The co-founder of The Bradley Method®, Jay Hathaway has looked at this question and come up with some reasons that I agree with. Here is a summary – for his complete list and explanation, you can refer to The Bradley Method® Student Workbook, ©2006, page 100.
Every teacher is asked to write on this topic as part of our final exam – I imagine that the American Academy of Husband-Coached Childbirth® has hundreds of unique reasons in their archives. You can read my answer to this question here.
The original reason I sought to have a natural labor and childbirth is that I am a big skeptic about putting anything in my back that doesn’t belong there. As a lifelong dancer and a yoga student, I had learned that “your spine is your lifeline” and don’t let anyone touch or mess with your back! There was no way I was going to let anyone stick a large-gauge needle, or anything else, into my spinal column.
The more I learned about natural childbirth, the more I realized that the experience of labor and birth, free of drugs and interventions, was going to be a life-changing experience. Even when we deviated from our goals to be completely drug and intervention free, we always had epidural-free births and felt all the physical and emotional sensations that accompany labor. These labors taught Bruss and I about each other, about our baby and cemented our belief that natural birth is a gift to all the people involved: mom, baby, dad and care providers.
So if you agree with me that labor is important and it is an essential part of the birthing process, let’s go forward. Let’s explore what first stage labor is physiologically and how it progresses.
First stage labor is the body’s preparation for the physical act of pushing the baby out from their warm, comfortable and secure uterus through the birth canal and out into the world to meet you – also known as second stage labor. First stage labor is designed to progress over a period of hours to allow the intensity to build gradually.
Depending on your body and your baby, this could vary, though, so if you are having a sprinting labor you will have to rely more on your coach and your relaxation practice. Your body will go from zero to full steam in a matter of minutes instead of hours. It is still do-able with ample preparation and good coaching.
There may be a period of pre-labor before you start first stage labor. Brace yourself – you could be in pre-labor for a week – or more. It is the body and the baby going for a “test drive”…How does the hormone exchange work? How will these contractions feel? How will we handle contractions? How do we get them to speed up or slow down?
The key here is that although contractions may start, they slow down or stop altogether with a change in position or activity. Nothing you do can get them to speed up or start up if they stopped. One phrase we say to our students throughout the course of class from this point forward is, “Don’t pay attention too soon.” You can waste a lot of physical and emotional energy getting ramped up for a labor that isn’t progressing. If the contractions slow down or stop completely: keep going about your business, continue eating to appetite, drinking to thirst, and for goodness’ sake, GET SOME SLEEP. You will need it when you are in true active labor.
Note to The Coach: This is an important time for coaches to remind laboring mothers that it is okay and that true labor will start soon. Understand that we feel like we have been pregnant forever and we want to be holding our baby already. Use any contractions that do happen to practice relaxation as you plan to use it during actual labor. This serves a dual purpose – coaches can make sure to review and commit the coach’s checklist to memory, and it builds mom’s confidence in your abilities to serve as her coach.
True labor is marked by contractions that do not slow down or stop with a change of activity or position. No matter what you do, the contractions are progressively gaining in frequency (how close), intensity (how strong) and duration (how long). That is not to say that they won’t start and stop occasionally – usually a change in venue can result in a stall. Whether you use natural stimulation techniques or decide wait it out, before long contractions will pick up again and your body will continue to work towards the second stage of labor.
During early first stage labor, a mom will be talkative and active. Maybe she will be cleaning or cooking or going about her work. She will still have an appetite. It is important to tune into your body and follow the cues. If you want to eat, eat. If you want to drink, drink. Your body will let you know when it’s time to get down to the business of having the baby. Until then, store your energy and rest as much as possible. In terms of dilation, the cervix is going from 0 cm – 3 cm. The duration of the contraction is anywhere from 30-60 seconds, and the frequency puts the contractions anywhere from 5 – 20 minutes apart.
Where they start in frequency and duration is a good indicator of whether your labor is going to be a sprint, a marathon or something in between. If the “happy to be in labor” phase starts and mom’s contractions are five minutes apart and closer to 60 seconds long, then you should pay attention for signs of a sprint. If her contractions are twenty minutes apart and are only lasting 30 seconds, then chances are you are running a marathon.
