This topic may be a point of contention for many, but it is something that deserves being aired out. I’m just going to go a head and say it. The last thing a labouring person (potentially you) needs in the delivery room is a support person who has no clue what is going on. Whether it be your mother, partner, husband, sister, aunt etc. Let me repeat it. The LAST thing a labouring person needs in their space is a support person who has no clue what is going on.
Now, lets set a few things straight. I’m not saying that a grandmother or father shouldn’t be in the delivery room. No, indeed they should be there, if that is what the mother wants. However, let’s unpack this a little bit.
Labour is no joke, it’s hard emotional work, hard physical work and spiritually a transformation is taking place as well. When you are learning to do new things, you need leadership; we all know that the type of leadership makes a world of difference.
There are good leaders and bad leaders. In labour, people need a leader with a clean emotional slate, someone with support skills, someone who is comfortable enough and not phased by labour that they could eat a sandwich during the process. I don’t advise eating a sandwich if you are a support person unless you’re on a break though.
If your main support person is your mother, fine. However, be mindful of what she is bringing into the room. Her energy will set part of the tone. Consider this, what type of birth did your mother have? What type of birth are you trying to have? Do your birth ideas align? Same, if your main support person is your partner/father, fine, but have they actually attended a live birth before? If not, how do they know how to support you? Personally, it's an unrealistic task to ask of someone. If you say "how are you going to support me" they are likely to reply with "by doing whatever you want/need." The trouble and truth of it is, they don't know what you need. It's impossible to know unless you have experience.
What often happens is they do their best, they really do. They try and support you, but often times, upon looking back, most people say that they didn't really know what to do and wished they had additional support and continuity of care. Think about it, it's a BIG ask to put your sole trust in someone with little or zero experience. My advice, have a honest conversation about whether your main support person feels comfortable advocating for you, feels comfortable navigating the medical institution, feels comfortable enough to eat a sandwich while watching you crown, is able to detach emotionally and provide objective support. The conversation may surprise you. This is an excellent book, The Birth Partner, for you and your main support person to read.
In addition, when working with clients as a labour doula, one benefit is that I am not emotionally involved on an intimate level. I mean shit gets intimate, fast, but I’m not bothered when a labouring mama cries out in pain. The difference is, I or the medical staff can suggest a new position after a long labour stall and she will likely comply, whereas if her partner were to ask, she will likely tell him to fuck off. Moreover, partners and grandmothers are blinded by love. Their emotions often cloud the support that the labouring mama really needs.
Want to know more about a doula? Watch below...
The point being, women in labour need leadership, the last thing they need is sympathy or empathy from a bleeding hearted grandmother/partner. Don’t get me wrong, women need sympathy, love, empathy, but that only goes so far. As a doula, I have the privilege of giving all of the above, but you also have the ability to coach the family. To help them through the difficult moments by holding space, by encouraging them, by believing in them, but more importantly, you do this from a clean emotional and objective state. I am honoured to hold clients hand, to wipe their tears and to witness the magic of birth.
If you think you can't afford a doula, or find continuity of care through a provider, do your research, the options in your community may surprise you. Many hospitals have doula programs that are free, many local doulas work on a sliding scale, sometimes even free or for a trade in services. Don't be shy to reach out and ask....all people in labour deserve to have a grounded, humble and supportive guide.
Oh, you’re pregnant, how lovely. Can I ask what you're having? Oh, you just wait girl, labour is a bitch, that shit hurts. Okay, next...mine was 48 hours of pure hell. We have all been subjected to horror stories. It’s as if women like to out play one another. Seriously, when was the last time you hear a positive birth story? Have you ever? If you haven't, ask me, I have hundred's to share.
My wish for future birthing women, is that the use of fearful and non-supportive language would stop. Does labour hurt, yup, but pain is subjective. Labour is intense as f%#, but so are a lot of things we mindfully choose to do in life. Um, exercise, say running a marathon for instance, or hiking, or fill in the blank with anything physical activity, really. Crap, sometimes mowing my lawn hurts. However, the point is that the way we frame birth and the language we use around it – hurts.
I’m going to present you with two scenarios and you can see how a few simple words can impact a situation.
