You’ve heard the stories… “my labor was over 60 hours!”, “it went on for days…”, or “I have no idea how long my labor was?!”
Some women (and even some birth workers) do not realize that there is a difference between EARLY labor and ACTIVE labor, or even aware of the changes that can occur during different phases of labor. It can look dramatically different for some, or hard to decipher when the phases start and end for others.
Labor and birth is an individual experience, and so disclaimer… not everything I say here is what you experience when in early or active labor, however, you can probably draw some similarities. I have definitely seen and heard of births where it jumped from early labor to a baby coming out!
So, how do I know when I am in early labor?
A simple answer, when the birthing energy is flowing. You know when you know. If truly in tune with your whole body and baby, the labor light switch will turn on and say, “this is it, the time has come.” Not always is this known until active labor, however, but for some women it can be made obvious (and I don’t mean physical signs). You may have a desire to prepare your birth space, remain talkative, and begin making phone calls. You may also still be aware and present, and possibly even excited or uncertain. I remember after an hour of low, abdominal area tightening (different than the normal practice contractions), saying to my husband, “I thought I was ready...now I am not sure!” This was confirmation for both of us that labor was real, and in the beginning, opening phase.
The next step I took was to call the midwife and go to bed, as I knew this was my time to remain calm, help contractions and oxytocin out with some melatonin hormones (yes, that’s a thing!), avoid adrenaline that could slow my labor start, and resting to save my energy while everything was still mild. The best thing you can do when labor has not yet, truly began is to eat, rest, sleep, and go about your daily activities as normal (or go see a chiropractor and stroll around the mall...close to home and with a friend of course). It may be good to have your doula or partner remind you of these things when you may be feeling excited or nervous. Rest is always best.
Another way to know you are in early labor are changing physical signs. Contractions that were once “practicing” might turn to mild, short 30 seconds in length, 10-20 minutes apart, and beginning to turn into a pattern (or maybe not). Some women lose a mucus plug or have bloody show in the days leading up to early labor or at the beginning of early labor. This is a good sign of cervical change and preparation. Some women also have an “emptying of the bowels” to make space for what will soon fill it. A real and true sign could also be the water breaking, but this is rare in the early phase, and sometimes means the early phase is now active phase. At this point the mother can be anywhere between 1 and 6 cm dilated (this is all depending on if it is your first baby, third birth, etc.), and early labor can last as long as it decides to last...for some women, it’s a LONG time. Notice I have not said anything about needing a cervical, vaginal exam… saving that bit for another day.
So now the birthing energy is flowing, you’ve rested or kept yourself active and distracted, and the physical signs continue to change… active labor is beginning…
You know active labor is here when it requires focus and deeper breathing. You can no longer be distracted, and the birthing energy begins to climb to new heights or “take off”. Some women prefer to seek solitude or comfort in ways best to them. Others like to walk or climb stairs, all the while losing some clothing and becoming more audible with moaning, lower pitched noise. Water can also be a nice comfort measure to have, and is often requested. If having a water birth, try not to enter the pool too soon as this could slow down the labor process. Continue to eat and drink if possible, as energy is needed to continue the marathon.
Everything becomes more physical, and changes can happen fast and sometimes slow. Contractions become longer, lasting at least one minute from start to finish, with a peak in the middle, and coming every 4-5 minutes (from the start of one to the start of the next one) or more frequently than that. It feels “active” in the sense that it is active; you may even experience flushed cheeks, more mucus or bloody show, or the rupture of the water bag as the uterus and cervical opening thins and baby adds more pressure. You may find positions that are more comfortable than others; use your instinct and ask for help if needed. Pressure will continue to increase; some women find their back hurts or experience extreme menstrual cramps down low in front. The body is experiencing stretching and pulling from places such as the pelvis, uterus, cervix, and back. At this point, most women are between 4 to 8 cm dilated in the active phase.
It is a commitment at this point in labor, that may need confidence or a boost of confidence from a doula or partner present to continue on. Active labor involves acceptance and surrender, as there is no turning back; something your mind and body has been preparing for the whole pregnancy (or maybe even before that). It is hard work and hormones are raging. Discover when the birthing energy is building or when it is blocked. Move through what needs to be moved through, and remain still when resting seems necessary. There can be peace in the resting, and there can be intensity (and even rage) during the hard. Time is lost for all present.
This is active labor. Can you see, hear, smell, and feel the difference?
Written by Alisha Stoltzfus, The Birth Servant on February 28, 2019