Physiologic Labor

Active Labor

Eventually, the contractions that you have been experiencing will become stronger and more intense. You will also find the contractions are getting closer together and lasting longer. When this happens, you will have moved into active labor. During this time your body is opening the cervix so the baby can move into the birth canal (vagina). At this point your body is also preparing for your baby to be born by stretching the pelvis, preparing the colostrum and stimulating the baby's nervous and respiratory systems.

Recognizing Active Labor

Emotionally, you will recognize active labor by a more serious constitution. Rather than excitedly wondering "Is this it?" you will have accepted that this is labor and you will be working with your contractions. At this point you will also notice that your contractions are demanding more and more of your attention. As they demand more of you, you will find your demeanor getting more and more serious. Eventually you may even be at the point that moving between contractions is uncomfortable and difficult to manage.

These are normal physical reactions to labor. As your body works harder to contract the uterus, you will naturally spend less energy on "non-labor" activities such as moving and talking. You will also find that your hunger naturally disappears so your body will not waste energy trying to digest food. For most women, the increased focus it takes to labor also prevents them from being concerned with societal norms leading to a decrease in modesty and the pleasantries of conversation.

You may find that as contractions begin to build in intensity, you are able to simply relax your abdomen or relax only at the peak of the contraction. As the contractions progress, you will also progress in your handling of them going from relaxing only your abdomen to relaxing your whole body until eventually the contraction is demanding your complete attention through the whole contraction.

You will find that not only does your attention change as labor progresses, but you will find that your hunger begins to subside until you have no desire for food. This is a normal process that occurs as your body begins to divert all its energy into contracting the uterine muscle. If you do not have a desire to eat, simply don't eat. However, you need to continue drinking water to remain hydrated during labor. Your support persons should offer you sips of water between contractions when you get to the point that you are not paying attention any more.

You will also find that as your contractions become more intense, your modesty decreases. Again, this is a normal process that occurs to almost every woman in labor. The woman who is horrified at the thought of exposing herself to a doctor and a nurse will begin to not care who sees her. She may get to the point that she seems to not notice she is naked at all.

Your desire to talk will probably lessen as your contractions get stronger. You may begin by merely not wanting to talk during the peak of the contraction, and move on to not wanting to talk during the entire contraction. Some women even get to the point that they do not want to talk or be talked to between contractions.

All these changes will happen on a continuum, it is very rarely that a woman jumps from completely excited and talkative to completely serious and quiet. As you progress through these changes, your contractions will continue to get stronger, longer and closer together until at last you have reached transition.

By keeping track of the behaviors, the physical signs (loss of hunger, loss of modesty and deliberate movement), and the emotional signs (focusing, decreasing talkativeness, decreasing humor) you can get a pretty good estimate of "how far" into labor the mother is.

It is important to note though, that not every mother will respond in the same way or with the same behaviors and signs. Some mothers do continue to talk throughout labor, some mothers do not make noise, some mothers focus on contractions very early in labor. As you use these markers of progress you must look at the total picture of the laboring mother, not simply one marker or behavior.

Managing Active Labor

During active labor, mothers find that changing their activity and position as desired helps them to remain comfortable. This may be due to two factors. First, it prevents over stressing one or two muscle groups by varying the way you hold your body. Secondly, it allows you to respond to changes in the way your body feels, which may be caused by the movement of the baby through the pelvis.

Although the desire for food may disappear, it is important to stay well hydrated. Dehydration will decrease the amount of work your muscles are able to do with each contraction, and it will decrease your ability to handle the stress and contractions.

Some women find that making noise, called vocalization, with contractions helps to keep them relaxed during the contractions. Many women also find that tuning out the world around them, sometimes called "going inside yourself," helps them to stay relaxed and handle contractions more effectively.

Most women will develop some form of pattern or ritual during active labor. This means that she will repeat the same responses to contractions for several contractions in a row. An example of a ritual may be walking in a circle between contractions; as the contraction begins she takes a deep breath and begins to moan; she leans over on her support person until the contraction is done; then she walks in a circle again until the next contraction begins. There appears to be some comfort in repeating what worked from the previous contraction.