Episode 212 - It’s Not ‘False’ Labour, It’s Prodromal Labour
Mel:
[0:00] Welcome to the Great Birth Rebellion podcast. I'm your host Dr Melanie Jackson. I'm a clinical and research midwife with my PhD and each episode I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth and postpartum journey. Hello, and welcome to today's episode of the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I've been a midwife for over 18 years now. And on today's episode, we're going to be talking about prodromal labor. And that is a technical way of saying long, drawn-out labor that seems to go for on and on and on and doesn't seem to go anywhere. We call it prodromal labor or a prolonged latent phase. Now today, my guest is Poppy Child, and she recently had her third baby and got thrown the curveball of a prodromal labor. So in the first half of this podcast episode, I'm going to talk to you about prodromal labor, what it is, what causes it, strategies to get through it. And then we're going to finish off the podcast with Poppy's story. And I know that if you're going through prodromal labor at the moment, or if you're a care provider and you're nurturing women through a prodromal labour, you'll find lots of tips and strategies within Poppy's story as well.
Mel:
[1:28] There's also a cheat sheet that goes along with today's episode. It's linked in the show notes below and it's got a list of strategies for managing prodromal labour or a long early phase, latent phase of labour. I've listed it all out in a bit of a snapshot in a summary and it's a great accompaniment to this episode, and you can use it to just make sure that you're ready if you've had a history of prodromal labor or if you want to make sure you're prepared or especially if you're a midwife listening to this or a doula listening to this and thinking I need to send my client some information this is a great tool the cheat sheet again it's linked in the show notes below, the other thing that is currently on sale and here is something that you will definitely need if you're working through prodromal labor is my guide to giving birth without pain medication.
Mel:
[2:19] A big thing of labor and birth is just the mental and physical toughness to get through labor and birth without needing to use pharmaceutical pain relief. And this is certainly a big element of prodromal labor because many women won't be admitted into the hospital unit or have access to pharmaceutical pain relief for this early phase of labor. So you're going to need strategies and tools that you can use for the long haul. And the Guide to Giving Birth Without Pain Medication will give you that. Again, the link for that is in the show notes below if you want to take advantage
Mel:
[2:53] of the strategies in the Guide to Giving Birth Without Pain Medication. All right, so let's kick off our episode on prodromal labor or a long, early, latent phase of labor. And firstly, I will say that this part of labor is under-researched. The definitions are inconsistent and studies often ignore evaluating this phase of labor because actually determining the onset of labor, I'm using onset of labor. I hate these words that I'm using, but this is kind of how the maternity care system will describe your pregnancy and birth experience.
Mel:
[3:29] Understanding and determining what the onset of labour, when is that actually occurring, it's subjective. And folks haven't really agreed on a clear definition. What is the actual start of labour? And there are traditionally stringent guidelines about when women would be admitted to a maternity care unit or when they, you know, at a point in the labour where they're deserving of or needing medical care or maternity care. But most women will be denied continuous or in-person maternity care until your cervix reaches a certain dilation. It matches the dilation criteria of the hospital or of your care provider. So some hospitals, many hospitals won't admit women into their birth unit until your cervix is at least more than four centimeters dilated. And it's getting a little bit further on now with the new criteria of what active labor is considered to be. So you might be five or six centimeters dilated before the hospital says, Hey.
Mel:
[4:29] You've now met our criteria for admission. You've now earned your way into some maternity care because your cervix is performing the way that we believe it should perform. Welcome into the maternity care service. However, if women arrive, if you arrive to the hospital unit and you've had prodromal or long early labor, but your cervix isn't dilating, there's a very good chance that they're going to send you home. That can be a good thing and a bad thing. And we'll talk about that as we go. But the truth is, from an organizational perspective, hospitals don't have the resources to be providing care to women in early labor. They resource to care for women who are in active labor, who are likely to go on to have their baby within the next 12 hours or so. This is the mindset of a maternity care system. It's an organizational perspective. And what we know is that women don't appreciate this. Women turn up to the hospital in early or prodromal labor and are asking for care because they genuinely don't know what to do next. Maybe you're at your wit's end. Maybe this has been going on for days and days and days. You might be exhausted. You might not be feeling like you can manage the pain anymore. You could be dehydrated. Anything could be happening. Yet when you arrive, they say, no, you've not met the criteria for care. And we know that women who have prodromal or long early labors are more prone to believe that their maternity care was not adequate and then also more prone to.
Mel:
[5:58] I guess, experience their labor and birth as a negative experience, not a positive experience because of not being able to get access to maternity care during that prodromal labor. So we have to know that although, yes, there's some organizational limitations to how many women the hospital can care for, the disadvantage is that women who come in looking for maternity care and get sent away then experience their labor and birth as a dissatisfying experience. So this is where the gap is. Women's needs aren't met because there are limitations to what organized maternity care can offer women.
Mel:
[6:36] And I'll talk about how you can navigate this as we go. Let's go back to what is prodromal labor. Because it's sometimes called false labor. Or other people might explain it as prolonged latent phase of labor. But essentially, prodromal labor, it talks about the labor that women experience, before they're having a regular labor pattern. And if you're accepting vaginal examinations, and I'm not suggesting that you have to, but if you are accepting vaginal examinations during labour and birth, usually the latent phase of labour is defined medically as before four to six centimetres of dilation. I'm not saying this is correct. This is just the medical definition and the way that our labours have been divided up like we're little teeny tiny machines that work off clocks. We're not. But the prodromal or latent phase of labor is the time you spend laboring prior to four to six centimeters. And this can be prolonged, in fact, and go for as long as it like. There is no predefined kind of cutoff for how long this can go for before it starts to become dangerous or a problem or pathological. So far, what women will be told is that if you're having days and days and days of labor that doesn't seem to be progressing anywhere.
Mel:
[8:05] That you're in a prolonged latent phase or you're having prodromal labor or what they'll call false labor. Not really nice terminology because you are in labor. Just so you know, you are in labor because you're not in not labor. So you've got to be in labor because that's the opposite. Anyway, this is how it will be described. And women are told this is normal. This is normal. it's okay, go home, come back when you're in active labor. This is what's happening. So essentially any consistent labor signs that you are experiencing prior to cervical dilation before four to six centimeters.
