Keep Calm and Labor On - Active Labor

I’m a tad behind schedule this week with posting part two of “The Stages of Labor” series. We’ll chalk it up to a combination of motherhood and 4th of July festivities - let’s just dive right in! (If you missed part one, check it out here!)  After you’ve tolerated manageable labor for what seems like hours and hours, things are suddenly changing. The mild contraction pattern you’ve come to know seems to be ramping up and you're beginning to require a whole lot more focus to manage them. Time for “chit chat” seems to have run out. Welcome to active labor, momma. You’re amazing! Keep powering through!

What is active labor?

Although we know that the pains and patterns of labor and it’s correlation to each stage can vary from woman to woman (#variationsofnormal), we’ll continue to discuss a very textbook picture of the stages of labor. Active labor is like “part two” of the first stage of labor. At this point in labor the cervix is

opened to six centimeters dilated (give or take). Contractions are now

averaging 3-5 minutes apart, with each contraction lasting about one full minute long. Whereas before in the early stages of labor, you may have been able to continue walking and talking through contractions, now you're having to stop and focus through them. Although the intensity of the contraction has picked up, some women are still able to be themselves and relax in between contractions. For lots of women, this is when they are starting to think about moving to their birth space, wherever that may be. 

What can you expect?

This stage is becoming more and more intense, but you’re doing it! At this point in labor, if you haven’t made solid preparations for pain management, you may be ready to start talking medication options. If your water hasn’t broken yet, this may be the stage it happens in (for some women water doesn’t break until closer to the pushing stage). If this does happen, you can expect things to intensify a bit. Your bag of waters work as a type of cushion under the baby's head so once its broken, its normal for labor to become harder or in SOME (not always) cases, speed up. Many women report labor pain being much more intense when the waters are broken. It’s me, I am those women. But don’t sweat it, momma, you can do hard things. You already are. As the cervix changes, you may also begin seeing bloody show. Usually, this is perfectly normal and is a good sign. It means that the blood vessels in the cervix are bursting as you begin to efface and dilate more. Although times can vary, you can expect active labor to last from just a few hours to several hours. BOTH are normal. Labor is not linear. 

What to do?

Obviously, you’re going to find what works for you and what helps you best cope - BUT here are a list of ideas that you may find helpful during active labor.

• ​CALL YOUR DOULA. Maybe I’m a tad bias, but doulas are invaluable assets to your birth team. Check out this article from DONA International about the benefits of a doula. (#DONAproud) If you’re entering the active labor phase and are having trouble managing labor on your own, or even with your partner’s help, it may be time to call in your doula. Your doula will likely carry in a bag of tips and tricks you haven’t even thought of yet.

• Massage - don’t be afraid to tell your partner or doula what you love and what you hate

• Counter pressure 

• Birth ball - there are LOADS of ways to utilize a birth ball in labor. Check out this info! 

• Tub / shower

• Walking

• Swaying / rocking / moaning - whatever it takes to find your “rhythm”

• Squatting - Did you know squatting can open your pelvis 10-15% more? Who wouldn’t want that when they’re trying to fit a small human through there?

• Sitting on the toilet - AKA “The Dilation Station”, enough said. You should be emptying your bladder regularly anyway, so this works great!

• Hands and knees positions - GREAT for back labor

• Resting - when you can! (I LOVE a peanut ball for this!)

• Aromatherapy 

• Music

• Birth affirmations

• Focus on relaxation - “Soft jaw, open hands”

• Eat and drink freely - you may not be in the mood to eat and drink, but good hydration and small refreshing, nutritious snacks can help maintain energy throughout the course of labor. 

Labor is tough, but so are you. Read these tips, educate yourself, make a plan, gather a team, etc. Keep calm and labor on! Next week, let’s discuss the third and final portion of stage 1 - transition. For most women, transition is a whole new ball game, so let’s learn to navigate it together!