Birth Articles:

External clues to see how your labour is advancing!


Happily, there are a number of external cues that can help you and your birth partners get clued in to how much labour is advancing. Some are more subtle than others, but if you are ignoring the clock and keeping focused on staying in tune with your body, you will see them.  Listen, embrace, wait.  Enjoy the way it responds!  It is amazing what it can do, this body that God gave you.

1. Sound. The way you talk changes from stage to stage in labour. With the first contractions, you can speak during them if you try, or if something surprises you, or if someone says something you strongly disagree with. You may be getting into breathing and moving and ignoring people – but if you really want to you can raise your head and speak in a normal voice. When the contraction disappears you can chat and laugh at people’s jokes and move about getting preparations done. However, during established labour, there is very little you can do to speak during a contraction. You feel like resting in between, you are not bothered by what people are doing around you. As you near transition and birth, you seem to go to another level of awareness – it’s almost like a spiritual hideaway. You may share this with someone else, staring into their eyes with each surge, or you may close them and go into yourself. In between surges you stay in this place. It is imperative for birth assistants and partners to stay quiet and support the sanctity of this space: there are no more jokes, and should be as little small talk as possible. Suddenly, the sounds start to change involuntarily: you may have been vocalizing before (moaning, talking and expressing your discomfort, singing, etc.) or you may have been silent. Listen – there are deep gutteral sounds along with everything you have heard before, just slipping in there. You are about to start pushing.

2. Smell. There is a smell to birth, that hits towards the end of dilation, during intense labor, just before birth. It is a cross between mown hay and semen and dampness. It has a fresh, yet enclosed quality, and is pervasive. The Navelgazing Midwife has also observed this scent and writes about it.

3. Irrationality. I love this clue – it often is a sign of transition. It always makes me smile, and I always warn women about this phenomenon so that when we hit it during labour I can remind them that what they’ve just said is irrational, and that I told her this would happen, and here it is! Relax, it means we’re nearing the end. Sometimes a mother will say she wants to go home, she is done now, she’ll come back and do this later, she wants to put on her dress and coat and go out the door. A mother who wants a natural birth and has been coping brilliantly will suddenly say she was crazy and needs pain killers right now, or that she didn’t want another baby anyway, who said they wanted a baby? Some will just curl up and say they’re going to sleep now. If she does this, that’s okay. The contractions may die down, get farther apart, and maybe she (and the baby) will get a few minutes of sleep. This slowed-down transition sometimes freaks out doctors or hospital midwives and pitocin is offered – try to see if you can put them off for half an hour. Send every one out, lie on your left side propped up by pillows and have a little nap before pushing; it is such a wonderful gift.

4. Feel. Here come some of the more fun tools that you might not have heard of before! Think about the shape of the uterus. Before labour, the muscle of the uterus is thick evenly around all sides, above, below, behind. As the cervix starts thinning and dilating, all that muscle has to go somewhere – it bunches up at the top. The top of the uterus thickens dramatically the more the cervix opens. During a contraction, at the beginning of labour, check how many fingers you can fit between the fundus (top of your bump) and the bra line – you will be able to fit 5 fingers. As the top of the fundus rises higher during labor, you will fit fewer and fewer fingers. When you can fit 3 fingers, I usually tell mothers they can think about going into hospital as they will find they are around 5 centimeters dilated. At 1 finger, you are fully dilated.

5. Look. There is something called the ‘bottom line’ or purple line, which is a shadow that extends from the anus up towards the back along the crease of the buttocks. It begins as 1cm and lengthens to 10cm, and its length correlates with cervical dilation. Why not look down there before inviting a stranger to put their fingers up inside you? It makes sense to me.  Research verifies the existence of the bottom line, and in their trial it was measurable and had acceptable accuracy for 76% of women checked.

6. Gooey Stuff. Also known as bloody show; there is usually one at around 2-3 cm dilation, and it can happen during the beginning of labour or a few days beforehand. Sometimes it’s hard to know what is or isn’t a show, since during the days before labor the amount of vaginal mucus increases in preparation and this can be confusing. A show is up to a couple of tablespoons in quantity, so quite a lot. It can be clear, but is usually streaked with pink, brown, or bright blood. If there is more than a couple of tablespoons of blood then you do need to go into the hospital to make sure the placenta is not detaching, but if there is just a bit and then it stops, then it is just show. There is a SECOND show at around 8 cm dilation. This second show means that birth is near.

7. Opening of the Back. This is at the spot where your birth partner has been doing lower back massage, at the area above the tailbone. It is a smaller than palm-sized, rather kite-shaped area that bulges out during pushing. At this point you’ve waited too long to go into hospital.

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I am living my dream while working with mums and babies. I see mums when they are 34 weeks pregnant and then go to their homes once they go into labour. I stay for the full duration of the labour and after the birth I assist them with breast feeding. I do another visit after the birth to see that all is well and to help where I can.  Mums are always welcome to call me in the event that they have any questions, whether before or after the birth. I am passionate about my work as a doula and I care and love all the families with which I work. Once you have been present at a birth you feel part of the family and it’s wonderful to hear news of the new baby’s life as he or she grows.

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