Mel:
[8:44] The medical establishment will determine you to be in latent phase and if you're in prodromal labor you're having a prolonged latent phase and then, after that you're in what we call active labor and you officially qualify for actual maternity care in a unit. This is the problem and this is the problem I want to talk about today because you might find that you're stuck managing labor and birth, this prodromal labor phase, this long latent phase at home with just the resources that you have and you might not be ready but if you're listening to this episode you will be ready. Now today in the later half of this podcast we will be hearing about Poppy's experience of prodromal labor. But before we do that, I do have some strategies that you can use to help you manage and cope through prodromal labor or this long early labor phase, because you're in a marathon. This is not a sprint. This is a marathon. You're going to have to pace it out, and persevere with some human, your human physical and mental energy needs to be sustained for the And this means doing whatever you can to meet your basic sleep, rest, hydration, hygiene, nutritional needs while you wait for labor to progress.
Mel:
[9:59] Now there can be some reasons why your body is in a prodromal labor pattern.
Mel:
[10:05] And so let's have a look first, before I explain how to manage a long early labor, let's have a look at why this might happen. Because if you know why it might happen, you could potentially work out why it's happening for you. And then maybe you could solve that issue and move further along in your labor process in order to get things going. So the first reason you might be having a prolonged early labor is this might just be how your body is going to do it. It is not untrue that this is a normal part of labor and birth. It's still a challenging part, but for the most part, it's normal. And around 25% of women will experience this prodromal or long early phase. It's not all that uncommon. It's quite normal. It doesn't make it any easier. But first, this might just be how your body is going to do it. There might be a particular reason why your baby needs a slower start. There might be a reason why your body needs a slower start. So part of it might be you shifting your mentality and saying, maybe my body or my baby needs it to be this way and coming to terms with maybe this is going to be your normal. That's the first reason why it could be happening.
Mel:
[11:23] The next reason is there could be an emotional or mental block that is stopping you from letting your body progress into labor. Our minds are so powerful in labor and birth. And this is why in the Guide to Giving Birth Without Pain Medication, I talk about the mental strategies or the strategies to develop mental grit and the self-talk that you can do to shift your mentality because your emotional and mental state will impact upon your physical experience and the progress of your labor and birth. If there's something emotionally or mentally blocking you from progressing in labor, our minds and our emotions can definitely stop the physical function of our body. And I have a story to tell with regards to this. It was a long time ago, a woman rang me to book me as her midwife and she said I never ever planned to be pregnant I didn't want to be a parent I in fact still don't but I am going to have this baby, but I really didn't have this as my plan in life she never ever wanted to have babies as it turns out she her pregnancy was uncomplicated she quite embraced it she seemed to be enjoying herself, and didn't really express much else through the pregnancy about this being an unwanted experience, until we got to the end, and her waters broke and she did not go into labor.
Mel:
[12:53] And for days and days and days we were having conversations about what are we going to do next your waters are broken how many more days would you like to wait what kind of tests would you like to do all these kinds of things, And as the days went on, I thought, I wonder if, her situation of this unwanted pregnancy and a pregnancy that she never intended was... Is this getting in the way of her actually going into labor? And I asked her, are you trying to hold off the time at which you'll actually start to be a parent to a baby that's outside of your body? And she had to really grapple with that. She thought maybe, yeah, maybe this is holding her back from actually letting her body go into labor. And she had to seek out help from her psychologists and her counselors to try and get her head around this idea that this new phase of her life was about to start. So we absolutely can emotionally and mentally block our bodies from doing the things that it wants to do. So have a think. Is there anything that you feel like you need to do before you go into labor? And you'll hear from Poppy's story. This is part of her story. There was something she was holding on for that she had to do before she let her body go into labor.
Mel:
[14:14] Now, the next reason that your body might be taking its time with kicking into a more active labor pattern is maybe the baby is not quite in an optimal or right position in order to, make for an efficient birth. Now, if the baby's malpositioned, so if its head's tilted to the side or the other side, or it's too far back, all the way back, or maybe the baby's rotated completely differently. And is posterior, so the baby's back is on your back. It could be anything about the baby's position, but maybe it's not quite right. And your body is giving you some early niggles, early contractions, and just doing some early activity to try and reposition the baby into a more optimal position before kicking off the strong, productive labor that's going to open your cervix and push your baby out. Maybe there's a purpose to this whole early labor process. Maybe your body and your baby know better that is trying to reposition the baby so that's something that you can explore, and your midwife can check the position of the baby or whoever your care provider is can check the position of the baby and give some advice if maybe yeah maybe if we optimize the baby's position this would help you go into labor.
Mel:
[15:34] The other thing that can cause you to have contractions maybe when you're not, it's not actually time for proper labor is dehydration Are you well hydrated? And that includes having things like electrolytes and other things that control muscle function like calcium and magnesium, sodium, potassium, these and the other electrolytes, to make sure that the function of your muscles are normal. And so potentially, are you dehydrated? If you hydrated with some electrolytes and water and all these kinds of things, maybe that would actually stop these early labor pangs and potentially not going into labor at all. You're just showing signs of dehydration.
Mel:
[16:15] The other thing that could be, and this is a sort of a more pathological situation, is there's something called an irritable uterus that kind of is just prone to contracting during pregnancy, not related to labor and birth. This can also happen with inflammatory conditions that actually the uterus becomes irritated because of other inflammation around or things like diarrhea and things can cause an irritable uterus. It could just be that you're not actually going into early labor. And the other thing that this can be caused by is an early latent phase or prodromal labor or sort of irritable type uterus is if you're, if you have a twin pregnancy, there's just a lot of babies in there or, you know, multiple pregnancies. So these could be a few reasons for why you could be in prodromal labor. So consider your situation. Could one of these things be contributing? And is it fixable?
Mel:
[17:10] Is it something that you can manage or is this just the way it's going to be? All right, let's talk some strategies to manage prodromal labor. And I've divided them into five categories. And the five categories are managing life at home, catering to your basic needs, gathering and saving energy, speeding up the labor process and getting the baby out. So I'm going to talk in those five categories as we talk through strategies to manage a long, early, latent phase or prodromal labour.
