What Do I Do If My Labour Slows Down?

Sometimes labour slows down. This might also be called stalling or “failure to progress” (bleurgh, nobody should be using that phrase if they’re giving proper personalised care). When labour slows down, contractions aren’t as effective and as efficient as they could be. Your body might need a little help increasing the frequency, duration and intensity of contractions in order for your labour to progress.

This is a checklist of things for you or your birth partner to consider if labour has slowed. Trying some or all of these might help ‘unstick’ whatever’s made labour get stuck and take a holistic view of what’s happening during the birth experience. Depending on what’s happening in your individual circumstances you may be offered medical augmentation of labour – all of these methods can be used before or as well as medical methods.

Progress Ps

Position: Are you in your preferred position? Is your position giving space for your pelvis to open, and is it using gravity to help your cervix to dilate and baby to come down the birth canal? Would moving help maximise your physiology? Do you need help and support to move?

Preferences: Has your birth plan been read and understood? Are your preferences being actively listened to? Are you being supported to work towards your preferences? Have your preferences changed?

Personal: Are your physical needs taken care of? Have you eaten and drunk to make sure your birthing muscles work effectively? Are you breathing to ensure your muscles are well oxygenated? Is your jaw (and therefore your pelvis) clenched? Have you had a wee recently – full bladders can impede baby’s progress.

Place: Is the room you’re in promoting oxytocin? Is it too hot, too cold, too cluttered to mobilise?

People: Who is present in the room with you? What are they doing? Do they make you feel safe? Do they need to be there if they’re not? Are they giving unbiased evidence based information for you to make your decisions? Are they asking consent?

Prohibitors: Are there any inhibiting factors that might be slowing your labour progress? Fear, stress, energy levels, mobility…?

Partner Potential: Is your birth partner/s doing everything they can to help labour progress? If not, what’s stopping them? Are they hungry, tired, in need of a pep talk? Do they understand what’s happening in the labour? Are they being respected in the birth room?

What The Heck Is A Gentle Caesarean Anyway (And Why Would You Want One)?

A gentle, or natural, caesarean section is a way of bringing person-centred care back to a birth when that birth is happening in a theatre. It’s common for people who are choosing caesarean births to feel like they’re ‘relinquishing control’ and that this type of birth is one that ‘happens to them’. But this shouldn’t be the case. A caesarean birth is still YOUR birth. You can still have an environment that feels comfortable for you. Utilising some of the gentle caesarean techniques can help you look back on the birth in a positive way.

The idea of a natural caesarean was first raised in 2008. Some of the things on this list are becoming more popular and embedded in caesarean births anyway. Some of these things might encounter some raised eyebrows or a flat out no from your doctor – but if you want something ask to see the evidence that prevents you from having it because unless there’s a very good reason for it not happening you should be supported in your birth choices. Some of them might be things that you have absolutely no interest in doing – and that’s ok! Your birth your choice. And in the minority of caesarean section scenarios things may move too quickly to get you or your baby safe that it’s not possible to have an in depth discussion about your personalisation of your birth.

Environment: Theatres are by their very nature, very clinical environments that need to be kept sterile. But that doesn’t mean there’s not options for you to make it a bit more oxytocin-promoting. Oxytocin is, after all, the hormone of attachment and bonding so having it in your system as you meet your baby is a good thing. You can have your own music or hypnobirthing tracks playing (or use headphones); music can help distract you, keep you calm, and there’s evidence that it reduces feelings of pain as well! You can ask staff to keep their noise to a minimum and for your voice to be the first one that your baby hears as they come into the world. I’ve also heard birth stories where the peripheral lights are dimmed, and where people have taken small objects of comfort into the birth with them. Just on the subject of the theatre environment during a c-section; sometimes the super shiny equipment can reflect your uterus while they work so if you don’t want to see ask them to give it a nudge!

Drapes: Usually a drape is set up, blocking your view of what’s happening, and remains there for the entire procedure. In gentle caesareans the drapes can be lowered or clear drapes used so you can see what’s happening – if you want to! Lowered drapes also help with facilitating immediate skin-to-skin after your baby’s born.

Delivery: This is where things really start to differ with traditional caesarean sections! After the uterine cut, your baby’s head is gently encouraged to come through the incision with the doctor remaining as hands-off as possible. Once their head has emerged they begin breathing while their body is still inside the womb and connected to the placenta. This slow emerging from your body causes pressure which replicates the pressure of the birth canal, helping to get rid of liquid in your baby’s lungs. Gently supported, your baby wiggles themselves out. They can then be passed over the drapes to you.

Skin-to-skin: Traditionally, when your baby is lifted out of your uterus they’re taken to be examined, weighed and wrapped up before being brought back to you. It’s becoming increasingly more common for your baby to be passed over the drapes and skin-to-skin as well as a first breastfeed to be facilitated in line with WHO and UNICEF guidance. However, this still isn’t something that’s the norm with some doctors refusing on the grounds of ECG and pulse oximeter equipment needing to be present. To create space the pulse oximeter can be placed on your foot so your hands are free and ECG electrodes placed on the back of your shoulders.

