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Wednesday
Jan202010

Labor: A Visual Guide

(Meant for student midwives, apprentices and doulas.) 

… from my experiences over the last 27 years, including discussions with others; ymmv. 

Sitting with my mama the other day, watching her wander around, leaning over every few minutes, I knew, even without a vaginal exam, that she wasn’t past 3 centimeters dilated. She’d been contracting since the night before and had been passing bloody mucous, but her demeanor, her movements and even her scent were not of a woman in active labor. 

Definitions: 

-          Labor – When regular contractions dilate the cervix somewhat continuously… typically after 3-4 centimeters; anything before would be considered early labor as opposed to active. I am not wont to use the phrase “false labor,” because, to me, any contraction serves a purpose, even if it is merely to draw the mother’s attention to her baby.

-          Gloppies – a term I use to describe bloody show or even extra mucous. I use it tenderly and women immediately know what I mean when I ask, “Do you have gloppies?” Gloppies can begin well before labor, but ramp up considerably as labor progresses. Big globs of mucous and blood are typical at about 6-8 cms. If you see this and you aren’t doing exams, this would be a great time to consider moving into the hospital if you are a doula or preparing for a birth if you are in the home setting. I am aware that some people think the term is juvenile at best and gross at the worst. You are free to use your own terms. 

Women in early labor can be somewhat chatty. They are in the here and now plane as opposed to the other-worldly plane of active and advanced labor. Some women are rooted in the here and now for a long time, well into what dilation would consider “transition,” but most women fall into their hypnotic, spacey place around 6 centimeters; some sooner, but that is pretty rare. They might be quiet and introspective, but not in that high place. 

(Mom at 7 centimeters.) 

(The same mom at 9 centimeters.)  

Some women can mimic heavy labor, yet be in the early phase. I was one of those… dramatic, needing attention; whining. A woman in good, active labor has a contraction like this: Walking, walking, slowing down, slowing, stopping, leaning, leaning and swaying, beginning to moan, moan and sway, moan and sway… throughout the contraction. As the contraction wanes, the woman stays hunched over, holding on, allowing the last quakes to recede before taking a deep breath and moving very slowly to a stand, then slowly moving again… the movement picking up as the contraction is totally gone. Whereas a more  dramatic woman (and there is certainly nothing wrong with a woman who tends towards drama) stops and starts suddenly… like this: walking, walking, walking upright... either sits, leans sideways on a wall when the contraction comes… her vocal tone is even different, being more breathy than deep. And once the contraction is over, she bops right back up and into the activity she was doing or the conversation she was having.  

A nurse told me about a woman who presented at the hospital in “serious” labor; she was 2cm. They sent her home and she came back in hard labor twelve hours later; she was still 2cm and got an epidural soon after. That’s dramatic and wanting help/attention for lack of support, playing out childhood issues or habit. Trying to fix it (whatever "it" is) in the moment can be frustrating (and unfair if resolving deep issues isn’t your specialty), so attending to the woman where she is is usually easier for you and the mom. 

In my experience, dramatic women tend to whine. “It huuurrrrts.” “Make it stop.” “I hate this.” This isn’t the “I can’t do this anymore” of transition (and we’ll get back to this in a few), but a whiny, negative attitude right from the beginning. It would seem counter-intuitive that this type of woman would choose a homebirth where anesthesia isn’t an option, but she gets a different type of attention from a midwife; more motherly than what she perceives the hospital to be… punitive. The psychology of birth is absolutely fascinating and I hope someone explores the dynamics, the relationships, the motivations and resolutions someday. 

Whiny women take longer to get into the labor high, being so in their heads, it can be a challenge for them to let go enough to be swept up into labor’s current. When she does, amazingly, she stops whining, but usually becomes very introspective and often moans very softly, whereas other women might be loud vocalizers. 