Mel:
[17:42] All right. First one, managing life at home. The first thing you have to know about prodromal labor or an early long latent phase is that commit to this thing for, you know, in your head, if you have a week in mind, and know that you are actually experiencing labor, even though your maternity care providers might not acknowledge that you're experiencing labor, you are. That means you need to extract yourself from usual life a little bit and at least enough that you're going to be able to conserve your energy for when labor kicks off into the type of labor that's going to progress to labor and birth. So the first category is managing life at home. The first thing you are going to do once you realize that you're in a marathon, is gather supporters you will need care, and you will need your needs met but you'll also need to tap out of your usual activities and that means gathering other adults it could be your partner to help but I've just realized they could absolutely get tied with this as well because they're supporting you and also managing the household and especially if you have other children. So gather adults around to take over your role in the family for a moment while you're in labor. So just see this as labor and that you need to look after yourself. That means that you'll need other adults to be involved.
Mel:
[19:10] And not only will they be catering to your basic needs, but the basic needs of your household. Cleaning, childcare, animal care, all the usual stuff that needs to happen. You'll also need to prepare your supporters. Let them know what prodromal labour means. Let them know, I'm preparing for the long haul.
Mel:
[19:30] Let's all just acknowledge that maybe this whole week is going to be taken up with labour and birth. And maybe you'll have the baby sooner. That would be amazing. But you'll be ready for if it keeps going and going and going. And certainly the longest that I've supported a woman through prodromal labor before she was done with it and ready to move on to a new plan was eight days. So, you know, and the other one before the eight day record was broken, it was six days. So if you're mentally prepared for that, the chances are you'll have your baby before, but you'll also be ready. So the first thing, manage life at home. Tap out of your usual activities. You need to gather adults so that not only are your basic needs met, but the basic needs of your household are also met if that was your responsibility. And prepare your supporters that we are having a week of labor. They'll need to understand what prodromal labor means, and they will largely be responsible for caring for themselves, your household, but also you. And so it's about helping them to understand what your basic needs will be and this is number two, catering for your basic needs, will be all about gathering and saving energy so think very hard about where you're putting your energy, do I need to spend it there because you've got to save it and gather it for the purpose of labour and birth and just so that your body is functioning normally.
Mel:
[20:58] And this means that you're going to rest and sleep at every single possible interval between contractions. It depends on what your contraction pattern is like. Some women will get long breaks. Some women will just keep contracting for 24 hours over and over and over again. Either way, you have to take advantage of every single rest. Even if the gaps are only five minutes, eight minutes, 10 minutes, maybe there's a three hour gap. Don't take that opportunity to cook a meal or drive somebody somewhere or tidy or clean something rest you have to be disciplined to take every opportunity to rest, because and even if it's just like super micro naps or power naps in between a regular contraction pattern, because the amount of time that you can humanly persist in labor will depend on how much rest you've managed to get because your exhaustion will be what will change your decision-making around prodromal labour. But if you're not exhausted, you might find that you can go longer.
Mel:
[22:07] So I would encourage you to establish what I call a supported sleep station, because you'll be heavily pregnant and you'll also be getting contractions. You need somewhere that you can collapse into during the rest period that has everything that you need, water and food close by, lots of comfy pillows, darkness that, the temperature is controlled to either cool down or warmed up depending on what the situation is. And somewhere where you can fully sink and take the weight off your body and fall asleep between contractions. Hopefully you've got some support people nearby who are also maybe heating up a heat pack for you or if you need to use the TENS machine. Again, a lot of the pain management strategies that I'm talking about are actually in the guide to giving birth without pain medication. So the link to that is in the show notes and you'll have a whole strategy in there of how to actually manage the labor contraction pains but you want to have your sleep station all set up with everything that you had planned to use for pain management, but also comfortable enough that you could fully sink into sleep with your beautiful big belly and between contractions actually have a restful sleep.
Mel:
[23:23] So set that up and then you want to tend to your basic human needs hydration, nutrition sleep and hygiene there's not a whole lot more obviously then you'll also be using strategies for pain management during the actual contractions when the contraction is not there it's about staying hydrated with electrolytes and water.
Mel:
[23:48] Having enough nourishment to sustain your energy, having enough sleep to prevent exhaustion, and then just, general hygiene, keeping yourself nice and clean and tidy and not too smelly so you're not thinking, oh my gosh, it's been three days since I had a shower. The power of a shower in a long labor or even during a short labor, oh my goodness, it's enough to refresh your mental energy and your emotional energy just help you to reset and it can always be a game changer to just have a nice refreshing shower. So don't forget these little things that it's going to make you feel like a new person a little bit.
Mel:
[24:27] Those are your basic needs and the medical establishment will acknowledge that these need to be had. In fact one of the strategies if you keep presenting to hospital in early or prodromal labour? Something that hospitals offer is something they call therapeutic rest. What this means is giving you some medication so you can be sedated and go to sleep so that you get the rest that you need so that your body can replenish and refresh in order to continue in labour. So if you keep arriving at hospital and you are just at your wits end with labor and birth because it's been going on for a while with sorry with labor not birth you haven't done that yet, something that they might offer you is something for a medication for pain relief it won't be particularly strong maybe like panadine fort or something like that you're not going to get something stronger.
Mel:
[25:24] And some kind of sedative medication to help put you to sleep. When I was a student, it used to be Tamazepam. I'm not sure what they're using now, but they might offer you something for therapeutic rest. They acknowledge that what you really need is your basic needs met for hydration, nutrition, sleep, hygiene. So that is the category number two, catering for your basic needs, all about gathering and saving energy. Don't do anything you don't absolutely need to do for your body and your baby because right now you are trying to gather and save energy. You're in a marathon. Okay, the third thing you've got to do if the tiredness and the dehydration hasn't already gotten you first, you might start to get really sick of the pain of labor.
Mel:
[26:11] And so you've got to be prepared for any labor. You've got to be prepared with what strategies you're going to use to manage labor contraction pain. Even more so if you're going to be doing it for days and days and days. And I can tell you, I had a 36-hour labor with my first baby. It wasn't necessarily considered to be prodromal labor or a prolonged latent phase. It might have been I didn't have many vaginal examinations. But I can tell you that having a clear and set strategy for pain management, meant that we could just keep going and going and going because we had all of the tools and strategies right there. And that is the information that I've put in the Guide to Giving Birth Without Pain Medication. It's a whole set of information. There's a collection of videos for you as the woman, what tools to gather and how to manage the pain of labor. And there's also a set of videos for your partner to be able to support you.
