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5 Really Good Reasons To Stay Home In Early Labor

Posted by on Nov. 16, 2010 at 11:53 AM
  • 15 Replies

5 Really Good Reasons To Stay Home In Early Labor

Posted by ceridwen on November 9th, 2010 at 3:20 pm

In the movies, the water breaks, everyone flips out and the next thing you know mom’s being raced down a hospital corridor on a gurney. But in real life, especially for a first labor, this is very, very rarely the case. Still, expecting women and partners are often shocked to learn that they will be sent home if they “rush” into the hospital at the first contraction or even when the water breaks.

In the absence of any particular concerns—like a preexisting maternal health condition that might require close monitoring—women can do a lot of laboring at home.

The idea of mom being in actual real labor at home, unsupervised by medical personnel, can be a bit disconcerting to those of us raised with The Emergency Birth narrative pummeled into our heads. Partners in particular can feel a bit out of their depth and eager to get a professional on board. I completely understand that feeling.

But there are logical, evidence-based reasons for staying home until active labor has really kicked in.

Before I list them, a quick breakdown of “early” vs “active” labor: Early labor, which can last hours or days, is when the cervix dilates the first three centimeters– contractions can be anywhere from 5 to 30 minutes apart and less than a minute long. These contractions can be mild to difficult– they may be strong enough to require some pain-coping, or easy enough to mostly ignore.

Active labor starts when those contractions move to about 3-5 minutes apart and last about one minute a piece. This is the more intense part of labor when pain-coping techniques need to be put to use and the mother needs more focus. It can still last several to many hours for first time mothers; this is when she dilates the next 7 centimeters. So leaving for the hospital sometime in early to mid-active labor will still get you in to the hospital with plenty of time barring serious commuting distances, in which case talk to your care providers about the best protocol. Now onto the reasons for staying home:

Staying home in early labor….

1. ….reduces the chances of induction and c-section.

At some point it was decided that a woman should dilate about one centimeter per hour. If this were true, most women would labor for precisely ten hours and bam: baby in arms. But that doesn’t happen.

This expectation—based on averages—has led to an increased use of induction drugs to move along supposedly slow labors. But are they really slow? A first labor can be ten hours, but it can be longer, too. Or shorter. Also labors have a normal ebb and flow to them. They can slow down and speed up for any number of reasons.

The averages are useless to almost all of us. And yet they are used to determine how we are “progressing.” If you come in to the hospital in early labor there’s a chance you’ll be declared “failing to progress” and given induction drugs that, while very useful in some circumstances, are not without risks. Induced labors are twice as likely to result in a c-section.

2. …. helps labor progress.

The labor hormone oxytocin requires a little hand-holding to get going. Oxytocin is an incredible hormone, it’s what causes contractions but it’s also responsible for feelings of love and bonding. It’s also released during breastfeeding, orgasm, falling in love, when you give, when you get a massage, when you feel safe and when it’s dark.

Oxytocin is not a fan of adrenalin and logistical maneuverings. It likes intimacy, basically.

This is one reason so many labors start at night. OK, so given this physiological set-up, why “rush” to a fluorescently-lit hospital? Oxytocin will flow a lot faster if you’re at home, in bed, in the dark or in the bath or with someone you love. Once that hormone is really flowing, it’s hard to shut down. But early in labor, it’s a bit more fickle. So give it some nice cozy environment to get that show on the road. Get it ramped up to the point of no return, so you’re labor will be faster and more efficient once you do get to the hospital. You may even meet those one centimeter an hour standards, if you’ve let that oxytocin build up a whole lot.

3 …means you can eat and drink, which is actually good for you in labor.

Hospitals are lagging behind the research in this area. Some places are allowing food and drink in labor wards, but many still offer IVs or ice-chips. Women, especially first time mothers who may be laboring for about a day (or night) can use some sustenance. This is muscular work, after-all. Most women don’t want to eat during very hard active labor—sips of water or Gatorade usually do the trick. But in early labor you can snack all you want.

4 …..gives you more flexibility about pain-coping techniques.

Some hospitals have birthing tubs for labor, but many do not. And water has been shown as effective in reducing pain in labor as a shot of narcotics. Taking a nice long bath during painful contractions can be very relaxing—mentally and physically.

You may also be able to move around more, which is so helpful. Women are monitored for some stretch of time upon entering a birthing facility. This requires being on your back and strapped to various machines. Not so comfortable and not as efficient for labor—changing position is very useful for taking the edge of pain but also for *helping labor progress.” I encourage you to move around the hospital and try different positions on top of and alongside the hospital bed but it’s nice to get some of those moves well established at home first.