No joke, this is a real situation I’ve been in as a labour doula.
Eve is a first-time mother, she is in labour and having a little boy. Eve and her partner, Cedric, are very excited and open minded with their birth plan. They have taken a prenatal class and feel ready to cope with labour with their learned breathing techniques. After a morning of labouring smoothly at home, contractions start to come closer together – 4 minutes apart. Eve and Cedric know they are supposed to go to the hospital because their childbirth educator stressed that when active labour starts, they should consider transitioning to the hospital. Now they are very excited.
When they arrive, they are greeted by a friendly staff member that states the following. “Welcome to the birthing centre, I can see you are working hard with your contractions, we will get you into triage soon.” As Eve and Cedric settle into triage, they are greeted by the nurse who is accommodating and encouraging. When she sees Eve start a contraction she encourages her to breath through it and to move her body physically to help cope with the pain. The nurse asks them the typical triage questions, i.e. have you been out of country? Around anyone with an illness? Any allergies? However, another contraction starts, and Eve needs to concentrate and breathe through it stay in control. This time she relies on Cedric for help by squeezing his hand. Cedric calmly encourages her by stating, “good job, you’ve got this, breathe with me, in and out, in and out…” until the contraction ends. When it is time for a cervical exam, the nurse asks Eve to lay back and let he know when she is ready. The nurse confirms permission before proceeding with the exam by stating “You’re going to feel a touch, are you ready?” Eve’s labour keeps progressing and contractions are staying stable and steady in intensity.
Back to the birth plan. Eve and Cedric are planning to use as few interventions as possible but are open to what Mother Nature directs. Keep in mind Eve is a low-risk pregnant person; she really can choose anything she likes. The triage nurse is supportive of this and provides a few tips for Cedric to help Eve cope before they transfer to a labour and delivery room where Eve and Cedric will meet a new nurse and labour away until their baby is born.
No joke, this is a real situation I’ve been in as a labour doula….
Let’s pick up here… After a morning of labouring smoothly at home, contractions start to come closer together – 4 minutes apart. Eve and Cedric know they are supposed to go to the hospital because their childbirth educator stressed that when active labour starts they should consider transitioning to the hospital. Now they are very excited. When they arrive, they are greeted by a friendly staff member that stated the following. “Welcome to the birthing center, how can I help you?”
Eve “I’m in labour and would like to be admitted to the hospital.” Staff member, “first time mom, so you think you’re in labour, we’ll see.” Eve and Cedric enter triage and Eve is asked to lay down. The triage nurse does need to monitor the baby and get a read on where things are with labour – all normal. When Eve starts to have a contraction the triage nurse is actively asking her questions about her health history and basic intake questions. Again, all normal, but no words of encouragement, space to focus or support given. Another 4 contractions pass, and Eve is being asked to stay as still as possible as a cervical exam is needed to assess how dilated she is. No biggie, all part of the process (for some). The nurse states that she is 4 centimeters dilated and "stretchy", that the worst has yet to hit.
See the difference? As a labour doula when I support families in scenarios as such, I call it birth deflation. When a family comes in ready and willing to do the work, but are deflated at the front door. It's bull crap! Language matters a lot to a labouring mama. If she is encouraged and supported, labour is known to go faster. Her mind will stay in a more positive and accepting space. She will remain more welcoming of the process and les interventions are lower. More importantly, the associated and perceived level of pain is lower.
Labour is a vulnerable, yet empowering experience for a mama to navigate. Most of us will bat off negative thoughts a few times throughout the process, but the difference is that you OWN the negative chatter. As a labouring mama, you shouldn’t have to bat off and carry the weight of another person’s subjective thoughts, beliefs and values when it comes to birth. They aren't yours and they don’t help you by any means.
Again, language matters, choose your care team wisely, and if you end up with a grumpy old crab, water off a ducks back mama. Ask for a new nurse! You hold the power to decide who comes in and out of your birthing space. You might as well fill it will supportive people. ESPECIALLY if you are aiming for a natural birth. Not to discount epidurals, they are bad ass too. Just saying. However, this makes a world of difference for a natural birthing mama.