Mel:
[27:08] And all of that is about being prepared to work with contraction pain. And later we'll hear from Poppy in this episode. And she's a creator of the Birth Box, which is full of hypnobirthing type strategies and the oxytocin bubble, which is a meditation track that you can use as a tool to work through labor. And if you click in the links in the show notes, you'll see the Guide to Giving Birth Without Pain Medication. In there is a link to the Birth Box as well. And there's certain sort of comfort measures that you can use to manage the pain of labor it might be different for every contraction.
Mel:
[27:44] But things that can really help with a long long labor are a warm bath hot water bottles the hypnobirthing tracks if you're going to use those a tens machine, position changes and just having your body supported so you might like a nice pillow fort, somewhere you can sleep with eye mask, you know, reducing the amount of stimulation that is coming in so that you can not feel overwhelmed when you're managing the pain of labor. Remember, you're in a marathon. It's about conserving your energy and using strategies that you can apply over and over and over again to contractions potentially for days. And you'll have all the resources you need in the Guide to Giving Birth Without Pain Medications. Have a look at that.
Mel:
[28:32] Okay, that was number three, managing the pain. Number four is about speeding up the labour process. All right, so if you've ticked off all of the reasons why you might be in prodromal labour and you're like, can't really find a very good reason that we have a solution for, you might be thinking, I need to get this thing going. And there are some things you can do to speed up labour that tip you over into labour.
Mel:
[28:59] And one of the major hormones for labor and birth is oxytocin, but also melatonin. So anything that you can do to enhance your oxytocin and your melatonin is hopefully going to edge you closer and closer to going into labor. So do something with people that you love, anything that sparks joy and helps you fall in love further with the people around you. Laughing something fun in the sun something that you really love and that you feel good then that's going to increase oxytocin the thing that increases melatonin is darkness, so maybe if you can close your eyes and have a good sleep too that could really do it and you'll hear in Poppy's story later she talks about you know creating a nest in which she could go into a metaphorical nest that she could go into that where she felt her oxytocin was flowing more Uh, the other thing that can start oxytocin is things like nipple stimulation, orgasms. If you, if your waters are broken, do not put anything in your vagina, but orgasms are completely fine. Uh, acupuncture is something that you could use. Certainly something I used in my 36 hour labor to finally get the baby out was acupuncture to keep stimulating those, contractions which had well and truly gone away for my labour but that can help as well.
Mel:
[30:28] Another thing that can elicit contractions that we can use in labor and birth is aromatherapy oil, clary sage. If your baby's malpositioned, you can do things to reposition the baby. I'm not going to be able to tell you all of those in this episode. That is for another day. But repositioning the baby using different kinds of movement. Some people go for a walk. You could use spinning baby techniques. In the show notes below, I'll put some podcast episodes that relate to turning your baby and changing the position of your baby. And if you've tried all these things and you're just thinking, nothing is really working.
Mel:
[31:09] And you haven't been able to sort of sink in and accept this process, because part of starting the labor process maybe is to just let go and submit to the fact that this is happening, but also having a strong mental game to be able to do that. If you're at the end of your tether and you just want to get things moving along and nothing else is working, there is the option of an augmentation with oxytocin. So this would be artificial oxytocin. Obviously, that would have to be administered with you in hospital to get the labour going. There are risks and benefits to this. And again, I've done some episodes on induction process in the Great Birth Rebellion podcast. So of course, we'll put the links to those episodes in the show notes. But certainly, if you keep presenting to the hospital in prodromal labour, one thing they might offer you after offering you the therapeutic rest option, is the opportunity to get the labor going with an augmentation with some oxytocin. They may also offer to break your waters and this is something that could also kick you off into stronger more more consistent labor that's going to lead to a birth. So that's point number four speeding up the labor process and the final one is number five, getting the baby out.
Mel:
[32:35] You may come to a point in your journey of a long prodromal labor where none of the more sort of self-managed options kick you off into labor. Maybe you're not interested in augmentation. Maybe that's not an option for you. Certainly if you've had a previous cesarean section, you might not have the option of an augmentation with artificial oxytocin. There may be a point where you are done with prodromal labor and you'd like to get the baby out with a cesarean section. And of course, this depends on the circumstances. But what you do need to know is typically prodromal labor is normal. We don't have a thorough understanding of how long it can go for before it becomes a problem. But essentially, we consider it a normal part of labor and birth where there's no additional danger posed to you or your baby.
Mel:
[33:29] However, you may make a decision to get the baby out or accelerate labour using medical options. And these are things that your care provider can talk to you about, of course. But if you're at home and you're in it for the long haul, the previous recommendations can help you strategise your way into managing labour and birth until you're ready to present back to your maternity care providers. Now, of course, if you've been a follower of the Great Birth Rebellion podcast for a while now, you would know that we have a huge resource folder, which is full of the research papers that I use to create every single podcast episode. And this episode is no different. The resource folder is jam-packed with research papers that you can use to explain certain things about prodromal labor. But one thing that I will mention is that if you have a look at those papers, a lot of then we'll talk about for women who are in prodromal labour that they have more of a chance of, an increased chance of things like oxytocin augmentation, caesarean section, meconium stained amniotic fluid and babies who need further care, as a result of needing resuscitation at birth or being admitted to NICU, the special care nursery for babies.
Mel:
[34:50] And what we know is that women who are admitted to labor wards in latent phase, so early labor versus an active labor, are at higher risk for obstetric intervention, including CTG, so the continuous electronic fetal monitoring, epidural, oxytocin, and cesarean section. So what you'll see in those papers is that what they've observed is that women who have prolonged early labor phases generally end up getting more obstetric interventions during labor and birth, but also that there's poorer outcomes for their babies. However, just a word of warning and a word of caution, and this is just something that ruminates in my head. The question is, does the long labor itself increase the risk of problems and interventions like epidurals and CTGs and augmentation and cesarean section.