I picture dramatic women as stomping around loudly, boots making all kinds of ruckus. It takes purpose to lift the legs up and clomp them down, but it’s worth it to have someone pay attention to her. Movements are sweeping, large and abrupt. As labor moves her deeper, she takes the boots off and slides softly across the floor, her movements closer to her body, her voice singing mostly to herself. (I hope this makes some sort of sense.) 

Another type of women who struggles to get out of her head is the academic. She will read every pregnancy and birth book she can find, sure she will be able to “out-think” this labor thing. If she just knows how to breathe/move/visualize, she will conquer the birth experience. In fact, these types of women have a hard time letting go of the (supposed) recipe the books talked about, confused when labor doesn’t follow the pattern she was led to believe it would be. Fumbling along, lurches and stops, I’ve seen these women with furrowed brows and shoulders up, as if they’re shrugging… trying to figure out where they’re going wrong. 

When you see a woman like this during pregnancy, it’s so important to let her know how labor isn’t a head experience, but a body one, that the head is better left aside. I really encourage these types of moms to stop reading everything after 37 weeks; that seems to help. 

It takes reminding in early labor, but usually around 4-5cm, they “get” the mind-body dis-connection and fall into the rhythm of labor. 

Women who exercise a lot frequently have similar issues even though it would seem they can tolerate more pain and are in touch with their bodies more. However, they know their bodies in exercise, not in labor, which is a different type of runner’s high. Of all the labor-challenged women, I find these women find their place in the contractions quicker than anyone else. Once they have surrendered their bodies, they can tolerate labor easier than others, although I have known plenty of extreme sports’ women to have epidurals. Athletes include any of the sports you might find at the Olympics, but also ballerinas, cheerleaders, dancers and the like. 

Some women have problems physically dilating. These women include those who’ve had procedures on their cervix… cone biopsy or laser surgery, for example… women working through sexual or physical abuse issues (whether they are aware of them or not) and women who are very modest. They are like the dramatic women who act like they are much further along in labor or, more commonly, have terrible, if not excruciating, pain, even in early labor. The hope, of course, is that the body takes over, leaving the mind (even if it is subconscious) behind to fend for itself. Even the scarred cervix can often open without intervention if contractions are long and strong enough. (As a midwife, I have “snapped” scar tissue on cervices before. VERY painful, but can dilate the cervix several centimeters once they are broken.) When these women are able to scale the hurdle, whatever it is, they quickly find themselves where other women would be without those impediments.

On the same subject, helping a woman feel safe or a modest woman remain covered, these kindnesses help women to be able to fall into their labors, allowing them the freedom to open and prepare for birth.  It isn’t fair to tell a mother, “It’s just us girls, so don’t worry about that,” or “You don’t have anything I haven’t seen before,” because she is not the midwife/doula, she is the laboring woman, baring her very spirit in front of relative strangers; the least we can do is provide her the privacy she requests.  Not every woman tells you she’s modest, but even if you don’t see it in pregnancy, she might try to keep herself covered, a blanket around her or shutting the bathroom door from even her spouse. It’s our responsibility to read our clients; their actions are just as loud as their voices… and often, more so. 

There are fewer of the above types of women than there are run-of-the-mill women (not that every woman isn’t unique of course), so it can be pretty easy to pick them out of the group. 

For most women, the more typical pattern resembles the one mentioned at the beginning of the piece, from able-to-communicate (3-5 or so cm.) to high and floaty (5-10cm). 

Scent is another way to tell where a woman is in labor. I thought everyone could smell a woman in active labor, but apparently that isn’t the case. Pay attention and see if you are one of those that can. When I smell that special scent, I know, for sure, she is in active labor and progressing. What’s interesting is women who are not progressing do not have the scent (for me). I have a heightened sense that something isn’t right and investigate further what it might be. Now, I’ve not smelled the scent and women have birthed perfectly fine, so I don’t really know why some women have it and some women don’t. 

