Am I in Labor?

How will you know you’re in labor?  Much like life, labor isn’t usually what it looks like in the movies.  You already have plenty on you mind, and now you have to wait around, often beginning a whole two weeks before your due date, wondering, “Am I in labor??”

Here are things that may happen leading up to you going into labor:

  • Dilation (opening of the cervix)
  • Effacement (ripening of the cervix)
  • Bloody show (loss of mucous plug)
  • Nesting (suddenly wanting to paint the nursery)
  • You water breaks (rupture of membranes)
  • Contractions

In the movies, a woman will be walking through a department store, when suddenly a gallon of water falls from somewhere up her skirt, and onto the floor.  This is certainly not common.  For most of us boring folk, we first noticed we were in labor when we had contractions.  The confusing thing is, though, that you’ve probably been having contractions on and off for a while, so how do you know this is it?  Here are questions you can ask yourself:

  • Are the contractions regular?
  • Do they start to last longer, get stronger and closer together?
  • Does walking make them stronger?
  • Do they continue, despite moving or changing positions?
  • Did they start in the lower back and move to the front of your abdomen?

If you answered yes, then you’re in labor, friend.  If you answered no, then go take a walk through a department store and see if you can make a splash.

The Scoop on C-Sections

Some women opt to have a cesarean weeks in advance, and some have a surprise one at the last minute.  There are many different reasons to have a c-section, including: convenience; wedged in baby; backwards baby; upside down baby; previous c-section; and baby in distress.  Many women get a complex about having a c-section; like their baby’s birth doesn’t count as much as another woman’s, or that other people tell her how “lucky” she is to have had her baby that way.  But the truth is that c-sections aren’t cheating, and there’s nothing “lucky” about them.

My optometrist planned her daughter’s birth.  Tanya works hard at her job, and she doesn’t have the time to wait around on maternity leave for a possibly late delivery.  She scheduled a c-section to happen right around Evelyn’s due date.  She worked until Friday, took the weekend off to finalize the nursery and get her bills paid, etc., and went in at 9am Monday to have Evelyn.  Some women opt to have c-sections for medical reasons.  Sometimes the baby is exceptionally big, and the doctor will tell the mother she should schedule a c-section before the baby gets too big to squeeze out.  Occasionally, a woman has physical problems, like scoliosis, that may cause a doctor to encourage a non-vaginal birth as well.  The rest of the c-sections, for the most part, happen on the fly.

No matter why you have a c-section, it doesn’t change the fact that you’re a real mother, who had a real birth of a real baby.  And as for you “cheating”?  The recovery for the mother is usually more difficult for a c-section than a vaginal delivery.  You’ve had major surgery – you’re gonna be a slow walker for a while.

Here’s how a c-section might go for you:

  • Anesthesia.  This will completely numb you from the middle of your back and down.  You will be totally awake for the surgery.
  • Operation.  Once you’re all numbed up in the operating room, the doctor will take about 10-15 minutes to make the incision and pull your baby out.  You’ll barely feel anything – most women feel a slight painless “tugging” sensation.
  • Baby’s here.  The doctor will take roughly 45 minutes to stitch you back up.  During this time, your baby will be weighed and checked out.  They will probably put your baby on you at some point during this time, so you can hold him or her.
  • Home sweet hospital.  With a c-section, you spend twice as many nights there after the delivery, as you do with a vaginal birth – usually four nights.  You may feel like you live there by the time you leave.
  • Bedridden.  For the beginning of your stay at the hospital, you will stay in bed, and pee through a catheter.  After a day or two, the nurses will force you to get out of bed and use the toilet like a big girl.  Walking from the bed to the toilet could very well be the hardest thing you’ve gone through yet.  But eventually, you’ll get there.
  • Recuperating at home.  For roughly two weeks, you should lift very little, and go for easy walks around the neighborhood.
  • Having feelings.  The area around the incision may remain numb for months after the surgery.  Thanks to modern medicine (and the popularity of bikini bathing suits) your incision will probably be horizontal and so far down that only your partner will ever see it.

As for the complex some women get about not having a vaginal delivery – you and your baby are healthy… that’s all that matters.

