Coping with a Long Labor
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Sweet Peas, Pods & Papas: All About Birth, B@@bs & Babies

Coping with a Long Labor

    
     We had a review class for our graduates last night.  It’s so exciting to hear how much they have learned in the last 12 weeks.
 
     We made time to talk about two different labor scenarios:  a fast labor (less than 8 hours) and a very slow, plodding labor.  Since I am an expert at the slow labor, that’s what I am going to share about today. 
 
     If anyone is willing to write about their own fast labor experiences, please send me your helpful hints and I will post them.  I promise not to be too jealous: one of our Bradley classmates had a fast labor for their second child and said it was three contractions before she was in hard, active labor.  After hearing that, I would take my way any day!
 
     So, onto a long labor – as in lasting more than 14 hours.  What are some indicators that you are going to be, as Dr. Bradley liked to call us, a “putsy-putsy” laboring mom?
 
     The first one is that your contractions are very far apart when they begin, as in 20 minutes apart or more.  You go through Dr. Bradley’s checklist to test for practice labor vs. actual labor: eat, drink, walk, shower and nap.  Your contractions don’t subside, and yet they haven’t increased in frequency, intensity or duration.  Sign #1 that you may be in store for a long labor!
 
     The second indicator of a long labor is that your contractions are taking their time to increase in frequency.  In early labor, they typically last 30-45 seconds, so don’t be surprised if the duration and intensity haven’t increased yet.  However, if you start having contractions 20 minutes apart at 9:00 pm, and you have stayed up all night because you are excited, and then at 5:00 am they finally start coming every 10 minutes, your body is probably in “putsy-putsy” mode.  Make every effort to accept you and your baby are going to take your time, and coaches, please help mom get some sleep! 
 
     A warm bath or shower can help relieve some of the tension and anticipation before mom tries to get some sleep.  If she is not able to sleep through the contractions, get her in a resting state, and try to get her to nap between the surges.  If you know that they are ten minutes apart, use your abdominal breathing to get your body to nap; trusting that your coach will wake you up about 30 seconds before the next surge starts so that you can breathe and relax through it before napping again.
 
     Sometimes, your labor can progress a little more rapidly at this point, and maybe it’s only four – six hours before your contractions are four-five minutes apart, lasting 60 seconds, and this pattern has been established for an hour.  You and your coach decide to go to the hospital since it seems that your body is finally making progress.
 
     So you make your drive.  It’s possible that the adrenalin of the move, whether it is caused by fear or excitement, can slow down or stall labor.  You can prepare for this by having mom take a shower before you leave, and have her in state of relaxation and security as you make your drive.  And again, sometimes the best-laid plans deviate from the course – especially if it’s your first baby and there is a real apprehension or excitement about the unknown.
 
     You arrive at your birthplace somewhere between eighteen – twenty hours after the first noticeable contraction, and mom is checked at admission to see where she is at in her labor.  We encourage our students to make vaginal exams count to make them worth the risk of infection:  have the attendant check dilation, effacement, station and position.  After 19 hours of labor, she is dilated to 2 cm, she is 50% effaced, baby is at -4 station (barely started to descend), and it feels like the baby might be posterior, or “sunny-side up”.
 
     Indicator number three of a long labor is that your body is taking time to prepare for second stage. As long as your vital signs and the baby’s vital signs indicate that everything is okay, chances are you are well equipped to handle a longer labor.  It is not, I repeat, IT IS NOT “failure to progress”.  Each and every labor is unique, and if your indicators have been slow, then it’s okay to take your time dilating and effacing, too.  Your body and your baby are working at the pace they need to have a healthy and safe birth. Labor is a whole-body experience, and about much more than your cervix!
 
     At this point, there are three things we want our students to remember.  The first one is that you go to the hospital with the idea that it’s okay to go back home.  The second thing we want them to remember is “Berman’s Law”, which states that if you are less than 5 cm dilated upon arrival at your birth place, go home.  It is a proven fact that women labor better where they feel comfortable, safe and secure, and for most of us, that is the place of our creation: our homes.  Thirdly, by practicing what they learned in their Bradley Method® classes: eating a well-balanced, high protein diet and doing their pregnancy exercises on a daily basis, mom and baby are prepared and equipped for their marathon event.  They are strong enough to handle their labor.
 