Mel:
[35:50] We know that a long labor can increase the chance of women needing those. But the problems that relate to that in regards to the baby and the extra cesarean sections, is it the medical strategies that we use to speed up labor that could potentially cause those problems? Because we know that augmentation and cesarean section do pose a risk to the baby and the woman. And I'm not being facetious. I'm genuinely curious, is it long labor that causes the problems or is it the medical interventions that we use to intervene in the long labor and to remedy the long labor that ultimately cause the problems that we've identified with long prodromal labor? So I have genuine curiosity about this because we do know that interventions have a risk. So are the complications a natural consequence of long labor or the interventions that have been applied to help remedy the long labor? And I don't think we have an answer to that. We just don't have an answer to that in the research. But certainly if you look through the research papers there, this is the kind of information that you'll find.
Mel:
[37:00] So I've put together a full list of papers in the podcast resource folder. If you scroll down to the show notes and you click on there, you just get access to the resource folder. We will send you the link and you can have a look at everything.
Mel:
[37:12] That's what I want to say about prodromal labor for now. Don't forget there's also the cheat sheet in the show notes and we're going to kick off to hear Poppy's story of prodromal labor and I'm sure that you'll find some more helpful strategies in Poppy's story as we talk.
Mel:
[37:30] Let's do it. Welcome Poppy to the Great Birth Rebellion podcast again. I'm so excited to hear your birth story. Start the journey where you want to kick us off.
Poppy:
[37:41] Amazing. Well, firstly, so, so lovely to be here. Thank you for inviting me. My story really begins on Easter weekend. We're down at my husband's folks house. It's vibes, full on, you know, Easter festivities and I'm 38 weeks pregnant. I do not think I'm going into labor because my previous two children, I was always past the due date. There was no thought in my mind that I would go into labor at this point. And then I started to experience contractions And I'm thinking, this is not where I'm meant to be giving birth. I'm like shaking with nerves, thinking we're two and a half hours from home. Oh my gosh, because my labors previously have always started with contractions and ended with the baby. So I say to my husband, like, I'm experiencing contractions, like this is going to happen. And I'm shaking, I have to get into a warm shower, I come out, and then he's like, well, what do we do? And I said, well, phone the nearest hospital, make sure my notes are transferred, make sure they know I'm low risk, ask them about a birth pool, just like get organized.
Mel:
[38:53] Like this is just going to happen now. I can't drive home.
Poppy:
[38:58] Yeah, because my last labor was three hours. So I'm thinking third baby, this baby is shooting out. And anyone who follows my Instagram knows that I've been talking about, I was terrified of how fast it was going to be. So my head was like, get the show on the road, this baby's coming. So I'm timing contractions. And my app is saying, go in, like now.
Mel:
[39:21] Whoa, yeah.
Poppy:
[39:22] Contractions are coming in fast, not strong, but, you know, regular. And I remember sitting upstairs and by this point, the whole house, the word had got around, like pops is in labor. I'm not because this is not the plan, right? And my sister-in-law said to me, she was like, do you not think you should go in now? Because remember, you do hypnobirthing, so you could be progressing. And I said, no, no, no. I know real contractions. like this this doesn't feel like it's established yet so we carry on waiting um contractions coming and going then whenever I would go into the lounge where everyone was they would start to fizzle out obviously contract oxytocin being a shy hormone so I would go back into the room and I was actually a little bit ashamed to say this but I was consulting Claude at the time um the AIs because I just I just needed some reassurance I was like you know putting the screenshots of the contraction um timer in and just asking it you know what to do and interestingly I asked my audience on Instagram if they were doing the same and over 85 percent of women and we asked over 100 women um are using AI during pregnancy so it's
Mel:
[40:30] Kind of give them advice real-time advice.
Poppy:
[40:33] Yeah which which is which is risky I mean it's like it started saying to me you need you need to go home um all sorts of things like you know full-on advising me yeah so then so then these contractions were not kind of getting into proper labor so I said to my husband um tomorrow I want to go home I need to be in my safe space so the next morning um we woke up and it was Easter Sunday and my two daughters were so excited about the Easter egg hunt so I said said okay let's stay for that but meanwhile the whole time I'm just like I need to go home I need my smells I need my environment I just didn't feel safe. I didn't feel where I was meant to be. Eventually the egg hunt was over and I was like please let's go you know like everything in me just was like I need to go home right now so we get in the car and I just remember feeling like oh like so relaxed like yes we're gonna go home we get through the front door I start nesting cleaning the house I'm like right let's just get organized we're having a baby soon still contracting
Mel:
[41:36] At that point.
Poppy:
[41:37] Still contracting but it wasn't get it wasn't like building it wasn't getting stronger, but it was just still contracting.
Mel:
[41:44] How regular do you think they were at this point?
Poppy:
[41:46] Sometimes every five minutes, then it would go to every three minutes and then it would space out and stop completely. And then whenever I was alone or feeling calm, it would go into a pattern again. And it was, it was like regular, like a regular, but not, it wasn't getting stronger. That was the thing. Yeah.
Mel:
[42:02] And had you had a good night's sleep that night before when.
Poppy:
[42:04] You had a good night's sleep yeah okay
Mel:
[42:06] Right so we just we had contractions good night's sleep but then back to fairly regular but not too strong not sort of really progressing on contractions exactly.
Poppy:
[42:17] So this continued over the days and I realized that I was in prodromal labor I realized that this was just you know this was the beginning of my labor this is what it was going to be and at first I felt a lot of resistance I was like come on like what's wrong with my body just go into labor you this is your third baby surely this uterus is rehearsed come on pronto like let's let's get this show on the road and there was real frustration there you know going to bed every night thinking is this it then waking up in the morning not having any you know not it not falling into a regular enough pattern it not getting strong and then eventually I thought to myself you know this is this is a lesson here I need to surrender my body is in charge there's no amount to thinking my way into this, I need to let go. And what was interesting with my previous two labors, I'd gone to 41 weeks and 40 plus five days. So I was that mom that experienced the frustration of waiting. I never experienced this kind of prodromal labor of my body showing me that it was readying, but it not getting into labor. So it was a very, it was very strange. I'm so familiar with waiting, like, hurry up. Why is my body not giving me signs? And this, this was really different in that it kind of heightened the liminal state. It really made me aware that I was in between states and I was going to meet my baby soon. My body was showing me it was doing stuff, but it just wasn't tipping into labor.
Mel:
[43:46] I was wondering what your birth intention was. Was the plan to give birth at home or were you going to give birth in hospital?
Poppy:
[43:54] At home. So the plan was always to give birth at home.
