Judging Progress in Labor

Traditional methods for judging the progress of labor depend on measurements of the baby's position in the pelvis and the condition of the cervix. The theory is that by recognizing "how far" you are physically in the process of dilation and effacement an accurate gauge of "how far" you have to go can be determined.

The theory holds that "normal" progress in labor is for a woman to dilate 1 centimeter an hour after she reaches four centimeters. This is considered normal because statistics tell us that this is the average change in dilation over time.

However, a problem exists in the determining of "averages" for labor. Simply knowing that for a group of women, the average dilation increased over time doesn't tell us anything about the actual labor patterns any of the women experienced.

In about 50% of all natural labors (labors that have not been altered by medications to speed them up or that slow them down), dilation does not follow a straight line but rather a gentle slope with a plateau, then a sudden cliff at the end.

Even though dilation is not increasing during this plateau, the labor is still progressing. It is important to remember that your body is doing more work than just dilating a cervix.

Another method for measuring progress is contraction timing. Women are frequently told that contractions 5 minutes apart means that they are in active labor and should go to the hospital. However, this doesn't take into account that some women begin their labors with contractions less than five minutes apart.

The most accurate way to judge the progress of labor is by using the emotional map. This method uses the common changes in mothers behavior, physical sensations and emotional state as markers for progress in labor. This works because every woman will go through some of these markers. When combined with information such as length of labor and contraction pattern during the labor, you will begin to recognize where the mother is in the labor process.

Follow the links to understand the behavioral, physical and emotional markers of each of the stages of labor, common obstacles at each of the stages, and how to overcome those obstacles.