Abigail Iovine, Midwife

Midwifery Care for the People - All the Glory to God

CONSERVATIVE CHRISTIAN MIDWIFERY PRACTICE

 

THE SHIFT. WHEN IT ALL HITS THE FAN.

There is a moment in labor we don't talk about often enough.

I call it THE SHIFT.

Let me explain~


I've been a doula for a few years now, but I've also given birth 6 times.

As a service provider who strives to understand her clients needs as deeply as I can-

I've always tried to incorporate what I've learned, needed, and witnessed, not as a doula, but as a laboring woman.

I have a good handful or more of personal birth experience.

One thing that I've witnessed and felt- was this moment in labor.

I felt it with my first - a 48 hour labor - and with my 6th - a 3 hour labor.

It was a shift.
A massive change in every bit of my body and my labor- but mostly my pain.

You're contracting along, acknowledging your pain- moving and breathing and feeling really confident in yourself-

THEN

BAM!

You can't move.

The pain is suddenly UNBEARABLE -

It feels like a brick was dropped down into your uterus from a mile above the earth.

It isn't really unmanageable - but unless you are prepared for the shift -

Who am I kidding. No amount of preparation can STOP your body from experiencing the shift.

But if you know it's coming, & understand what it means - you may be able to regain your rhythm, and find what works for you to manage your labor.

 


The 3 phases of the first stage of labor

Sounds confusing? It isnt. Labor comes in 3 stages.

1. contractions and dilation

2. pushing

3. placenta

That first stage is where you hang out in all that pain.

Some as little as 3 hours -  some.....much longer

You dilate from 0-10, and your baby drops deep into to your pelvis.

THIS first STAGE OF LABOR HAS 3 PHASES for most women.

EARLY


>>>>>here is the shift<<<<<
ACTIVE

TRANSITION


*Disclaimer: Not every woman labors the same. Some women will have little early labor and move right into serious contractions. Other women seem like they experience no pain at all, moving through active labor and transition as though it were EASY.


This shift is exactly what it looks like.

A shift into active labor.

Somewhere between 4 and 6 centimeters dilation. The beginning of the real work.

Your next contraction feels different then the earlier ones, your bones ache, you feel it in your legs and deep inside your pelvis.

You can't talk through your contractions, you feel strange in between. This is it.

You have hit active labor! HOORAY!

Just kidding.

As a doula I'm like
YAY BABY IS COMING!!

As a laboring woman I'm like

OH FUCK NO PLEASE OUCH OUCH OUCH


This is the point in labor where you need to find your rhythm (again). This shift from early to active labor is hard, and it's intense. But there are several GOOD reasons to understand that this shift comes, and be ready for it.

  • If you are aiming for a natural birth- understanding the shift is coming will help you PREPARE to cope and refocus. Your partner or doula can remind you that this is normal. You can use keywords or specific triggers to remind yourself, that this is normal - and you can find your rhythm again. The shift can be frightening!
  • If you don't want pain medication- this shift is a point in your labor that feels so different, it can be disheartening. Many women at this point decide they would like pain medication, when they initially intended on having a medication free birth. ((I am not against pain medication)) If you can PREPARE coping and focus techniques for the shift, it will still hurt like crazy, but you will be able to move through your contractions one at a time and find your rhythm. This is a good point in labor to start using COMFORT MEASURES you may have learned or practiced.
  • If you want to wait as long as possible before considering pain medication - Many women would like to consider pain meds ONLY after labor has been well established, and the risks of slowing or stalling labor are minimal. If you understand that this shift is coming, and prepare to refocus and cope you may save yourself from a labor that slows down from the epidural medication. Often this shift happens when you are between 4 and 6 centimeters dilated. With support and encouragement, you may be able to move through the contractions one at a time, and you may be able to wait just a little longer!
  • Trying to stay home as long as possible before going to the hospital or birth center? - Knowing this shift is coming can help you stay home longer! Some women prefer to labor at home as long as possible. This shift can be so intense, that some women feel immediately that this means IT'S TIME TO GO. It doesn't have to. You have a good journey ahead- if you have goals of staying home to avoid interventions or discouragement, prepare to be hit by the shift. Prepare you PARTNER AND FAMILY for the shift. They can help encourage and support you, one contraction at a time.
  • The shift is scary, intense, and causes a massive surge of adrenaline. What does adrenaline do to us in labor? It's INCREDIBLY counterproductive to your labor.
    • Adrenaline can cause labor to stall, (this was important in our evolution, and allows mothering mammals in danger to move to a safe place before delivering)
    • Adrenaline works against oxytocin (the hormone that keeps contractions coming)  and endorphines (these block pain receptors).
    • Adrenaline can cause your brain to jump into overdrive, and you experience the flight or fight feelings and thoughts that come with surges of adrenaline. (In labor, you really have to shut down the thinking part of your brain - the neocortex -  to find your labor rhythm, and allow these hormones to flow freely. This is the trance that women seem to experience once the throws of labor are upon us) Adrenaline turns your brain up to HIGH POWER~

It's important to bring it back down, quiet your thoughts, and find your focus and rhythm.

If you understand the shift is coming, you can prepare yourself, and you can ready your partner for one of the MOST difficult support roles they may play in your life.


What can we do?

Be ready for it.

Have cues and keywords for yourself and your birth team, to get you back on track.

Practice comfort measures ahead of time. Some will work great, some will suck.

Surrender.

It's coming, and you can't fight it. Surrender to each one as a singular mountain to climb up and then down. And breathe in between.

You can do it!

 

 

Lookout for the next exciting blog post - Transition makes me crazy-
 

Midwife care for the people.
Client led autonomous homebirth practice.
Lehigh Valley, Pocono, Bucks county, Montco, Philly, | Eastern PA Homebirth