Mel:
[43:58] And did you have an NHS midwife or a private midwife?
Poppy:
[44:02] We had NHS midwives and I was mentally initially, well, I'd done the preparations for potentially an unassisted birth just because Olivia's went that way because it was so fast. And I thought this would be the same. So mentally I'd done the same sort of preparation, but we were keen also to have midwives if we had, you know, if it wasn't fast, essentially. So that was our plan.
Mel:
[44:25] Had you been in communication with your midwives during these early labour or did you know what it was and then you just knew what you needed to do?
Poppy:
[44:34] So I had gone to a midwife appointment and I told her and she just said, look, this is normal. Just go with it. So that was kind of reassuring. And yeah, I basically spent that week going for walks with close friends. My brother and my dad came around and helped me blow up the birth pool. So we had like ice lollies music. And it ended up being this week that was more joyous in the end, just really kind of making friends with those sensations, being one with my body, surrendering and just really saying to my body, you do this, like this is okay and I was affirming that every contraction was work it wasn't a fake labor it wasn't a false start this was my body doing it and I was simply in labor just going through the motions and I got myself into such a beautiful calm state honestly I look back on that week and I wouldn't have had it any other way it was really quite powerful just me with my body these
Poppy:
[45:35] Contractions. And then I went for another midwife appointment and they measured my bump and they said, your baby's measuring a head. So we need to book you in for a scan. Yeah. And, um, you know, we, you may even need to be induced, like, you know, all of those things, you know, the familiar conversation, um, at that time, then I accepted the scan, but then I went home and I was thinking, do I really want to put myself in that position where I'm in the NHS scan and I'm being potentially coerced into an induction? No. Do I want to know what's going on right now? Yes. So I booked in for a private scan and I went in with my husband and my two kids. And this was on the Sunday now. So I'm 39 weeks pregnant. And the sonographer said, look, you are measuring ahead, but everything looks perfect. There's nothing to be concerned about. It could just be a big baby. So that was really reassuring. I didn't have the pressures of induction. To be honest, we didn't know the sex. And I did think to myself, this could be a lad. I was just thinking like, you know, that was my instinct. I was like, I feel like, you know, this could be a boy, big chunky boy here. And so 39 weeks pregnant now. And that evening I had booked in a masterclass. So my last live workshop and I had a few thousand women signed up.
Mel:
[46:57] A master class that you were running not that you were a.
Poppy:
[47:01] 10 no I was running online yeah yeah yeah so this was going to be my last work engagement um 39 weeks I know cutting it fine um in this room my birth pool was set up just over there so I put the kids to bed I come out here at eight o'clock I log on there's women from all around the world um and I run this master class on how to deal with contractions I get them to visualize what it would feel like kind of fighting embracing versus melting into it so I do this whole one hour live coaching fully in the moment because I know that I'm experienced I was literally contracting whilst teaching the workshop and it but it was so powerful um because I was in it right like I'm literally in this experience the whole workshop was so oxytocin-fueled, I cannot tell you. And everyone was just sending each other love. And I remember towards the end, I just didn't want to log off this workshop because everyone was just like, good luck. And I'm saying good luck to them. And it's just like, I'm almost crying in just such a euphoric state, really. And during this masterclass, I'm feeling these contractions are getting stronger, obviously. Like the oxytocin's flowing.
Poppy:
[48:18] And then I close my laptop and I look around this room and I'm like, you know, this is it now. I'm closing the studio. In fact, this is the first time I've come back into this room since that masterclass. So I'm closing up. I walk past my birthing pool and I'm like feeling this sense of nostalgic, you know, like just this is an end of an era for me. I'd just done this class. There was a real kind of rounding off. And I locked the studio and I walked back to the room, to the house. And my husband's like how was it and he could see on my face just so much excitement and I'm just like so happy just full of oxytocin and happiness and I sit down on the sofa and And I can feel now these contractions are getting stronger. And this was kind of the first time it was, these were like, you know, like the proper ones.
Mel:
[49:14] Well, and I wonder, because you knew that you had this 39-week workshop that you were going to run. And your body was like starting to contract at 38.
Poppy:
[49:24] Yeah.
Mel:
[49:25] And one thing that I say to my clients when they're like, why isn't any, why haven't I gone into labor? Of why aren't things progressing I'm like are you holding on, to something mentally in your mind is there something that you haven't done that you really need or want to do is there something in your to-do list is it like is there a deadline in your head and typically they're like oh I just need to, do this thing or I just need to speak to this person I just need to buy that thing before I feel like I can do anything I'm in my head I'm wondering if your body was like absolutely not we are doing this 39 week workshop.
Poppy:
[50:02] Well when you've got a few thousand people signed up for something it's pretty much like you know yeah absolutely because I mean I can't see how that can be a coincidence like
Mel:
[50:10] There is just some kind of it's almost like a mental stop that got put there, yeah before you could progress for it I'm interrupting.
Poppy:
[50:19] Yeah great so workshop could well be um so I forgot to say that I was also wondering about the baby's position at this point for because obviously um you'll you'll you'll know a lot more about this but um i was doing research onto into prodromal labor and um one of the reasons could possibly be baby trying to get into a good position and your body you know pre-contracting to help them rotate and align and things like that so that was definitely playing on my mind as a possibility and i wasn't quite sure if it was instinct or fear voice that was speaking but that was absolutely on my mind um and i forgot to mentioned that in the week I was doing a forward leaning inversions and birth ball and doing some things to kind of help that process along.
Poppy:
[51:04] So I'm sat on the sofa, husband's next to me and I'm saying to him, you know, these contractions are getting pretty strong now and he's kind of smiling. And I think part of him maybe was just was keeping his cool because we had a week of this, you know, there was a lot of stop starts. So he was keeping his cool.
Poppy:
[51:24] And then, you know, I'm never one to try and actively encourage labor. But after a week of stop-start contractions, I was thinking to myself, I want to kind of do something to encourage this along, to get me into labor, to tip over into labor. So I started to do some nipple expressing, but just really slowly. And that was really bringing on the contraction stronger. So I actually had to slow it down. So I said goodnight to my husband. He sleeps upstairs with Juniper, no judgment. And I was sleeping downstairs, heavily pregnant, you know, just needed my own space. And so I went into the downstairs bedroom and I lay on my side and I was just experiencing these contractions. And I knew this was it now because I could feel the regularity. I could feel the strength.