Thinking about it (and it isn’t a thinking thought, but a sensory thought), it isn’t a scent on the woman, but a scent that comes from a woman. I’ve tried to figure out where it comes from, but have determined it isn’t directly from the vagina. I mean, it isn’t the heavy, musky, oozie scent you get when you are between her legs or changing a Chux pad and, as far as I can tell, it isn’t the smell of ketones on a woman’s breath, that sweet smell that comes from not having eaten for hours on end. It seems to come more from her breasts, her chest area. It’s a “deep” scent… not musky, necessarily, but primal and vaguely familiar (and not just from having smelled it before). 

Why would women have a scent in deep labor? Would it be an ancient clue to get the woman to a safe place? Get her into “the red tent”? Is it a sign to step back and let the woman fall deeply into herself so she might be one with the baby as they work to bring him into the world? 

The scent can be fleeting, a whiff gotten and then it vanishes, but the woman labors on and births triumphantly. 

There was one time when “birth” walked into the room. When Beth was in labor, right before she delivered, The Scent came from beyond and came to her instead of from her; it was almost tangible. When I smelled it/felt it, the assistants and I went to wash our hands quickly and, as we came back, the baby began to be born. I was high from that ethereal moment for weeks! 

So, now we have a mom in heavy labor. How can you tell where a she is? 

Remembering that everything is merely a guideline, I find women get deeper and deeper into themselves the further they move towards delivery. When women are unable to communicate anymore… unable to answer even simple questions, they are moving beautifully towards meeting their baby. We are so used to offering choices to each other, family members and even doulas will ask, “Do you want some water? Juice?” “Do you need to go to the bathroom?” Instead, offer a sip or take mom for a walk. When we ask a question, it pulls mom back to the real world when she should be permitted to stay inside her bubble of labor energy.

So, your mom is now in that incommunicative place and then she begins talking again, telling you she can’t do this anymore, that she’s so, so tired, she just wants to sleep. 

This is the time to throw a party! (Not literally.) She is on the cusp of pushing when she says these statements. Women do not need to be taken to the hospital or given an epidural during this time, they need to be supported, encouraged that they are almost finished. I find that telling them they will be able to sleep once the baby’s born, his body cradled against hers, helps women keep going. 

When we watched Lynsee give birth live on the Internet back in November 2009, many natural birth supporters, myself included, were terribly dismayed when she got to that point, reaching out and asking for help, telling her providers she just couldn’t do it anymore. Instead of looking her in the eye, staying with her while she rode the wild waves, touching her, letting her squeeze their hands… instead of this type of non-interventive, but extremely important support, Lynsee was whisked out of the tub she was in and nearly thrown onto the bed in the fetal position so the anesthesiologist could get at her spine. Before we could even type, “STOP! You’re doing great!” to her, she was numbed from the waist down, at 8 centimeters, and her dreamy hormones abated, she then able to chat and laugh as if she wasn’t even in labor anymore. 

I wish I could show pregnant women the difference, how Lynsee was moaning beautifully, somewhat scared, but reassured with tender words and hand-holding versus her demeanor after the epidural. All ethereal qualities vanish with an epidural. 

As women come through the last of her uterus’ dilation, after she believes you that she can do it and doesn’t moan, “I can’t” anymore, watch… many women’s contractions start to spread out (not slow down as some would describe it), she being able to rest more inbetween contractions. (Not all women have this happen! Don’t teach/counsel women that this will occur; it very well may not.) I have often heard women snoring softly at this point. Do NOT, under any circumstances, tell a woman she is snoring and try to keep anyone else from saying it. Women can be humiliated knowing they snore. And, most women would argue with you that she did not even go to sleep, so how could she possibly be snoring? 

Watch for this subtle spreading out of contractions and listen carefully as mom begins the slight Nnnnn of the beginnings of pushing. It really takes a learned ear to catch the earliest nudgings, but it gets easier with time. It is not hard to notice when she begins the familiar “catch” at the height of the contraction. By that time, she has been moving from first to second stage… not a solid shift, but a more fluid evolution from pregnant to birthing. 

