October 10, 2009

Pregnancy Pathway, Birth — Labor

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The First Stage of Child­birth is the long, hard labor. It is the slow process that pro­duces dila­tion, or open­ing, of the cervix — the “neck” or out­let at the bot­tom of the uterus. Once the baby’s head can fit through the open cervix, it is time for the Sec­ond Stage, but that is anoth­er top­ic for anoth­er post.

Before the baby can leave the moth­er’s body, s/he must leave the uterus. The open­ing of the cervix to let the baby out of the uterus gen­er­al­ly takes up the most time. For a first time mom it can be 10 or 12 hours…or, yes, a cou­ple of days. Of course, for some moms, this time is dif­fi­cult and for oth­ers it only becomes dif­fi­cult in the last few hours.

But, you know all this, right? What you want to know is:  Why do I have to go through this? And, if I must, how can I make it the least painful?

Why labor is impor­tant. Let’s go to anoth­er ques­tion:  How impor­tant would your off­spring be if it was no big deal to drop one out? If you were walk­ing along the side­walk and you could sim­ply drop a new­born on the pave­ment, would you even stop to pick it up if you could do it again in a few days, when, of course, it will be much more con­ve­nient?

Frankly, preg­nan­cy and labor remind us to pay atten­tion. A new­born can­not sur­vive on its own for at least two years. If we don’t pay atten­tion, it will die.

Okay, now that labor has your atten­tion, what else does it do that is ben­e­fi­cial? It stim­u­lates the baby’s stress response and teach­es the new­born to be alert dur­ing sit­u­a­tions of duress. Each con­trac­tion is pulling the cervix, help­ing it slow­ly open. If you are upright, each con­trac­tion is also alert­ing the baby to the influ­ence of grav­i­ty.

Why is labor painful? So, you need to go through this because it is the bridge from preg­nan­cy to par­ent­hood. Why does it have to be painful?

The first thing to keep in mind about pain is that pain is a com­bi­na­tion of sen­sa­tions and emo­tion, main­ly fear. Fear makes you tense; ten­sion reduces blood flow. Reduced blood flow to the uterus makes the con­trac­tions less effec­tive. In addi­tion, cor­ti­sol is released, mak­ing sen­sa­tions stronger and evok­ing greater fear.

Fear is the emo­tion of fight or flight. Inter­est­ing­ly, the oppo­site response, the relax­ation response, is very effec­tive in pro­mot­ing labor. So, relax. Breathe deeply and slow­ly, focus, move through the cen­ter of your expe­ri­ence. You don’t have to be in fear if you know what is hap­pen­ing and if you are phys­i­cal­ly fit and pre­pared. Both child­birth edu­ca­tion and phys­i­cal fit­ness teach your body to work with dis­com­fort. By includ­ing them in your prepa­ra­tion, you give your­self a tremen­dous advan­tage.

Does this mean you will nev­er feel like you want to stop in the mid­dle of labor? No, but it does mean you can do it. It is finite. The notion that the baby will not do well is also tied to your phys­i­cal fit­ness…babies of fit moth­ers less often expe­ri­ence fetal dis­tress. Your care providers will let you know if there is some fac­tor beyond your con­trol that requires med­ical inter­ven­tion.

Birth is an empow­er­ing event. But, before the baby can be born, it must escape the uterus. It is a clas­sic con­flict and the moth­er’s body is the venue. Give your­self over; go with it. Only women can do this.