Plus, your baby doesn’t come out looking all squished and wrinkly.

Exercises to Prepare For Labor

If you are like most women, chances are that by your third trimester, you have lost that honeymoon feeling that enveloped you most of your middle months.  With your growing belly, swollen limbs and a lackluster supply of energy, what’s a mom to do for exercising?   As with any exercise program, it is essential to consult with your medical practioner prior to beginning.  Once you have the green light, here are a few exercises to try at home or at the gym which will help keep you in shape but help your body prepare for delivery.

Exercise #1: Side to Side lunges.

Why we love them: lunges really open up a pregnant woman’s hips and pelvic area, creating a wider cavity for baby to navigate through during the birthing process.  This move also provides stretching for the leg and back muscles.  Place your legs farther than hip’s width apart and hold the back of a chair or table to keep steady.  Sway from side to side, deepening the leg bend gradually (but never more than 90 degrees.)  Think of the movement as really exaggerated slow dancing from junior high!  Train up to 30 lunges on each side.

Exercise #2: Wall crouches.

Why we love them: similar to the side lunges, wall crouches help open up the pelvic cavity as well.  This is an extremely great exercise to perform the last couple of weeks and is especially helpful in preparing the pelvic floor.  For moms to be who have back complications, this exercise is heaven for the back!  Slide down a wall until your crouched down a the bottom.  Try to get your knees pointed slightly outwards like a ballerina plie, keeping your feet flat to the floor.  (Try to think of how young children can crouch on the ground to examine a bug; that is the crouch you are going for!)  Hold for up to five minutes.

Top 6 Tips For Creating a Birth Plan That Works

As you draw closer to your due date, your caregivers might have asked if you have written or created a birth plan.  A birth plan is a communication tool that is used by everyone involved with your labor and the birth of your baby.  Your birth plan effectively puts everyone on the “same page” when it comes to you and your partner’s preferences regarding the different options available to you during the course of your labor, birth and even after-care of your baby.

Why write a birth plan?  First, it allows you and your partner to get in sync with one another before your baby’s birth.  Creating a plan will give you a chance to bring up any fears, strong desires, etc. that you may have not talked about up to this point.  It also allows you to create a “team approach” with your caregivers.  More than likely, different people involved with your labor, delivery and aftercare.  As new caregivers join in to assist you, they will be able to know your preferences no matter what stage you are in.

Of course, a birth plan is not a set of orders to be followed, but it does give you reminders as to what is important in an ideal birth situation.  To get started, make sure you and your partner have some time to talk about your ideal birth story.  Read up on the subject and/or take a childbirth class with your partner so that you are aware of all options available to you.  Once you have a rough-draft, schedule time to review your birth plan with your care provider.  They can suggest any changes based on hospital guidelines, etc.  When your final birth plan is complete, make sure that you have copies for yourself, additional support persons/doula and your caregiver.  It is also helpful to pack an additional one in your hospital bag for the caregivers that will be attending to you.

A birth plan should include the following:

  • You and your partner’s names and baby’s name if already selected
  • A brief list of your strongest preferences during the labor process, including lighting, music, visitors, conversation with caregivers, etc.
  • Your preferences for managing the pain of labor.  Notify the care staff if you intend to labor without medication and what kinds of other tools you would prefer to use to deal with the discomfort.  If you remain open to using pain medication, specify at what point you would like to be offered pain-relief options.
  • Your preferences during the birth/arrival of your baby.
  • Indication of whether you are breastfeeding or formula feeding the baby
  • Any newborn care preferences. You should also include the baby’s pediatrician name and number here so they can be contacted to arrange for a baby check up.

Your birth plan will be best received when it is kept short and sweet.  Too much wording is hard for caregivers to read and discern what is truly important to you.   Short and direct sentences or “bullet points” allow all of those involved to quickly reference your preferences at each step.  Keep in mind that a birth plan are your wishes under normal birthing circumstances.  Labor is unpredictable and the birth plan should not be a list of orders that restrict the caregiver’s ability to keep you and baby healthy.

Not sure where to get started?  There are some great birth plan templates available on the web to choose from.  Because they can get lengthy covering so much material, it is a good idea to print one out, make the selections you desire and then type those preferences to create your own birth plan.