When women have vaginal exams, this can be a time when she’s 9 to 9+ centimeters dilated. Sometimes there is moulding of the baby’s head, part of the skull crossing over itself and pushing downward before she is dilated completely. So if she isn’t pushing full of gusto, she, most likely isn’t complete. 

There was a recent discussion about cervical lips. This is my take on them. I believe (and have never read proof) that the cervix does not dilate in a spherical fashion, but more on a rolling opening, the left side being 7, the right being 7+… the top being 5, the bottom being 4. I believe this because, when a mom is moving around, the head and the pelvis are in a state of flux, adjusting each other and themselves so the head can get into a great position to birth. Especially when a mom is in bed, we see the cervix dilating at odds with itself, often having to turn her from side to side to get each side even with the other. 

I believe that a cervical lip is merely the last stage of a woman dilating unevenly (but correctly) and if we didn’t have our fingers in there, we would never know there was a lip. 

Now, I’ve felt my share of cervical lips, so don’t get me wrong that I think all lips would be avoided with no exams, but I feel they are over-“diagnosed” and we’d be better letting the woman work through the end of her labor on her own. 

So, when she’s doing the small Nnnnn’s, I believe she’s dilating that last little bit, some of the head already without cervix and nudging downward while the other side still working to eliminate the rest of it. Once she is complete, the pushing tends to begin in earnest. 

When we don’t do vaginal exams on second and subsequent birthing women, especially when they’ve previously birthed in the hospital, the question invariable comes up: “How will I know when I’m 10 centimeters?” My answer is: “You’ll know.” Women rarely miss the pushing phase.

(Pushing & the Birth of the Placenta next.)

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Reader Comments (39)

Okay LOVING this. Loving.

January 20, 2010 | Unregistered CommenterSabrina

Nice. Thanks Barb. I have a sniffer too :~) You explained that part so well..."it isn’t a scent on the woman, but a scent that comes from a woman." And I am so glad that you mentioned that some women have (that smell) and some women don't. I was wondering if it was me that missed that cue at some births. Hugs, R

January 20, 2010 | Unregistered Commenterrosie peterson

This is fabulous Barbara! Thank you for sharing your wisdom, I will be sharing this with my childbirth class students when I talk about labor. I also smell the "scents" of birth, it totally draws you in. Maybe we are ingesting sometype of hormonal milleau that affects us all at the birth.....

January 20, 2010 | Unregistered CommenterKimberly Durdin

A wonderful piece! Interesting to hear more in detail on what the labors look like as they progress, especially in light of my own recent experience with natural birth. :)

I was still in the moment and talkative right up until about 45 mins before the birth. As long as I was in the tub, I was fine. Once I got out and transition hit full force along with gravity, the talking and laughing between contractions stopped pretty quick! Lol. Still, I'm surprised it took that long for me to get to that point mentally. (And the rest of active labor was only a few short hours so for me at least, it was no hold up)

Looking forward to the next bit. :)

January 20, 2010 | Unregistered CommenterStassja

I loved this post - especially the psychology of it - have you read Raphael-Leff???

January 20, 2010 | Unregistered CommenterLiz

I absolutely LOVE the power of birth!! You have described so many different senses and observations of birth in such an exquisite way.

January 20, 2010 | Unregistered Commenteratyourcervix

Love this! Can't wait to devour this blog!

January 20, 2010 | Unregistered CommenterSherry Rothwell

This is my favorite teaching blog thus far! So neat you mention scent. I went to help clean up birthing things after a friend of mine transferred to the hospital. I went into her bedroom and ran into the wall that was the scent of her birthing. It was such a neat experience. The smell made me so charged and excited at the thought that she had been there birthing her baby, and the scent was the most prominent evidence left. I thought it was so obvious, but when I made mention of it to her parents they didn't really know what I was talking about, and I got to thinking it was just in my head! Thanks for letting me know it wasn't!

