Nursing Birth

One Labor & Delivery Nurse’s View From the Inside

Top Ten Things Women Say/Do During Labor (And trust me… they are totally normal!) February 8, 2009

You’ve read about it.  You’ve talked about it.  You’re totally prepared for it…right?  Until it actually happens, no couple can be totally ready for what they will feel, say, and do during childbirth…especially when she gets to transition.  Transition, the shortest of the three phases of the first stage of labor, is the most intense as well as the most physically and emotionally demanding phase.  For those that have been planning a natural childbirth, it is also a time when many women want to change their birth plan and ask for pain medication.  The good news is that since transition is the shortest phase, when she finally gets to it (at about 8-10 centimeters) she is almost there!! 

 

The following is a list of the top ten things I have discovered to be very common among women working through labor, especially if she is doing it naturally!  If you have experienced or assisted someone through labor, you might remember these moments with a chuckle.  If you are about to embark on a natural birth, either personally or as a coach for your wife, partner, sister, daughter, niece, or best friend, my hope in writing this list is to alert you to these very thoughts, feelings, and actions that you/she will probably experience. 

 

It is easy to get scared when your loved one is in so much pain she wants to change her birth plan.  Not to say, of course, that a woman shouldn’t have that right.  There is a great chapter in the book The Birth Partner by Penny Simkin that describes this very phenomenon and suggests reviewing the “Pain Medications Preference Scale” and discussing the use of a “code word” before going into labor.  I highly recommend this book as part of your childbirth preparation.  However, if more couples knew about these thoughts, feelings, and actions, they might realize what their labor & delivery nurse, midwife, or doula already know…that she is acting totally normal!

 

10) “I don’t know how much longer I can do this!”

            Many L&D nurses are used to hearing this phrase typically as a woman begins the transition phase.  When you hear it, know that reminding your loved one of how much progress she has made and how little she has left to go will probably help her cope.  Many women mistakenly feel that if their labor took hours and hours to get to this point that it will take a comparable amount of time to get to the second (or pushing) stage.  Except in the rare case of arrested dilatation, this is NOT the case!  She is way more than half way there, in fact, she is almost done!

           

9) “I’m done!”

            Wanting to “give up” and just have it be over with is also a common desire of a woman going through natural labor.  It may be helpful to remind her that the pain she is in right now does not feel as bad as holding her baby will feel good!

 

8.) Throw Up/Burp Frequently

            Vomiting is a common sign of the transition phase, whether or not a woman has been eating throughout early labor.  Some coaches find this hard to handle.  Think of it as a way of “making more room” for the baby J.  In fact if something was rhythmically squeezing your insides, you would probably throw up too!  And let’s be honest, with a new baby around, you are bound to see a lot more throw up!  Since vomiting, like holding your breath or making a bowel movement, is a vagal response, it inadvertently helps your cervix dilate and hence, is a great sign to a labor & delivery nurse!  The body does awesome things to help the process along!

 

7) “No really, I have to poop!”

            As the baby descends further into the pelvis with each contraction, the pressure on the rectum becomes incredibly intense.  So intense, in fact, that it feels exactly like the need to have a bowel movement.  I can’t tell you how many times I explain to a patient who is in early labor that if she feel rectal pressure “like she has to poop” that she has to call me first and NOT just get up to the bathroom.  But time and time again when my patients begin to feel this pressure what doe they do?  They almost always get up and try to poop!  Many a woman I have found on the toilet straining to pass a BM and when questioned, try their best to convince me, “No, you don’t understand, I swear I have to poop!”  Okay, okay, if you had just eaten a meal and it was during early labor, I would agree.  But you are 8 centimeters now so TRUST ME!  It is the baby! (SEE: Top 10 DOs & DON’Ts of Pooping During Labor & Birth)

 

6) Shake/Tremble

            The hormonal rush a woman experiences during labor, especially natural labor, is overwhelmingly intense.  These hormones will cause all women to being to shake as they approach full dilation.  This shaking, in fact, continues for at least an hour post partum, even after a cesarean section or medicated labor.  Many partners and family members try to pack a woman with blankets to help her out only to find that she insists on not only ripping off the blankets, but sometimes even her clothes!  In reality, it is unlikely that she is cold and if you continue to ask her if she is, she will just start to get irritated with you.  It’s normal to shake, I promise J

 

5) “Can’t you just take/cut the baby out of me!?”

