Labor Progress Tips with the Three Principles of Spinning Babies©

Find what to do when in this list of labor activities for each phase and stage of labor.

Note: If labor is progressing on its own, don’t try and make it progress more. It is distracting and leads you away from your natural progress. If, on the other hand, labor seems not to start well, pauses in the middle or contractions are strong without bringing dilation you may benefit from some of the following suggestions.

Pre-Labor or Early Labor when contractions are irregular

Length 20-60 seconds but not consistent

Is abdominal wall loose? Does your uterus hang forward and make a crease underneath it at your panty line in front? Then use a pregnancy belt or a Rebozo to lift your uterus and allow the baby to come down on your cervix. Wear it until the baby is out to prevent a stall in labor after the head is born

Rest Smart

Aim your belly button down while you rest.

Gravity will help you with Rest Smart positions.

Sit smart, too.

Sit up with your back straight or a little forward to help the baby settle in the front of your abdomen.

Remember, contractions help gravity improve your baby's position.

When there is pain or discomfort in pregnancy use the inversion. See the article on inversion in this web site. Move with Pelvic rocking on hands and knees, walking, circles on the ball.

Check in w providers if special needs present.

 

Early Labor when contractions are regular

Frequency 4-10 minutes apart

Length 20-45 seconds

Bloody show possible

Relax the abdomen with the same things listed in Pre-Labor. Wait on the tub.

Regular daily routine (special considerations if water broke) Eat every two hours and drink water, electrolyte drinks, a little grape juice or hibiscus tea (for examples) each hour.

Rest Smart when tired, walk or slow dance, lean forward, by say, washing the floor on your hands and knees.

Use Gravity with the Abdominal Lift.

Hands and knees or kneeling over the back of a couch or hospital bed. 

Or, kneeling on pillows and resting your arms in a comfy chair.

Move: Lively hula-hoop circles on the Birth Ball for 20 minutes.

Stand and lean forward in the Shower if sitting is painful, do pelvic circles while standing.

Check in w providers to let them know potential for labor to bring you to the hospital (or them to you, if having a home birth). Call the Doula, doula supported labors are statistically shorter than labors without a doula.
 


 


  
  

Active Labor – beginning about 4 cm

Frequency 4-6 minutes apart

Length 60-75 seconds

May need quiet, dark, privacy

Continue to Rest Smart when tired and use the relaxation methods in Pre-labor. Massage between contractions.


Rebozo sifting for serious relaxation.

Movement: Walking can help contractions continue to come, be sure to eat, too. Slow Dancing is more for relaxation and not that dramatic for progress Circles on the Birth Ball, perhaps while in the Shower, Lunge for one sided pain, asynclitic head after 4 cm, or just progress when slow.

If baby has a hard time engaging, do an abdominal release followed by the inversion. Some doulas and midwives suggest the Open Knee Chest for a stall in a labor for which the baby is high. Ask your care provider if there is any reason you wouldn't want to be upside down in the inversion or Open Knee Chest, such as abundant amniotic fluid and a loose abdominal tone which could risk a baby flipping breech. Uterine contractions will help prevent such a flip, and help the baby rotate to a left occiput transverse (left occiput lateral for UK, Aus, and NZ readers) position. The baby can then tuck his or her chin (flex, flexion) and engage more easily.

The Open Knee Chest means the knees are away from your pubic bone. (Left, Penny Simkin, PT, teaches us Open-Knee Chest)

The "Open" doesn't mean that your knees are far apart.

"Open" means there is a wider distance from your spine to your pubic bone! Your knees are as far apart as your shoulders are, so not very far apart. In this photo, Physical Therapist and DONA founding mother, Penny Simkin shows us the correct way to do the Open Knee Chest position.

You can use a Rebozo like reigns around the mother's THIGHS to support her weight while she rests in this position and lets the baby reposition. The rebozo is NOT on the abdomen or the baby. It is wrapped on the thighs to hold some of mom's weight. (Right.)

Confined to bed?

Some providers persuade or direct all their moms to stay in bed during labor. Sometimes a woman’s health is such that she has to stay in bed. Keep rotating the pelvis. Lay on your left side with a pillow between your knees or lift your right knee high up on a stack of pillows and shift your left hip back behind you, so to speak, so your belly aims in the mattress. Use pillows to support what needs supportin’

Then switch to your right side and try each of the variations. If you can kneel and lean over a birthing ball or the raised head of the bed, do so for 30 minutes between sides. Each thirty minutes change positions.

If your labor starts progressing rapidly, don’t worry too much about position changes for the purpose of labor progress. On the other hand, if labor doesn’t continue to progress, try and keep your back straight, not curled!

Active Labor – 5 cm (or 4-6) “Five Centimeter Slump”

Frequency 3-5 minutes apart Length 60-85 seconds If you cope thru 5cm, likely to have a natural birth

 Relax your involuntary muscles as described before. Or, if you have a loose, pendulous womb, wear the pregnancy belt all during labor. Rest Smart when tired.