5. … means you’re less likely to be sent home.

Women do get sent home if they come in too soon. Some midwives and doctors will want to listen to you have a contraction over the phone. If you are able to talk through it, it’s probably not active labor and probably not time to come in.

The bottom line is that your labor will seem, and possibly even be, shorter if you stay home for the first stretch—this can be hours or even days if it’s a very long early labor. (Some labors take a long time to ramp up.) You can and should call your care-provider once you think labor has started, but you don’t necessarily have to “rush” to the hospital.

So what can you do during all this time? Ignore the labor for as long as possible is usually a good idea. Distract yourself or sleep if you can. Have your partner massage you, watch movies, eat good food, relax, go for a walk, stretch out on the couch with a good book. If contractions become more intense get in the shower, get in the bath or try moving into positions that feel good to you.

by on Nov. 16, 2010 at 11:53 AM
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Replies (1-10):
RugersMommy06
by on Nov. 16, 2010 at 12:21 PM

I was so hell-bent on staying home, that I almost stayed home too long. I didn't realize my 1st labor would be so quick. 4h39min start to finish. We arrived at the hospital & I was at 8cm, baby born an hour later. With #2, I was expecting a somewhat fast L&D--but only had 4 hard contractions before I woke my husband up. His birth (he'll be 5months on the 24th) was 1h26min. I was that lady--the one being wheeled down the hallway blowing the pain away and squeezing my eyes shut trying to focus. Once in the room, I moved myself to the bed & was crowning. lol   So stay home, but pay attention to what's going on so you can get to the hospital with a little time to spare-if that's your plan.

Caroline2010
by on Nov. 16, 2010 at 12:27 PM

lol! i was the one who rushed to the hospital at 4 am cuz my water broke! i have never seen my hubby get out of bed so fast!! lol! but i really wanted to stay home and wait until labor had really set in but being the 1st time dad my hubby just about carried me to the car since the doc said if my water broke first we should go to the hospital since labor would be fast! lmao yeah fast 14 1/2 hours i dont think that was fast at all!! my next child will be born way differently!! i would like to do a home birth or a birthing center!

kitty8199
by on Nov. 16, 2010 at 12:31 PM

I want to sit in my moms tub as long as I can.  She has a real deep one.  The hospital will take about 30 minutes to get to.  My doc changed hospitals.  Since this is my first, I don't really know when to go.  Can you check your own cervix? 

doulala
by on Nov. 16, 2010 at 1:35 PM


Quoting kitty8199:

I want to sit in my moms tub as long as I can.  She has a real deep one.  The hospital will take about 30 minutes to get to.  My doc changed hospitals.  Since this is my first, I don't really know when to go.  Can you check your own cervix? 

There are ways to watch for progress.   Are you reading/taking birth classes?   It will be covered there.   Also, a birth doula will be very helpful with this, too!  ;-)
You can check your own cervix, but shouldn't need to.    Many of us do no checking at all.  














In True Labor

Contractions will:
Get progressively longer
Build in intensity
Have shorter rest times

It seems unfair that the best advice most experienced mothers will give you is, "You'll know when it's labor." Even if it is true, it isn't especially helpful for the first time mother. What signs should she be looking for to let her know that labor is really starting?

Your body is going to go through periods of contractions that may be regular or irregular for days or weeks before your true labor begins. These contractions may feel strong or mild, some women don't even notice them. But they will have some differences from true labor contractions.

The first difference is that true labor contractions will not space out or slow down when you change activities, pre-labor contractions will. In fact, very often true labor contractions will increase when you change activity.

Another difference has to do with the overall pattern of contractions. In true labor, contractions will build in intensity and length, and they will get coser together. In pre-labor contractions will remain the same for many hours, sometimes days.


Testing for True Labor

There are a few "self-tests" you can do to determine if what you are experiencing is true labor.

Drink some water - Dehydration can cause you to feel contractions that look just like true labor, but are not productive.

Eat something - Some women find that hunger brings on Braxton-Hicks (pre-labor) contractions. Eating seems to stop these contractions.

Change your Activity - With pre-labor, changing activity (like resting if you have been walking around or going for a walk if you have been resting) can cause the contractions to stop.

Watch the contraction pattern - Even if you are having contractions less than 10 minutes apart, it may not be true labor. If the contractions are staying the same (not getting closer together or longer) it is pre-labor.