January 20, 2010 | Unregistered CommenterAubrey

Thanks so much for these photos and essays you've been doing lately - they are so helpful!!! I have had two homebirths and have noticed many of the things you mentioned.

With my first baby, I never noticed the difference between dilation/pushing stages. With my second, I could tell the exact second when dilation changed to pushing. My doula said she noticed that moment as well. It's easier to tell things with #2!

Also, I did my own vaginal checks with #2, and I noticed that there was a thin rim of cervix during pushing, but it didn't impede 2nd stage one bit. I don't know if that was considered a "lip" or not, but the pushing stage definitely arrived before I was 100% dilated.

Love your blog... Please keep writing! Love it!

January 20, 2010 | Unregistered CommenterDiana J.

It's interesting, you all talking about the blog as a teaching blog. I'm just along for the ride of my mind and right now I am terrified of dying without sharing my knowledge first. I know that sounds all arrogant and whatnot, but my state of mind has been thinking about what happens when we die. Of course, the terrifying events around the world haven't helped (which is why my Psychiatrist told me to STOP watching the news).

Scanning, I keep finding random pics of things I've seen over the years, so am sharing them as they come up. This post came about because I was talking to someone about how to tell where a woman is in labor without a vaginal exam and voila! this post is what was born.

Writing is so amazing sometimes, and so confusing. But, I keep putting pen to paper (so to speak) and writing what flows through my mind. I'm very thankful and thrilled you are finding something good in the words.

January 20, 2010 | Registered CommenterNavelgazing Midwife

I have very fast, very painless labors until literally pushing. I'm not in "labor land" until pushing with most of my babies, with the exception being my 11 lber where I hit labor land somewhere in that last centimeter of dilation. My 11 lber took a while, but my other births have been as short as 2 hours labor duration.

I'm enough myself that it's actually a very odd experience to be in labor. Maybe it's that I naturally tend to be a very reflective person so me in labor is virtually indiscernible from me not in labor personality wise, but the biggest discomfort I have in labor is knowing that I do NOT fit with what "laboring woman" is "supposed" to look like. I always feel like a watched pot because I don't look any different during contractions and the midwife and assistant are always looking at me to see if I'm contracting regularly enough, and I almost feel embarrassed saying that I have to push.

I think your post is really good as a general "see? Labor progression in normal, unmedicated moms" post. It's just also really weird to be "the lady who never looks like she's in labor." If I hadn't checked my own cervix with baby #3 in particular, I would not have called the midwife until literally pushing.

January 20, 2010 | Unregistered CommenterJHolmes

I find that I am able to maintain a mostly positive outlook on life by NOT watching the news or reading the paper. Of course, I do not have any depressive tendencies. I find that most news sources are all about fear-mongering which can be difficult to resist for the sunniest of people.

And yes, I find this blog educational and interesting.

January 20, 2010 | Unregistered CommenterJen

Nice post, but please, how about an alternative word to "whiny?"

January 21, 2010 | Unregistered Commentersara

Maybe I shouldn't be reading this since I'm one of those logical mothers at 40 weeks today...but I found it to be very insightful. I know that I can be an overly modest/self conscious person and I'm hoping to be able to overcome that obstacle when in labor without too much overthinking. Since I'm stuck in a hospital birth at this point I'm really hoping that I'll be allowed by providers to find laborland and stay there without distraction!

January 21, 2010 | Unregistered Commentersara

I'm a Psychology student and will be graduating this year. I'll be going off to get my Masters and I find that your point of view on the psychology of birth pretty amazing. I think that would be a great study to do and I hope I am part of that team when it happens.

Thank you Barb for all of the wonderful posts you do. I met you in San Diego at one of your mother's day at your office. Your demeanor and how you interacted and the stories you had were wonderful and I'm so grateful that you are willing to share your knowledge with everyone!