At any time in active labor (through the next three described phases) you can

1.) Do a sacral release,

2.) Do the inversion through three contractions, then,

3.) Do a pelvic floor release.

Afterward, you will probably want to sink in a full tub or take a warm shower to mentally relax after those three techniques which can be challenging this for into labor, but amazingly effective.

Gravity: Abdominal Lift and Tuck as before, do for 10 contractions in a row, resting between. Lunge for 6 contractions on each side.

Showering is very useful, maybe while sitting on birth ball, or leaning forward.

Feeling dispair? Or, labor is just very intense?! Time for a tub bath.

Stand and hang on to your partner’s neck. Stand and hang on to a sheet thrown over the bathroom door-tie a knot in one end and throw the knot over the door, then shut the door with the knot on the other side. Now the sheet won’t slip off the door and you can hang on the sheet and bend your knees and move to the contraction.

Movement: Slow dancing or slow dancing in the shower with the wall, or grip bars, while partner sprays your back with a warm stream of water from the shower hose.

 

Active Labor – advanced 6-8 cm

Frequency 2 1/2 or 3 -4 minutes apart

Length 60-85 seconds

If not at birth site, now is a good time to go!

Balance: as before, plus, Relax the throat by “cooing,” deep, low tones are usually better than high pitched ones to relax the throat.

Gravity: Lots of moms like to be low to the ground...and they feel grounded with thier knees deeply bent. Kneeling on the floor while leaning forward, for instance, or crouching down like in this photo.

Need to speed things up? Sit on a toilet for three contractions, then stand for 3, and then sit for 3 contractions again. Shower or tub. Birth Balls are rarely desired this late in labor, but if so, go for it.

Movement: Lunge, if you haven’t before, or try again for 6 contractions on each side Walking can still be helpful, but may not be practical. You will know what you need.

 

Active Labor – Transition 8-10 cm

Frequency 2 1/2-4 minutes apart

Length 75-120 seconds

bloody show likely even if saw in early labor or before labor.

Balance as before: Inversions are a common success for the stall in a posterior labor.  Use of Doula and face to face support is commonly appreciated. Loud moaning to a rhythm, cool cloth

Gravity: Standing and leaning forward, Rest Smart when in bed. Birthing sling. Stand and hang on to the Rebozo or give the squat bar a try through 3-6 contractions.

Movement: Lunge, Holding Rebozo or sheet and straightening back. Bending knees with contractions and moving freely. Baby still high? Trocanter Role with Walcher’s Maneuver. Pelvic floor release.

 

2nd Stage – Pushing or Releasing

Frequency 3-5 minutes

Length 45-75 seconds long

Balance: Be upright with your back long and extended. Don't curl your back. That's right, don't curl your back. When labor is not progressing readily, let your back be straight the way it naturally wants to lengthen. Sit up on a toilet (the porcelain birthing stool), lay on your side with your back arched instinctually, or stand and lift your arms to hang onto something sturdy above you.

Relax well in between contractions. Let the contraction get well started before pushing voluntarily. If you need to push, use exhale pushing to conserve strength or mental stamina. At the end of each contraction, take several deep cleansing breaths. Smile and feel the joy. Make deep vocalizations, vowel sounds or roaring as desired. Kiss your lover. Know that your baby is helping you by pressing that pain out of your body. Work as a team. Let the baby rock back and forth in your pelvis, this relaxes the tissues in the perineum.

Gravity: Vertical positions or side lying on bed to open the pelvis. “Towel pull” squat for 3-6 contractions, hot washcloth on perineum for privacy, cold wet washcloth on anus to prevent or sooth hemorrhoids.

Movement: Rock forward and back while kneeling and leaning over a ball or raised head of the bed. Lunge if baby is asynclitic.

Back pain?

For back pain at any point in the dilation phase: Start with the abdominal Lift and Tuck for 10 contractions in a row. This may solve the cause (extension of fetal head, posterior position or asynclitism) and the effect (the pain).

In any point in dilation phase and the pushing stage: Do the lunge for 3-6 contractions on each side.

1.) Do a sacral release,

2.) Do the inversion through three contractions, then,

3.) Do a pelvic floor release.

Afterward, you will probably want to sink in a full tub or take a warm shower to mentally relax after those three techniques which can be challenging this for into labor, but amazingly effective. See Comfort Measures for more ideas.

Fetal Rotation is one sign of progress. If the baby can’t rotate then relax the pelvic area and open the pelvis so the baby can come through as is.

Bibiography

Labor Progress Handbook by Penny Simkin and Ruth Ancheta

Active Birth by Janet Balaskas

Comfort Measures with the Rebozo (video) by Guadalupe Trueba

Hands of Love (video) by Carol Phillips, DC

Web article with lots of blog entries describing and showing photos of maternal movement in labor at the Lamaze blog,  http://www.scienceandsensibility.org/?p=736

A blog with maternal positions for labor Birth Faith

Copyright© 2006 Maternity House Publishing