*      *      *
Pre/Early labor indicators: Nausea/vomiting, diarrhea, losing mucous plug, bloody show, contractions (regular~increasing in intensity), back pain, menstrual-like cramps, pressure very low. While these are normal things to notice in the third trimester, it's a combo that gets your attention. Especially, when the contractions increase to a point where you must stop what you're doing to focus on getting through it.


*      *      *

The contractions will sort themselves out. 4-1-1 is the "general rule" for knowing when "it's time" to get serious. Contractions are 4 minutes apart or less, 1 minute long or so, and happening this way for 1 hour or longer. ***Remember, to gauge how far apart they are: time contractions from the start of one to the start of the next.






As soon as you start to realize it's truly started then begin the count.  Note what time it is on the clock (hour & minute).


When it is over stop timing.


This gives you the length of the contraction.


When the next one starts you can begin timing again.  See what time it is on the clock (hour & minute) to get the Contraction Frequency.


 


 


You can also use this for timing help:   http://www.contractionmaster.com/faq.html






Labor: A Visual Guide










Just as a woman’s heart knows,

How and when to pump,

Her lungs to inhale,

And her hand to pull back from fire,

So she knows when and how to give birth.


- Virginia Di


ICAN

Pandapanda
by on Nov. 16, 2010 at 1:55 PM

I had my first in July, and I didn't know when to go based on my contractions. They were 1:30-2:45 long and 5-12 minutes apart the entire 16 hours of labor. I suggest paying attention to the intensity first before you pay attention to timing. When you feel like you just can't do it, you're likely close and it would be a good idea to head out.

Quoting kitty8199:

I want to sit in my moms tub as long as I can.  She has a real deep one.  The hospital will take about 30 minutes to get to.  My doc changed hospitals.  Since this is my first, I don't really know when to go.  Can you check your own cervix? 


DixieFlower
by on Nov. 16, 2010 at 5:27 PM

I agree. With my first I went to the hospital a few hours after my water broke. Bad idea. This time I labored at home as long as I could. I woke at 4am with contractions 7min apart and 1 min duration.  I decided to head out to the hospital when my contractions got to 4 min apart 1min duration. Now personally I wish I could have stayed home longer but do to my living situation that wasn't an option. (I am a live in companion for two ladies that have developmental disabilities. One has severe anxiety problems and as my labor progressed she was getting very anxious and worried about me.) When I got to the hospital I was already at 6cm.

Quoting Pandapanda:

I had my first in July, and I didn't know when to go based on my contractions. They were 1:30-2:45 long and 5-12 minutes apart the entire 16 hours of labor. I suggest paying attention to the intensity first before you pay attention to timing. When you feel like you just can't do it, you're likely close and it would be a good idea to head out.

Quoting kitty8199:

I want to sit in my moms tub as long as I can.  She has a real deep one.  The hospital will take about 30 minutes to get to.  My doc changed hospitals.  Since this is my first, I don't really know when to go.  Can you check your own cervix? 



truealaskanmom
by on Nov. 16, 2010 at 5:38 PM

Knowing what I now know if you labor at home and everything is going well I really don't see the need to go to the hospital at all. Especially since my son got MRSA just from being born in the hospital and that wouldn't happen at home.

DixieFlower
by on Nov. 16, 2010 at 7:26 PM

Wish I could have but that wasn't really an option for me, especially after two CPM's risked me out :(

Quoting truealaskanmom:

Knowing what I now know if you labor at home and everything is going well I really don't see the need to go to the hospital at all. Especially since my son got MRSA just from being born in the hospital and that wouldn't happen at home.


Roadfamily6now
by on Nov. 17, 2010 at 12:27 AM

I agree. It all is going well, chances are they will continue to go well.

Quoting truealaskanmom:

Knowing what I now know if you labor at home and everything is going well I really don't see the need to go to the hospital at all. Especially since my son got MRSA just from being born in the hospital and that wouldn't happen at home.


Tammy

"It is not the healthy who need a doctor but the sick."

 Join us in the Natural Birth Group!






katcb1019
by on Nov. 17, 2010 at 8:54 AM

WIth my odd I went straight to the hospital when my water broke and was stuck in bed for many hours, even ended up with epidural that I was reluctant to have. However, with my second I stayed home. I got to the hospital, I was already 9 and half cm. It was great, no drugs, everything went splendid. I just hope this one is as easy.

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