1. Timing of contractions is not usually as important as how they make you feel.
The first thing couples do is get out the contraction timer and become so focused on timing contractions that they seem worse than they are. Put the timer down and listen to your body. Find something to distract yourself instead of hyperfocusing on the timing. Get a quick feel for the time between but then move on. I've seen women with contractions 2-3 minutes apart for 24 hours and women who were having contractions 10 minutes apart with a baby 90 minutes later. Usually contractions that bring a baby last over 60 seconds long. Wait for contractions that cause you to vocalize... Like a tea kettle building so much pressure that it whistles when it lets off steam.
2. Don't go to the hospital too early.
Women need to be in a well established labor pattern or 'active labor' before heading in. There are several reasons for this. One is that the change of environment and adrenaline release can slow or even stop labor. Secondly, being in the hospital longer can increase the number of interventions because your body doesn't operate the same way in a hospital environment as it does in your own home. Your sphincter muscles are more relaxed at home.... You don't feel like you have an audience so you will most likely progress faster in early labor in your own space. If you need a nap, your bed will be more comfortable than the hospital bed.
3. Eat FOOD before you go in.
First of all, you may be labor longer than you expect. There are quite a few providers who are comfortable with light snacking in labor, but there are many who are not. Going on an empty stomach can cause low blood sugar, which can make your baby appear sleepy. Your body needs calories, your uterus is working very hard. Your baby needs calories, your baby is working very hard.
4. Don't lie down for the 20 minute strip!
Providers like to see a reactive heartrate on baby as soon as you are admitted. No matter how amazing the nurses are, they will always lay the head of the bed down in a reclined position and ask you to lie down while they monitor baby. It's truly the most painful position to be in and I often find clients clinging to the rail just trying to "get through" this period. Those hospital beds are made to move, experiment with the head and foot functions and sit up... Or get on your hands and knees...or Stand next to the bed... Or sit on a birth ball while being monitored. The nurses don't care what position you are in, as long as they get the assessment they need but you need to be proactive about it.
5. Drink lots of liquids
Most providers are supportive of a saline lock (the IV without the tube feeding you fluid) so you need to be responsible for staying hydrated. Dehydration can cause short, painful contractions that don't do much to change the cervix. Hydration is critical. Women may choose to drink water, coconut water, broth or juice. You can also ask the nurse to order you a "clear tray" with things like broth and jello, etc. They will usually bring in a popsicle too! Ice chips alone don't usually suffice. If that's all your provider allows, think about hooking up the IV when they are monitoring baby's heartrate or when you are near the bed, then unhooking when you want to move more. And don't be afraid to ask for some IV fluids if you are nauseous or unable to drink. Your bladder needs to be filled and emptied frequently, it helps your baby to move down.
6. MOVE your body
I think it's a huge mistake for women to just lie in the bed during labor. There is a great position for lying down. Spinning babies calls it the "rest smart" position. Doulas call it any number of things...from The running man to the rotisserie. It's a productive labor position and encourages baby to rotate downward but lying on your back or writhing around side to side is usually not good for comfort or productivity. Once your labor is active, change positions every 5-6 contractions. Move your hips, sway and dance. Go from hands and knees, to standing, to sitting on a ball, to the toilet and back again. STRETCH your body.... Extend your shoulders, reach up and rock your hips, hang loose and open.
7. Make noise
I think that women are afraid to make too much sound in hospitals because...well, You have neighbors. But don't be afraid to make the sounds that come natural to you. Women in labor almost always make universal sounds. Once you've seen a couple hundred natural births, you know those noises... And it makes me so happy when I see a woman finding that natural rhythm and vocalizing with contractions. There is a certain sound for transition, when labor is coming to an end and pushing is soon to start. Don't fear those sounds, invite them in and roll with it.
8. The staff is there to help you, not sabotage you.
Don't be afraid to ask for what you want. If you need water, extra pillows, wash cloths, a blanket...socks Even. I've never met a nurse who doesn't want to help. They want to be useful, they want you to have a good birth. Go in with an attitude that you will have a supportive nurse, call her by her name and let her know that you would love for her to help you. Nurses ask what your pain level is because it's their job, many hospitals require them to. They may offer an epidural because they want you to be comfortable. everyone has a different idea for their ideal birth and many women want the meds...so If you don't, simply communicate that.
9. Use B.R.A.I.N.
Don't assume that just because something is suggested, you have no choice. Talk through your options. Ask:
Benefit-What is the benefit of this procedure?
Risk-What is the risk of this procedure?
Alternatives-What are the alternatives?
Intuition-What does your intuition tell you?
Nothing-What if you do nothing? (or wait an hour, two hours)
Don't be afraid to communicate and be informed.
10. Be open to the flow of your own unique birth
Most often, it's the couples who have an idea and a goal about what they want but who are open to what is needed in the moment who do best and are most satisfied with their birth. Don't get fixated on avoiding every single intervention no matter what it costs. Be open to what is needed at the time while honoring your own journey. Interventions can be hazardous when used routinely...but There are plenty of times that I have seen a much needed intervention...something That the couple initially wanted to avoid but helped labor and birth tremendously. Don't compare your birth to anyone elses. Only you can decide what is right for you and sometimes that changes dramatically in the moment. Be forgiving of yourself if your birth goes differently than expected. Find the good in honoring it as uniquely yours.
~Fort Worth Doula
Abbey Robinson, ProDoula CD-Labor
Abbey is a birth and postpartum doula and placenta specialist in Dallas/Fort Worth and a mom to 4 children between the ages of 25 and 12.