Just the Basics, mam
As a labor doula and birth photographer, I have attended my fair share of births. From home births to birth center births, hospital births, and emergency C-section births, I have found that the majority of parents know the basics, have done research, and generally know what to expect. Parents know about using a birth ball, they know they will have contractions, they know they will need to push a football out of their vagina. Most are super excited, but some are a little scared. Fear and anxiety about birth come from not knowing. Not knowing what happens beyond the breathing and pushing creates apprehension.
The goal of this blog post is to let you in on the little things that happen that you may not think of. Knowledge is power, and power over rules fear every time.
Hospital Birth
Generally speaking, parents, and mothers in particular, have more fear and anxiety around hospital births as opposed to home births or even birth center births. Please don’t come at me with hate, I am only generalizing here. Every birth and every person is different. Because I have seen the fear and anxiety most pronounced in the hospital, this is what I will speak of today.
Braxton Hicks or a Real Contraction?
So you’re sitting at home, sleeping in bed, or otherwise engaged in your everyday life when a full-on contraction happens. This doesn’t feel like simply tightening and relaxing like previous days. This feels somehow different.
Braxton Hicks contractions are the way for your body to get ready for the “real thing”. They are often felt in the front of the abdomen and can be relieved by changing position or resting. They are irregular and not particularly painful, just a tightening. A true labor contraction is far more intense and felt in the abdomen and wraps around to the back. True labor causes cervical dilation, so you may see a little bloody show in your underwear and/or leaking of fluid. Braxton Hicks does not cause dilation, so these things are not generally seen. If you are unsure which you are experiencing, reach out to your OB, nurse, or doula.
My Water Broke and/or Contractions are Starting!
Now that you have decided this is the real thing, many parents may want to rush to the hospital. We see that all the time in movies and TV shows, right? Assuming you are healthy and there are no medical issues that warrant going to the hospital immediately, you have time, so relax. It’s exciting to be sure, but if you are in early labor, hospital staff will send you back home anyhow. If you rush to the hospital, they will check you, and let’s say you are at 2cm, they will, generally speaking, send you back home. The hospital wants you to be in active labor, which means at least 5cm dilated.
Ok, so now you know you are staying home for a bit. This is a very good thing. You are more relaxed at home. You can walk around (or rest), take a shower, and have some food. All of which are heavily restricted when you go to the hospital. They want to monitor the baby, which restricts your movements; showers are not offered (but you can certainly request one, as most rooms have them), and food is a no-no.
Why is Food Withheld at a Hospital?
The long and short of this question is cesarean birth. If, for whatever reason, you need an emergency C-section, they do not want you to aspirate. You may be asking, “How would that happen if I am awake”? Good question. Sometimes emergencies arise so fast, they do not have time for an epidural (if you don’t have one to begin with), and they need to put you out fast and deliver the baby. That’s when the aspiration can come into play.
Contraction Timing at Home
If you time your contractions and not the intensity of them, you can pretty much determine when it is time to go to the hospital. “That’s a lot of pressure!” you may think to yourself, but it’s pretty easy. I would suggest a contraction timing app. Those are super easy to use. I always recommend the Freya app by the Positive Birth Company. Not only is it a contraction timer, but the affirmations are so helpful in remaining relaxed.
The timing is just part of the equation. Intensity is the second part. Are the contractions becoming more intense over time? You want this. You want the intensity to increase over time since that is an indicator of progression.
My Water Has Not Broken. Is this Really Labor?
Your contractions are here, and you’re timing them like the beast you are. They are becoming more intense. Then you realize your water hasn’t broken yet. You must be doing something wrong, right? No, you are doing nothing wrong. Your waters don’t always break during early labor. What happens during a contraction is your body’s way of squeezing from the top and moving baby down. The more it is squeezed, the more baby moves down. The more baby moves down, the more pressure on the waters.
In pregnancy, “frontwaters” and “backwaters” refer to the location. The “front waters” are located in front of the baby’s head, and a rupture here can cause a gush of fluid. The “backwaters” are behind the baby’s head, and a rupture here may result in a slower trickle.
The more pressure from the contractions, the more likely the waters will break.
When do I actually go to the Hospital to have my Baby?
A Loose rule of when you have reached or are close to reaching active labor is the 5-1-1 rule. Some say it is the 4-1-1 rule, but that personally makes me nervous; but use either one.
The 5-1-1 rule is this: You have a contraction every 5 minutes, lasting for 1 minute over the course of 1 hour. The contractions are increasing in intensity.
Contractions every 4/5 minutes: This indicates that the contractions are becoming regular and frequent.
Each contraction lasts 1 minute: This means the contractions are becoming longer.
This pattern has been happening for at least 1 hour: This signifies that the labor is progressing and becoming more intense.
What Happens When I get to the Hospital to Have My Baby?
When you first get to the hospital, they will put you and your partner in triage. This is where they monitor you and check your cervical dilation to make sure you are in active labor. This can be a lot of waiting around. They will want to see a series of contractions, how you are handling it, and how the baby is handling it. If you have a doula or photographer, they will not be allowed in this area. If they decide you will be staying, they will usually put in an IV port in case you need fluid or Pitocin, or anything else. It’s a “just in case” IV port.
They will have you change into a hospital gown unless you have brought your own. I always advocate for bringing your own things. The less “hospitally” things feel, the more relaxed you are. The more relaxed you are, the less tension your body has to fight through to deliver baby.
In this triage space, they often give you and your partner paperwork to sign. Read through everything carefully. There will likely be a section on photography saying something like “photographing staff is prohibited”, blah blah blah. A birth photographer ALWAYS has the right to photograph you and your partner, even if the staff is off limits. Most don’t care, but some do. Most OBs don’t care about photographing the moment of birth, but some do. And nurses most always will tell you “no”. The OB has the last word on that. The hospital has to cover itself, and nurses tend to want to uphold it. Again, the OB has the final say.
I am in Active Labor and Transferring to a Birthing Room, What Now?
Ok, my fingers are going to fall off my hands, so I will end this here and do Part 2 in a day or so!