January 21, 2010 | Unregistered CommenterAmanda

Sara: 1st - Good luck on your birth. DON'T THINK! ;)

2nd - What word would you suggest besides whiny? It's very descriptive. Describes me to a T - and many other women, too. It's a word like "fat"; one that some women find offensive, but others relate to really well. I think women who are whiny know they are.

And I *do* say there's nothing wrong with it. It's just a different way of communication.

January 21, 2010 | Registered CommenterNavelgazing Midwife

I delivered my first baby naturally just three weeks ago. Reading this helps me to remember, tells me where I was (and where I was not). Can't wait to keep reading.

January 21, 2010 | Unregistered CommenterLacy

Congratulations, Lacy!

January 21, 2010 | Registered CommenterNavelgazing Midwife

Fabulous Barb! I love this post. As a labor nurse then CNM, it took me a a couple of years to figure these behaviors out. I knew what I had read but where I worked as a labor nurse, rarely saw natural childbirthing. I learned lots of thoery in graduate school about labor and birth but didn't get to really know it in a visceral way until I was working as a CNM. I have discovered so much about birth, trusting birth, etc. in the past couple of years. I love to be able to educate nursing staff now on why it isn't necessary to do a vaginal exam every two hours. I was always taught to only do one if it would change my management - and I think that's good advice as well.

January 21, 2010 | Unregistered CommenterTiffany

I have found a similar pattern to what you describe in my own births.
up until about 4cm I am chatty and alert between contractions. From 4-8 I am deep in laborland and good luck getting me to talk, answer questions, respond at all. From 8-10 I get very active and can't find a position to stay in, and fairly vocal and start pushing (grandmultip here, I always start pushing well before 10) once I am complete and baby is moving down it is like a light goes on. I am 'back' and chatty and alert between contractions. This has been my pattern for a good 6 births now. I remain chatty and 'up' until hours after the birth.

January 21, 2010 | Unregistered CommenterKaren

LOVE, LOVE, LOVE this information. Keep up the fantastic posting Barbara!!!

Diana :)

January 21, 2010 | Unregistered CommenterDiana Hurwitz

This was pretty neat to compare with my own labor (at least, what I remember from my perspective).

I was hardly making any progress for a long time despite what looked like monster pitocin contractions on the monitor (and what felt like monster contractions to me!), and I think my midwife was getting a little worried though she was trying to be encouraging.

Then she had me lie on my left side for a while, and when she checked me after that while, I was, as you would say, very gloppy. She got really excited, and my husband asked what it meant, and she said "It means she's changing" in an almost giddy voice.

January 22, 2010 | Unregistered Commenterchingona

I just couldn't let this go, sorry, I really tried. You said "she was numb from the waist down and talking and laughing like she wasn't even in labor". Why the indignant tone? Because she chose what she felt she needed to do, regardless of what others thought?

This is a sore spot with me. I was basically coerced into a "natural" birth by a labor nurse who put her beliefs before mine. I requested an epidural several times, only to be told "the anesthesiologist is busy, he will be here soon". Only to find out later he was RIGHT THERE ON THE FLOOR. When I cornered her about it later, she said......I knew you would do fine without it. That's not the point. It's not what she knew, I didn't ask her. And before you ask. I hated it, every last second.

I realize some women want unmedicated births, and I respect that. But why is it so hard to accept that some women do NOT want that? We all have to do what we feel is right............don't we?

January 25, 2010 | Unregistered CommenterRose

I do not EVER have an issue with a mom choosing an epidural, so the interpretation of the piece is your own, not in my wording. I have suggested epidurals when I see a mom suffering and think it is abhorrant that a midwife denied you one. I would have been shocked if you said you were glad she did.

Your experience is important to share, though, so I appreciate your writing it out for us to read and learn from.