Labour Anatomy 101
Let me start by saying that if you are a woman, your body is designed to grow and birth a baby. Do I believe that is a woman's soul purpose? Hell no! However, my point is that your body is physiologically designed to grow (you have a uterus) and birth (you have a birth canal) a baby.
Let's talk labour anatomy & hormones. Birth isn't rocket science, it's a complex process, but it's quite simple when you break it down. Let's start from the top. So, you have unprotected sex, or the condom breaks, or you go through IVF treatments. Whatever the situation is, a sperm meets an egg and viola, a little bundle of cells start to multiply, attaches onto the uterus (implantation) and starts to grow. It grows and grows and grows until it is full term. Just an FYI, full term is somewhere between 37 and 42 weeks. Yes, you are technically due for 5 weeks, 40 weeks is just an estimated due date. Your uterus does not have a calendar attached.
If you want to check out one of my labour anatomy videos, you can find them on YouTube. It covers a lot of the same content.
This is where it gets a little more complex. No one really knows why or when labour will start. Some researchers believe that the baby releases oxytocin as a signal to initiate the process. Conversely, some believe that the mothers body releases oxytocin first. For those of you who don't know, oxytocin is a hormone that is released from the hypothalamus (a fancy part of your brain) and tells the uterus to contract. It's also the same hormone that floods the body when you fall in love. Funny huh! However, before the uterus starts to contract another hormone is released to soften and move the cervix, namely prostaglandin.
What we know for sure is that prostaglandin and oxytocin are two hormones that initiate labour. Think of those two hormones like a drip, at first, they start slow and steady, building up to a larger drip as labour progresses along. Now, as the uterus contracts a few magical things are happening. One, uterine muscles are pulling the cervix up into the wall of the uterus. Most of this muscle building happens at the top part of the fundus. As the cervix is being pulled up the result is that it starts to dilate. Two, a different muscle group gently pushes the baby down. Simply put, the two muscles groups work together, one pulls the cervix up and builds a big wall of muscles at the top of the uterus, while another helps by gently pushing the baby down.
There are other hormones at play during this process too. If you are relaxed and welcoming of labour, you will be releasing lots of oxytocin and prostaglandin, but your body is super smart and has a built-in antidote to labour pain. The antidote is called endorphins. The combination of the three hormones is a powerful cocktail. They keep you relaxed, feeling content, loving etc. I have been in labours where women literally fall asleep in-between contractions and slowly rouse when the next contraction starts. A euphoric like state. It’s amazing to watch. However, that is not what we commonly see on the media. That’s another blog post though.
Moving forward, the above isn’t true for everyone. Some people are not welcoming of labour, some people are rattled with fear and are not accepting of the process (no judgement, girl!). Not surprisingly, their bodies produce stress hormones, namely cortisol. Now, cortisol is an important hormone, but when in stressful situations it acts like a fight or flight response. Therefore, it can interfere with the production and release of oxytocin and prostaglandin, potentially making labour longer and seem much more painful. The antidote to cortisol production is simple. When women are accepting, supported and encouraged during labour their stress levels remain lower. Easier said than done when we constantly inundate women with fearful images of birth in the media. Again, another blog post, ha ha.
I digress, one way or another, the body will work hard and hopefully the cervix will dilate to 10 centimeters. When it does, your labour may potentially slow, so you are able to rest. What I mean is that it isn’t uncommon for contractions to space themselves out. I have seen women contract every 2-3 minutes during transition (the last 2 centimeters of dilation) and then every 5 minutes once they hit 10 centimeters. I have witnessed people rest for upwards of a 20-minute period just before spontaneous pushing starts. Now, during this rest think about what is happening, you’re not just chilling, no, no. They body is super crafty. During this phase your perineum (the area between your vaginal opening and anus) is being flooded with hormones. These hormones tell it to become malleable and stretchy so by the time you are pushing out your new babe, it can handle it like a boss. That’s right, your vagina is a BOSS.
So, the long of the short of it is. The more knowledge you have, hopefully you become more comfortable with the process of labour.
If you want to check out one of my labour anatomy videos, you can find them on Youtube