Laboring at home

This momma was a nurse herself and frankly had no problem speaking up for herself. I was, of course, this family’s birth photographer, but also their labor doula. I was their doula “just in case” things went sideways. I arrived to do all the at-home laboring which I love. Mom, was completely in control and dug deep inside herself. Some mom’s to be are loud and proud and some look inward for their stability. She was the latter. I found myself wondering how to help or if I was doing anything at all. I voiced this later and she assured me that just being there was comforting and I hadn’t needed “to do anything”.

When contractions started to become more frequent and increasing in intensity, we all headed to the hospital. It was important to do this first bit at home. She was more comfortable, able to walk and do as she pleased, and reduced time actually in the hospital.

Heading to the Hospital when Active Labor Begins

Once at the hospital, the nurses did all the things, began an IV port, monitored the baby, and checked her cervical dilation. But that is when any hands-on “stuff” ended. It was only her, her breathing and deep concentration. This portion didn’t last long at all. She did most of the work at home and now she was going to meet her child.

A completely hands-off OB

I have never seen such a doctor listen so well and be completely hands-off. There was no coached pushing. No “1,2,3,4 PUSH“, there were very few people in the room, and there was dimmed lighting. Gone were the sounds of voices, the beeps of machines, and fingers on and in her vagina. The OB was there, but simply watching and not right on top of her.

Baby was Born into a Peaceful Environment

The baby girl was born and came out all on her own. No yanking baby out, no pulling, no guiding, and no yelling “Here she is!” It was calm. It was breathtaking. It was amazing.

Postpartum

These very calm parents, doctor and the nurses took such good care. I wished all OBs could be so accommodating. There was no rush. He waited to cut the cord until it was white and aided in delivering the placenta. There was no tearing. He calmly finished up, congratulated this couple, and silently left the room.

I hope you take the time to watch the video. Don’t expect a lot of screaming and fanfare, but instead watch the quiet determination of a strong woman and her equally strong partner welcome their baby daughter. A natural hospital birth can be accomplished.

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In April of 2020, I started my journey to understanding on a deeper level and become a doula. As I write this, I am not finished with my education, but I would like to impart some knowledge as I go. In this episode of “What the heck is birth about” I will talk about the physical changes a body goes through while in labor.

What the heck is birth about and what are the Stages of Labor?

Ok, ok, we all know that birth is about pushing a tiny human out of our body so that we can love him and hold him and life will be magical. Maybe you have dreamt of this day forever. Perhaps you have gone into this as a warrior, steadfast in your knowledge. Or maybe you are a bit fearful of any pain. Maybe, like me, you didn’t give it a lot of thought and just waited with baited breath to hold your baby. However you think about birth, knowing the physical changes your body undergoes is hugely important. Why? Well, knowledge is power. When you know what your body is physically doing during the stages of labor, you can mentally prepare and the fear can subside.

The Physical Changes-Prodromal Labor

The first stage of labor-Prodromal Labor- are contractions may begin hours or even days before active labor. They are irregular in length, frequency and intensity. The key word here is irregular. On average they are not longer than a minute and range 7 to 10 minutes apart.

• The cervix is moving from a posterior (back) position to an anterior (forward) position.
• The cervix is softening.
• Effacement or thinning of the cervix is beginning. It may thin anywhere from 0% to 50% during this stage.
• May lose the mucous plug from the cervix.
• The cervix may begin to dilate, opening anywhere from 1 to 4 centimeters.

It’s quite normal to get excited that the moment is finally here, but remember this is just the beginning and to remain calm as this transition can take awhile. The stages of labor are just beginning!

The Physical Changes-Active (Latent Phase) Stage 1

The latent phase is the beginning of active labor and can last anywhere from a few hours to 10 hours or more. The contractions will grow longer, stronger and closer together.

• The cervix continues thinning out (effacement).
• The cervix will dilate to 4 or 5 centimeters.
• You may have a couple of loose bowel movements.
• If it hasn’t happened already. you may lose your mucous plug.
• You may notice a bloody show. Bloody show is thick vaginal discharge that contains mucus and blood from the cervix.

The Physical Changes-Active Labor (Active Phase) Stage 1 continued

The active phase of labor will continue with contractions that grow longer stronger and closer together. At this stage you will find yourself working so hard that everything outside your body almost ceases to exist.

