Dealing with Super-fast Labor
Gina wrote this week with a big worry. Apparently, her first labor was fast, furious and freaked her out. She says contractions started at 6 AM, she went to the hospital at 7AM and had her daughter at 930 AM. Some of you might say, Lucky! Yeah, sort of. Getting labor over with in lightening speed is a bonus, in some ways. In others, it's a nightmare. Poor Gina never intended a natural delivery yet, there was no time for her epidural to kick in and do its job before her baby came screaming out. Her big worry is, how about next time? She's pregnant again and doesn't want a redo of her first labor. What can she do to minimize the pain? Gina was also worried that the rapidity of her labor meant something was wrong. Au contraire, Gina. It means your uterus is a hyper-efficient well-oiled machine ready to do the job and do it well.
Gina, I feel your pain. One of my own babies arrived in a hurry and I swear, that was the last time in her life ever she felt the need to rush. It felt like a freight train running down the tracks. Those tracks were my personal insides and I didn't like it one bit. Speedy-quick labors are fierce. We call them precipitous births. Most first timers take an average of 12 hours of active labor (not counting all those hours leading up to it) to deliver their babies. When you shorten the time considerably, as Gina did, you have to take all the power normally spread out over 12 hours and compress it into just a few. That hurts like nobody's business. It also tends to compound perineal tears, as those babies don't tend to hang out "down there" allowing the skin and tissues to gradually stretch.
Here are a couple of suggestions for next time. Most importantly, talk about your concerns with your doctor/midwife. He/she probably has some good suggestions for managing a quicky labor. One oft-used solution is induction of labor. When you're near your due date (at least 38 weeks gestation based on a really solid due date), and your cervix is favorable (soft, thinning, dilating and baby's head is descended into the birth canal) check in to the maternity unit. They'll start an IV and get you all ready for an epidural. They'll give you medication to start your labor and you'll deliver under more controlled circumstances. Sure, it takes all the surprise out of labor but it also minimizes some of the stress. First labors are supposed to be the longer ones. This next baby may be destined for delivery in the car if he/she is also in a big hurry.
Other suggestions are, obviously, head to the hospital at the first sign of labor. Take a good prenatal class that teaches breathing and relaxation techniques you can use to cope with another ferocious labor without using an epidural. If your body has determined that you're a birthing-like-a bullet kind of girl, there may be nothing you can do about it but hang on for a bumpy but fast ride.
Some labor techniques that tend to slow things down a bit are oral hydration (drink lots of fluids) to "dilute" the hormones racing around your bloodstream that cause you to contract. Try side lying or hands and knees positions instead of walking, squatting or standing. Side lying is also good for delivery as it minimizes trauma to the perineum.
But what if this baby comes even quicker than your first? Take a class in emergency, infant CPR with the American Red Cross, be prepared to call 911 and stay put. If you're still at home and the baby's on her way no matter what, don't get into the car and head to the hospital. If you've got an urge to push, call 911 and get ready for delivery. Get clean towels to receive the baby, wipe baby off, clear the nose/mouth and wait for the emergency medical team to do the rest if possible. If baby's not breathing, do CPR (that's why you took the class). Keep mother and baby as warm as possible. Delivering in the car is a lousy idea. It freaks out the driver, ruins the upholstery and leaves mom with no one on the receiving end. The down side of a speed-racer delivery is—no pain relief and a certain loss of control. The up side—you'll make it onto the evening news.
Got a question for Jeanne? E-mail it to firstname.lastname@example.org and it may be answered in a future blog post.
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