Emotional Signposts in Labour

When you’re expecting, especially for the first time, you often spend a lot of time reading books and attending classes to learn about what will happen within your body during the physical process of birth.  But have you learned about what happens emotionally?

There  are three stages that many people go through between the beginning of labour and the moment of birth.  Not everyone experiences all three, but knowing what the stages are and their typical order will help you to understand what is happening and, hopefully, be more relaxed and empowered during your birth.

Stage 1:  Excitement

The first emotional stage begins when you get the first indication that your baby is really on the way – the initial contractions, the breaking of your water, or perhaps the loss of your mucous plug.  At this stage, you feel thrilled, because things are getting under way!  The long-anticipated birth is imminent, and you’ll be meeting your baby soon!

It’s great, at this stage, to make sure that everything is ready, double-check that your bag is packed, and be in touch with those who may be caring for your pets or other children.  But bear in mind that, especially with first babies, it may be many hours, or even days, from the first twinges until things really get going.  As much as possible, as long as contractions are manageable, go about your business as usual. If you think there’s a reason you might need to go to the hospital (for example, if your water breaks before contractions begin) contact your provider.  But otherwise, relax, bake something to eat after the baby is born, watch a movie, or try to get some sleep while you still can!

And some people skip this stage entirely and wake up in the middle of the night to find themselves clearly in active labour, also known as –

Stage 2:  Focus

When I was a first-time mom in early labour, my midwife came over to check me and, as she was getting ready to go, said, “Call me back when the contractions are demanding your full attention.”  The need for complete focus is what defines the second emotional stage.  It’s no longer possible to talk, or do anything else, during contractions; getting through them is doable, but it takes work and concentration.  They get longer, stronger, and closer together, and (although the precise timing depends on your history, situation, and the advice of your provider) it’s during this stage that you will call in child and pet care, contact your doula, and make the decision to go to the hospital or birth center (or call your midwife if you have planned a home birth).

The second emotional stage can last for less than an hour, or for 24 or more.  If a person in labour is well prepared and well supported, they can sustain the intense focus required for this stage and manage the contractions for as long as necessary.  But sooner or later, the intensity becomes overwhelming, which is when the parents and support team recognize the arrival of:

Stage 3:  “I Can’t Do This”

Those who attend births have seen it over and over again, but for the labouring person and their partner, it may take them by surprise:  someone who has been coping well with contractions for hours suddenly seems to lose control.  There’s writhing, yelling, swearing.  The labouring person goes into the corner of the bathroom and refuses to come out – or plants themself on the bed and won’t move.  They flatly inform the medical staff that they’re done with this baby-having thing; they intend to leave and come back tomorrow.  And they holler the trademark phrase of the third emotional stage of labor:  “I can’t do this anymore!”

Far from being a sign that everything is going wrong, this kind of meltdown actually indicates that things are progressing very well.  It means that the phase of labor known as “transition” is under way – that complete dilation is very close, and pushing is just around the corner

It can be extraordinarily difficult for the partner, especially, to witness the “I can’t do this” stage. This is where the support of a doula can be essential, both to alleviate the pain and panic as much as possible until dilation is complete, and to reassure the partner that, alarming as it all is, nothing is actually wrong, and that the labouring person’s emotional response is actually a sign that baby’s arrival is very close.

For most people giving birth – but not all – the pushing phase is an improvement over the intensity of transition.  For more on that, stay tuned for my next blog post!