Failure to Progress...Setting the Space

Failure to progress. According to the Society of Obstetricians and Gynecologists of Canada (SOCG) it’s the number one reason c-sections are preformed. Not because the baby isn’t doing well, not for medical issues that reside with the mother, but failure to progress. What that means is that many c-sections are preformed because people don’t produce “sufficient” contractions to dilate the cervix.

Read that again, our bodies, our perfectly designed bodies, don’t produce “sufficient” contractions to dilate the cervix enough to birth a child. I’ve always had a hard time wrapping my head around this. No other species on earth suffers from this, none. So, what gives?

Well, birth isn’t just a physical process. It’s a mental, emotional and spiritual one also. Under our current model(s) of care, we often birth like animals in a zoo. Not always though, some care providers and birth settings are working hard to remedy this, but often, we do. Think about it, birth has become more of performance; women are watched. Yet, many educators, doctors, midwives and nurses’ opinions state we’re off the mark as a species.

Let’s keep it simple, we are mammals. In a low-risk pregnancy, women really don’t need a lot. For sure, they need a well trained watchful medical eye, but that’s about it. However, the space and environment that people labour under, matters. The more calming the space, the more labouring people can focus and stay in control of their contractions. However, currently most people leave their safe homes (calm), drive in a car, enter triage (where all sorts of people go,) labouring women, pregnant people who are ill, pregnant people who are miscarrying etc…think about it (not calm). That’s just one simple transition from home to hospital. It may sound simple, but a lot has the potential to be happening and all the “happening” can affect your birth. How would you feel listening through the curtain to the person in the next bed who is miscarrying a child?  It’s tough.

Labour is like sex, well more like a female orgasm.  You need to be the right mind frame, you need to feel safe, you need to feel comfortable in your vulnerability. You need to be with someone who you trust. You need to have minimal interruptions, so you can find your grove, your rhythm and enjoy the flow…until you reach the point of climax. BANG! Essentially labour is the same, you need to find your rhythm (and keep it), your grove, feel safe, accept your vulnerability until you reach full dilation and your baby is born.

Let’s go back and look at how we as a species are birthing again. Essentially, we are like animals in a zoo. Being watched, judged, told what to do etc. We go from home to hospital and instantly the rhythm of labour shifts. We are asked questions (often while contracting), asked to lay down etc., etc., etc.  Yet, we expect people to produce “sufficient” contraction under these conditions.

Now, I’m not saying that hospitals are bad. They are bad ass agents who serve sick people. They save lives. However, the rules, protocols and such have the potential to interfere with the rhythm of labour.  Rhythm & relaxation are two components that produce sufficient contractions. You don’t need someone interrupting you by asking questions mid contraction, you don’t need the lights being turned on, you don’t need a cervical check every hour, you don’t need…and the list of protocols goes on. I’m writing this so you as a potential mama, simply, know.

Now that you’re aware, let’s talk about what to do with this knowledge. Again, hospitals are bad ass agents who serve people. You are a person. If you are planning a hospital birth, or even a home birth, this is critical information. You never know if, or when, a medical transfer will arrive. For instance, my 3rd baby was our 3rd planned homebirth, turned hospital delivery. Meh.

I digress. When you leave your home, you can expect your contractions may slow down, or potentially even stop. That is because your physical, mental, emotional and spiritual situation is changing, dramatically. It is entering a (potentially) unknown space, with people you have never seen and being asked to perform a task (labour) while being watched, asked to talk, provide a sample of blood, lay down for a cervical check, a heart monitor read etc. It’s a massive interruption to your cozy established rhythm. Remember, trust, vulnerability, safety and comfort all lead to your rhythm, rhythm lead to your baby, just like sex, but the big “.O.”

However, don’t fear. You can control many of the things that will come your way. Triage is often coo coo bananas, but once you are settled into a labour and delivery room, SET the SPACE.  Plan it. As part of your plan, my advice, ask the care team to only ask you questions between contractions, ensure your support team is aware so they can advocate for you too. In addition, ask them for an hour of alone time to establish your rhythm; lower the lights. Go back to what you were doing at home.  Walk, talk, breathe, visualize, vocalize, move, sway, moan etc. Connect with your baby. Welcome your labour back and relax into your new setting. It’s an assimilation period.

Once your labour has established itself again, it is important to keep the space. By space I mean safe, calm, limited interruptions to the person in labour, dimly lit etc. FYI, low lights = more oxytocin = stronger contractions = more feelings of love = faster birth…most times. You got this. Now that you know what has the potential to happen during your transition to triage, you can plan and accept the process.

What causes failure to progress is a debated topic.  Fear of birth, lack of prenatal education, unwilling to accept the process, previous trauma, the list goes on. No judgement! However, many care providers agree with the above (that setting the space matters) and there is plenty of research to support it. Many providers are striving and making headway in all sorts of birth settings. If you’re Canadian, check out the Markham Stouffville Hospital…or maybe don’t, you might be jealous and sad.

Keep it simple, humans have been doing this for eons and birth still looks this way in many industrialized nations. Less is more while walking through a low risk labour. Less interventions, less talking, less lighting, less interruptions. Honour the space that a woman is in. Support her by offering words of calm encouragement, simply holding her hand or wiping her face with a cool (pick your favorite essential oil) infused cloth. Go back to the basics…

Gestate well loves,

Rhea

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