What to do when labour has begun
Have you ever watched a movie where a pregnant woman's water breaks and all of a sudden, contractions come on hard and fast, so she's rushed to the hospital and then has her baby right away?
Unless someone's experiencing a precipitous labour, that's not exactly how it happens. So let's break down what you can generally expect when you first go into labour, and what to do during this time..
First of all, your bag of waters can break at ANY point during labour, and if it does happen to break before contractions start, it can be hours, days, or even weeks before labour actually starts. However, when it does break, note the time it broke, amount of fluid, colour of the amniotic fluid, and odor (T.A.C.O. Time, Amount, Colour, Odor) and then let your care provider know that you suspect your water has broken.
Next, contractions generally start out mild and spaced out, gradually getting stronger and closer together. Labour can span anywhere from a few hours to a few days.
So....labour has started, now what?
Well, there are factors that would constitute you heading to the hospital right away, but these are things to discuss with your doula or care provider. For everyone else, with "normal" pregnancies and no concerns at the onset of labour, it's usually best to stay at home for as long as possible (unless labour is progressing quickly).
Most people feel safest and most relaxed in their homes, and so your home or a home-like setting would be the best place to labour, if you want to help avoid any hindrances in the progression of labour.
Time your contractions. There are lots of contraction timer apps that you can get on your phone, so you can use one of those, or just keep mental notes of your progression. Labour progress usually consists of contractions getting closer together (how much time between each contraction), and how long they're lasting (30 sec - 1min or longer). You can use this as a gauge to help you decide when to head to the hospital. Some people say to use the 4-1-1 rule (contractions are 4 minutes apart, lasting 1 minute, and they've been this way for 1 hour), but my guide as a doula, is usually when my client no longer wants to talk or make jokes between contractions, that's when it's time to head in. This all just advice though, listen to your body, that will also tell you.
What could you do at home?
Well, that depends on the time of day (or night) that contractions start, as well as the intensity of them;
If contractions start in the middle of the night and they're mild, then it's best to stay in bed and try to get some more sleep, till they get a bit stronger, then you can continue with the activities below.
If contractions start in the morning, then eat breakfast, have a bath, and go for a walk, or do some pelvic stretches. You can also clean the house (the movement is great for helping baby lower into your pelvis), do some baking, watch funny or romantic movies (for the oxytocin), have sex (for the oxytocin). At some point in the day, take a nap! And drink lots of water! Also try sitting on the toilet for a few contractions, every time you use the washroom.
If contractions start in the afternoon or evening, have a nap before they get stronger. When you wake up, have something to eat, drink lots of water, take a bath, do some stretches, have sex, and then finish off the evening with a funny or romantic movie. At bed time, have your partner or doula do a side lying release on you, so that you can get a little rest, if contractions are too strong to sleep through.
What if you live more than half an hour from the hospital? You can spend early labour at home if everything is going smoothly, and once things start to pick up, you could head to the hospital, if that feels more comfortable for you. You could alternatively labour at a friend or family members home, or somewhere like the Ronald McDonald House and just use a day use room.
What if you go to the hospital too early? A nurse will get you set up in triage, check your cervix, monitor baby, and ask a few questions. If you aren't dilated enough to be admitted, they might send you home, or keep you in triage, if they have the space or they feel you are close to needing to be admitted. Once you are admitted, if everything is going well with you and baby, you might be allowed to walk around the hospital, or move about your room. It's best to change up your labour position at least every 20 minutes, if you don't have an epidural. Remember also to keep hydrated as much as possible! A water bottle with a straw will be the easiest for you to drink from, especially if lying in a bed.
Why is a having a bath so important? It helps relax your muscles, so if it's prodromal labour that you're experiencing, it can ease off the contractions, until your body is ready for true labour. If you are in true labour, it will warm up your muscles so that they can stretch more and relax, encouraging baby to engage deeper in your pelvis.
What stretches should you do? Wide hip rotations on an exercise ball. Squats, with your whole foot planted on the ground. Inversions on a couch, for 30 seconds. Deep lateral stretch or side lying release. Rebozo sifting. Stairs - two at a time. Walking.
Why is Oxytocin important? Oxytocin is the body's love hormone, this is what brings contractions on, and keeps them coming steadily.
Ways to increase oxytocin;
Being intimate with your partner (sex)
Laughter and dancing
Getting rid of distractions, and staying as relaxed as possible.
Labouring with dim lights and soft music.
If you are neither a relinquishing mother or a surrogate, it may also help to visualize holding your baby.
What if your contraction pattern is inconsistent? Labour patterns generally start out fairly inconsistent, until they find a good rhythm, however, in some cases, if a person has been labouring for a while and contractions are getting more intense, but some are 4 minutes apart lasting 1 minute and others are 10 minutes apart lasting 30 seconds, this can be a sign that baby is malpositioned in your pelvis. This would be a good time to start doing some more stretches or activities to help shift baby into a more favorable position.
If you have any questions or concerns about how your labour starts out, please contact your care provider or doula, for guidance. Most importantly, listen to your body, don't wait to long to head to the hospital or call your midwife, if something doesn't feel right. You are the best advocate for yourself, so make sure you use that voice, when needed.
Disclaimer: This blog post should in no way replace the advice of your care provider or birth doula. This is just a guide to help you, if you have a healthy pregnancy with no medical concerns.