Active first stage labor is marked by an emotional shift as mom starts to get more serious about contractions. Contractions start to be 45 – 60 seconds long and their frequency is every 2 – 5 minutes. The cervix is dilating from 3 – 7 cm during this time. As you can see, the contractions are definitely more powerful now and mom will want to concentrate during a contraction and rest between them. She still needs to drink to stay hydrated, but chances are she will lose her appetite, start to lose her modesty and will move around less and want a more quiet environment in general.
Dr. Bradley taught that this was the time for a laboring woman “to nest”. He suggested that mom’s get into their side relaxation position so that they could completely relax with their contractions and let their uterus work with gravity to get baby in the correct position.
Although this position was not comfortable for me in a hospital bed, I seem to remember that we got into a seated (on a birth ball) or squatting position (on a birth stool) at this phase of labor. I would lean forward onto our doula with each contraction, and as I got more experienced, I would lean back against Bruss and nap between contractions.
For some reason, although the contractions are continuing at a regular pace, some of us find that our dilation stalls for a while. It could be an hour with no change in dilation, or sometimes even longer. As with all averages, people forget that there are variations that are still normal. The accepted medical belief is that in labor, the cervix dilates one centimeter per hour. If you are in a hospital setting, you are probably going to start hearing the dreaded phrase, “failure to progress.”
Marjie Hathaway (who along with her husband Jay helped Dr. Bradley co-found The Bradley Method®) came up with an ingenious phrase that describes what happens to some of us at this point in our labor. She looked at this phenomenon, and evaluated it with an experienced eye: she had three natural births herself and years of experience attending births and serving as an assistant coach. Marjie realized that sometimes a woman’s body was smart enough to know that more time was necessary. Her phrase for this phenomenon of continued contractions with a stall in dilation is Natural Alignment Plateau.
It beautifully describes in three little words the wisdom that Mother Nature built into all of our bodies. Sometimes the baby is in the wrong position and needs time to give the line-up a second or third try. Smart: take a little longer now to make the pushing phase more comfortable, safer and shorter for all involved. Sometimes the cartilage needs to soften some more – especially if things have been speeding along to this point. Smart: the more pliable mom’s pelvis and baby’s head are, the easier and safer the passage. Sometimes the body wants to make more immunities for the baby – maybe it’s increasing the supply and quality of colostrum. Smart: the mom’s body is designed to perfectly nourish her newborn and growing child – it knows what it needs to do to feed the baby and will take the time to do it well. The list goes on – see The Bradley Method Student Workbook, ©2006, page 35 for a more complete list.
There might also be an emotional component that could stall dilation although contractions are continuing. It goes back to Jay’s list – the rite of passage. Mom needs to accept that she is now a mom – whether it’s a mom for the first time, or her ability to be the mom to multiple children. Baby also needs to accept that they are ready to live independently of their mother’s – that it is literally time to cut the cord. When it becomes apparent that dilation is stalled, we suggest that coaches take the time to talk to mom and find out if there is an emotional component that needs to be resolved so that the cervix will dilate and allow the labor to progress.
Instead of accepting the pronouncement of, “You have failed to progress”, look at the whole picture. How is mom doing – is her blood pressure normal? Is her heart rate strong? Is her temperature in a safe range? How is the baby doing – does baby sound good and seem like he or she is doing well throughout labor so far? If these things are all showing that mom and baby are well, then be confident in your choice to accept your labor for what it is and ask for more time as long as everyone is strong and doing well.
The good news is that once the body has its Natural Alignment Plateau, the cervix will dilate rapidly and usually to completion (10 cm). The extra time your body took turns out to be a gift because after the break, labor is in full swing and you will be in transition and into the second stage of labor in a matter of minutes.
I hope this little journey into first stage labor will start to give you the confidence and the patience to accept your labor and use it wisely to learn about yourself, your baby and deepen your connection with your coach/assistant coaches. The team of you working together will be a memory that will last a lifetime.
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®.