Delayed cord clamping: Delayed cord clamping allows your baby’s blood to transfer from the placenta back into their body and is beneficial for nearly all babies to receive. Recent research suggests there are no safety concerns with delaying cord clamping during a caesarean.

Many practices within gentle caesareans are already slowly being embedded within standard caesarean section policies but it’s worth being really explicit what you do – and don’t – want during your caesarean section. Your healthcare provider should be able to discuss the benefits and risks relating to your own individual circumstances.

Things For You To Try That Could Shorten Labour

If you’re pregnant, you may be wondering what you can do to shorten labour – because who wants to spend longer than necessary in labour rather than meeting your baby?! The good news is that there are several things you can do to help prepare your body for labour and potentially shorten the process, which can last between 14-21 hours depending on whether it’s your first baby or not. But of course, all bodies are different and there are lots of factors that affect how quickly a baby comes.

Stay Active In Pregnancy

Staying active throughout your pregnancy can help you prepare for labour and birth. Exercise strengthens your muscles, including your pelvic floor muscles, which can make pushing easier. Walking, swimming, and antenatal yoga are all great options for staying active. People who exercise 3 times a week in pregnancy can reduce the length of their labour by 50 minutes!

Antenatal Yoga

Yoga and other forms of stretching are excellent ways to help get your body for labour and birth. A lot of the movements help to keep you upright and open up your pelvis, as well as stretching and releasing the psoas muscle which supports the pelvic floor. If any of the muscles in your pelvic area are tight or imbalanced it can cause suboptimal positioning for baby, which in turn can cause labour to be longer. Yoga can also help turn your baby into an optimal position with their head down and chin tucked, and if baby’s in a great position then that can help reduce the amount of time it takes to meet them.

Antenatal Education

You wouldn’t head off to a job interview without doing some prep work first would you? Giving birth is exactly the same – birth preparation can help you prepare for your labour and birth. Knowing what your body does when giving birth, how you can optimise your birth physiology and what you might encounter if your birth throws you a curve ball can really help you reduce your stress hormones when the big day arrives. And we know stress hormones impact oxytocin and can slow your labour right down. The good news is we cover all of that and more in my classes – check out the store page to see what options suit you.

Eat Dates

Research tells us that eating dates can reduce the length of your labour as well as increasing your chances of going into spontaneous labour rather than being induced. Eating them also decreases the chance of having heave blood loss after birth. Around 7 dates a day from 36 weeks of pregnancy might mean you get a little bit bored of dates, but not bad for a humble fruit!

Raspberry Leaf Tea

Many women and birthing people swear to the power of raspberry leaf tea to tone the uterus and make contractions more effective, and in doing so making labour shorter. The evidence behind it isn’t robust but we do know it’s not going to cause any harm. Worth a shot, eh?

Oxytocin Boosters

Oxytocin stimulates contractions. Having a good healthy dose of oxytocin in your system will ensure your contractions are as effective and as efficient as possible leading to a shorter labour. Without enough oxytocin in the system, your contractions will slow and things will take longer. Find out ways you can encourage oxytocin here.

Breathe!

Breathing is a very powerful tool when giving birth. Not only does it help you relax which reduces physical tension and soreness, it trips your parasympathetic nervous system and reduces stress hormones – allowing oxytocin levels to rise and the wonderful positive feedback loop mentioned above to start. But that’s not all! A steady breathing pattern makes sure your body has plenty of oxygenated blood to carry to the birth muscles, and well oxygenated muscles work more effectively.

Continuous Support Partner

Whether this is from a birth partner, a doula, or both, research tells us that having a continuous support during birth can help improve outcomes. Having a non-medical person to help support you in different positions, with oxytocin boosters, to help you relax, and to make suggestions if things seem to be slowing down can help you optimise your birth.

Stay Home

We know that people who plan home births have fewer interventions because things aren’t progressing as quickly as expected as well as a whole heap of other benefits. Even if you’re not planning a home birth, staying at home for longer helps keep your oxytocin levels up which can reduce the amount of time you’re in labour (and hospital) for.

Try Different Birth Positions

Changing positions during labour can help ease pain and pressure and encourage your baby to move down. Some positions to try include squatting, kneeling, or standing and leaning forward. You can also try using a birthing stool or a birth sling. Positions that help you be upright and open are great ones to try. Being on a bed on your back generally slows things down as your body has to work against gravity and the pelvis doesn’t have space to open.

Use a Birthing Ball

Sitting on a birthing ball can help open up your pelvis and encourage your baby to move down. The gentle bouncing motion can also help ease pain and discomfort during contractions. If you don’t have a birthing ball, you can use a regular exercise ball or even a chair.

Eat, Drink and Be Merry

Staying hydrated and fuelled with calories is important during labour, as dehydration and not having enough calories can slow down the process. Make sure to drink to thirst (or have someone remind you) and snack on calorie dense food throughout labour.

Consider Medical Intervention

For some people, no matter what they try, labour will be slow progress. This might be due to lots of different factors such as baby’s position. If your labour isn’t progressing your midwife or doctor may suggest medical help such as an oxytocin drip or rupturing your membranes. When interventions are offered they must always discuss the benefits, risks and alternatives with you so you can give informed consent.

