Emotional Signposts in Labor

When you’re expecting, especially for the first time, you often spend a lot of time reading books and attending classes to learn about what will happen within your body during the physical process of birth.  But have you learned about what happens emotionally?

There  are three stages that many women go through between the beginning of labor and the moment of birth.  Not everyone experiences all three, but knowing what the stages are and their typical order will help you to understand what is happening and, hopefully, be more relaxed and empowered during your birth.

Stage 1:  Excitement

The first emotional stage begins when you get the first indication that your baby is really on the way – the initial contractions, the breaking of your water, or perhaps the loss of your mucus plug.  At this stage, you feel thrilled, because things are getting under way!  The long-anticipated birth is imminent, and you’ll be meeting your baby soon! It’s great, at this stage, to make sure that everything is ready, double-check that your bag is packed,  be in touch with those who may be caring for your pets or other children, and call your doula to notify her that today may be the day!

Bear in mind that, especially with first babies, it may be many hours, or even days, from the first twinges until things really get going.  As much as possible, as long as contractions are manageable, rest as much as you can, and then about your business as usual. If you think there’s a reason you might need to go to the hospital (for example, if your water breaks before contractions begin) contact your provider.  But otherwise, relax, bake something to eat after the baby is born, watch a movie, or try to get some sleep while you still can.

Some women skip this stage entirely and wake up in the middle of the night to find themselves clearly in active labor, also known as – 

Stage 2:  Focus

When I was a first-time mom in early labor, my midwife came over to check me and, as she was getting ready to go, said, “Call me back when the contractions are demanding your full attention.”  The need for complete focus is what defines the second emotional stage.  It’s no longer possible to talk, or do anything else, during contractions; Getting through them is doable, but it takes work and concentration.  They get longer, stronger, and closer together. Although the precise timing depends on your history, situation, and the advice of your provider, it’s during this stage that you will call in child and pet care, will most likely want your doula by your side, and may make the decision to go to the hospital or birth center (or call your midwife if you have planned a home birth).

The second emotional stage can last for an hour or for 24 or more.  If a woman is well prepared and well supported, she can sustain the intense focus required for this stage and manage the contractions for as long as she needs to.  Some women may experience a point where the intensity becomes overwhelming, which is when the mother and support team recognize the arrival of:

Stage 3:  “This is Intense”

Those who attend births are familiar with, and even excited for this stage, but for the laboring woman and her partner it may take them by surprise. A mother who has been coping well with contractions for hours may need more help finding her rhythm.  Her behavior may change dramatically, as hormones and intensity bring forth her more primal self. She might be vocalizing more emphatically, or wish to remain more secluded - moving to the privacy of the bathroom or laying in bed. If she decides 'this isn't fun anymore,' you could hear her flatly inform the medical staff that she intends to leave and come back tomorrow.  As contractions are now the longest, strongest, and closest together they will be in her labor, she could feel overwhelmed and question if she can do this. Far from being a sign that everything is going wrong, these changes actually indicates that things are progressing very well.  It means that the phase of labor known as “transition” - a phase experienced by only about 40% of women - is under way.  The beautiful thing about this phase is that, while it is intense, it typically lasts only 10-30 minutes. Often, by the time you realize you are in it, you are nearly out. Mom is very close to complete dilation and being able help her baby out! It can be difficult for the partner, especially, to witness the intensity of this stage if neither of you are prepared for it. This is where the support of a doula can be essential. Your doula can help alleviate mom’s discomfort and concern, as much as possible, until dilation is complete. She can also reassure the partner that all is well, and baby is close behind, as well as gently advise them on ways to help. For many women the pushing phase - with a clear goal in mind, and new sensations to focus on - is an improvement over the intensity of transition.  For more on that, stay tuned for our next blog post!

Finding the Divine in the Earthly

When you're a doula, mentioning what you do for work is rarely simple. Of course, there are plenty of people who know just what a doula is, and those lovely folks are usually eager to tell you their birth stories, their spouses birth stories, or just any ol' birth story they can think of. I know I should be tired of the stories by now, but I love them.

   For a large number of people the initial response is, “You're a what?” Followed by explaining that you are not a midwife.  

  • No, I don't actually deliver the baby. I'm there for emotional support.
     
  • No, I don't coach like you see in the movies; I hate counting at births.  
     

   This is usually followed by the more fun part of the conversation, where they begin looking at you like you are completely insane, or as if you might hold the understanding of one of the great mysteries of the universe.

  • Isn't it gross? Isn't it scary? Isn't it stressful? How do you do it? Why do you do it?!

    I smile, usually delivering some cliché explanation of how beautiful it is, and that it is, typically, nothing like the movies. All of that is true, but like telling a woman who is 4 weeks pregnant for the first time that her life is about to change, it is only the very surface of the truth. The truth is, that birth is a lot of waiting, a lot of unknowns, and that I am a person who likes control working in a field where there is no such thing as control. The truth is that life on-call leaves much to be desired, and has trained me to live with a question-mark hanging over my head – eternally tethered to my phone. So why, oh why, do I do this work?

   Birth is where I stopped grappling with the bigger questions of the universe, and learned to trust. I do not need to know exactly how things are unfolding to know my place. I do not need to know how dilated you are, mama. I just need to know how you are feeling, and what is helping you. Baby will come. I do not need to know how long it will be until baby arrives. I know my client can sleep if I keep pressure here, and place lavender over there. So, let her rest as long as she needs.  

   Birth is where I first understood that we are not meant to know everything, because that may be too much, but that we should always keep a keen curiosity and unabated desire to learn. It is where I may not know why this placenta is causing my client so much pain and refusing to come out, but I can see the longing in her eyes to feel peace and hold her baby, so I hold her hand instead. It is not knowing why another mother is holding such strict posture and staying quiet, but still being able to find the words to help her let go. It is where I do not understand why things are taking so long, where we try every trick in the book to get baby to descend, and he refuses. It is where my intution tells me his mother, so very committed to natural birth, is right when says 'not this time,' and requests intervention, only to find that the cord never would have reached

  The truth is that I do like control. I like to schedule. I like to plan. I like to know how A leads to B and that it always will. And all of that is exactly why I love birth. Because in birth A sometimes leads to B unless, this time, it doesn't. Because there is no control in birth, and I can let go. I know my clients wishes, I know how to help them get there, and I know that I trust the process. That is all I can, really, know. If I say “she's 8 centimeters and vocalizing well. I should be home before sunrise!” I will be home in two days. If I say “I just got home from her prenatal, but I think I'll head back to check on her.” The baby will arrive before I pull in the driveway. My truth, is that birth is where I find my faith; Whatever that may be.  

   It is incredibly hard to describe, but for someone who thrives on managing things, birth is where I trust. Where I feel strength born of calm. It is where I trust in the knowledge I have obsessively cultivated for the last six years, and do not need to be in control. It is the one aspect of my life where I go in with no preconceived notions, other than the paramount task of a good experience for my client and her family. For all of the vast myriad of possibilities I could encounter at any birth, the one thing I need to focus on is the experience of the ones who chose me to be there. For all that each experience is full of the unknown, it is a space in which I feel at home. It is my quiet.

By: Amber Barrett