            Even the most level-headed, experienced mom can sometimes feel so out of control that she begs for a c-section.  Trying to rationalize with her is not going to make it better.  As an L&D nurse, both you and I know, as well as she, that a cesarean might seem like less pain now, but it is a hell of a lot more pain later!  It might be helpful to gently remind her that she is almost done and that everything she is doing to regain control of her breathing is helping the baby.  But please don’t try to reason with her…you are just going to upset her!

 

4) Cry

            Whenever a patient of mine begins to cry, my heart always starts to break.  It is at this moment that most L&D nurses, partners, and other birth coaches wish they could trade places with her, if even for a moment, to just give her a small break!  (Alas!  If only it was possible!)  If my patient begins to cry, I try to gently persuade her to save her tears for happy times when the baby is born and that crying is only going to give her a headache and make her feel more terrible. 

 

3) “Don’t touch me there/like that!”

            Many birth coaches are hurt to discover that the techniques that were working wonders in early labor only make their loved one upset and annoyed during transition.  In my experience the major culprit is rubbing her belly!  I know, I know…all the Hollywood movies show the father of the baby rubbing mom’s belly as she moans through her contractions.  Looks loving and almost romantic right?  WRONG!  (At least during transition anyways!)  To all the well intentioned fathers and birth coaches out there, my humble advice to you is this: unless she asks, don’t rub her belly…seriously, don’t!

 

2) Ignore You

            The only time I start to feel bad for the partners and labor coaching working with my patients is when their loved one starts to ignore them.  In reality, it is a fantastic coping mechanism!  Fact: Women often do not know what they want during transition.  They feel out of control and utterly uncomfortable in every way.  So when you ask her if she wants a sip of water or a cool cloth on her forehead or to change position what does she do?  She ignores you!  It is hard for me to explain that this is normal while in the labor room so since I have the opportunity now, I would like to let all birth coaches know that your loved one is no longer with us.  She is in her own world so she can make it through!  Hence don’t ask her any questions, especially silly questions!  My humble advice is to just do what you think will help and she will tell you otherwise if it is not working.  Many women can only talk in one work responses at this point anyways: “No!,” “Stop!,” “Drink!,” “Stronger!,” “Softer!,” “Oww!”  So just hold the straw up to her face; if she wants to drink she will!  If not, she’ll tell you!  And while I am on the subject, please don’t take offense if she is short with you.  Just do what she asks with an understanding smile and for the love of God please don’t sass her back!  She is, after all, having a baby!

 

1) “This is the last/only time I am going to do this!  No more babies for me!”

            If every labor and delivery nurse had a dollar for each time we heard a woman say this during labor, we could bailout this country single-handedly!  This comment makes me chuckle every time I hear it.  Let it be known that once she has that baby in her arms, she is going to forget all about the pain.  What she will remember is how well loved and supported she felt during the whole process.  And if you have done your job right, she is going to want a lot more kids someday!

 

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24 Responses to “Top Ten Things Women Say/Do During Labor (And trust me… they are totally normal!)”

  1. Molly Says:

    The only one I did not experience… In fact I was the opposite… was the last one! I said I couldn’t wait to do this again!!! That high afterwards is too good a drug for me to quit!!! I’m a birth junkie!

  2. [...] while I push, Woman in labor thinks she has to poop On February 8th, 2009 I wrote a post entitled Top Ten Things Women Say/Do During Labor (And trust me… they are totally normal!).  This piece has been the most popular post on my blog yet, which is pretty exciting!  When I [...]

  3. Joy Says:

    LOVED THIS! I’m going to read it to my husband when he gets home.

  4. DoulaAndie Says:

    Could you explain a little how the vagal response works (throwing up helping dilation)? I’ve read about Ina May’s sphincter law, and I assume it’s all the same thing. But I don’t really understand how it works. Part of the reason I’m curious is that I once passed out after a TB test (I’m a wimp!). A friend who’s a physician’s assistant said something about my vagal nerve being sensitive?