There are no guarantees when it comes to giving birth but we do know that lots of things can help – and hinder! – the process. Make sure the team around you know how they can help you with some of these things.

Top Tips For Why Breathing In Birth Is Really Important

Breathing is a super important part of your giving birth toolkit. Here are some top tips why:

  1. Relaxation: Deep breathing can help you to relax your mind and body by triggering the parasympathetic nervous system, slowing the heart rate and relaxing your muscles. Relaxing can help release the fear of labour.
  2. Pain management: Deep breathing can disrupt the fear-tension-pain cycle. When the body begins to relax, tension and pain release from your body.
  3. Increase oxygen flow:  Proper breathing helps to maintain an adequate supply of oxygen to you and your baby, which is crucial for your wellbeing. Not only that, with an adequate supply of oxygen, lactic acid doesn’t build up – lactic acid can cause your muscles to hurt more.
  4. Prevent hyperventilation: Rapid and shallow breathing can lead to decreased oxygen and lightheadedness, triggering the sympathetic nervous system or ‘flight or flight’ reflex. The heart rate increases, adrenalin is released into the body stimulating you out of your birth bubble and your blood pressure increases. Controlled deep breathing can help prevent this.
  5. Focus: A focused deep breathing technique can give you the psychological benefit of having something productive and useful to bring your awareness to.

Focused, deep breathing is a really simple, easy  and above all effective tool for managing your physical and mental comfort levels during labour and birth. One of the central tenets of hypnobirthing is to be able to encourage the body and mind into the calm relaxed state we practice during sessions. The more you practice in pregnancy the easier you’ll find it – especially if you do it alongside your oxytocin boosters and in a peaceful environment.

17 Fantastic Facts About Oxytocin in Birth

Oxytocin is often referred to as the “love hormone” or “cuddle hormone” because it’s associated with social bonding, love, and trust. It’s produced by the hypothalamus in your brain and is released into your body by the pituitary gland.

Oxytocin is produced in large quantities during birth where it helps to stimulate and strengthen contractions. These contractions help to push your baby down the birth canal and into the world. Although in labour your body naturally produces increasing amounts of oxytocin, there are things that you can go to help promote the production of the hormone in your body.

17 Facts About Oxytocin in Birth

  1. Oxytocin stimulates the muscles of your uterus to contract, and these contractions help to dilate your cervix and push your baby through the birth canal.
  2. Oxytocin can’t coexist in your body with stress hormones; we know that if we can reduce the stress, anxiety and fear you might be feeling, we can reduce stress hormones and promote the production of oxytocin. This also breaks the fear-tension-pain cycle.
  3. Once oxytocin levels start to rise in your body, a positive feedback loop is created. The cervix is pulled up and over your baby’s head which drops your baby down, triggering more oxytocin receptors to release oxytocin, resulting in stronger contractions which pull the cervix up and over baby’s head…
  4. Oxytocin helps to reduce your pain during labour by stimulating the release of endorphins, which are natural pain-relieving hormones.
  5. When oxytocin and endorphins mix, you enter a hazy dazy birth bubble where you zone out of the world. Peace man.
  6. An oxytocin and endorphin fuelled labour can reduce your need for pain medication during labour (although, of course, it’s still available for you if you want it…)
  7. …however, note that epidurals can impact the release of your own oxytocin, which may impact the strength of your contractions.
  8. A good amount of oxytocin in the system makes labour more efficient and effective, ie shorter!
  9. An increase in oxytocin levels during birth can lead to you feeling like you had a more positive birth experience.
  10. You’ll have the most oxytocin in your body in your lifetime just after your baby’s born but before the placenta arrives.
  11. Skin-to-skin contact with your baby can help to enhance oxytocin production and promote bonding. This goes for partners too!
  12. Oxytocin is responsible for the feelings of love and bonding that are often experienced between mothers and their babies during the postpartum period.
  13. Oxytocin helps to stimulate the release of milk in the breasts by contracting the muscles surrounding your milk ducts.
  14. After birth, oxytocin helps your uterus to return to its pre-pregnancy size and shape by contracting and reducing its volume.
  15. Oxytocin has been shown to have a calming effect on babies, reducing stress and promoting a peaceful and restful environment. Wearing your baby in a sling and having skin-to-skin contact can help with this.
  16. Oxytocin has also been linked to improved sleep patterns in both parents and babies, promoting overall health and wellbeing.
  17. Oxytocin production in your baby helps to organize neural circuits in the brain, as well as promoting a sense of attachment, security and confidence in them.

Oxytocin is an important hormone that plays a crucial role in the birthing process and in promoting the health and well-being of both the birthing person and baby. Its many benefits, including shortening labour, promoting bonding, increasing pain tolerance, and reducing stress, make it a vital hormone. By enhancing oxytocin production during labour, you can promote a positive and empowering birth experience, and create a strong foundation for the future.

To read more about oxytocin during the birth process, head over to Sara Wickham’s site where she looks at the evidence.