Monday, April 16, 2012

The Effects of a Crowded Room

For years I've been talking about emotional relaxation.  Emotional relaxation is how you feel about your laboring environment.  For example:

Are you confident in your care provider?  
Do you feel that your nurse is supportive of natural birth?  
Is the on-call doctor respectful of your birth plan? 
How is the temperature in the room?  
Are people talking during your contractions?  
Do you feel supported not only during contractions, but between them as well?  
Are your needs anticipated by those around you?  
Do the people at your birth really know how to help you?
How is the lighting?
What does the room smell like?
Are you hungry?  Are you encouraged to eat/drink?

The answers to these questions will impact your labor.  Someone posted on my Banned From Baby Showers Facebook page wanting to talk about prodromal labor and someone else about "longer than normal" labors.  When I hear about a woman having a very long labor, there are some things that pop into my mind, the first one being how many people were in the room?  What did she do in early labor?  Did she watch the clock and wait for contractions to get closer?  Or did she announce it on Facebook and deal with phone calls for the next 3 days?  Did she feel like a watched pot?

My two bits of advice for all my couples in early labor are:  1) Depending on the time of day you realize contractions are regular, SLEEP.  2) Depending on the last time you ate, EAT.  Eventually, you may want to do both of these things and will likely not be able to.  

The 4 top things that women worry about for their labor:  
1) The sounds they will make during labor and birth
2) Modesty and being/feeling exposed
3) Fear of tearing
4) Fear of pooping during the pushing phase

Let's look at this list further.  The only one that is actually a physical fear is #3, the fear of tearing.  The other 3 have more to do with how she is perceived by others in the room.  There are few times in a woman's life where she is more vulnerable than when she is in labor.  She may act like a wild animal, making sounds that might be embarrassing otherwise.   Or, her sounds might be low and sexy -- and she may stop when her mother or mother-in-law comes into the labor, even though those sounds were her "rhythm" and helping her through contractions.  

Very carefully consider the people you invite into your birth.  Often, women feel the need to "perform" for their audience.  Maybe it's for your mother or best friend who never had a natural birth and has been very negative about you having a homebirth.  You feel like you have something to prove.  Maybe you have "media" at your birth, a photographer or are recording a video.  The pressure to "perform" can really hurt a labor.  I feel strongly about recording your birth, but not at the cost of not being able to give in to your labor.  It's just another thing to evaluate and be flexible during labor.

As hard as it may be, you may need to banish these people from your labor.  Most women labor best in dark, quiet, undisturbed places The more people involved in your labor, the harder these conditions are to achieve.  Mom needs to feel free to move and vocalize.  We have this idea that if we are vocal, we are not doing well.  This simply isn't the case.  In fact, the opposite may be true.

Of course, there may be physical reasons for a long labor, but the people in the room is something that each couple has direct control over.  Even in a hospital birth, if you don't like your nurse, request another one.  Have your doula or midwife do it if you can't.  If they suggest it, acknowledge that they may able to see something you can't see in the throngs of labor.  Many people don't want to believe that having their mom or sister in the room is slowing their labor, but I've seen it many times over the years.  Hindsight is always 20/20 too. Often, women can't see the effects of the "spectators" until after the birth.

If you feel self-conscious about how you will sound, act, or look, you might consider not having anyone not crucial to your birth team at your birth.  Birth is not a spectator sport!


AtYourCervix said...

Oh my goodness --- YES!! Birth is NOT a spectator sport. I wish I could tell that to the myriads of visitors traipsing in and out of a laboring woman's room.

Brittney said...

Another Point regarding choosing your support people and who is there is to make sure they can BE there.... With my 1st and 2nd births, my mother, who has always been my support and helped me through my labors more than my husband did, arrived at 37 weeks from the west coast (we are east coast) and my water broke around 38 weeks for both of them. With my 3rd, my mother was unable to come until 2 weeks after my due date.... Thinking this would still be fine and helpful, and I would be up and moving around and would likely (based on my previous births) have a 1 month old, so we could do more in the short time she would be there, I was fine with it. Then 38 weeks came, with no signs of labor.... Then my due date came and went, and as I was approaching 42 weeks, the magic number when I would be risked out of homebirth and need a hospital induction, my midwife mentioned that maybe the reason I hadn't gone into labor yet was because she wasn't here.... My mother who could practically read my mind, and comfort me like no other, wasn't here. The one I trusted to care for my older babies while I was recovering, and my husband was working. I was induced on December 17th, exactly 42 weeks, the day she was flying out. Her flight was delayed, and she didn't arrive until the next day. With my next pregnancy, we plan in her being here earlier ;). I don't know if it was that, or some divine reason (like my sons nuchal cord) that I never went into labor on my own with him, but I do know that apparantly, I need my mothers touch and comfort and precense to go into labor.

Samantha said...

I'm not sure why so many people want to have their entire family and the neighbors and the local gossip crew at their birth. Birth is so very, very intimate! Just as conceiving a baby is a wonderfully intimate experience, so is birthing the baby. It helps you to feel calm and relaxed, knowing that it's just you and your husband, and at the end, the midwife. The world can wait.

Brittney said...

For me personally, I needed someone there other than my husband. He is of absolutely no help to me while in labor :(. I gave him books, read and emailed him articles and blog posts, tried talking to him, getting him to watch movies, he had no interest and would actually get irritated and just leave the room. I don't think having everyone there is the right choice either, but as long as the people you choose aren't going to hinder your birth, bring their own negative feelings into it, or make you uncomfortable or less able to be vulnerable around them, then having other people there is a personal choice.... But I do suggest choosing those people wisely. I could never have my MIL at my birth, and honestly, I think I would've labored much better all 3 times and had less interventions if my own husband hadn't been there. He was completely unable to support me.

NurtureYourBirth said...

Wow....this is written VERY well!!! I will be sharing this! :-) Great work! I've got to get my blog going again -- so hard for me to write without getting mad and ranting. You seem to have that under control! :-)

Doula, Student Nurse-Midwife

momto5 said...

from my own person experience i would have to agree. with my third we had a freakin' crew there and the labor went on for 3 days (not hard labor at all, but just constant contractions it seemed like. lol) but with the last one (#6) it was just me for most of it and it went so quick and was honestly the best birth i had, although non of them were unpleasant, just this one was most definitely the quickest and best. this piece was really well written. thank you!

Sally T. said...

Just posted a link to this from my blog!!! THANK YOU!!! This explains it all so beautifully. If I have anyone pushing to be present I'm referring them here.

Arual said...

My first labor wasn't particularly long, and I labored alone for the first five or six hours (contractions started around 2am), and I didn't feel I was in real labor until transition hit. Pushing took over an hour and I felt the need to perform calmness because that's what I saw in all the hypno-birthing videos I watched for my childbirth class. So my personal experience says that being surrounded by two midwives, my husband, my two sisters and my mother in a birthing center didn't work out for me. I wasn't comfortable. Yes, I was totally freaked out by the pressure on my rectum and worried about pooping. AGH.

My second labor I also didn't know I was really in it until transition, but this time I stayed home and kept moving throughout labor instead of trying to hypnotize myself and rushing to the birthing center in the midst of transition. "Pushing" took less than three minutes, and I didn't actually push, just caught.

My midwife missed it by ten minutes because I called her so late, still thinking it might not be the real thing. So ultimately, transition and second stage were just me and my husband, and it went much more quickly.

In other words, your words resonate with my experience.

Olivia said...

So true. I watched one of those horrible TLC birth shows the other day and there were 7 or eight people in the room and and aunt on live video! I was astounded that the hospital even allowed that many people in the room.