    I really love your blog, by the way! I just found it. It’s SO TRUE!

    • nursingbirth Says:

      Doula Andie, Ina May does an amazing job describing it. When you passed out during your TB test you had a Vasovagal episode (http://en.wikipedia.org/wiki/Vasovagal_syncope) When people consciously bear down to push or poop they are voluntarily doing the Valsalva’s Maneuver (and if they are throwing up or coughing or involuntarily pushing like with the fetal ejection reflex they are involuntarily doing the Valsalva’s Maneuver.) The vagal nerve and the valsalva maneuver are related. Stimulation of the vagus nerve occurs during the valsalva maneuver. Have you ever heard of an elderly person with coronary artery disease having a heart attack on the toilet? It’s all related! It’s kinda complex when you get into it so this little ditty isn’t even touching the surface. Bodies are crazy awesome huh! I hope this helps though!!

  5. [...] everything I do.  (For example, one mom linked to a lighthearted post on my blog entitled Top Ten Things Women Say/Do During Labor on a popular baby website and wrote something to the effect of “Beware of the rest of her posts [...]

  6. Renee Says:

    Hi, I know this is an old post but I thought it was a great list. I would add to it what I always say like a broken record when I am in labor, “I’m scared.” I must have said that thousands of times but my support people were always great about that. Also, I think your response when women cry is a great sympathetic one but often that may not be the worst pain or the lowest point in labor for someone. For me during my second labor (homebirth yayy). I found that I was crying because I was so sad about my son–that now it wasn’t going to be just him and I anymore and that time was over. Of course, I was happy to be having another baby–I was just really open emotionally during labor and thoughts of my older child were getting to me. My doula and I talked about it and I got through that part. So, sometimes the crying is just an overwhelming emotional response that you can’t control just like pushing etc. In addition, I for one, never forget the pain of either birth (both were really difficult for me–second baby had an asynclitic head and some other issues) but when you weigh the amazing times with your baby and child later on (after labor is over) it makes it worth it to attempt again. I did experience an incredble emotional high after my second birth that does feel really great after all that pain but doesn’t erase the memory of the pain. With my first birth because of meconium my son was basically ripped away from me and then spent a week in the NICU so we felt upset instead of any natural high. Even though I think one should try for a natural labor–I’m not in the camp of thinking the pain should be gone if you just do all the “right” techniques or are undisturbed.

    Sorry to go on so long–I’m not a frequent commenter on blogs. I just want you to know that your writing, is very moving, honest, and informatve. You have a really engaging style as well. I am lucky to have stumbled upon your blog! Keep up the good work. In addition, the nursing work you do in the hospital to support women is amazing. If I had had someone like you as a nurse in my first labor it could have made all the difference in many ways.

  7. sutana Says:

    I’m nervous about shaking afterwards…I mean who likes 2 shake!?

    • nursingbirth Says:

      sutana, please dont worry about the shaking. It isnt “violent” shaking, its about as much shaking as you would do if you went outside to get the mail without a coat on in a snow storm. And it only lasts about two hours. And anyways, you’ll have you baby in your arms so you wont much be thinking about the shaking!!

  8. leslie Says:

    i too have to agree with a commenter: i didn’t forget about all the pain right away and i still remember it, even though i don’t find it that hard anymore…..
    one of the most important things in labour is the nurse/midwife. i had a horrable experience in my 2nd delivery and i still feel sorry for my child, because i don’t have good memories about her birth and all that….

    i love your site! it’s great!

    oh and the “poop”-post? fantastic! i think it’s one of the biggest fears and really no one actually talks about that (it’s like the sex-thing while being pregnant…:)

  9. Meg, RN Says:

    Regarding #10: Believe it or not, last week I walked into a room at shift change about an hour after my patient had given birth and she said, “That was the coolest thing ever, everyone should do it! I can’t wait to do it again!” I laughed and told her she was the first woman I ever heard say that so soon after delivery. She was so sweet and just had a great birth experience and was totally in love with her baby…gave me a renewed sense of appreciation for my job and the neat stuff I get to be a part of when I go to work!

