How to cope when your labor plans go awry
The piece-of-cake delivery you’d hoped for turns out to be more like hours spent sweating over a hot stove. Or, your partner, who dutifully attended every childbirth class, snacks on tuna salad during your labor, then breathes into your face just as you’re riding out a strong contraction. And sometimes, even pleasant surprises occur.
Preparing for childbirth inevitably involves developing expectations, but it’s unwise to get too attached to them. Instead, be ready to respond to the experience as it unfolds. Here are just a few ways having a baby may surprise you and what you can do to prepare for and handle the unexpected.
What you expect> Your partner will be a helpful, supportive labor coach.
What can happen> His attempts are unhelpful, annoying, even anxiety-producing.
What to do> Be realistic about your partner and don’t expect him to miraculously change. The fact is, adequate labor support from fathers-to-be is not something all women can take for granted. “It’s unreasonable to put some inexperienced guy in a six-week class and say we’re going to teach him everything he needs to know to support his partner during something as powerful as childbirth—especially when he needs help as much as she does,” says Henci Goer, author of The Thinking Woman’s Guide to a Better Birth (Perigee, 1999) and a former Lamaze instructor.
If you have any early doubts about how your partner will perform, find a doula or ask a friend or relative who’s given birth to stay with you during labor. Too late for that? If he won’t stop kneading your arm like a piece of dough or shouting “You go, girl!” every 30 seconds, ask a nurse to give him some more helpful suggestions.
What you expect> Labor will proceed smoothly and you’ll have an uncomplicated vaginal delivery.
What can happen> Your doctor thinks labor is going too slowly and wants to speed things up with drugs or even a Cesarean section.
What to do> If the baby is not in distress and you’re not exhausted, you may want to try nondrug strategies for speeding up labor. “Taking a walk, changing positions, and nipple stimulation all can help sometimes,” says Claudia Sencer, a nurse-midwife in Charlottesville, Va. As for a C-section, unless it’s an emergency, you don’t have to agree to one on the spot. “Evaluate the situation with your doctor,” Sencer says. Some considerations: How long have you been in active labor? Do you have the energy to continue? Is the baby doing well? If your cervix isn’t dilating, consider other signs of progress: Has the baby dropped at all? Has your cervix effaced (shortened and thinned)?
Two studies published in Obstetrics and Gynecology show that normal labor lasts longer than most doctors are taught, and that given enough time, many women with slow or “stalled” labors ultimately have safe vaginal deliveries. “I will suggest a Cesarean if a woman’s water broke many hours earlier and there are signs of infection, or if either the woman or her baby appears exhausted and a vaginal birth cannot be safely accomplished,” says Heidi Rinehart, M.D., an OB-GYN at Northern New Mexico Women’s Health and Birth Center in Taos. “But a long labor in and of itself isn’t necessarily a bad thing.” When making your decision, of course, keep in mind that a safe outcome is more important than the way in which you give birth.
What you expect> You’ll spend your entire labor in bed.
What can happen> You feel like vacuuming, taking a walk, showering … anything but staying put.
What to do> Go with your urges; don’t fight them. “Moving is helpful,” Sencer says. “When you’re upright, gravity helps the baby find its way down, and the distraction of moving around can make pain more tolerable.”
This may be easier to do at home than in the hospital. “In an uncomplicated pregnancy, a woman can stay home until she’s in the active phase of labor,” says New York obstetrician Donald S. Matheson, M.D. This is when contractions become stronger, longer and closer together—about five minutes apart for a first-timer.
What you expect> You’ll give birth without medication.
What can happen> The pain seems overwhelming.
What to do> If you’re at home or in a non-hospital birthing center, you don’t have the option of an epidural or other drugs tempting you, and your midwife and partner will try to ease your pain with massage, counter-pressure, position changes and similar low-tech measures. But in the hospital, you’re in the challenging position of attempting to fast in a bakery. “The epidural cart gives you an out if that’s what you really want,” says Tammi McKinley, a doula in Arlington, Va. “But if you’d like to keep laboring naturally, asking for encouragement and reassurance can help enormously.” Often when a woman says, “I can’t do this,” the most helpful response is, “You are doing it.”
What’s important is that it be your choice. “Try not to be influenced by blanket pronouncements such as ‘natural childbirth is best’ or ‘epidurals are wonderful,’” Sencer says. Don’t take the all-or-nothing approach, either; it’s OK to “go natural” for as long as you can, then ask for pain relief.
What you expect> Labor will be long, hard and painful.
What can happen> Labor is easier than you anticipated. Expectations, pain thresholds, caregivers’ attitudes, the quality of labor support and other factors all affect the experience. In a USA Today poll, 31 percent of women said that having a baby was easier than they thought it would be. “Women are often surprised at how well they handle the challenge,” Sencer says.
What to do> Enjoy!