Posted by My OB said WHAT?!?.
Jul
25
Posted by My OB said WHAT?!?.
“Up Until Now, You Weren’t *Really* In Labor.”
“Up until now, you weren’t *really* in labor.” -L&D Nurse to mother who had been laboring with slow progression for about 12 hours.
There are 27 comments to this post.
LeedleFishy had this to say,
Jul 25, 2010 @ 4:19 pm (Quote)
“Ok! So we’ll just start the clock now, and you won’t have to worry about me laboring too long. Good to know you won’t rush me into a C-section! …unless you decide this isn’t really labor, either, and label me with Failure to Progress?”
My goodness. It’s always something, isn’t it?
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beccaisadoula had this to say,
Jul 25, 2010 @ 4:25 pm (Quote)
I don’t see the point in her stating this. Seriously, why say something like that? It just distances you from the birthing mother and makes you look like an insensitive jerk.
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Sarah Dorrance-Minch had this to say,
Jul 25, 2010 @ 4:26 pm (Quote)
Translation: “It’s not labour until I say it is, and I’m the expert. If you’re not writhing in pain and screaming for an epidural, you’re wasting bed space and giving me an added burden of paperwork and visitation, you little princess. I can’t wait until the Pit gets cranked up. That’s what we do to patients who come in here too early and give us extra work.”
Am I being too cynical? 
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I am confused, out of my 60 hour labour, how long was I not in labour for? Because the conx were too close & too painful to sleep that whole time. & I had to breathe through them. Oh right, I was in labour for 60 hours, b/c that is what I was told in the end when they said “you have been in labour for 60 hours & haven’t had this baby yet so you probably won’t be able to have it naturally. I recommend c/s” funny how the rules change isn’t it?
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Elise Reply:
July 26th, 2010 at 7:57 am (Quote)
well, I see the point I must say. A woman is in labor when she has painful regular cx, 100% effacement of the cervix and at least one cm. But if this woman was not in labor, why admit her to L&D then? Some women have very painful prodromal cx, but it is not labor. The distinction is very important. And if a woman has such a painful prodromal phase she should be offerd something for the pain and to sleep on so she is not exhausted by the time labor starts. If you had been treated according to proactive supprot of labor (www.proactivesupportoflabor.com) you would not have had a 60 hours ordeal. I cannot recommend this book too much.
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factchecker Reply:
July 26th, 2010 at 9:17 am (Quote)
I don’t know where you are getting your information about the definition of labor, but labor is defined as progressive cervical change. You can have cervical change without having painful, regular contractions and you can have cervical change without being completely effaced.
Latent phase of labor: 0-4 cms dilation (some women can have a very long latent phase of labor, but it’s still labor!)
Active phase of labor: 4-10 cms dilation
It’s true that women can have prodromal labor – that’s when they are contracting without cervical change.
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Funny, they never count my labor until I go to the hospital. They think I have “precipitous labor” but I will often labor at home all day/night before going in. So if I am at the hospital for 2 hours before the baby is born, I will have been in labor for at least 10-12 hours before.
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This was mine, said by a nurse at a hospital birthing center. I had been having contractions 3-5 minutes apart for about 12 hours at that point. I was dealing very well with the contractions on my own (that is, with a birthing ball, relaxation techniques, and my husband’s help), but I was certainly in labor! My contractions had stopped for maybe half an hour, then suddenly picked back up with increased strength and frequency, which I commented on, prompting her dismissive remark. She checked me then (next time, no checks during labor!) and told me I still had “hours to go”, it was already maybe 1am and over 24 hours after my water had broken, so I asked to be transferred from the birthing center to the hospital next door, so I could get an epidural and some rest. I know now that I was entering transition, and wouldn’t have asked to transfer if I had known this at the time. She made me sign the transfer papers and get dressed again while I was doubled over with pain, as I wasn’t getting any break between the strong contractions. No compassion, just rush, rush, rush, probably so she could go home, as no one stayed at the birthing center when there wasn’t a laboring mother there, and I was the only one there at that time. The baby was born at the hospital shortly thereafter; I was pushing before they could even give me their admission papers or do any exam themselves, the doctor wouldn’t have even made it if he hadn’t been right down the hall. At least I got my pain-med free birth!
Speaking to the nurses, and the doctor, they still refused to believe I was in transition at the point of transfer, because, again, I “wasn’t dilated enough” and “it’s just not possible”. I really don’t think there’s any mistaking transition, especially when a mother has been dealing with contractions so well previously, and suddenly is begging for relief. But no, that was just me entering ‘real’ labor, I guess.
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Bonita Reply:
July 25th, 2010 at 5:09 pm (Quote)
Yeah, there is no mistaking transition when you hit it. I’m sorry you had to go through all that. 
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Your Name Reply:
July 25th, 2010 at 6:01 pm (Quote)
Yeah we were wandering around the cemetery (midwives recommendation as it was quiet and no one would stare LOL) when I suddenly looked at my husband and said “we NEED to go back now” little guy was born 3 hours later. Labor was nothing up until that point. Sorry to hear that nurse was so horrible, but glad you got the birth you wanted despite her 
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Umm Abdullah Reply:
July 26th, 2010 at 5:53 am (Quote)
Wow, thats a great idea! I will have to remember that, laboring in the cemetery, awesome!