    • Sideways Says:

      I was exactly the same, I had a horrid pregnancy and a great birth, and straight after the delivery I said I would rather give birth 100 times over than ever be pregnant again . . here I am almost 10yrs later pregnant again . . and for the record, this time things are much better :) GREAT list!

  10. nervousmumtobe Says:

    Hello, I know this is an old post, but I’ve been searching info on vomiting during labour for a few hours (lol!) and can’t quite find what I’m looking for, so, with the housework waiting, I thought I should come out with it and ask! Your post is very informative and you seem lovely so I hope you are able to help me! (or others who have been through it) I have emetophobia, and find I am able to calm myself about the potential of vomiting (because I have had to face that fact that I can’t just escape it!), if I 1: know that “everything will be ok” if I do vomit. ie: mainly, that people won’t be disgusted, or freaked out; and that someone will be able to deal with, well, the result, if I’m not able to (even though I’ve never vomited anywhere except in a toilet, it’s just the potential that terrifies me) My husband is a wonder, and it’s only actually since being with him that I’ve begun to get over the phobia because he’s not scared about it, and not phased by it. And 2: I can handle vomiting much better if it isn’t preceeded by hours and hours of painful nausea. SO, I find myself trying to prepare mentally for the possibility of throwing up during labour, and I have some questions stemming from this for you (I know it is an irrational fear, and these questions seem trivial but they are things that really stress me out – I actually lose sleep over them – so I appreciate your answers); Will the midwives be ok if I throw up all over the place? Will they clean it up or will I or my husband have to? What happens if it gets in my hair? Will I choke because I might be lying down? And, is it a different kind of vomiting – one that just kind of happens, rather than following hours of terrible nausea?
    Anyway, I don’t mean to waste your time, and many thanks in anticipation of any answers – I’m just trying to mentally calm myself so I can fcus more on the really important things about labour – like my baby!!

  11. [...] Comment left at: Top Ten Things Women Say/Do During Labor (And trust me… they are totally normal!) [...]

  12. [...] Top Ten Things Women Say/Do During Labor (And trust me… they are totally normal!) [...]

  13. [...] came across the following article about the transition phase of labour. I found it to be very accurate and insightful. Part of the [...]

  14. Kelly Says:

    I WISH I had read this list before I had my son. I heard about a few of these things, but I was definitely never heard of, nor was I ready for the crying and shaking. I started shaking about an hour or so before I had to start pushing. At first it started with my teeth chattering a little, then my entire body was shaking like crazy. Since I had NEVER heard of this, despite having read 3 pregnancy/labor books, I freaked out when this started happening. I literally thought I was dying, so I began to cry, HARD. I didn’t know what was happening and the nurses kept telling me I was fine, but never really told me that it was normal and that it happened to alot of women. I freaked out and was sobbing thinking that something was going horribly wrong. Lol i can look back now and laugh, but at the time, it was so scary.

    • Niamh Says:

      I’m so delighted to read about the shaking too. I shook like I was freezing with my teth chattering too at every contraction. The bath was the only thing that helped. I’m pregnant with my second child now and want to find out a bit more about the shaking. No books mention it.

  15. Landra Says:

    I am about 7 weeks from my due date with my 5th child. All of my births have been natural and the first two were with a midwife. I honestly only remember pooping once (second child, nine days overdue, REALLY quick labor). I whispered to the midwife what had happened and she wiped it away so quickly that my husband didn’t even know anything had happened! Transition is the hardest part for me to get through and I am pretty sure I have said ALL of these things and more in my attempts to find some comfort and logic to the situation. Also, the shaking annoys me because I shake when I am nervous and it reminds me of all the things that are out of my control. But I thank you so much for writing this! Makes me feel more normal :).

  16. Christina Says:

    Brilliant advice. It may have been 27yrs ago since i was last in that position but now with my daughter anout to give birth and I’m her birthing partner, its good to know what to expect from the other side if the proceedings

  17. Nadz Says:

    This was very informative…I wished I read this before, it would have helped me understand the shaking as well…..i was a shaker too!!! great post!!!


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