Related Podcasts:

Is Labor REALLY as Painful As Everyone Says?: A Single Effective Strategy for Coping With Pain

American pop culture– sitcoms, TV talk shows, and Hollywood movies, in particular—all tend to portray labor as the single most painful experience a woman can ever have. The pain is depicted as both inevitable and total, best dealt with by taking a generous dose of a drug that will dull the pain and make it bearable.

It’s all rather anxiety-producing, especially for a woman who will be giving birth for the first time.

In the months leading up to the birth of our daughter, Mariel, my husband and I watched one documentary after another about labor and delivery. I wanted to try to understand exactly what I was in for, and whether any alternative experiences of the birthing process were available. The goal wasn’t to deny that giving birth was painful; rather, it was to learn how the pain could be managed in a way that wouldn’t overshadow the singular moment of being present to bringing our child into the world.

It was helpful to watch “The Business of Being Born,” “Orgasmic Birth,” “Gentle Birth Choices,” and “Birth Without Violence,” all of which portrayed women responding to pain without drugs– and seemingly enjoying the process. I spent an hour thinking about how one particular woman in “Orgasmic Birth” could have seemed so…well, orgasmic. Her ecstasy in labor was utterly contrary to everything I’d ever seen about the pain of giving birth.

And yet, I was under no illusions that the head of a child squeezing out of a comparably small birth canal would not be painful. “It’s called the ring of fire for a reason,” said the woman who taught the birthing classes we attended a few months before Mariel was born. “But,” she continued, “there are natural ways to decrease the pain, and they’re really effective—maybe even more so for some women than an epidural.”

You could almost hear the “sure they are” retorts echoing in the room where women in various stages of pregnancy sat on pillows and leaned back on their partners’ legs. But all of us were in the class because we intended to give birth in a birthing center rather than a traditional labor and delivery ward, and this meant that we were voluntarily foregoing any interventions like an epidural. In other words, we had to give these natural pain management techniques a try.
The teacher walked around the room with a cup of ice, and placed a cool square cube in each woman’s hand. She asked us to be present to the feeling of the ice cube in our hand, and over the course of a minute, I experienced a searing pain that seemed to dig deeper into my palm with every passing second.

“Stop,” the teacher called after a minute. The collective clatter of cubes hitting the wood floor could be heard, followed by sighs of relief and several of us wondering aloud how an ice cube in our palm could be so painful.

The teacher smiled, didn’t say anything, and circled the room with another round of ice cubes. “This time,” she said, directing her instructions to our partners, “I want you to be present to this pain with her. Rub her shoulders, run your fingers through her hair, talk with her, encourage her.” She looked at her watch again. Each couple retreated into itself, the intimacy of encouragement between couples making a low buzz. “Time,” the teacher called. “That wasn’t even 10 seconds!” I said, almost protesting. She laughed. “It was a full minute, just like the first time.”

Again, the cubes dropped, but the remarks this time reflected a similar perception shared by all the women– the full minute had seemed like only a few seconds, and those seconds were totally bearable.

“Labor,” the teacher explained, can be just like the ice cube in the hand. If you’re totally focused on the pain the ice cube is causing, then you’re going to be attuned to the pain. But if you have someone with you to provide active support, then the pain becomes manageable and the entire experience is usually more pleasant.”

As I labored and pushed our daughter into the world, my husband on one side of the bed and my mother on the other, I thought about the ice cube melting in my hand. Yes, I went through the ring of fire. Yes, the birth was painful. But this single coping strategy for managing that pain was extraordinarily effective. It just doesn’t make for nearly as dramatic a story as a Hollywood movie.

Related Podcasts:

VBAC Is the New Black! Why VBAC Is Making a Comeback

One of the mommies featured in our Pea in the Podcast on VBACs is pregnant again! Yay! Kim’s story of her succesful vaginal birth after a c section is inspiring, and here’s hoping she has another successful VBAC.

If you’re interested in trying for a VBAC, the International Cesarean Awareness Network website is loaded with information for you, including a checklist that will get you started.

