An easier first birth

Cindy Harmon-Jones

Influence the process
As a doula, I've learned that the birth of a first baby is much more likely to be a long, difficult process than the birth of a second or subsequent baby. Although birth is a process that can't be controlled, a pregnant woman can do many things to influence the process and give herself the best chance of a joyful, relatively comfortable labor and birth. If you are pregnant with your first baby, or planning your first VBAC, I hope you will read on.

Typical trouble spots
In general, first labors run into trouble in one of two ways. The first of these is a difficulty with early labor. It's only natural for a woman in late pregnancy to be anxious to be in labor. Late pregnancy is uncomfortable; she is excited about seeing her baby; she is a bit worried about labor and wants to get it over with. A first time mother has never experienced labor before, and wonders how she will know when it's the real thing.

Many first time mothers go to the hospital or call in their support team as soon as they begin having contractions. They begin using the coping techniques they learned in childbirth class right away. They focus all their attention on the contractions, and soon it seems that labor is taking forever. Women may go to bed, lying there and waiting for something to happen.

On the other hand, they may try to make labor stronger by walking, using herbs or nipple stimulation. Contractions then become more painful, but progress is no faster. All of these activities are tiring, and the woman may find herself exhausted, hungry and dehydrated before hard labor begins. If a woman has already gone to the hospital, she risks receiving early interventions that can disrupt the smooth course of labor. These may include electronic fetal monitoring and IVs, which restrict mobility; an early epidural, which may impede the progress of labor; and pitocin, which, through more powerful contractions, can enhance the pain of labor and may increase the likelihood of fetal distress and the chance of a cesarean section.

Help through early labor
Early labor may last for only a short time, or it can last for many hours, even days, without much progress. Contractions can be regular for several hours, then space out or stop altogether. Once active labor begins, progress is often quick, no matter how long early labor has lasted up to that point. The trick for first time mothers is to recognize early labor and to continue with normal activities as long as possible. Women who have already had a baby usually know how strong labor contractions get, so they are able to ignore early labor.

How can you cope with early labor? Drinking lots of water, eating regular meals, sleeping at night and napping when tired during the day, can help you to maintain your strength. Watching a movie, shopping, visiting friends, going ahead with whatever activities had been planned for the day, all can help to pass the time of early labor.

If you go to the hospital, receive a vaginal exam and are dilated less than 2 cm, you might consider going back home to continue, as much as possible, with normal life until active labor begins.

Hallmarks of active labor
During active labor, a woman is not able to continue with normal activities, no matter how hard she tries. Her state of consciousness changes, so that she is not able to focus on anything besides the labor.

Active labor contractions are a minute or more in length, less than five minutes apart and feel very strong, much stronger than any menstrual cramps. While early labor contractions feel about the same for long periods of time, active labor contractions become progressively stronger. Some caregivers recommend that contractions meet these criteria for at least two hours before the first time mother goes to the hospital.