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qtberryhead Reply:
July 25th, 2010 at 6:11 pm (Quote)
I swear that medical attendees must get amnesia between births, because I have been able to identify transition THROUGH IM just from what a mom says. I’ve also seen a mom go from a 6 to a 10 in under 60 seconds and I have yet to figure out why people don’t just pay attention to physical cues and give mom the benefit of the doubt. Oh, and babies arrive when they decide to, not when someone decides it’s “time”.
Thank God you made it to the hospital so that you could get the go ahead to birth your baby. Hahaha!
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Jenny Reply:
July 25th, 2010 at 6:37 pm (Quote)
How ugly of her to treat you that way! I also had negative experiences with dilation checks during my hospital birth. It not only discouraged me, I think it also caused me to undilate. It was a long, hard labor with an epidural I had tried to avoid.
I had a homebirth the second time and never got checked–in pregnancy or in labor. My midwife could tell where I was by looking for emotional signposts, and when I needed to push, my body knew it! It resulted in a calm, beautiful waterbirth–and it didn’t take very long either! I’m never getting “checked” again.
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Brenda Reply:
July 25th, 2010 at 8:36 pm (Quote)
Not only were the dilation checks painful and discouraging- I believe they caused my son’s pneumonia when he was born. My waters had broken before labor had started, and they actually scolded me for waiting until the next morning to inform them and insisted I come in right then. Its ridiculous to me that they would be so concerned about infection with my waters being broken, and still insist on so many invasive checks.
I’m so glad your 2nd birth went so much better!
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Mama Mirage Reply:
July 25th, 2010 at 6:39 pm (Quote)
You poor mama! Ugh some people… I went from a 6 to a 9 in about 20 minutes. It’s stupid how they have to go and discourage moms like that. It has nothing to with time.
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Susan Reply:
July 25th, 2010 at 11:30 pm (Quote)
I can somewhat relate. When I finally consented to a check with my son, I was at 3cm and gave in to pethadine (demerol, for those in the US). I was at transition, and pushing 30-40 minutes after the injection, but of course was too tired to do much then. My son was back-to-back, and I was on my back, and the mw didn’t suggest a different position, just told another mw that I wasn’t pushing (she didn’t talk to me except to yell “Push!”), and so I ended up with a ventouse delivery.
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Brenda Reply:
July 26th, 2010 at 5:31 pm (Quote)
What an awful way to treat someone! I’m so sorry that mw was such a beast to you.
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Susan Reply:
July 26th, 2010 at 10:27 pm (Quote)
Thus why I chose a home birth for my daughter (also chose that because of fast labour & not wanting to have to find care for my son). My home birth midwives were awesome and were quite happy to not do any checks. They could tell over the phone what stage I was in, and one was concerned she wouldn’t make it in time. She arrived just a little bit before I started pushing.
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Aron Reply:
July 26th, 2010 at 6:35 am (Quote)
As a doula, I’ve been able to accurately recognize transition every single time, obviously without any vaginal exams. It’s so frustrating to know what’s happening and watch a mom’s confidence be sabotaged by a stupid number after a pointless exam. It’s also nearly impossible to rebuild the mom’s confidence in herself once she’s been smacked with the “no progress – hours to go” prediction. Infuriating!
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This pretty much happened to me with my last birth. It was a homebirth, so you wouldn’t think to expect comments like that, but I guess you never know. I had been in labor for something like 34 hours and was MISERABLE. I was checked at 11 pm the night before and was 4 cm. It was 2 pm and I had just found out that I was STILL 4 cm, even though I’d felt like I was in transition since 6 am. I totally lost it, and said that I was D.O.N.E. and wanted to go to the hospital. The birth team (midwife plus 3 apprentices) went to the other room and talked and came back and one of the apprentices gave me my “options.” She said they wanted me to spend an hour going up and down the stairs, squatting, and basically being upright with no rest…or I could just go to bed and everyone could leave and I was “never in labor.” WTH??? If I hadn’t been an emotional wreck at the time, I would have told her to shut up and leave, because I didn’t need people there that didn’t even believe I was in labor. And if she thought that would magically stop my contractions, then have at it.
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This is a very normal labor pattern for many moms, regular painful contractions for hours and then BAM mom dilates quickly from 0 to complete. The same thing happened with my two vag births, ESP notable with my last one where I had light contractions every 10-15 min for 15 hours, then 3 hours of hard contractions same spacing and then went active and dilated fast (basically like one long transition!). I arrived at the hospital at 7 and was pushing within an hour. It’s such a crying shame more hospital practitioners don’t know what natural unaugmented/induced labor looks like. Dilation isn’t steady progression sometimes (often!) and that’s just fine and normal!!!
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ACOG defines the term trial of labor as a trial of labor in women who have had a previous cesarean delivery, regardless of outcome. Also, the term vaginal birth after cesarean delivery is used to denote a vaginal delivery after a trial of labor.
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It’s called prodromal labor. For those experiencing it, it’s REAL. Sheez.
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Knitted in the Womb Reply:
July 26th, 2010 at 7:12 pm Knitted in the Womb(Quote)
I agree! I HATE when care providers say that prodromal labor isn’t “really” labor.
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