But of course the first place you should go is to Pea in the Podcast to hear Kim’s story. I would be proud of her even if she hadn’t been one of my best friends since second grade! :)

To be clear, if Kim has another c-section, that would not be the end of the world. I will be just as proud of her. Having a healthy baby is the most important thing, no matter how they’re delivered! Sometimes a c-section is necessary. That’s how my girl got here!

If you’re pregnant for the first time, VBAC is not one of the millions of things you will have to consider before your baby’s birthday. However, you may want to prepare yourself for the possibility that you might have a c-section, no matter what you’ve planned (I planned a peaceful natural childbirth, in dim room with soft music and liberal use of the birthing suite’s jacuzzi tub). To familiarize yourself with what would happen should you end up giving birth to your baby with the help of a surgeon, please check out our Pea in the Podcast on cesarean sections.

-Bonnie

Orgasmic Birth: The Link Between Pregnancy, Birth, Nursing and Sex

I knew that would get your attention!

Debra Pascali-Bonaro is a childbirth educator and a doula, and she has done a documentary promoting the idea that childbirth can be a pleasure!

A real pleasure. ;)

Imagine that? Imagine the idea that you could go through your pregnancy without fear of labor! Imagine that some people may even enjoy it so much they have an orgasm.

I haven’t yet seen the documentary, but I’m sure Pascali-Bonaro isn’t suggesting labor is not work. I’ve spoken with many experts who say it’s called labor for a reason. It’s hard work. I’m also sure she’s not suggesting that labor is not painful, although several experts tell me the pain you experience is exacerbated by fear, because if you’re afraid of the pain, you are more likely to be tense. Muscle tension makes the birthing process more difficult. Your body begins fighting against the very thing that will ease your pain…the birth of your baby.

But she is surely suggesting there is the possibility of pleasure during your birth experience.

Orgasmic pleasure…

What a revolutionary idea!

Some people are bound to find this icky. Heck, some people won’t even nurse because they claim “my boobs are for my spouse/significant other!” But we can’t help but acknowledge the parts most closely associated with your erotic life are also the parts with which you give birth and feed your baby. They just are. There’s a reason for that. Your baby comes out the same way it went in, if you know what I mean. Sex, pregnancy and birth are inherently linked. It’s ok, y’all. It’s not icky. Relax.

This taboo about acknowledging the link between pregnancy, birth, nursing and sex, which can lead to a sharp division between these amazing parts of your life, certainly impacted me. I was so ashamed when I noticed breastfeeding my baby felt good. That was my baby eating her dinner! What kind of sicko was I? I was embarrassed to admit this to my post-partum doula, but I did. She told me it’s normal for nursing to feel good.

It’s normal. I was normal. Not a sicko. Good to know.

The good feeling from breastfeeding is probably caused by the release of oxytocin, a hormone also released during labor and — yes — sex. And why shouldn’t nursing be pleasurable? After all, you may have to deal with sore, cracked nipples, pain from latch problems, cluster feeding that never lets you rest, and a variety of other challenges (more on the joys and challenges of nursing your baby in this podcast).

Think of it this way, it’s about survival of the species. If breastfeeding didn’t feel good, maybe we wouldn’t do it. Not so very long ago that was the only option, and if we didn’t like nursing, maybe we wouldn’t feed our babies. Nothing good could come of that.

Also, remember, feeding our babies the reason we have boobs in the first place.
That’s what they’re for, and that’s why men don’t have them. Any fun you have with them outside of feeding your baby is just gravy!

Really, really good gravy………………..but I digress….(sicko!)

So back to birth orgasms. Why not? Our hormones are surging all over the place, and the baby is coming out the same way it went in. If you can relax, and if you decide that physical affection with your partner makes you feel better (some women find they do not want to be touched during labor), maybe an orgasm will follow.

Or maybe not. I’m sure it’s far from a given. But what an interesting possibility!

Maybe you still think the idea is icky. That’s ok. But the idea that — even without an orgasm — the birth experience doesn’t have to be something you dread…well, isn’t that nice? Sure there will be pain, sure it will be hard, but if you can only relax, maybe it could also be pleasurable, you know?

Happy orgasms!

Please check out our podcast on labor options for much more information on how to make your birth experience as close to what you wish for as possible.

-Bonnie