All the tips below are meant for a pregnancy without complications and for a natural birth (i.e., birth without drugs or interventions) that would take place either at home or at the hospital. By no means should these tips replace the advice of your midwife or doctor. These tips have been gathered from the books on labour and delivery (see Pregnancy and labour resources), as well as from the prenatal classes and the information given to me by my midwife and my doula. Use at your own risk.
Stages of labour
Early labour (may last 12 hours or more, dilation 0-3cm, contractions lasting 30-60 seconds being 5-20 minutes apart, possibly water breaking, possibly loss of the mucus plug) is best ignored. Go about your day as much as you can. Work on a labour project (do something that keeps you moving, in touch with your everyday life and mentally engaged: bake a cake, write letters or postcards, wash/fold clothes, clean, etc.) If the labour starts in the evening, it is best to halt it. Getting into a warm bath (if your water have not broken) and having a glass of wine can help stop contractions. This might give you a chance to sleep and gather up the strength for the inevitable resumption of labour that is to follow. It also gives your birthing group a chance to rest up before the labour marathon. Many hospitals will send you home if you arrive there in early labour.
Active labour (may last 6 hours or more, dilation 3-7cm, stronger contractions lasting 45-60 seconds being 2-5 minutes apart, possible increase in bloody show, possible increase in pressure in the back) is when it starts to get real. Various pain relief measures can be used: massage, putting pressure on the tail bone in case of back labour, using the physio ball to lean on, slow-dancing or hanging from a partner, finding a rhythm that works for the woman. The warm bath or shower is better not to be used before the dilation reaches 6cm. Many women are ready for an epidural at this point, and water might help them get over the need for it and allow to continue drug-free. It is said that it is about as hard to get to 6cm dilation as it is to get to 10cm, so once the woman gets to 6cm it will not get progressively more painful, but will stay approximately at the same level.
Transition phase (may last from a few minutes to a few hours, dilation 7-10cm, much stronger contractions lasting 60-90 seconds being 2-3 minutes apart, possible increase in bloody show, possible strong pressure on back and rectum, possible vomiting, possible urge to bear down) is the intense part of labour before delivery. Very intense contractions, keeping a rhythm it seems is the only help here.
Pushing stage (may last a few minutes to more than 1 hour, dilation 10cm, slightly less painful contractions lasting 45-90 seconds being 3-5 minutes apart) might bring with it an overwhelming urge to push. This is when the baby’s head is crowning and the baby is eventually born.
Tips for active labour, transition, and pushing stages:
- Labour in private or be comfortable with those in attendance. Women have been known to not only stop dilating and completely halting labour, but also reversing the dilation, if they feel uncomfortable with the atmosphere in the room. This stems from the adrenaline-producing response to a frightening stimulus in nature, where a female of the species must flee or fight before the labour can continue.
- Laugh and relax your facial muscles, mouth, and jaw. If your jaw muscles are tight, chances are your cervix is not opening up either.
- Use nipple stimulation to produce oxytocin – the hormone that helps the uterus contract.
- Try hydrotherapy: take a warm bath (unless your water broke) or shower, preferably after dilating to 6 centimetres.
- Walk, dance, change positions – move around during labour: the movements help your baby move down. Move your hips, it helps the labour progress.
- Concentrate on an opening mantra (you can make one up) or a piece of birth art – it will help you open up.
- Relax pelvic muscles – the baby is coming out one way or another. Relax your bottom to help the process along.
- Breathe slowly and deeply – this is the basis of many yoga teachings: deep breathing helps relax the muscles.
- Speak loving words – Ina May categorically states that she has never seen anyone’s cervix remain tight when they spoke words of love to those around them.
- Use the “horse lips” technique – relax your lips, blow a good amount of air through them while flapping them like a horse would. This relaxes the throat and jaw muscles and with them the cervix and the perineum. If it makes you laugh – so much the better, since laughing aids in muscle relaxation.
- Sit on a toilet, a birth stool, edge of a bed, squat. Move in ways that feel natural to you – the hip movements help the baby move down.
- Let gravity do the work – use upright positions. The “classical” Western childbirth position with a woman on her back with her legs up is possibly the most illogical one: not only does the pelvis get narrower in this position, but the baby has to be moving horizontally and then upwards. The only reason for this position is to allow doctors easier access to the patient, not to make birth easier for the woman.
- Drink a lot to stay hydrated (take a sip after every contraction – make your partner bring the straw to your lips), urinate every hour (this will ensure that at least once an hour your pelvic muscles relax which will help the progress of labour).
- Explore touch and massage: pressure on the tail bone or on the lower back, hand and foot massage, thigh and leg massage.
- Invoke goose bumps on the mother – this manoeuvre causes a release of endorphins.
- Explore being shaken by others to speed up a prolonged labour – this can be the rhythmic shaking of the woman’s thighs or a Chinese approach called chung when two or three people vigorously shake the mother all over.
- Pant when pushing to reduce probability of tears, push only when you have an urge to push.
- Stimulate clitoris as baby emerges – this increases vaginal engorgement and might help prevent lacerations.
- Make low register noises, such as moans, – the vibration will be reflected in the lower part of your body.
- Use the relaxation, rhythm, and ritual technique described by Penny Simkin: she found that women that cope well in labour exhibit the same three basic traits: they are able to relax between or during contractions, they use rhythm to get through the contractions, and they create their own ritual by following the rhythm they have chosen.
And remember, labour is hard, it is painful, and you can do it.