January 27, 2010 | Registered CommenterNavelgazing Midwife

Rose, it's one thing to not have an epidural because it's actually not available, but to be denied because the HCP thought you didn't need one? That is so not her place to judge and inappropriate as well. I hope that you followed up with letters to the head of the nursing department and possibly the hospital as well.

I am a proponent of natural birth - for me. I think that every woman could probably give birth without an epidural with proper education, nutrition, exercise, mindset - if she's willing. But I see no reason for a woman to be denied an epidural esp. if she's gone through her whole pregnancy wanting to have one.

January 29, 2010 | Unregistered CommenterJen

Reading what you said (so beautifully, BTW!) about scent is so affirming to this new doula! Since birth #2 or 3 I've noticed my own primal reaction (more energy and quiet focus) to the scent. Now I look forward to it when I'm at a birth. In births that are progressing well for the mother, it always seems to come just when I start to feel doubt and worry. Just amazing. Thank you for saying what you did!

February 12, 2010 | Unregistered CommenterVanessa

I had to respond again with an update about my birth- I posted saying that I was 40 weeks on Jan 21st- as it was I went into labor at 11:45 that night and my daughter was born at 4:56 am! I have really appreciated the information I've read on this blog, but I seem to have skipped over several stages of labor, haha. I had about 2 hours of mild contractions (read my books on labor, decided that I had hours to go), followed by some labor in the shower and tub for about an hour, and then BAM! contractions were coming super fast and then I felt the urge to push. I was like nothing I had read!
The good part is that we were hardly at the hospital- she was born 19 minutes after arriving. I got to pull her out and hold her while the cord pulsed :) It was pretty awesome. Next time we're doing a home birth for sure- the only annoying part was having to go to the hospital and feel like control was taken away. I can't imagine being there longer!

March 6, 2010 | Unregistered CommenterSara

Fabulous article! I'm a birth doula and I'm very familiar with the scent you mention. I usually notice it right before a baby is about to be born, towards the end of the 2nd stage. At first I found it mildly unpleasant; now I welcome it as I associate it with the birth of a new being! Most people I've asked describe it as an unpleasant odor so my personal theory is that this is a pheromone released to repel predators.

March 7, 2010 | Unregistered CommenterJen C.

I'm currently training to become a labour doula and this article really took me back to my daughter's birth -- I absolutely remember the smell and that 'nnnnnnnnn' sound that I made before starting to push. Beautifully written -- thank you!

March 17, 2010 | Unregistered CommenterDesiree Fawn

I am a birth doula and I have had fathers tell me they don't like the smell of birth. Women seem to like it and it always reminds me of my own births, a welcoming, warm, nurturing feeling. I always thought the smell came from the vagina, but I will take notice of it more from here out.

June 21, 2010 | Unregistered CommenterDebbieM

I just discovered your writings. Thank you! The way you explain resonates with me and I will be returning to read more. :)

November 22, 2010 | Unregistered CommenterNicole

Wow, how cruel. Now we're divided into "whiny" women, and women who stomp around with boots in labour? You make me never want to see a Doula, because now I am well aware how acutely you judge us lowly laboring folk. Seriously, you did not do yourself any favors with this nonsense. I have birthed 3 children, the first I arrived at the hospital in transition, and yes, I did request an epidural (I was 19). My second (at 21), I was *determined* to make it through, and was quiet, (but probably moaned a little bit), walked, bathed, and did my damndest to make it through labor.....nope, requested another epidural during transition....I couldn't take it, and believe me, I WANTED to. My last, again....made it to transition (but there were several other complications too, possible c-section due to such severe heart decelerations because of a wrapped cord). I am positive no one that I invited for my births would describe me as "whiny". Wow, have you shamed women with your condescending and unrealistic descriptions. Guess what? Unless YOU are the one in labour, the one feeling and describing it, and sharing it with everyone else.....you don't GET to judge how other people give birth. Totally disgusted with what I have read here. Shame on you.

