My Client’s Body is Broken

My Client’s Body is Broken

It happens all the time in doula forums. A doula comes to the group and is desperate for ways to help make a client’s labor efficient. The breakdown goes a little something like this:

“My client has been in labor for (insert random #of hours or days here) with contractions that stop and start. They range from 8-10+ minutes apart and then stop completely for hours at a time. What can we do to get this labor to be more productive?”

And then the replies start:

• ”Baby might be malpositioned. Try hands and knees, miles circuit, three sisters.”
• “Do Walcher’s to get baby engaged!” This one is the one that drives me totally bonkers. It’s suggested so frequently we should make it part of a “terrible suggestions for prodromal labor” drinking game! Because it makes *total sense to try and get a baby you’ve already said you suspect is malpositioned to engage that way deep into the pelvis. Especially with using a technique that is supposed to be used with active labor!
• “Open knee chest with some rebozo work to help shift baby.”
• “Get her marching up the stairs two at a time. If she doesn’t have stairs take her out for a long walk with one foot up on the curb. But make sure you go both directions!”
• “You gotta get those contractions closer together, have her use a breast pump!”
• “Try to really work the acupressure points to stimulate labor.”
• ”She might have some emotional block holding her back, try to get her to talk about her feelings.”

All of these suggestions have their place in our work as doulas. But they shouldn’t be our first suggestions. Your client’s body has been doing exactly what it should be doing as it gears up for the big event.

Prodromal labor is not a problem that needs to be fixed. It is normal!

S doulas, WHY are you buying into the belief that pregnant bodies are somehow broken just because they have some degree of prelabor dilation and bouts of practice labor contractions before the big day? This is not a situation where you need to be suggesting ways to “get labor going”. This is not a situation where you send a client messages that something must be done because somehow their body isn’t doing it right!

While I’m sure that it occasionally happens, not many people can just put on a pair of running shoes and run a marathon or run across the country Forest Gump style. It takes practice. It takes interval training to build up muscle strength and endurance to distance run.

Is that not what our client’s bodies are doing as they prepare for labor? Conditioning bouts of contractions that tone and strengthen the uterine muscle. Boughts of contractions that move the cervix from posterior to anterior. Contractions that help soften and ripen the cervix. Boughts of contractions that help the client learn how to move and work with their body. Contractions that come in small intervals in preparation for labor.

This is the client’s body WORKING exactly as it should.

Under the ideal circumstances and with an encouraging and supportive doula who is confident in their client’s body to know exactly how things should go, the doula will help the client see that their body is doing exactly what it should be doing. Allowing them to move into labor with an increased sense of self-confidence when the time is truly right.

So what should a doula be doing when a client reaches out for support, reassurance, and suggestions for coping with prelabor contractions?

• Validate their frustration.
• Listen to their fears.
• Remind them of how beautifully their body is preparing for labor day and that it is doing exactly what it should be doing.
• Help them find ways to gain increasing periods of rest.
• Give them the recipe for rest, relaxation and distraction.
• Ask them what they need right now. Nine times out of ten the answer will be “sleep”.  Help them get rest by going the opposite direction and offer ways to help calm and settle the contractions so they can get rest.

What you should not be doing is feeding into the belief that something is wrong and needs to be corrected.  We rant on about medical care providers who do this type of thing. We are just as accountable as they are for our suggestions and the repercussions.

At the end of the day, a “potentially” posterior baby isn’t going to prevent labor from starting.

The fact is the body is doing exactly what it needs to do. Using bouts of pre-labor contractions to ready the baby and body for birth.

You have a choice to make. Do you build your client’s confidence up by telling them that while exhausting and frustrating at times their body is doing exactly what it should be doing? Or tear them down and send a very clear message that you believe that something is wrong and needs to be fixed. Their body is broken and can’t labor without intervention.

At the end of the day, the choice is yours.