How do you know whether your labor will be easy or hard?
Birthing is experienced across a wide spectrum of possibilities.
Unusual ease or challenge are uncommon experiences.
Many first births may involve more physical work than expected. That’s why we call it “labor.” The work involved in opening to birth can be a beautiful expression of one’s own life.
Spinning Babies® offers an approach to help more parents experience childbirth towards the easier side of the spectrum of possibilities. Let’s take a look at the spectrum and where you might find yourself on it.
For instance, research shows a posterior labor (baby faces the front, spine-to-spine) may be longer and need more professional help than a labor with a baby in the anterior position (facing the back, spine toward the abdomen or left). it’s unusual to have a super-easy posterior. While sometimes a cesarean is needed for a posterior baby, most posterior babies rotate in labor.
One reason for a cesarean to finish a posterior labor is baby doesn’t fit. But seriously, too many women are given cesareans because no one there knew what to do to help the baby rotate so the baby could fit!
Balance moves you toward the easier side of the spectrum. When the muscles are in balance, then it’s up to the bones when a baby is in a good position.
There is a spectrum of how hard and painful any labor might be, and that includes labor with the baby in a posterior presentation. I believe ease has more to do with the symmetry of the muscle tensions in the body and the angle of the pelvis in a mis-chosen birth position than the size of the pelvis or even the baby’s position
A malposition is when baby can’t fit due to their position in the pelvis without causing a dangerous level of exhaustion or harm. Nature wouldn’t make that fetal position normal. Such a malposition is usually a symptom of asymmetry or another imbalance, but could sometimes be caused by how an arm is positioned, or the cord or placenta makes a position improvement unavailable.
Balancing activities that keep the pelvic joints gently and regularly mobile will make any labor easier than it would have been with an imbalance or stiffness.
Choosing a caregiver who understands both physiological birth and how to use interventions only as needed can make the difference between vaginal birth and finishing with major surgery. Supportive birth helpers speak to the body, the heart, and the mind.
How your caregiver attends to and manages your labor will also affect your experience. Some providers want to do something early while others have a wait-and-see approach. Which is right?
“Clear evidence shows midwifery care, “community birth” settings (birth center and home birth settings), and doula support(including the extended model of prenatal, childbirth, and postpartum support) provide excellent and appreciated woman- and family-centered experiences, leading to improved birth outcomes.” -National Partnership
Many pregnant parents with a natural birth plan are seeking care from an obstetrician. While I know a few obstetricians who trust the birth process and are patient to wait during long labor with a healthy mother and baby, many just don’t have the exposure to spontaneous, natural birthing.
When labor is long or painful, drugs are often offered to dampen or hurry the experience, or surgical tools to shorten or finish the birth. Unless interventions are needed to avoid suffering, dangerous risks, or death, physiological birth practices should be the first choice to help reduce pain or the time of labor. After adding body balancing, emotional support, and better birth positioning, then either the baby may be born or the necessary intervention may be easier on baby. Working with a doctor or midwife will improve the determination whether time is available to use a body-centered technique before a surgical one.
Seeking help outside the medical system (a home birth midwife or doctor) is another way a woman might achieve her natural birth plan.
Adding a doula to the hospital birth experience reduces the amount of pain a woman perceives (statistically according to surveys) and has been shown to shorten active labor. A trusted doula moves your birth toward the easier side of the birth spectrum. Some doulas are also helpful at a home birth situation and perhaps they had a home birth themselves. Doulas have been proven to improve birth outcomes in randomized control studies.
Having a history of one or more of the following conditions could mean that your body is storing some of that stress in the form of tightened muscles. It may not be obvious either, as you may feel no discomfort now if an event happened long ago or came on gradually.
Remember, I am addressing a variety of causal factors. People are too complex to share the same results from the same events. Knowing your history can help set your expectations to better match your unique experience.
The causes leading to a baby being in a challenging position in one pregnancy are likely to still be present for the next pregnancies.
If so, it may affect labor progress in your first birth. A uterus gets tipped when the supporting ligaments are not of equal length. A tipped uterus is only one
correlating factor that may be associated with fetal malpositioning. Painful periods are an indication of a tipped uterus, but are by no means conclusive.