"In my experience, dramatic women tend to whine. “It huuurrrrts.” “Make it stop.” “I hate this.” This isn’t the “I can’t do this anymore” of transition (and we’ll get back to this in a few), but a whiny, negative attitude right from the beginning. It would seem counter-intuitive that this type of woman would choose a homebirth where anesthesia isn’t an option, but she gets a different type of attention from a midwife; more motherly than what she perceives the hospital to be… punitive. The psychology of birth is absolutely fascinating and I hope someone explores the dynamics, the relationships, the motivations and resolutions someday.

Whiny women take longer to get into the labor high, being so in their heads, it can be a challenge for them to let go enough to be swept up into labor’s current. When she does, amazingly, she stops whining, but usually becomes very introspective and often moans very softly, whereas other women might be loud vocalizers.

I picture dramatic women as stomping around loudly, boots making all kinds of ruckus. It takes purpose to lift the legs up and clomp them down, but it’s worth it to have someone pay attention to her. Movements are sweeping, large and abrupt. As labor moves her deeper, she takes the boots off and slides softly across the floor, her movements closer to her body, her voice singing mostly to herself. (I hope this makes some sort of sense.) "

April 2, 2011 | Unregistered CommenterRachel

Rachel, not sure how you missed it, but perhaps you didn't read the other comments? There is *zero* negativity meant when describing women in labor. The word whiny is no different than using the word fat... they're adjectives, nothing more.

Having a baby @ the moment, so can't elaborate yet, but will tomorrow. Didn't want to let this sit, though.

Shame on me? Nahhh. Not this time.

April 2, 2011 | Registered CommenterNavelgazing Midwife

Back from a successful VBAC (yay!), so have more time to answer now.

It's always so interesting how some people interpret what I (and others) write sooooo differently than the intention. If it happened all the time, I would totally think I had some serious communication issues to work on, but they aren't all the time. The confusion pops up out of nowhere and what I've written jabs into some serious nerves, like they did to yours, Rachel.

I promise, there was nothing but love in my "voice" as I wrote this piece. I'm sorry you "heard" it differently, obviously as if I'd been mocking women in labor, but I assure you, that is so not the case. I have nothing but the utmost respect and love for birthing women and their samenesses or differences are equally magnificent in my eyes.

I hope you're able to translate the piece using the angle I'm coming from, not the angle you initially heard.

April 2, 2011 | Registered CommenterNavelgazing Midwife

I am curious as to whether the scent that you smell could have anything to do with the scent that a woman's nipples are supposed to smell like after birth to facilitate the breast crawl.

July 5, 2011 | Unregistered CommenterSydney

Oh, that's not something I ever thought about! I wonder, too. Hmmm.

July 5, 2011 | Registered CommenterNavelgazing Midwife

Absolutely Wonderful read! Start to finish!
Love this!

August 15, 2011 | Unregistered CommenterAngela Hawk

Hi. I am a student midwife from Australia. I have always been in tune with a woman in labour and had a natural unexplainable way of recognising all of the behaviours, signs and smells that you have discussed here. I remember asking one of my supervising midwife's during a birth when I first started if that 'smell' I was picking up on was a usual scent of a labouring woman and they said they have never heard of it, or could they small anything so to read that it does exist has been very exciting for me. There are so many things, sight smell and sounds, that I recognise but can't explain how, and have been able to use them to support a woman through her labour. Thankyou so much and I am loving your blog. xxx

March 10, 2012 | Unregistered CommenterDannielle McCarthy

I had two home births. I noticed a really unique smell, but this is the first time I have read about it. I want to share with you... Soonish after the birth of my first child my husband was getting into the shower (his first since baby was born) I moved in for a snuggle and he had the same smell, very noticeable. I sniffed right into his armpits, and it was unmistakable. I remember musing that maybe because we had had such an undisturbed experience that his hormones/pheromones had been able to develop too.

October 26, 2012 | Unregistered CommenterPene

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