Poppy:
[52:12] And then I could just feel this trickle down my legs and I'm like, oh my gosh, is that my waters? Yeah. And with my last two, my waters are always broken before baby arrives, like before the birth. So this was such a strange start. The whole thing was so different. Couldn't have predicted it. And I was like, oh my gosh, this is it. This is it now. I knew like, you know, baby's coming within the next 40 hours one way or another. And then so I could feel the wet down my legs. So I get up quickly, decide to get into the shower downstairs. And I know now I'm like, this is my labor. This is it. Feeling excited, feeling nervous as well.
Poppy:
[52:52] And at that point, I needed to think about if to phone the midwife and let her know if the waters are broken. Here in the UK, the advice is that you let your midwife know. So in that moment, I actually decided not to tell the midwife because I pictured ahead me phoning her, her telling me the risks, her telling me, you know, possible induction, all those things that I already knew. So why would, what was the reason basically? I was aware of all the possible risks. And for me, that conversation in itself posed a risk to my oxytocin levels. So I decided I made an informed decision not to, but I was also prepared to tell her later on when I was ready. But I didn't want anything to disrupt my oxytocin. My plan was to get the labor going. I had a week of this. You know, I didn't want any risk to this oxytocin that was now finally building and getting into this rhythm.
Poppy:
[53:48] So I put, I had these little sanitary towel, nappies, whatever, put one of those on and I get into bed and I lie on my side and this is the position that I felt so happy in. And I'm experiencing the contractions, literally living and breathing the workshop that I had just taught. Feeling the surges come in and just allowing it to like wash over me, just each one just washing over me. And the mantra that was carrying me through was these contractions cannot cause me harm no matter how intense they get this cannot harm me and although that wasn't taking the pain away it was enabling me to drop into my body and just melt into it and that's what I was doing with each contraction just melting my whole body into it and it was making it easier just knowing like this is intense. No one's sugarcoating you. It's intense. It's hard work. But I was able to relax into it with that mindset. And my husband, obviously hearing me clanking around in the shower and everything, came down and checked on me and said, is everything okay? And I said, look, I think this is it now. My waters have released and I'm okay. I'm just, I want to get on with the labor. And, you know, you go to bed basically.
Mel:
[55:09] The evenings through the week. because something that can really happen with prodromal labor is women get worn down by the, I guess the frequency of the contractions can get in the way of them resting. Was that part of your experience?
Poppy:
[55:26] I was able to rest. I was actually able to sleep through them and sometimes the kind of peak of the contraction would kind of wake me up but then I would drop into sleep again But I do know that some women have more painful experiences with the contractions and, you know, I can only imagine how difficult that would be. And it's just absolutely exhausting. So I was really lucky in that I was able to kind of drop in and out of sleep.
Mel:
[55:53] So it wasn't like you were coming into this now labor where you think, yeah, I think it's time for the baby, but I'm already like tired, hungry, dehydrated, just mentally.
Poppy:
[56:04] No, luckily not. No, luckily not. So I, you know, after that masterclass that gave me such a buzz of energy and luckily I had been resting. So I was in a really fortunate state. So then I, then I labored listening to the octitucin bubble, helping me to remind me of my breathing and just connecting in with the, with the baby as well.
Poppy:
[56:26] And so I spent the next, I think like seven, eight hours just in the room, just lying on my side, allowing the contractions to kind of move through me, And then I felt like my mind was getting a little bit active. Like I was kind of thinking, is this baby coming?
Poppy:
[56:44] Is it in a suboptimal position? I could hear these anxious thoughts kind of coming up. So I decided to put on Eckhart Tolle. I don't know if you know him. Talks about the power of now. Yeah. And Alan Watts, my all-time favorite philosopher. And those two voices have carried me through difficult times in life. And so I wanted those voices. So I had them on in the background. And I was just kind of tuning in and out of their words whilst experiencing contractions. And it was just providing me with some light distraction in the moment. And then it got to about half seven and I'm thinking, right, come on now, guys, like wake up household. That's kind of our time that everyone wakes up in the house. And at this point, I'm now like, I need my husband because they're getting stronger. So I text him and I just said, look, been contracting all night.
Poppy:
[57:32] I'm a bit hungry. I was like, I need a snack. Like the peeps are hungry. I need some snacks up in here. So I messaged him just saying, could you make me some porridge with honey? And then I said, I think I fancy a massage as well, but not a hard one, just like a little tickle. So I left him like this long message of all these instructions. So he woke up. Our nanny, we told her as well. So the plan was for her to come and take the girls out to school. And i'd you know got up and my smallest daughter olivia um came out and she got into bed with me and i experienced one contraction with her and i had always fantasized around like having children you know present at the birth but no it was horrific the pain was more intense she was so distracting she was like climbing on me and it was it was uncomfortable and i was just like get these children out the house like everything in me was like no no no i can't have any of them around shoe.
Poppy:
[58:30] So all these fantasies around like you know oh it'd be oxytocin fueled to have the girls there it was the opposite of just wanting to flick them away so then I went upstairs and I could hear all the commotion downstairs and in my head I was just like oh just get off this house I need I need to just get in this zone right now yeah then eventually they left and then I made my cocoon upstairs dark I had the peanut ball at this point lying on my side just breathing through each contraction really kind of managing it well and then my husband came and he said um you know should I fill up the pool the pool was in the studio and the plan was to give birth in the pool and I was thinking to myself I could really picture myself walking across the lawn and getting in a pool right now it just felt so inappropriate I was just like maybe another day like I think this labor has other plans like I'm pretty happy in this room we had planned to film it as well and at this point didn't take any videos and in my head I was just like
Poppy:
[59:30] Really you know I just I just wanted to be alone in this cocoon I didn't want any of it I didn't want the pool I didn't want just I just wanted to lie on my side in the dark with no one and eventually I wanted the baby to emerge like you know it was so different to all the plans I'd had and then eventually he was like look we've got this pool let me just fill it up we don't know how this labor's gonna go so he went and did that.
Poppy:
[59:55] Now these contractions are coming in stronger and I'd always used vocalization with my last two labors. And interestingly with this birth, um, it was, that wasn't really working for me, but I was doing audible breathing. So really kind of, and that was helping. I was listening to my outward breath.
