Prodromal Labor

I attended a nice little workshop several weeks ago.  Alison Williams, a midwife from New Zealand, came to help a family member have an empowering birth experience and also chose to share some wisdom with those that were interested.  As she spoke, I was reminded of the Friedman’s Curve article I posted awhile ago.  Alison was speaking to a group of mostly young mothers or mothers to be and she spent a good amount of time discussing Prodromal labor, sometimes referred to as Pre-labor.

Prodromal labor is common.  It is an important tool which helps the cervix soften, and sometimes even efface and dilate the cervix before true or active labor kicks in.  It is also sends other signals.  It means a woman is getting closer to delivery.  It means she needs to be more attentive to her biological needs.  She should be napping (because sleeping may become increasingly difficult), eating healthy, regular meals and snacks, and taking the opportunity to center with the sensations that are communicating with her body.  When a woman begins to have surges here and there, she should be taking deep slow breaths and welcoming them.  She can allow herself to get excited, but to also hold back a bit…it may be pre-labor!

Prodromal labor can start at the end of a long day, or in the freezer isle of the grocery store.  It’s unpredictable and can come and go at any time in the last weeks of a pregnancy.  Sometimes it lasts a few hours, off and on for days, or even weeks!  Often the contractions have some quality to them, meaning there is something different about them than the simple tightening and releasing of braxton hicks contractions, and may even come at pretty regular intervals. That is why its important not to PUSH pre-labor, though it is good to maintain low impact activity.  Finding a place to swim, a shady path to stroll, a hill to hike, dancing and keeping loose hips, savoring those last few pregnancy yoga classes all help pre-labor remain tolerable. Also, staying hydrated will reduce the frequency of braxton hicks contractions.

Sometimes it is hard to tell the difference between pre-labor and true/active labor, especially if it is the first labor the woman has ever experienced.  If a mother is unsure if she is having pre-labor, changing activity can often slow or even stop the surges.

The main cause of prodromal labor is hormones.  A woman’s body ripens and the uterus contracts as it prepares for delivery due to the release of hormones from the placenta, the mother, and the baby.  If there is a malpresentation (such as OP – sunny side up, asynclitic, or breech), the body may pre-labor off and on for a few weeks as it tries to coerce the baby into better alignment. There are other possible reasons for long bouts of pre-labor which is why practitioners like to check in with mothers and babies weekly, to ensure the health and wellness of the pair.

Patience. Trust. Aloha.


Friedman’s Curve is failing our mothers

This is a very informative article and has lots of current statistics for the “average” labor and delivery in a hospital setting. I have been reading more and more articles about when “true/active labor”  begins.  The most recent article I read said that there is strong consideration to change that number from 3 or 4cm dilated to 6cm dilated, especially for first time mothers (the attached article touches on this, too).  That is a BIG difference and honestly, from the mothers I have labored with, this is at least 50% true.  Whether early labor is 2 hours or 2 days, it seems the fastest progress (in MANY scenarios) happens once a woman is at least 6cm.  Sadly, in todays OB world, many women are not provided with the correct or current information about how their labor may begin or how long it may really take to get through that first phase.  It is not uncommon for a woman to have prodromal labor, meaning she will have irregular contractions (some strong and far apart, some mild and close, resulting in little to no dilation) for a few days leading up to her delivery.  Preparing a woman for that possibility and teaching her how to care for herself during that time is paramount if she does not want a C-Section.

Since this is the paradigm most OBs and hospitals are operating in, I feel this is where an experienced birth doula is so very helpful.  OBs do not have time to educate their mothers and many childbirth education courses offered through our hospital system are geared towards an expectation of epidural, or other pain relief, as well as post-surgical recovery.  This is not ideal for the woman who wants to have a natural birth. Doulas can help fill the holes in a family’s childbirth education, either during prenatal visits, or along the way to meeting the baby.  They can help a woman labor at home before heading to the confinements of a hospital room and the distraction of the many rotating faces. Once there, they can keep the commotion to a minimum so the mother may focus on meeting her child.

I also believe that a doula can be very helpful in a home birth setting.  If a woman has a longer labor, the midwife is able to rest more, allowing her to have a more clear mind during the last stages of labor and delivery. The doula can help keep the mother fed, hydrated, napped, and generally more prepared to endure active labor and the pushing phase when it finally crescendos into that mind blowing stage!

So…read up!  Be informed!  Get ready for the most life changing journey you will ever embark on!  Be prepared for that journey to be long and be pleasantly surprised when it is short!