Assessment of Labor


To try and put any type of assessment on labor is limiting the vast realm of differences labor can be for each mother, and each pregnancy.  There are so. many. factors. that play into our labor experiences it really is impossible to do so... and yet, we still try.  One of the most significant restraints we've given to birth is the Friedman's curve based on poor research and the belief of control.  Because of this curve, we've also separated birth into 3 stages, which further reduces our ability to see labor as the intricate, emotional, transition that it is for the family.  This causes us to believe that anything happening prior to stage 1 is false, and that all the major events happening (like the baby's transition to breathing, physiological needs of breastfeeding, and the emotional changes of postpartum) after the placenta is birthed as less than significant.

I even find myself talking about the stages of labor, with little belief in this description, because of such a cultural stigma.  I try to refocus my students on the important aspects of the labor experience, and the questions always arise about dilation, effacement, labor length, pain, and the fundamental belief that labor is something that it is not.  The difficult part is that many couples asking these questions have providers using these descriptions and cannot move away from the years of misinformation surrounding birth, and hold on to the numbers and assessment tools of modern medicine.

The following is an illustration that depicts the transition of labor as it relates more to the emotional aspects of the mother and her environment (and a comparison to Friedman's curve).  As mammals, we are responsive to our instincts and surroundings (whether we want to be or not).  We are subconsciously affected by scents, feelings, visions, and all other aspects of intuition.  Our culture, however, teaches us to not listen to our instincts, but read books instead.  While this can prove beneficial, it rarely allows us to tap into our biological knowledge of our bodies and overall health and wellness.

EB Labor Progression

Look at this diagram, and think about how your birth choices influence this transition.  Think about how smooth this change can occur, and how your environment will play a direct role in the length of your birth.  Think about how birth is not a specific pattern, but a transition from finding safety, obtaining safety, finding power within, embracing our power, and once again seeking safety.  Most of the changes within the birth environment occur when we are calmed by our environment and subconsciously encouraged to progress.  Our emotions are one of the most significant driving forces behind pregnancy, birth, and postpartum.  For so long, fathers have been either left out or forced into the support role of birth when what mother really needs is his biological tendencies for protection.  For so long, we've believed a few lines on a piece of paper will - or should - give us the birth we desire, without making the choices that support our biology.  For so long, we've tried to control birth, not only in a way that doesn't take into account our emotional connection to our physiology, but also the thought that nature doesn't know best.  We've done this so much that women are seeking unassisted births because of the fear of the environments (routines, procedures, and personalities) forced onto their childbirth experience.  We've done this so much that the significant transformation of the mother isn't occuring, bonding is decreased, and health is compromised in both the mother and the baby.

How has the modern approach to birth affected your beliefs about this transition?  Did your birth class enhance this belief, or try to dispel myths?