Gratitude bestows reverence, allowing us to encounter everyday epiphanies, those transcendent moments of awe that change forever how we experience life and the world. --John Milton

Monday, February 6, 2017

Mama in Labor: What's Happening?

Would you like to understand what your marvelous body and your amazing baby do during labor? Read this, dear mama, from a midwife with a PhD.

Assessment (what you might see)
  • Her contraction pattern becomes increasingly stronger (based on her response to them). Note that contractions may not necessarily become closer, but they will become increasingly powerful. There should be a shift in the pattern/power every 2 hours (as a general rule)

  • She will be in ‘her own world’ – she may have her eyes closed and doze off between contractions ie. look stoned. She may cover her eyes with a cloth or bury her head into something (eg. pillow).

  • She is less able to respond to questions or anything else that requires her neocortex to function. Her communication (if there is any) will be short and to the point eg. ‘water!’ rather than ‘Can you please pass me the water’. If you ask a question (best not to) it might take a while for her to answer and she will not speak during a contraction.

  • Her movements and sounds will be instinctive and rhythmical. She is likely to vocalise during contractions – often the same noise with each one, and/or make the same movements each time.

  • Her inhibitions reduce. It is during this phase that the previously shy woman rips all her clothes off and crawls about naked.

  • At this point the hormonal symphony is in full swing and it is very, very difficult to stop or slow contractions. A significant stress at this point may generate a fetal ejection reflex but it is unlikely to stop contractions.

  • As the baby moves downwards and her pelvis becomes less stable (opening), her posture will change. She will want to hold onto things (and people) when standing/walking. She will not be able to sit directly on her bottom. She will walk leaning slightly with a ‘waddle’ as the pelvis tips.

  • If she is in an upright/ forward leaning position, you may be able to see / feel the ‘opening of her back’ as the Rhombus of Michaelis moves.

  • A purple line might be visible between the woman’s buttocks as the baby’s head descends.

  • During transition you may see fear as she reaches out for reassurance and support. However, some women do not, and instead feel this on the inside without their care provider being aware of it.

  • During transition E-EN can cause a dry mouth and she might suddenly be very thirsty. High levels can also cause vomiting as the stomach empties in the fight or flight response.

  • As the cervix opens to its full capacity you might see a bloody/mucous show and the waters break.

  • There may be a ‘rest and be thankful’ phase after transition where contractions slow and the woman rests as the baby descends into her pelvis.

  • She might mention pressure in her bottom, or that she need’s to poo. And you may see poo as the baby compresses the rectum and squeezes it out.

  • Contractions become expulsive and the pattern will change. Her noises and behaviour will also change.

  • If you are able to visualise her perineum (and you really don’t need to) you will see signs of the baby’s head descending through the vagina – gaping anus and vulva, flattened perineum, bulging bag of waters (if still intact), the baby’s hair/head, etc.

  • As the baby’s head stretches her perineal tissue she will hold back her pushes, gasp, scream, close her legs, and/or hold her baby’s head in – protecting her perineum.

  • One the baby’s head is born you may see him/her rotate or wriggle then be born with the next contraction (there should be some movement or change with the next contraction).

Read more of this phenomenally researched article.







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