Working with the New Early Labor

Doula applying low back pressure to laboring woman leaning on partner

Last week I wrote about the changes made in 2014 to the definitions of the three phases of labor. You can go back and read that if you missed it. I’ll wait.

While the ideals behind changing the defined dilation that starts active labor are good, and in theory I support it, I have noticed an unfortunate side effect that is a challenge for parents as they are trying to figure out when to come to their birth place. Let’s take a look at two versions of the exact same scenario: someone coming in to the hospital with regular, strong contractions and the triage exam shows that their cervix is dilated to 5 cm:

I want to emphasize that the actual physiology of labor has not changed. Only the definitions, policies and procedures have changed! Because this presents a challenge for new parents in deciding when to go to their birth place, I want to give you some tips for managing your early labor at home:

Before labor begins

  • Choose a birth place and care provider that is a good fit your you. You can learn more about that in my free “Stacking the Deck for a Great Birth” online class.
  • Learn and practice coping skills for labor, even if you plan to use pain medication. That way you’re not left without any resources if early labor takes a while. My online childbirth classes can help with that!
  • If you can, hire a doula to help you at your home and help you consider when to go. Having someone to labor with you in your home can help you feel comfortable staying home longer.

During labor

  • Ignore your labor and continue normal activity for as long as you can. Distraction is the name of the game.
  • Sleep, eat and drink as you need to in early labor.
  • Don’t time every single contraction. Time 5 or so, then put it away until you notice it seems different. You can go a few hours without timing if there hasn’t been a big change in intensity.
  • Unless you have specific instructions to do otherwise, wait until your contraction pattern meets the 5-1-1 rule: They are 5 minutes or less from the start of one to the start of another, they all last at least 1 minute, and have been that way for 1 hour. They should also be strong enough that you have to pause and focus to work with them.
  • Remember that moving to the hospital will not magically progress you. Sometimes there’s a tendency to think “I’m done with this laboring at home thing, and I want to move forward, so let’s just go in now.”

If you do go in and find out it isn’t quite time yet

  • Remember this isn’t the end of the world. All is not lost.
  • Ask if your baby might be posterior and get tips to help with rotation if it is.
  • Change what you’re doing.
  • Try the tub or shower, go for a walk, sit on the birth ball. Upright positions can be useful.
  • Maybe watch a funny movie, have a good cry or call a friend and talk about how you feel. Catharsis can be good.
  • Get something to eat. Have a drink.
  • Get as much rest as you can.

Early labor has always been a bit of a challenge, but having good support and the mindset that you can and will do the bulk of it before going in can make it very manageable.

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