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the absurd “P’s” of childbirth January 29, 2007

Posted by guinever in : babies, birth, labor, pregnancy , comments closed

Here’s a common labor scenario: you’ve been in active labor for awhile and it seems you’re stuck. You were 5-6 centimeters dilated a few hours ago, and you’re still 5-6 cm dilated even after several hours of hard, active labor. So your doctor or midwife diagnoses you with failure to progress.

Your caregiver starts the 3 p’s talk. Something must be wrong. It’s either the passageway, passenger, or power. Your birth canal seems fine, big enough for the baby, so it’s not the passageway. The baby is handling your labor great, not showing any signs of distress on the EFM (electronic fetal monitor) and doesn’t seem too big, so the problem isn’t the passenger. So it must be the power. Your contractions just aren’t strong enough. Therefore, you need pitocin to make your contractions stronger, more powerful to dilate your cervix to ten. That’s what your OB/GYN tells you.

p1Passageway? Passenger? Power? Who first came up with this ridiculous way to evaluate labor? Totally absurd. How about patience. The fourth p in labor should not be pitocin, it should be patience. As long as mom and baby are doing fine, patience is called for.

I just described an example of where even with an active labor pattern, dilation seemingly stops. Another example that the 3 p’s of labor is brought up is when labor just stops or slows down. A woman who had been having long, hard, and strong contractions suddenly finds her contractions shorter and not so hard and spaced apart. This isn’t her body shutting down; it’s her body resting.

How marvelous our bodies have been designed to labor in this way. Our bodies have the ability to start and stop labor as needed. Enjoy and savor these resting minutes. You are regaining your strength for more work ahead. But all too often in the hospital, a laboring woman is diagnosed with failure to progress and told her body shut down and just can’t labor and she is given pitocin or worse, wheeled to the OR when all that is needed is just a little time.

Patience, ladies. Patience.Trust your body to birth your baby. You can read the birth story of my third baby where my labor kept on stopping, and with time and patience, the baby finally was born.


how long is it ok to push during labor? January 29, 2007

Posted by guinever in : babies, birth, labor, pregnancy , comments closed

How long is it ok to push during labor? The answer is as long as both mother and baby are healthy, it’s alright to just keep on pushing until the baby is born. Just be patient. The second stage of labor or pushing phase can take anywhere from just a couple minutes to many hours.

From what I’ve observed, most primiparas (first time moms) take about an hour to push out their baby. But going over one or two hours is normal and acceptable. If labor seems long and the baby isn’t descending, a change of position is usually all that is needed to bring the baby down. Positions to try besides the typical hospital position of lying on back with feet in stirrups include

For more information about the second stage of labor, read this comprehensive article about pushing for first time moms at Midwifery Today.

If mom is overly exhausted or her blood pressure is rising or the baby starts showing signs of distress (the baby’s heart rate is measured with a doppler or fetal monitor), then that is the time to try to shorten the pushing stage and try to get the baby out quicker. This would include pushing a lot harder for a couple contractions, trying vacuum extraction, forceps, and eventually surgery.

Again, it doesn’t matter how long it takes for pushing as long as mom and baby continue to do alright. It’s important for the laboring woman to eat if she’s hungry, drink if she’s thirsty, and change positions if she feels like it.


what does being 2 centimeters dilated mean? January 22, 2007

Posted by guinever in : babies, birth, labor, pregnancy , comments closed

So you’re nearing the end of your pregnancy and your doctor or midwife “checks you” and you find out that you’re 2 centimeters dilated. What does it mean? When will you have your baby?

Well, your labor could start today, tomorrow or not for another month. Cervical dilation is not a good indication of when exactly you will have your baby.

You can be 36, 37, or 38 weeks pregnant, 2 centimeters dilated and not have your baby for several weeks. Or you can be 2 centimeters dilated and be in very early labor or pre-labor having a couple contractions an hour and maybe have a baby within the next couple days. Or you can be 2 centimeters dilated and be having very long, hard contractions that are close together. In this last scenario, you will have your baby very soon. You can actually be in late labor or in transition, but your cervix hasn’t caught up yet and is showing early labor.

I’ve heard a few women say that they got the epidural, but it didn’t take effect until after the baby was born. The contractions were overwhelming and they just couldn’t handle labor anymore especially when they got checked and their cervix was found to only be 2, 3, or 4 centimeters dilated. They ordered the epidural and as they waited for the anesthesiologist to show up, they had the baby.

So remember, you can’t predict when your baby will be born based on the dilation of your cervix. Dilation doesn’t happen in a standard, uniform way.

Feel free to ask a question and then check back later for an answer, but please don’t ask me when I think you are going to have your baby or if your doctor will induce you because I don’t know. (these questions could be deleted and will not be answered)

You will find additional clarification of when your labor may start by reading  cervical dilation 101:frequently asked questions and How long does it take the cervix to dilate 5 centimeters?
For more articles about pregnancy and birth, please refer to my welcome page.
If you enjoy reading birth stories, you might like
diary of a primipara
my second birth: a lot quicker than my first
the labor that kept on stopping
born in our living room

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