We had the privilege of completing our sixth series as Bradley Method® instructors last night. It is humbling to have couples trust us to help them prepare for the birth of their child – we always wonder if we did the best we could and break down every class on the way home. We feel honored to have these wonderful people choose us as their childbirth educators given the variety of classes available to birthing couples today.
For labor rehearsal last night, we did an exercise in which we read out two scenarios: the “sprint” birth and the “marathon” birth. It was interesting to hear some of the reactions our couples had to the scenarios. Some of them felt anxious at different parts of the birth stories, or realized they weren’t prepared for the circumstances in the stories. These reactions are exactly why we do this exercise. As their due dates approach, we want them to consider and address any situations that might cause them anxiety. By resolving these ahead of their own birth, we hope that they avert a ride on the fear-tension-pain cycle.
So how can you tell if you are having a sprint birth? What does a coach need to be aware of in this situation?
The first sign might be that mom’s contractions start at ten minutes apart and last 60+ seconds. The second indicator is that they continue to get closer despite a change in mom’s activity or position. The third indicator is that she goes from wondering if it’s labor to acting serious and concentrated, totally skipping over the “putsy-putsy” and/or excitement that most mom’s experience. The fourth indicator might be that her modesty changes from her usual modesty to losing it completely within a few hours of her first contraction.
If this is how your labor seems to be progressing, the coach needs to make a decision: how does he best support mom’s comfort and choices in labor while getting her to the chosen birthplace? If you are having a homebirth and you want your midwives present at the birth, it would be a good idea to call your midwives when two or more of these indicators start lining up.
If you are driving to the hospital or birth center, talk now and discuss what your ideal birth situation is: would you want to get there at transition with just enough time to check in and push? Would you want to arrive with enough time to monitor the baby for a little while before the pushing phase starts? Does mom need or want to make it in time for any medication (antibiotics, analgesics, anesthetics) to be administered before the birth?
In consideration of making a car trip, talk about how you can best get mom in the car – what will motivate her to move from her “zone” and get to the birthplace with the timeframe you want? Know what your options are to get her to the hospital or birth center before you find yourselves delivering the baby with 911 on the phone line.
An assistant coach or doula would definitely be an asset in this kind of birth story – they can help coach convince mom that all signs are pointing to the fact that they are having a sprint birth and it’s time for action in regards to calling the birth team to your home or making the trip to your birthplace. As the labor is also intensifying quickly, they can help the coach support the mom through the sensations. With a slower labor, the mom’s body has time to ease into the intensity that produces a baby. If you are progressing quickly, mom is going to need a different level of emotional support to encourage her that she can see this labor through without pain medication although the pace of the sensations she is experiencing is possibly overwhelming.
Let’s look at the opposite scenario – the marathon. We are experts at this type of labor. Although it breaks my heart to write it, if you are on pace for a long birth story, nothing will speed it up unless your baby and your body are ready.
If your contractions start more than ten minutes apart and they continue in a very random pattern, you are likely to have a longer birth story. The second indicator is if you change activities or your position and the intensity of the surges decreases and/or the frequency spreads out. The third indicator is that walking doesn’t seem to speed the frequency or intensity of your contractions. A fourth indicator is that you hold at one frequency of surges for two+ hours, and then when you establish the next pattern, you hold there for another two+ hours…and the mom’s body doesn’t seem to speed up the process no matter what you do to make labor progress.
If this is the birth story you seem to be having, there are two things we have learned from our experiences: getting sleep, at a minimum quiet rest, is crucial to having enough energy once you get to the pushing phase. The second factor is to have a coach who is emotionally strong for mom: they never show her any doubt. The coach completely believes in mom’s abilities and conveys this with every ounce of their energy and their being.
