sesasha.wordpress.com/2012/06/07/aidens-birth-story-or-but-babies-are-born-in-the-hospital-right/

  26. Not everyone labors in a big show and individual labors are quite different. Of course you know this, but some of what you said did not ring true for me. I would be somewhat likely to compliment your shoes, if I cared much about shoes, when about to give birth.

    I had my third baby unassisted because my midwife poo-poohed me (in person at an appointment!!) when I told her I was in labor and would be seeing her later that day. My baby did, in fact, arrive less than 2 hours after I left the appointment. Having her tell me I wasn’t really in labor caused me to doubt myself – and what I KNEW was happening in my body – as well. I did have the most lovely labor and birth that time, though. It was kind of blissful to lie on my bed laboring, feeling the sensations without having them interpreted for me or being told what to do, completely un-harassed, and then to have my baby arrive safely with just me and my husband. The midwife arrived, with apologies, about 5 minutes later. I wouldn’t plan a birth unassisted, but it was truly the best birth EVER.

    I subsequently switched to a midwife who *did* listen to me and what I knew and believed about my own body. When I started to tell her I felt that I would have an especially short labor with my fifth, she responded by arranging for a different backup midwife who lived very near my house. This proved to be a good move as my birth process with that baby was an hour and 15 minutes from “wake up with a mild cramp” to “it’s a girl!” In those 75 minutes, I had time and with-it-ness to use the bathroom, call the midwife and tell her I “had something going on but not sure how long it’s going to take” – but she took me seriously and set things in motion, post on facebook, change loads of laundry in the basement, get a loaf of bread going in the bread maker – which turned out GREAT even though I had my doubts when I was measuring the ingredients, wake up my husband, and then shower until I felt complete. The backup midwife (who was wonderful, quiet, and respectful so that this was my second favorite birth of all 5) did arrive just minutes before the birth, while the primary midwife was still 20 or so minutes away.

  27. ‘At that moment, I realized that she wasn’t really in the birth process. (If a woman is really having a baby, I could be naked and she wouldn’t notice)

    I don’t understand this comment. I was more than capable of holding normal conversation and making observations between contractions right up to the push part of the labour. What do you mean by ‘in the birth process’?

  28. I guess everyone is different. I had the “birth stages” in my mind, and anticipated on still going to my scheduled mani pedi after my labour started. Soon after my first contraction, within the hour, just after checking into the hospital, I remember thinking I feel the baby’s head it’s coming. No one took me seriously, I was not flushed, I didn’t “look” like I was in heavy labour but felt like it. It was my first child so of course I wouldn’t know…I was squating and I got more frustrated and feeling angry as none listened as everyone insisted on moving me and “checking” on the bed,…yup fully dilated, baby has crowned. Me, frustrated, as I had been telling them so for the past half an hour that I felt the babies head. I had been left in the hospital room with my husband and a student nurse, the midwife was with another person down the hall who was “farther along” and “it was very busy”. So for me the best advice is trust yourself. 🙂 Everyone is different.

  29. I agree with Elsa. We talk a lot about how all women are different, but sometimes we forget that means some women, even first-time moms, go quickly. I had never even heard of precipitous labor because everyone (myself included) imagined I’d be like everyone else I knew and be in labor for hours or days. But I’d had no noticeable contractions when my water broke at 8:05 p.m. If I’d listened to my doula about taking a shower and getting some sleep, I’d have had my baby on the kitchen floor at 11:02 p.m. I was NOT prepared for such a fast labor. (Also, I wouldn’t recommend it! There’s a reason it takes a while!)

  30. Pingback: YOU’RE NOT IN LABOUR by Gloria Lemay - Birth Balance

  31. Yes, every woman and every labour is different! My first 2 births, I woke up, started to contract and progressed to birth. No pre labour contractions at all. 6 weeks before my due date with # 3, I started having mild regular contractions. I visited my Dr. Who said I was not beginning labour. But I knew better! I certainly knew I was not in active labour, but also knew this was the beginning of the end. The most concrete giveaway was a vaginal odour I smelled regularity as a maternity nurse when assisting labouring women. I progressed into an on again off again contraction pattern for the next 2 1/2 days, eventually delivering my very healthy premature daughter. I learned through out my career to really listen to women’s intuition and self knowledge! Can a woman be incorrect? Yes, as can medical professionals.
    Thank you Gloria, as always, for this great post.

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