3 Guiding Principles for Effective Contractions & Baby's Descent
I am constantly reading new books, articles, and talking to experts in the birth community about what they've seen work well to keep labor progressing and to work with your contractions in labor to allow the baby to descend. It really comes down to 3 ideas: keep the oxytocin flowing to produce strong and effective contractions, relax your body to allow contractions to be as effective as possible, and move your body to keep the pelvis open and give baby plenty of room and opportunity to move downward. So here you go, an inside peak at my favorite "tips and tricks" that I like to teach my clients for helping to get that baby out and into the world!
1: Keep that Oxytocin Flowing to produce strong contractions
You need strong, consistent contractions to get your baby out. Oxytocin, the love hormone, helps to create strong contractions and can also be a natural pain reliever. Catecholamines, or stress hormones, can work against contractions and interrupt natural labor patterns. So it's important to create an environment where you feel safe and cared for. Below are just a few ideas for keeping that oxytocin flowing to stimulate effective contractions.
Comforting touch: Massage or any type of comforting touch from a birth partner, care provider, or doula can not only help you stay relaxed, but can also stimulate the flow of oxytocin. I love focusing on the shoulders, lower back, feet, and thighs when I am massaging my birth clients. But even just a loving hand placed on you to let you know you're not alone or a hug can do the trick!
Alone time: While I, as a doula, obviously think that having a support team in labor can be incredibly helpful, I also think there are times when a laboring person needs some alone time or private time with just their partner. Don't be afraid to ask for space when you need it, or if you don't feel comfortable asking to be left alone when you know you really need it, go hide in the bathroom and lock the door! Often, I find that the most intense contractions happen when the laboring person is alone in the bathroom. If you have a partner, private time with your partner in the bathroom can also be a great opportunity to smooch and snuggle, which creates oxytocin and stimulates effective contractions.
Nipple stimulation: If you feel that contractions are slowing down or not as strong as you'd like them to be, nipple stimulation is a natural way to stimulate oxytocin. You can either try hand-expressing, or pumping some colostrum (make sure to talk to your care provider before trying this).
Comfortable Laboring environment: Creating a comfortable and safe environment is also a great way to protect the flow of oxytocin. Dim the lights, minimize interruptions from medical staff, put on some relaxing music, put a few drops of lavender on a cotton ball or washcloth, consider a soothing bath, and do whatever else you need to in order to feel cozy and comfy in your laboring space.
2: Relax your pelvis
A contraction during early and active labor is, essentially, your uterus working to pull open the cervix. If you are tensing your body and pelvis, you are exerting energy that is essentially working against the uterus. But it can be hard to keep your body relaxed during a contraction! For many of us, our natural reaction to discomfort is to tense our bodies. So here are a few ideas for how you can keep your pelvis relaxed and work with contractions, rather than working against them.
Horse lips & jaw relaxation: Ina May Gaskin, a world renowned midwife and childbirth expert, discusses at length in her book "Ina May's Guide to Childbirth" the connection between the jaw and the pelvis. She believes that if the jaw is tense and tight, it is much more difficult for the pelvis to relax and open.
It takes concentration to relax your jaw through contractions, and sometimes a gentle reminder from a birth partner, doula, or care provider can help. If you're not sure how to relax your jaw, you can try "horse lips" (see video below). See for yourself how well it works - try clenching your bottom, do horse lips and notice how hard it is to keep your bottom clenched!
If you're not a fan of horse lips, you can also relax your jaw by letting your lower jaw separate from your top jaw,and letting your teeth separate. A deep sigh can help. You can even massage the muscles in your jaw to help release tension.
Labor on the toilet: Sitting on the toilet can be a great place to spend several contractions. We're used to releasing while we're on the toilet, so laboring there triggers some muscle memory reflexes that help us to relax our bottoms. Some people find contractions on the toilet extremely intense, but if you can manage it, they tend to be very productive.
3: Give baby room to descend
Optimal baby positioning in the pelvis can help your cervix to dilate by putting even pressure on the cervix. Sometimes, very long or stalling labors happen because the baby is not in an optimal position for birth. You can help to your baby engage in the pelvis and help your cervix to dilate by creating as much space as possible in your pelvis and switching positions frequently to keep creating new pathways downward. Here are a few specific tips to make room for your baby!
Pee frequently: Your bladder in pregnancy sits rights under the baby's head. You can imagine how having a full bladder can make it a little more difficult for the baby's head to descend! Remember to pee frequently, shoot for every hour. If you're having trouble peeing, try putting a couple drops of peppermint in the toilet bowl.
Move: Whether you're planning a natural or childbirth or can't wait to get an epidural, movement in labor is possible and will help give your baby room to descend.
If you're planning an epidural - you will likely have some time in early labor before you get an epidural to move around and give the baby a chance to descend and make its way into the pelvis. Even after the epidural, there's plenty of opportunity to move around, despite what you may have heard! Switching from side to side every 30 minutes is incredibly helpful, and many nurses will also feel comfortable helping you onto hands and knees or into a squatting position using the squat bar on the bed. Using a peanut ball (both hospitals in Madison have these available) between your legs can also help to keep your hips open and give the baby plenty of room to shimmy its way down!
If you're planning a natural childbirth - trust your instincts and move in a way that feels good. Balance rest and movement the best that you can - allowing your body to totally relax between contractions, and moving during contractions to get the most bang for your buck.
So what types of movement should you try in labor? The Miles Circuit is a great option for early labor, particularly if you're feeling like baby might not be in an optimal position. Spinning Babies also has a lot of great recommendations for movement during early labor and ways to get the baby engaged in the pelvis. Squats, forward-leaning positions like hands and knees, stairs, and walking around are also great options. If you're ever not sure what to do, try closing your eyes and just find a position that feels comfortable & trust your body to know what to do. I generally recommend switching positions every 5-10 contractions to keep giving the baby new openings & pathways to move downward.
Hope this was helpful!