Episode 44: Clip from "Progress in Labor" (Sneak Peak!)May 30, 2022
Here is another sneak peak clip from the Comprehensive Brave Journey Birth Preparation Course!
In this clip we're discussing the 6 signs of progress in labor. It's really important to understand these signs of progress in labor as many Doctors, Midwives, Labor & Delivery Nurses as well as you and your birth partner might use this information to make decisions on medical interventions. Having a full understanding of all 6 signs of progress in labor is essential for making informed decisions.
Let's summarize all of them. We've talked about so far, the cervix was moving forward. The cervix begins to soften like the inside of your cheek and the cervix begins to thin to become as thin as the uterus.
then it starts to dilate. So, as I said, when you hear birth stories, you're most often going to hear people talk about cervical dilation. And this has given as a measurement. If somebody checks your cervix, it's a measurement from one centimeter to 10 centimeters. And keeping in mind you, if you have different people checking your cervix through your labor.
Keep in mind that different people, they do their best to standardize their measurements, but different people are going to give you a different rating. And this is why [00:01:00] some medical care providers will do these half centimeters. And sometimes that means that they, so they'll stick their fingers into your cervix and see how far they can spread their fingers.
If it has some give, but it's not starting there. They'll give that like a half centimeter. So I want to suggest that this is a bit subjective. And I know that medical care providers have done a ton of training to try to standardize this. But if you have a nurse check your cervix at one hour and then three hours later, a doctor checks your cervix and then three hours later, a different midwife checks the cervix , what you potentially are going to get are different subjective assignments of cervical dilation, same with effacement. I mentioned that a nurse, mentioned that she would stick her finger in, if it goes to the knuckle she'll give it a 60%. Maybe another nurse would give it a 50%.
So I just want to introduce some of this subjectivity so that, because I have seen birthing people and their birth partner just devastated by a cervical check that doesn't show any progress. And it's hard because you also want to [00:02:00] have information to make decisions on what to do. And so these cervical checks give you information, but relying too heavily on them is also problematic. Especially if these checks are being done by lots of different people, because it may lead you to think that progress has happened where it perhaps hasn't or progress isn't happening, where it perhaps is.
Does everyone's cervix extend and dilate to exactly 10 centimeters? Not really. At later stages of labor, your medical care providers, as they do a cervical check, they're just feeling to see how close it is to being totally open.
Just understand where you're getting this information, especially if you are making decisions based on that information.
So we've talked through cervical changes.
The last two signs of progress in labor are the baby descends down through the pelvis and the baby rotates. So those are the last two.
So the baby's descent is given as a station and the station will be a number between negative two, negative one, zero, [00:03:00] plus one, and plus two. And the descent of the baby is a huge indicator of progress in labor as is the rotation of the baby. And one thing I want to say about the rotation of the baby. I like to invite birthing people to think of the rotation of the baby as like, if my hand is the baby, and this is the birth canal that the baby is doing this like massive, um, Turn to being born.
It's not as dramatic as this looks, but when you think of it this way, you may move and, and access different positions. And we'll talk about positions in a few lessons after this. But you want to think about you're helping as you move, you're helping your baby make these turns, right as they're born and it's an essential element of the baby's birth is an understanding of where is the baby in your pelvis? Is it high or low? And where is the baby in terms of their positioning. And we'll also talk about optimal fetal positioning in a later lesson, which is what are some of the more optimal ways for an infant to be positioned [00:04:00] within the uterus or excuse me, within the, um, well, yes, within the uterus, but within the pelvis.
Okay. So in summary, what we've talked about in this lesson: we talked about how it's important to understand the linear birth model.
We've also talked a little bit about how the linear birth model isn't always helpful because birth rarely feels linear.
We talked about the mechanics of contractions and the purpose of contractions, which is to position the baby and open the cervix.
And a reminder, the cervix is part of the uterus. It's the neck of the uterus. And then we talked about the six signs of progress in labor, which is the cervix moves forward. The cervix becomes soft and squishy it ripens and; is the official term. The cervix thins, becomes effaced, and ; is the official term.
The cervix opens and dilates, and then the baby descends and the baby rotates. So those are the signs of progress in labor.