Active Labor Cheat Sheet: How to Cope in Active Labor
Active Labor Signs
Before diving in to things you can do to cope in active labor, I want to define what active labor even is. Most providers have their own definition of what "active labor" is to them. Most of the time, though, you're considered to be in active labor when contractions are consistently coming about every 4-5 minutes and they're lasting at least a minute long. In theory, this is about 5 cm... but like most things in birth, it seems the exception is nearly always the rule. You may have heard of the 4-1-1 guideline: come to the hospital when your contractions are 4 minutes apart, 1 minute long, for one hour. I'm here to tell you that this rule is bologna! Honestly. Most families that I support have early labor contractions that fall in and out of a pattern... sometimes for WEEKS. What's most important to consider here is if contractions are getting harder to work through and are much stronger. I tell each client of mine, "if you're getting ready to go to the hospital and you're still thinking about what you need to bring with you... it's not time to go." For early labor coping techniques see this post.
No, For Real. This is Active Labor!
Alright, alright. We're not playing around, now. There's no stopping your contractions. They're strong. They're long. They hurt. You need to find some way to get through them! I hate to tell you this if you're in labor right now and you're reading this without previously having secured support... but the first thing I would highly recommend is to call your doula. Your doula is specially trained in ways to help you cope with these waves. You've hired them, utilize them!
Movement
The first tool to put in your toolbelt is to know that movement is known to help ease labor pains and progress labor. If you're sitting in bed, contracting away, you're working against your body in many ways. Get up. Get vertical. Move around. Some of my favorite movements are:
- Swaying/Slow dancing with partner
- Side lunges
- Squats
- Circles and/or bounces on the "birth ball"
- Standing with support from the bed
Changing positions in active labor can be hard. I'm here to tell you to give new positions 3 contractions. If in 3 contractions it still feels TERRIBLE in comparison, then change it up. It typically takes your body a few contractions to find ease in the new position. If you're confined to the bed, fear not! Ask for a peanut ball and have your nurse (or doula) help position your legs. Be sure to switch sides often to more adequately mimic "movement".
Labor Positions
In addition to the "movements" above, these laboring positions are favorites:
- Sitting backwards on toilet
- ANYTHING in the water
- Hands and knees/Forearms and knees
- Side-lying with a peanut ball (great for rest!)
Alternative Pain Management
You want to avoid the drugs. Cool. I get it. Here are some of my tried and true alternative pain coping techniques:
- Get in the water!
- Run a bath or get in the shower.
- Counter Pressure
- If you have a doula, she'll likely default to counter pressure at some point in your labor. If you're without labor support, have your partner do this... find the small flat area of your back just above your buttocks (that's the sacrum) and place your palm there. Now press. This sacral pressure feels amazing during contractions.
- Hip Squeezes
- Again, your doula will likely default to hip squeezes during your birth. Find the bony points of your hips (what most of us call our "hip bones"), work your way around your thigh and back a bit to the iliac crest, and place your palms on each side. Now, squeeze squeeze squeeze during a contraction. I've created a very rudimentary diagram below.
- Find Your Rhythm
- Whether you make your rhythm or you just fall into it, doing things rhythmically can help you ride the waves of a contraction and gear up for the next one.
- Use heat or cold
- Cold cloth on your forehead, warm compress on your lower back or abdomen -- whatever feels good!
- Use massage
- Massage between contractions can help make your body relaxed.
- Use meditation
- Whether your pushing the "squishy blue button" in your mind, or your picturing yourself running up a hill, meditation can help many through contractions.
- Use a rebozo
Pharmaceutical Pain Management
Maybe you've decided to give drugs a go. Perfect! If you wish to use pain meds to cope through labor, active labor is a good time to get them. Here are some of your options (birth location depending):
- Nitrous Oxide
- IV Pain Meds
- Sterile Water Papule Injections
- Epidural
Read all about medical alternatives to epidural in this post.
What About TRANSITION
Transition is the four-letter-word of labor. It's the period in labor (around 7-10 cm) where many women start to lose absolute control. You may feel: nauseous, shaky, lost, sad, scared, uncertain, and so much more. This is typically the "emotional dump" stage of labor. It's the stage where many women say something along the lines of "I cannot do this anymore," or "I'm going home." I have 3 words for you: it. will. end. I promise you, labor will end. Luckily, this period of time is typically the shortest part of the entire labor! Sometimes, you even get a break before your body starts to push on its own. Isn't biology grand?
Active labor is when the fun really starts. It's also where all hell can break loose. It's so important to arm yourself with knowledge prenatally so you can be prepared for what might come your way. Coping through active labor may seem daunting, but good support, a game plan, and a few tools in your toolbelt go a long way... Next up, PUSHING!
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