Getting sleep is much harder to do when it’s your first baby. There is the excitement of meeting your baby soon; the anticipation tied to discovering what you don’t know about labor…and the list goes on. My point is that there are lots of reasons not to sleep. If your contractions are very far apart and you are easily talking, walking and there are no physical or emotional signs of late stage labor GO TO BED. Instead of watching the clock for contractions that are twenty minutes apart for two days, build and save your energy. Eat if you are hungry, sleep if you are sleepy. Trust birth and know that your baby and your body are figuring things out and enjoying the scenic route to active labor and the pushing phase.
Our experience with this labor pattern is that although baby and body are taking the scenic route, once they arrive at active labor and pushing, they decide to cruise at high speed into your waiting arms. After two days of an easy, lazy pattern I would suddenly switch into high gear where I needed to chant and focus my energy to handle the intensity, and within a couple of hours of this switch would come the announcement that it was time to push.
It is of utmost importance that the coach reminds mom that her body is not "broken" and that you will be meeting your baby when the time is right. It is easy to get discouraged even when you know what to expect. For me it was always the hope that maybe this time would be different…and then it wasn’t. Remind mom that there is a reason that you can’t see that is causing the slower labor and that it will all be revealed when the baby is born. Our two longest births produced babies with umbilical cord issues – neither of them life threatening, nonetheless the cord had restricted movement during labor. Bryan had his cord wrapped around his neck several times; Angelika had hers wrapped around her tummy. As long as mom is okay and baby is okay, encourage mom to embrace her journey and sleep so that when you do hit the sprint to the finish line, she has the energy to run that sprint with all her might.
An experienced assistant coach or doula can help the couple recognize the signs that they are having a marathon birth and urge them take appropriate steps to conserve their emotional and physical energy. They can help encourage mom to eat and sleep, and everyone should sleep when mom is sleeping. They can read a relaxation script while dad does massage to ease mom into deep relaxation if she can’t sleep – at the very least she won’t be expending energy if she is resting quietly in bed. They can help coach watch and assist mom in shifts if she refuses to sleep, because both dad and doula will need their full energy to encourage mom when she gets tired and wants to give up later. When the time does come and labor finally starts to intensify quickly, they can help mom embrace the stronger sensations and help with any counter-pressure or assisted positions to ease the intensity.
This scenario brings up the importance of having a back-up assistant coach or doula. With our marathon hospital birth, we called in a second doula to help on the second day we were in the hospital. She lent us all her fresh energy, and she came with new ideas and most of all, her encouragement that we were doing the right thing in letting our baby come, as he needed to come – slowly. This also allowed our first doula the chance to go home and see her family – she came back refreshed and energized. We all needed the sleep and recharge. When our whole team was together again, we were working intensely – Bryan was born two hours later.
A last thought on a long labor: your birthplace will make a difference in your outcome. In our hospital marathon, we were very blessed to have this birth with our third child. We had history with the providers at our practice, and the two we saw on-call were happy to give us the time we needed since both baby and I were doing well. You have to know that you know that your birth team will support your choice to have the birth you and your baby need, and that they will not tell you that you are "failing to progress" and you need to start taking interventions or head to the OR for a cesarean. However, just being in the hospital added a level of stress to the whole situation - we were afraid that hospital policy might trump our doctor's evaluation of the situation. I have a feeling many first time parents in our situation might start to be pressured to have a cesarean.
With our home birth, it was a completely different experience. We were home with our children, so we were able to interact and love them the two days we were in labor. Our midwives would check me and check the baby's heart tones, and reassure us that we were fine to keep going on - no vaginal exams, no threat of intervention - we just did what we needed to do. On the third day when their sister was born, they got to enjoy the joy of the hard work with us.
I will close this post by saying that a good way to handle either of these scenarios is to encourage mom’s emotional relaxation. If she is having a sprint, she will need your reassurance that she can do it despite the quick onset of intensity. If she is having a marathon, she will need your encouragement that she is not broken and her body is doing exactly what it needs to do. With loving support, we can and will do amazing things to welcome our children with power and confidence.
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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