June 2020

When it's Not Really Labor


All labors are unique. Some begin with a bang and move right into active labor. Other times, contractions build for a bit, then stop with real labor starting hours, days or even weeks later.  

But what happens when poky contractions feel like labor, but persist often for several days, without kicking over to active labor? This is called prodromal labor.  Because prodromal labor and normal labor have similar beginnings, it’s important for a person to pace themselves until active labor.  

How can we recognize real labor? Generally, it’s a labor pattern consisting of longer, stronger and closer contractions. Once the contractions are about four or five minutes apart, lasting one minute and consistent at that pace for more than an hour, the cervix has usually begun to dilate past 4 centimeters – heading toward active labor. Prodromal labor on the other hand can be days of labor limbo, not stopping but not really progressing.

The reasons for prodromal labor aren’t fully understood. Perhaps this contraction pattern is doing other important work before dilating the cervix. Gently nudging the baby into a better position for birth, moving the cervix into a more forward position, or is just taking its time to efface (thin out). Whatever the cause, the key is to get through it with enough energy to cope with real labor.
Approaching bedtime in not-quite-labor is best served with trying to rest. Forget about writing down contractions – sleep is more important. Turn off the birth music, blow out the candles, and lie down together with the lights out. Even if sleep is elusive, lying down with eyes closed and minimizing chitchat can result in some good rest, even with contractions every 10 minutes. A warm bath beforehand and a gentle back rub can also help. A care provider may also have suggestions for herbs, homeopathy or medicationsto help with sleep.

During the day find a balance between activity and rest. Some people try acupuncture or prenatal massage to either pick things up or help with rest. Being in motion may help the baby find a better position. Pelvic rocks, movement on the labor ball, chiropractic, acupuncture, massage and just walking may cause a beneficial shift.

While being active is good, overdoing it can result in sore muscles and spent energy that will be needed later for labor. Try not to waste any more energy on contractions than absolutely necessary. Fold the laundry, bake some cookies or watch a movie to stay busy/distracted. Lying around making toning sounds with every contraction makes the time drag and can be hard on the throat. Save it until you really need it. It’s often better to try to ignore contractions as long as possible.

Staying hydrated and nourished is vital. Carbo-loading for the work ahead can be a good idea. Choose whole grains and foods that are easily digestible. It can help to try to have a bite of something at least every half-hour or so. Drink, drink, drink – dehydration can cause dysfunctional contractions. Water is great, but consuming fluids containing electrolytes such as recharge, gatorade, or coconut water will help your body keep going for the long haul.

Keep the spirits up.

  • Eat, drink, rest, – taking care of the body makes it easier to keep up the spirit.
    Know that the baby will be born! It only seems like forever.
  • The last thing anyone in prodromal labor needs is phone calls and texts constantly asking if the baby is born. Designate someone to be contact person and give them updates to relay to others. Better yet, try not to announce the first contractions on social media.
  • There are times to try to push a prodromal labor along, but prodromal labor alone generally isn’t a reason for induction. It is important to consider all circumstances in play, such as ruptured membranes, specific health concerns, or being well past the due date. The midwife or doctor will help with these decisions.

Knowing about and recognizing a prodromal labor pattern can help families cope with this potentially frustrating situation with patience and action instead of fear and reaction. Check-in with a care provider, partner and/or labor support person for reassurance and to process fears; with anxieties relieved and good coping advice, parents often do best without fulltime attendance until active labor kicks in. Without extenuating circumstances, prodromal labor is not a cause for induction or augmentation and care providers kept in the loop will be less likely to feel the need to intervene when the parents are coping well.
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