What to do in Early Labour

Early labour or what is sometimes termed “false labour‘ can be a bit of an emotional roller coaster for expectant parents. It is a time where many are unsure of what to do and when to head into the hospital. In Toronto, many childbirth classes say to go to the hospital when the contractions are 5 minutes apart lasting a minute for at least an hour. Others say 5 minutes apart, lasting a minute for 2 hours or 4 minutes apart for a minute lasting an hour. These guidelines can be described as the 5:1:1, 5:1:2 or 4:1:1 Rule for determining when it is time to contact your medical care provider.

Confused yet?

Many couples are because of the wide range of suggested guidelines. We suggest heading to the hospital when contractions are CONSISTENTLY 5 minutes apart or less, lasting a minimum of 60 seconds, intense enough that you need to focus through them and would prefer not to talk, and they don’t spread out with rest.

The other tricky part of early labour is that it can start and stop. Even contractions that are under 5 minutes apart can slow down again. This is why there are so many stories of parents being sent home from the hospital because they were not in ‘active’ labour yet. This can be so frustrating because there is nothing ‘false’ about what you are feeling.

There are many important things happening in early labour.

• Softening– The cervix ripens similar to the texture of a soft brown banana
• Thinning– The cervix starts to thin or efface
• Opening– The cervix starts to dilate from closed to approximately 4 centimeters
• Change in Cervical Position -The cervix moves forward from a posterior position to an anterior position
• Change in Baby’s Position– Your baby gets into an optimal position for labour

So many things are happening and therefore it can take a little bit of time for your body to get organized. If your body wants to accomplish one of the above changes and that has been done, the body may take a rest. This rest could be for a few hours or even days.

Staying calm and relaxed during this time can help it feel less intimidating. It is also a great idea to stay home as long as you can so the likelihood of being sent home is less and if you are planning an epidural it will be more likely that they can get it for you at the hospital. Many care providers prefer to administer an epidural after 3-4 centimeters with active and strong contractions when possible.

So what are some things you can do during this time to stay relaxed and not freak out?

• Hire a birth doula-since this a very uncertain time for parents it is so nice to be able to contact an expert who can guide you through the process. 3 AM is a difficult time to fall back to sleep when you are feeling some mild contractions and are not sure what is happening or what to expect next. It is also challenging for couples without doula support, as their first point of reassurance is when they arrive at the hospital. Reassurance is needed way before then for most families to feel good about what is happening and being given a heads up about what might be coming next. Taking away the mystery allows moms to progress in a more manageable way and allow partners to feel comforted by this information too.
• Take a bath-when our clients contact us with the early signs of labour, we always suggest a bath as long as the bag of water (amniotic sac) is not broken. Taking a nice warm bath is one of the best ways to relax the whole body and see if the relaxation slows things down. Please note that baths and showers work differently. Showers can be a useful tool to relieve some of the labour discomforts but the bath can help you decipher if this is early or active labour that you are experiencing.
• Go to bed-a common misconception is that if you stay active, you will put your body into active labour. However, if the body is not ready then all that happens is you get tired out. After taking a bath the next thing to do is head into bed. With the contractions a bit farther apart and not as long and strong this is the best time to rest. Sleeping helps to pass the time so you are not as focused on the contractions. You can time a couple of them to get a sense if they are getting closer to the 5 minutes apart mark but then take a break from timing until you feel like there has been a change.
• Take a walk-If you are feeling well rested or the contractions have gotten to a point where you are not comfortable lying down anymore but it is not time to go to the hospital, taking a walk can be a great option. Take it slow and stop during contractions to breathe and sway your hips from side to side. Don’t overdo it as a 3 hour hike may be too much at this point 🙂 After your walk you can go back to your bath to see if the contractions slow down again. If they do then you can head to bed for a nap and repeat the process later.
• Watch a movie, read a book, and generally stay distracted. Many of our clients who have stayed distracted during early labour and tried their best to ignore sensations as much as possible, have felt like it was a shorter process overall. Does it mean it ACTUALLY was shorter? No, it just means it FELT shorter to them.

If you are feeling a lot of discomfort in your back or early labour seems to be lasting a long time, we have an added suggestion:

• Get on your hands and knees, possibly with your chest down and bottom in the air. Sometimes there is more discomfort associated with early labour because of baby’s position. Back labour can be very uncomfortable and longer because baby is trying to rotate into a better position therefore putting more pressure on the low back during this process. Getting onto all-fours can allow gravity to help with this rotating movement and ease some of the discomfort. If baby is already low in the pelvis and having a bit more difficulty rotating, a position with hips higher than the chest can help baby come out of the pelvis and rotate easier. Partners can help with back labour by pushing the heel of their hand into the low back where mom is feeling the discomfort and help ease the discomfort. Swaying hips from side to side can also open up the pelvic bones to allow more space for baby.

Most important…

• Trust your body. There is a reason for what you are feeling. Stay relaxed and contact us for support during pregnancy, labour and the transition to parenthood. Birth Doulas help you enjoy the whole process and take away the stress and anxiety of trying to figure all this out.