• The cervix continues thinning out (effacement).
• The cervix will dilate to 9 or 9+ centimeters.
• Your body will be working very hard during this stage.
• Your water may break at any point. If it does, you may find contractions are increasing in intensity.
• You may notice a bit more bloody show. Some blood is normal now as her cervix stretches open and some of its tiny blood vessels break.
• It is important to continue to get enough to drink to avoid dehydration.

The Physical Changes-Active Labor (Transition Phase) Stage 1 

Transition marks the period when her body completes its labor and prepares to move into birthing the baby. It is perhaps the most intense part of the labor process, physically and emotionally. It is the shortest phase of labor and pushing will soon begin.

• -The cervix will dilate to 9 or 9+ centimeters.
• -Your body will be working very hard during this stage. Some women will tremble or shake.
• -Some women may be nauseous and/or vomit.
• If your water hasn’t broken yet, it may do so at any time.
• The contractions come closer together, perhaps one to two minutes apart. They will last from one minute to ninety seconds. Some may come in pairs with no rest period between them. These are called camelback contractions. These contractions will be the most intense in strength. They reach their peak quickly and maintain it for most of the contraction.

Birth (Latent Phase) Stage 2

The latent phase of stage 2 is the period that it takes the body to “switch gears” so to speak, moving from the dilating of the cervix to pushing the baby down the birth canal. It begins when the cervix is completely dilated and ends with the urge to push along with the contractions.

• The cervix is completely dilated.
• The uterus is shifting gears from dilating contractions, to pushing contractions.
• Contractions are becoming further apart since the work of dilating the cervix is completed. It is not unusual for there to be five or more minutes between contractions.
• For some women contractions may all but cease.

Birth (Active Phase) Stage 2 continued

The active phase of stage 2 is when the pushing comes.

• The baby’s head is molding to fit through the pubic outlet, stretching the birth canal as it goes.
• You may expel some feces, urine or gas.
• You may feel nauseous.
• Pushing contractions are usually five to ten minutes apart and are accompanied for most women by an intense urge to push. It is not unusual for some women to feel little or no urge to push.
• You may be able to feel the baby’s head moving down the vagina.

Crowning and Birth (Active Phase) Stage 2

As the baby’s head begins to emerge it is referred to as crowning. This is an extremely intense phase emotionally and physically. This is the actual birth of the baby.

• The baby’s head will emerge.
• These pushing contractions may be a bit farther apart if she is especially tired.
• Following a short pause to make sure the umbilical cord is not wrapped around the baby’s neck (this is called a Nuchal Cord and is not usually as dangerous as TV and Movies would like to make you think it is); the doctor/midwife will gently ease the top shoulder out first, then the bottom shoulder. The rest of the baby’s body should slip right out.
• You may feel an intense burning at the vaginal outlet, although many women do not.

Delivery of the Placenta (Afterbirth) Stage 3

Although the baby has been born, you still has some work to do. The stages of labor do not end with the birth of baby. The placenta needs to be expelled. If the placenta is delayed, your doctor, nurse or midwife may encourage its expulsion by ‘kneading’ your belly to get the uterus to contract more effectively. This is called fundal massage. 

• Many women notice no sensation at all until they are asked to bear down “one more time.”   The placenta separates from the uterine wall and is expelled through the vagina.
• You may feel the uterus cramp, especially if the baby begins suckling immediately.
• You may feel an uncomfortable “full” sensation even though the baby is out, until the placenta is delivered.
• Other than a cramping sensation, there will be no more contractions.

To sum it up-Stages of Labor

The changes in your body are pretty amazing. The more knowledge you have about what’s going on, the easier it can be. Knowledge of the stages of labor is power. The more knowledgeable and powerful a woman is, the less fear there is. The less fear there is, the less stress there is. The less stress there is, a more positive experience a woman can have. Some women may forget everything when the chips are down, this is why a doula can really make a difference.

If you are ready to talk about your birth plan, please contact me today. If you need doula support through the stages of labor, I can help. For more information about the stages of labor, the Mayo Clinic site has some interesting pieces of information.

The post The Physical Stages of Labor–Los Angeles Birth Photography appeared first on BIRTH AND BEAUTY.