     Here are some ideas on how you keep from getting discouraged in this situation:
     -  Try to refrain from calling your family until you are admitted at your birthplace.  If it’s taking longer than they think it should to hear news about the birth, this may add stress to the situation.
     -  Coaches, remind your partner that she and the baby are fine, and that this is the course for your birth, and that you are with her every step of the way.
     -  Coaches can remind mom that her time in active labor has been six of the 19 hours so far, and that she is doing very well managing the contractions, and that you are confident you can do this together, no matter what kind of time it takes.
     -  Coaches can remind mom about the Natural Alignment Plateau: the fact that labor is more than dilation.  Mom may be making more labor hormones, she could be making colostrum to nourish the baby, the baby could be trying to figure out how to get properly aligned in the birth canal, there may be an emotional element that needs to be dealt with before labor can progress.
 
     It is not uncommon for labor to slow down or stop given the transfer of location and the emotional response to the news about your progress thus far.  Should you decide to go home, talk about your feelings in the car, and get mom back to a relaxed state once you arrive at home so that labor can start again.  If you decide to stay in the hospital, it is time to start talking to your birth team to negotiate for the time you need to welcome your baby into the world according to the wishes on your birth plan. 
 
     Whether you are at the hospital or at home, there are things you can do to help your baby turn to the optimal delivery position – we cover a variety of ways to do this in our Bradley Method® classes.  You can help mom get back to complete relaxation and help her focus on the task at hand.  Instead of looking at the clock to see how long you have been in labor, take one contraction at a time and help mom visualize what her body needs to do to meet your baby.  You can talk to your baby between contractions and tell them that you are ready to meet them and it’s time for them to line up so they can make their grand entrance.  Turn on some soothing music, and get mom to eat a little something if she is willing.
 
     Coaches can also attend to the nuts and bolts of labor:  is mom as comfortable as possible?  Does she need a little snack for energy?  Have you given her 8 ounces of water this hour? You want your partner fed, hydrated and rested so that she doesn’t show indications of dehydration or exhaustion, called “distress” and a cause for intervention in a hospital setting.  Is she going to the bathroom on a regular basis?  A full bladder can 1.) keep baby from descending and 2.) add discomfort that keeps mom from achieving complete relaxation. 
 
     The importance of getting nourishment and rest early in labor is now more obvious.  You want your body fed, hydrated and rested so it can work efficiently.  You want to be able to handle the emotion of labor without the overdrive caused by hunger and exhaustion.  You want to be able to go to your birthplace with calm and confidence, not drama and despair.
 
     One of our students brought up a good point.  She asked, “Wouldn’t walking help speed up labor?” They learned in their coursework that according to studies done by Dr. Roberto Caldeyro-Barcia, walking can speed the course of labor by 28%.  I had a two-fold answer.   First of all, if your contractions start at 20+ minutes apart in early labor, you are better off sleeping to conserve energy, and save the walking for the point labor when your contractions are about 8-10 minutes apart.  You can keep walking as long as it is comfortable.  If you tune into your body, you will know when it’s time to stop walking and stay closer to the bed.  The second part of the answer is that if your labor has an emotional roadblock, nothing you do naturally will speed it up until you deal with the emotional component of your labor. 
 
     As we found out with Bryan’s birth, even the use of artificial augmentation – we opted for Pitocin – will not make a difference if you are not emotionally relaxed.  (I don’t know of anyone else who has been given Pitocin with little or no effect – I would be interested hear your story, so please leave a comment and let me know what you experienced.)  It wasn’t until I accepted his birth and his place in our family by giving him his full name that I had my first real, eye-watering contraction after 41 hours of labor, the last six of those being hooked up to a Pitocin drip.  He was born pretty soon after that: five hours later we were holding our little bundle of joy.
 
     Looking back, I wish I had recognized the emotional component of Bryan’s birth sooner so we could have avoided the intervention with Pitocin.  I also know that we wouldn’t be the teachers that we are today without this birth experience, so I accept it as a lesson that we will never personally repeat. It is also one that we can share with our students to help them recognize the importance of emotional relaxation during labor.
 
     If you and your baby are on the course for a long labor I encourage you to accept that this is your unique labor.  No matter how long it takes, as long as you and your baby are doing fine biophysically, you will be able to have the natural birth that you have planned and prepared for.  I can assure you that your body is not broken, you are “normal”, and that you will wear the amount of time you labored during childbirth as a badge of honor when you are holding your beautiful child.
 
     As a first time parent, it has got to be close to impossible to contain your excitement and get some sleep in early labor.  Having learned our lesson from our first labor, we have always been able to sleep in early labor with subsequent births.  We implore our students to conserve energy and at least practice deep relaxation if they are too excited to sleep.  To date, we have yet to hear any birth stories where first time parents heeded our advice and slept in early labor.  However, if you are going to have a long labor: read the signs, accept them, do what you can to get some rest and have the best birth for you and your baby.
 

Disclaimer:
The material included on this site is for informational purposes only.
It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®.

 
 
 

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