A Homebirth Midwife’s Tips for Early Labor
Five ideas for before your doula or homebirth midwife arrives
If labor is like a mountain, early labor is like the foothills. Some mountains are surrounded by lots and lots of foothills. Others seem to rise up straight out of the ground. This article addresses the journey through the foothills, especially when they are abundant.
Whether you are planning to give birth at home or in the hospital, you’ll likely spend a considerable amount of time laboring on your own before it’s time to call your doula or homebirth midwife or head to the hospital.
As many educated parents planning hospital births know, going in too soon can make for more unwanted medical interventions. Many pregnant people choose to hire a doula to support this plan. Because the more time you can spend laboring at home, the greater your chances for having a vaginal birth and receiving care that aligns with your birth plan. Of course, if you are at higher risk for complications, for example experiencing high blood pressure, you might need to head to hospital sooner. Most of the advice below still applies, even for a labor induction.
In case the terms describing different phases of labor are unfamiliar, here is a resource to learn about the process.
Now lets go a into a little more detail about pre-labor and early-labor, and then I’ll get to my best advice.
Prodromal, warm-up, or false labor is the very beginning. Contractions may feel like cramps; achiness in the back, hips, thighs, or belly; like strong toning contractions (aka Braxton-Hicks); or even like real labor contractions. They might come every 20 minutes, or even every 3 minutes. The pattern might be all over the place or rhythmic. It might start and stop, sometimes coming on only at night. This can last for a day or two or a week or two. There is lots of variation of normal here. Your uterine muscle fibers are getting organized, coordinated, toned up. Your baby may be moving down lower into your pelvis. Your cervix may be moving forward, into alignment with the birth canal, and may be softening and starting to open. You may start to lose your mucus plug. Mentally and emotionally you’re aware that the next phase of your life is beginning, and it’s time to prepare. It’s all for a reason!
Early labor begins when contractions start to get longer, stronger, and closer together. All the same things can be happening as described above. But the pattern is more consistent. Early labor contractions often pick up with increased activity but can also ease up or stop altogether with rest or a bath. It might become harder to speak and walk during contractions. Lying down might become uncomfortable. The sensations might be so strong that it’s hard to believe it’s going to get any stronger - hard to believe you’ll be able to handle it if/when it does. You can bet that they will. And that you can do it! But this part can also take a long time. Going to the hospital at this point for pain relief, even with no particular risk factors, even with care from a certified nurse midwife, can really mess with your birth experience.
Here is my best advice to support your mental, emotional, and physical well-being during this time.
1. Distract yourself!
Create a to do list for early labor. For example:
bake a birthday cake
watch a favorite show
go out for a walk
take a nap!
play cards
make a craft project
spend time with a dear friend
take showers
go out on one last date before baby comes!
re-pack your hospital bag
set up your birth space
If you are planning a water birth, set up the birth pool. But don’t fill it or get in just yet.
2. Stay nourished, stay hydrated.
As your body prioritizes uterine muscle activity, blood and energy for digestion are diverted. You might not feel hungry or thirsty. All the same, labor is like a major athletic event. If your electrolyte balance and blood sugar destabilize, you will feel pretty crappy and may start to vomit and then need IV therapy. So hydrate diligently.
Some good options for fluids:
water with electrolytes
sports hydration drinks
labor aid (recipes in link)
coconut water
tea with honey and a little pinch of salt
red raspberry leaf infusion (recipe in link)
chicken broth
miso broth
You probably won’t want to eat during labor, but it might be a long while til you’re all done and ready for a meal. Eating nothing will make labor feel harder and longer than it needs to. Protein, healthy fats, and complex carbs will keep you going longer than just fruit and sugary foods.
