Friday, July 22, 2011

The Emotional Signposts of Labor

Nicole here for your post today!

Did you know that for most women it's completely possible to have a baby and never have a gloved hand in your vagina the whole pregnancy?

In this world of routine cervical examinations starting at as early as 35 weeks in some practices and hourly progress assessments in the hospital it's easy to forget that! But an experienced and knowledgeable birth attendant or supporter can make a pretty accurate guess of how close the birth is by how the mother is feeling and behaving. These indicative behaviors and feelings are widely called the "emotional signposts of labor" and all it takes for someone who has spent a fair amount of time with the mother is to watch her for a few moments and her labor progress becomes pretty clear.

Today you get an inside scoop to what birth workers know. Handy, right? Especially for you dads out there!

Unlike the stages of labor, there are five, instead of three, major emotional signposts.

1. Excitement. When labor starts many women think "FINALLY!" They want to walk or move to encourage contractions, they glow with anticipation and enthusiasm. Smiles come easily, some women want to tell everyone, others worry that this isn't really "it", and keep the news to themselves for the time being. This usually lasts from wherever labor started off at dilation wise until about 4-6 centimeters, which is when active labor kicks on. Best thing a supporter can do? Help distract mom with conversation, jokes are especially effective, since laughter helps sphincters open up (which is essentially what the cervix is). Make sure to keep it away from anything that offends her, and stop when she gives signals she wants you to stop!

2. Acceptance. Mom becomes more introverted, quieter. She still smiles and interacts between contractions, but during contractions she likes to concentrate. Many are still excited about the upcoming birth, others, especially if labor has been long, start to feel a little anxious. Wow, it's really happening, the baby really will be here soon! As this stage progresses, most women want to call in their supporters, though others will want to retreat into dim lighting, silence and solitude. This is active labor, from about 4 centimeters dilation until about 7-8. The best thing you can do for mom now is to follow her cues. If she wants quiet and dark, give it to her. If she wants lots of physical contact, give it to her. She's really working hard here, and stress or too much outside stimulation can make labor more difficult, longer or even reverse.

3. Doubt. For many women labor gets even harder. She may be thinking "Can I really do this? This is too much, I can't take it any more." This is transition, from about 7-8 cm clear to 10. She communicates in one-word sentences, grunts, groans, even screams and curses much of the time, as talking takes too much of her focus away from what her body is doing. There are powerful forces at work and mom starts to wonder if she's up to the challenge. Many women cry out that they can't do it, for someone to take the baby out of them. They can't get comfortable, and many want to run away. You may see a lot of squirming, position changes and hear a lot of vocalizations, or mom may become completely silent. For many women this is the most intense part of labor. The best thing supporters can do during this signpost is respond to mom verbally when she tries to communicate, praise her efforts (those are good sounds, that's a good position), touch or don't touch as she wants (many women can't stand to be touched during this phase), and remind her that she IS capable of this, she IS doing it and labor WILL end!

4. Second wind. Out of the ashes of transition rises the birth phoenix. Slowly or all at once, mom gets a surge of adrenaline and like magic she comes down from the cloud that labor took her to, and she can move and speak again. She is more cognizant of what is going on around her. Some women are astounded by the change in their mental state, others accept it calmly and make the switch from passive participant to active force in their labor more slowly, but the change comes. She goes from riding the contractions to using them and puts all her energy and focus into getting the baby OUT. Many women report that the pain of labor greatly diminishes during this phase, which is the second phase of labor, or the "pushing phase". The whole energy of the room changes and you can see it in the mother's and your birth team's faces. Eyes are bright, the face is focused and calm, the birth is near! The best thing for you to do now is to help support her in whatever position she feels most comfortable in and encourage her verbally as she pushes. Talk prenatally about whether she wants you to coach her pushes (counting to ten, for example) or if she wants to listen to her body. If you plan on catching, now is the time to prepare for that.

5. Lastly, after labor has ended, the baby is born, mom's hardest work is done, relief and joy expand and fill up the whole room. Everyone is smiling, some are crying. This is the 5th signpost. Afterglow :)

Enjoy your birthing experiences, everyone!

No comments:

Post a Comment