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Labouring At Home (Hospital Births)


A mama labouring, captured by me.

When it comes to labour and birth, one of the most vital pieces of information I stress to new mums is that you have options. It is so common that women and families don't comprehend this, and what it truly means for their journey ahead. Oftentimes in today's society we follow what the crowd does. Also, what we see portrayed through the media is deemed normal and acceptable. If you've watched a movie where a woman goes into labour, it's typically very dramatised and they will head to the hospital right away as if the baby might fall out in minutes. But labour (in most cases) doesn't come on that strong from the get go. It takes time to build in intensity, which leaves you with time on your side to settle into the waves and surges of labour. If you intend to birth at the hospital, a great way to promote a positive experience is to labour at home until you are in well established labour. Let's dive in!


Why stay home?


Research and outcomes have demonstrated that staying home while labour progresses has many benefits, and below are a few contributing factors for why, plus a few great resources to refer to as well.


Safe Space


A space that you feel safe in allows you to surrender to the experience of labour and birth. When we feel safe, we release tension and strain in our body, and in birth this allows us to lean into sensations rather than resist them. When we are in unfamiliar territory, are stressed or fearful, our body can reflexively become tense and tight, which in turn can increase pain in the body (fear-tension-pain cycle). If we resist the pain of labour (which is purposeful, physiological pain), we can ultimately cause additional unnecessary pain in the body, and also hinder labour progress. For many, home is a place we associate with safety and comfort, which supports labour progression & increases the likelihood of avoiding the fear-tension-pain cycle.


Lowers Intervention Rates


Interventions can be life saving, but in the current climate they are routinely overused and can result in a cascade of interventions. This is the domino effect that occurs when the natural onset or progression of labour is interrupted by medical interventions, affecting the labour dance between the mum and baby, and often leading to further interventions due to side effects.


A hypothetical example may look something like this; a low risk mum reaches 40 weeks + 5 days and is strongly advised to have an induction because her baby is 'overdue' (see blog post 'Overdue' at 40 Weeks). The induction interrupts the release of essential birth hormones, resulting in unmanageable pain that requires an epidural. An epidural typically will see a woman on her back now, and paired with fetal monitoring this really restricts the mother's movement, thus impacting the ability to open the pelvis as the baby navigates the birth canal. This may cause distress for mum and baby, and a drop in the baby’s heart rate may be recorded. Due to the concern for baby's health, and the slow progression of labour (because the woman has lost much of her innate senses to birth, she feels unsafe, and her restricted movement is closing the pelvic outlet), she is told an episiotomy, forceps and/or vacuum assistance will be needed to deliver her baby.


If this mother had have been informed that her baby was not in fact overdue, but still healthily in the full term recommendation of gestation (up to 42 weeks), and was told that rightfully she was allowed to wait for the natural onset of labour, her experience may have been completely different. Within the next week, labour may have started, and the cocktail of hormones could have prepared her body for birth. Labouring at home, she would be on her time rather than the hospital's ticking clock, and could trust that all progresses as it needs to. She'd have the ability to drop into her primal instincts and get out of her thinking brain, which is essential for birth. She would be able to move freely around her home as she feels the need for new positions, could shower or bathe in the comfort of her own bathroom, rest in her own bed, and truly relax into this safe space. When labour becomes more established, she can head to the hospital, ready for birth and less likely requiring medical interventions, as labour has progressed naturally (as it often does when the process of birth is trusted and uninterrupted).


Another hypothetical example may go something like this; labour begins naturally, and the mother heads to the hospital in the early stages of labour. Her cervix is measured at 3cm dilated. Once the woman is at the hospital, her birth is 'on the clock'. It's important to remember that hospitals have a limited amount of rooms, and need to get people in and out on an efficient rotation. This mother's birth may be progressing perfectly normal, yet it also may be longer than the hospital can allow for. An intervention such as a syntocinon (synthetic oxytocin) drip could be offered to speed up the process. The synthetic oxytocin does not reach the brain to produce the 'high' that real oxytocin does, and it interrupts the release of natural birth hormones in the body once it's in play. This interference of augmenting physiological birth may lead the woman to feel as though her body is inadequate or incapable of birthing her baby, putting her back in her thinking realm and reducing the feeling of safety. As a result, her body cannot relax and open for birth, because this sense of being unsafe tenses her muscles. The woman's dilation is checked, and it's noted that the cervix has dilated to 5cm. They diagnose the woman with 'failure to progress' and discussion of an epidural occurs (read this article for an amazing resource on failure to progress/failure to wait). Further impact is had on this mother's confidence to birth with the negative association of 'failure', and her cervix won't continue to dilate as she is too emotionally and mentally vulnerable for her body to surrender and soften. An epidural is given not an hour later, and the birthing woman feels as though birth is something that happened to her, rather than being an active participant.


Hormones


The cocktail of hormones released in labour and birth help to prepare you physically, mentally and emotionally for the marathon that is childbirth. When medical interventions occur, they interrupt the natural release of essential birth hormones such as oxytocin, prolactin and endorphins, thus impacting the progress of labour. As mentioned above, staying at home while you labour reduces your chances of interventions, and allows your birth hormones to do their job!


Oxytocin - known as the love hormone, oxytocin supports bonding between mum and baby. It also reduces stress and anxiety, increases the effectiveness of contractions, promotes thinning and lengthening of the cervix, positively impacts breastfeeding, encourages physiological (natural) birth of the placenta, and reduces postpartum bleeding.


Prolactin - can often be referred to as the mothering hormone; an essential hormone for milk production & establishing breastfeeding. Prolactin also stimulates the release of oxytocin, and supports progression of labour.


Endorphins - are known to be calming and pain-relieving. As labour progresses, the release of endorphins rapidly increases. These hormones contribute to a more enjoyable and possibly even transcendental (spiritual) birth experience.


 

Hopefully this gives some insight into why labouring at home can truly make a difference in your birth journey. This is your gentle reminder that women are biologically built to birth. Notice when you surround yourself with people that love and worship birth, your perspective on birth will also shift in this direction. When you surround yourself with people who fear, diminish or suppress the power of birth, your perspective is heavily impacted by these attitudes.


That's me for now!

Alicia xx


 

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