Some easy labor foods include:
yogurt
fruit
soups and stews
smoothies
toast with peanut butter
eggs
popsicles
energy bars
trail mix
cheese sticks
chia pudding
3. Rest.
Sometimes rest is the limiting factor of all the resources needed to move through labor. I have heard many mamas say, “if I could just sleep for an hour…” The majority of transfers to the hospital from planned homebirths are for therapeutic rest aided by epidural anesthesia. So move around when you have the energy, and rest when you feel tired. Because oxytocin is higher at night, you may end up becoming nocturnal. If this is the case, go with it. If you can lie down and go to sleep at any time during this phase of labor, do it. If, everytime you lie down to rest, you have a contraction that hurts twice as badly as they do when you are standing up, Do Not Give Up On Rest! Lie down anyway. Enlist your partner to gather all the pillows in the house and help you try to get comfortable. Stick it out lying down through at least three hard contractions, and just try to relax in between them. You might be surprised. You might fall asleep. Breathing through contractions in this position might become easier. Also, women in labor have super powers. The three to five minutes you get in between contractions actually count for half an hour of a normal person’s sleep. Another trick is to find a way to prop yourself upright, leaning forward, so you can fully relax and possibly even fall asleep. Use a birth ball, cushions, and all the furniture creatively.
4. Move.
Here are some ideas:
Spinning Babies is a great resource for activities to do during labor. Learn about optimal fetal positioning. Try the releases. Use them during labor.
Walk.
Assume upright, forward-leaning positions.
Go up and down the stairs, taking two at a time on the way up.
Try lunges with one foot up on a chair.
Sit on the ball and circle your hips.
Turn on music and dance!
Don’t tire yourself out. The Miles Circuit is a good one for balancing the priorities of movement, rest, and optimal fetal positioning.
5. Trust yourself, go deeper, dive in.
At some point, active labor will kick in. But for some of us, our strong wills and minds can actually overpower the natural flow of labor and hold us back. We may have to intentionally get out of our heads and let go of control. Try putting one hand on your heart and one on your lower belly, closing your eyes, and taking some deep breaths to get out of your head and into your body.
Believe that you can do it! Some of the most incredible laboring behavior I have witnessed in all my years as a doula and homebirth midwife has been by mamas who said they had a low pain tolerance. After a seemingly interminable early labor, they thought they couldn’t go on. They were exhausted. But when they finally entered active labor, they were goddesses. They glowed from within and gracefully sang, swayed, and breathed their way through active labor. You have what it takes! Your endorphins, the body’s natural pain killers, will soar as your labor intensifies. There will likely be a lag before the endorphins flood your bloodstream, when the contractions feel like more than you can handle. But they will increase after a few contractions. And each time your labor stair steps up in intensity, the endorphins will rise, too.
Challenge yourself! If there is something you are doing because it makes labor more comfortable or makes it slow down, that’s great, up to a point. You can use those tactics to give yourself a break. But you may also be holding yourself back and making things last even longer and be even more exhausting. Embrace the intensity. Do whatever makes your contractions harder, stronger, closer, longer, “worse.” And use affirmations to remind yourself that this is good, this is what you want, you have everything it takes. Say, “ooooooohhhh-pen.” Say, “yeeeeeeeees.” Say, “fuuuuuuuuuuuck.” Whatever you want. Just do it. You’ll be so glad you did.
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Wondering if you are a candidate for home birth? Click here to learn more about working with a homebirth midwife, and reach out to me for a free consult! If you’re interested in working with me as a doula, go here. And here is a blog post for partners wanting to take an active role in labor support.
Frequently Asked Questions
Can I give birth at home with a midwife?
Probably, yes! Homebirth midwives serve low risk parents. It’s worth reaching out to ask, even if you’ve been told you have one or more risk factor. Some risk factors, such as advanced maternal age or previous cesarean section, do not necessarily risk you out of having a home birth.
What does a homebirth midwife do?
Homebirth midwives provide complete prenatal, birth, and postpartum care for our clients. We can draw labs, suture tears, administer emergency medications, and register your birth with the state. We also offer holistic guidance, including nutritional counseling to help you optimize your health for a safer, healthier pregnancy, birth, and breastfeeding journey. And we clean up after your birth, of course.
Can midwife come to home?
Yes! A homebirth midwife provides care in the home for labor, birth, and the postpartum period as well as at least one prenatal home visit. Some of us also us office space for prenatal care.
What’s the difference between doula and midwife?
A midwife is a primary care provider, like an OB. A doula is a support person you can hire to provide physical, emotional, and informational support. Doulas do not provide clinical care services.
