How will I know I am in labour? The ways this question usually gets answered leave women out of the loop. Definitions offered are misleading at best, disempowering at worst - and so often, result in feelings of confusion and uncertainty. On the day itself, a kind of helplessness.
Is this it? Am I doing ok? Is this what they mean by strong?
I've been having contractions for 15 hours - this MUST be labour.
Active labour is almost always described in abstract terms. Standard maternity care, natural birth education - no matter the source, very, very rarely does anyone explain to pregnant women how it's all going to feel. What to expect. INSIDE THEIR BODY
It's always amazing to me that midwife appointments aren't an automatic provision point for this kind of practical information. Given most women still transfer to hospital to give birth, it's surely imperative that they understand what it is they are waiting for. At what point they can be accommodated.
Don't get me wrong, it is entirely natural and right to want to go into hospital when things are starting to get intense. All mammals seek out and head for the safe space they're planning to give birth in, in advance of labour itself and we are no different. The problem is standard maternity care in a labour ward or birth centre, isn't able to 'host' us at that point.
There just aren't the resources and when women are confronted with that, at a point when they are sensitive and can easily feel vulnerable/exposed, it's often a shock. It's easy to feel unsupported, overwhelmed, and even scared, and this drop in confidence is one main reason so many births become unnecessarily long and complicated.
Vaginal examinations and dilation scores offer information on one isolated point in time. It would be like measuring a sneeze. Contractions are just the wheels on the car - the means of propulsion. Neither are reliable measures of labour.
A far easier way to know active labour has begun is to know what it's going to feel like.
Active labour is the point when your baby descends down and through the pelvis. The body is now on automatic, highly coordinated - and there is on-goingly a feeling of dynamic physical change.
Hips spread and flare as the baby makes its way down and through.
Pelvic joints release forward and out, opening more space
Sacrum and lower back lift and open.
The uterus has folded and folded and folded again at the top, a bit like a toothpaste tube, shrinking the wombspace and thus driving the baby towards the only available exit - the soft, giving cervix. The baby now has no choice but to find more space for itself and is drawn down. In a well provided for labour, gravity and the chance to be mobile and free are also going to aid and accelerate the baby's descent and the overall feeling of this is
. a sense of fullness - of filling up
. a feeling of nudging and burrowing around the pubic bone/vagina
. growing weight and stretch round your hips and in your pelvis generally
. increasing pressure and intensity as the pelvis spreads and opens, that in time spreads to your lower back and bottom
It's like a handbrake has been released and now contractions are urgent, super-powerful, all-consuming, and intensely repetitive. Now there is nothing you can or want to do but concentrate.