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!