Have you had a fall or a slip on the ice? How about a fender-bender or a more serious car accident? Perhaps you played soccer, or another sport with sudden
stops? If your pelvis is out of alignment, or your ligaments were jerked out of balance, it may affect the progress in any labor.
A history of abuse can tighten the psoas muscles that protect your abdomen. The tightened psoas can hold your baby up high,
lengthening the labor or making a cesarean necessary. However, many women with a history of abuse go through labor just fine.
Baby #1 (or the first to be born vaginally): Be sure to use the pregnancy exercises on this site to achieve even more balance in your womb.
Baby #2-4: Did your previous labor proceed well? If so, you aren’t likely to have trouble, even if this baby is posterior. It may take a couple extra hours in early labor to get the baby rotated around or the chin tucked, but unless this baby is significantly bigger and can’t rotate due to the pelvic shape or an epidural before the baby is tucked low in the pelvis, the baby will follow the road signs left by its earlier siblings. However, if you’ve had an accident or another event between children that would possibly affect your fascia, pelvic floor, alignment, etc., then it may not be as easy for you.
Baby #5 and beyond: Wearing a pregnancy belt can help lift weakened abdominal muscles so that the baby is positioned well and aimed toward the pelvis when labor starts.
A few babies, regardless if they’re your first or fifth, have trouble getting through the pelvis. This is why it’s rather important to do a self check for the following:
If any of these are true, it may indicate tight ligaments. The grinding against the bladder or pubic bone may be the baby’s forehead trying to move past a tight round ligament (late pregnancy). Spasms in the broad or round ligaments (piercing cramps) generally come from a twist or torsion in the womb. Myofascial release and chiropractic adjustment can help with these.
At home, do the Forward-leaning Inversion repeatedly to release your ligaments and help the womb back into balance. A woman who is quite uncomfortable in pregnancy because of twinges and aches is more likely to have a posterior baby. This is because the tension and twist in the uterine ligaments causes the discomfort as well as fetal malposition.
That’s not to say that a comfortable woman can’t be carrying a posterior baby or an uncomfortable woman doesn’t have an anterior baby, but on the spectrum of ease, the woman who is often bothered by pregnancy discomfort is more likely to have a posterior baby.
Your baby’s positioning is a significant factor when it comes to the ease of a labor. This is something you can—and should—be keeping track of.
This baby would have its back in one place, most likely on your right side. The baby doesn’t seem to shift its bottom or trunk position much at all, except to stretch his or her bum
up once in a while or stretch a foot or hand. The baby may lean to your right, and may have hands in front where they are felt above your pubic bone and below your navel.
There are two pertinent interpretations of this. One is that the head is not moving but the baby shifts his or her trunk to try to turn the head.
The other is that the baby simply settles to the right when you lie on your right side and settles to the left when you lay on your left.
By noon, or after you’ve been up and walking around a bit, the baby settles into a more central position for when you are vertical.
This baby isn’t changing sides, but simply leaning because the uterine ligaments are loose. This isn’t a problem unless your womb is too loose to direct the baby into—and through—the pelvis. A pregnancy belt (in pregnancy and in labor) or the abdominal lift and tuck technique (during labor) will help the baby aim into the pelvis.
If a first-time mom’s baby doesn’t engage into the pelvic brim by the time labor starts (or very early on in the process) her chance of having a cesarean is far greater than for women whose babies have “dropped.”
Babies usually drop around 38 weeks (two weeks before the due date), give or take. Babies of the moms who have given birth before may drop before labor or may not engage until labor is under way.
They are not at a higher risk for a cesarean unless they have other mitigating factors, such as induction with an unripe cervix, an epidural before engagement, or having the doctor break their water, etc. These factors have all been shown to increase cesarean birth.
Women with a triangular pelvis and women with a pelvic entrance that is wide side-to-side but short front-to-back typically have to help their babies into an LOA or LOT position mid-pregnancy. You can read more about pelvic shape and fetal rotation here.
Belly Mapping℠ is a method I’ve developed to help you make a picture of the fetal position using the the baby’s kicks and wiggles inside the womb. Give it a try today!
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