Poppy:
[1:00:11] And then so I was doing this for a few hours upstairs. And then I started thinking maybe some warm water would be nice. And he said the pool's ready. So I waddled across the lawn. It was a beautiful day, sunlight, kind of waddling, waddling, waddling. And I get to the studio and then I get into the pool. And I experienced a few contractions in the pool and my body was thinking actually no I don't want to be here I don't want to be I don't want to be in this water right now I need to go back to the position in the sideline position with the peanut ball and now in my head I was kind of doulaing myself a little bit which was not actually helpful I was kind of thinking to myself is this is this good to stay in this position or should I be upright should I be doing things should I be on the birth pool and I spoke to my midwife friend Lily and I was like do you think I should be you know on the pool right on the ball and she was like stop trying to do yourself just listen to your body and I was like you know that that is what I need to do and my body wanted to be side lying in in that position so now contractions are getting stronger and stronger and I'm thinking this is this could be it now my husband said should we phone the midwives and I said sure let's phone them so he calls them and I could see on his face the way the conversation was going I could see that There were no midwives, you know, because his face was just like, what, okay?
Mel:
[1:01:33] Is that what they told you? They said there's no midwives.
Poppy:
[1:01:36] Yeah, so he hung up the phone and he was like, there's no midwives available.
Mel:
[1:01:41] They were all at other births? All at other births, yeah. Right, okay.
Poppy:
[1:01:45] So at that point, we needed to decide, do we now stay at home and try and, you know, do this labor just us or do we transfer it? Now, I knew that going into a car, going into triage, activating my thinking brain would wreak havoc on my oxytocin levels. I had done so much work to build that oxytocin. I had done a week of prodromal labor. For me, the thought of these contractions stalling right now was not appealing.
Poppy:
[1:02:15] So we both decided we were going to do it and we were going to do it at home, just us. I get back into my position and the contractions are now flowing again. And I do think actually kind of consciously making a decision helped them to strengthen the contractions because my body then knew this was where we were
Poppy:
[1:02:35] giving birth. Everything was fine. You know, I committed. So the contractions are now getting really strong and I start to experience what I now know was transition. So with my last two labors my transitions have always been very vocal very um kind of outward like ah fuck like this is really hard like you know very very like she's in transition kind of thing you know very very um obvious what i was going through but with this third labor it was very very different and i spoke to my husband about this last night and he basically said that I looked vacant, passive, and I was just saying things like, maybe we should go in, maybe I should get the epidural, maybe this birth is meant to be different. Maybe I should have the CTG. Maybe. And he was looking at me like, yeah, like she's gone. She's saying these things. And I was kind of fantasizing of being passive in hospital, strap me up, drug me up, and just finish it.
Mel:
[1:03:41] It sounds like you were kind of dissociating a little bit from like, I don't think I really want to do this next part. And what I would really like is for somebody to just take over.
Poppy:
[1:03:52] Do it for me.
Mel:
[1:03:53] Do it for me. Can I just say this is not, if anybody's listening to this and thinking, why, why would she do this after two births that weren't like that? Women who have subsequent babies, like it's usually third, fourth, fifth babies, especially if they feel like they've got what they needed from the other first two births. They don't feel like they need to do birth again and would really rather not.
Poppy:
[1:04:22] I've just got goosebumps. You have just articulated what was going on. I had done it. I had died. I had the... Someone else do this one.
Mel:
[1:04:32] Yeah, you were like, I've got nothing to prove. I know I can do this. I actually feel like I have nothing to gain from pushing another baby out.
Poppy:
[1:04:40] This is it. This is it.
Mel:
[1:04:42] So this is, I see this semi-regularly as a private midwife. The women who really feel like they need a redemptive birth, they are like, no way. I am doing this whole thing. I am not going in. I'm not having an epidural. I am like staying home. And they stick to their guns and they're so committed. And then the women who have like done it before, who are like, yep, I know I can do it, got nothing to prove, don't need to have this whole experience again, they are the ones who say things, you know, like what you were saying is maybe like what if we just put the epidural, just pull it out. I've had women go, maybe it's just going to also pull it out. Maybe just the cesarean. And you're like, okay, this is transition talk, but this is like third, fourth, fifth baby transition talk.
Poppy:
[1:05:30] Just fascinating.
Mel:
[1:05:31] Yeah.
Poppy:
[1:05:32] Anyway, that is exactly what was going on for me. And interestingly, this was going on even in the pregnancy. I had already kind of surrendered to multiple birth plans and it was so much easier for me to get my head around any type of birth for this third pregnancy. Whereas my first two, no, I was headstrong, wanted, you know, I was like, no one's taking this. I've got to have these, you know, which is not a healthy mindset, I don't think, because had those births not gone to plan, I probably would have experienced a lot of, you know, disappointment. So, but it was so much easier with this third pregnancy to, to just go, whatever happens. Fascinating that you say that. And what was really interesting, we were talking about this last night is that had genuinely, genuinely, had my husband had said in that moment, let's go.
Poppy:
[1:06:20] I would have gone and the birth would have been so different. And so it was so good that he was clear on really what I wanted for this birth. And it also really made me reflect on how when you're in labor and you are a vulnerable pregnant woman, you are in an altered state of consciousness, which does make you more susceptible to ideas. And you can actually get easily swayed and into, you know plants because you are not you you're not in your analytical brain and we know this right that women can kind of go okay and submit far easily when they're in labor rather than when they're in their head um absolutely normal yeah so he reassured me and then we we decided because i was still having this this thought in my head that this this baby could be in a suboptimal position you know is it is it really safe to have this birth just us what if I need help and so these thoughts were kind of circulating in my mind fear very fear-based thinking
Poppy:
[1:07:21] Then we decided to just really give this a good few hours and then we we thought if it doesn't if baby doesn't come in a few hours we'll go in and that was quite a healthy thing to think because at least we had this kind of mental cut off it wasn't just let's see for hours and hours remember I'd been contracting for a week so we're now talking a long time like you know and this is it was about 14 hours into labor at this point as well so um contractions are now super strong i'm lying i'm on the sideline uh position and my husband obviously knows
Poppy:
[1:07:58] I'm a doula and childbirth educator. And so he wasn't really kind of actively encouraging me with positive affirmations. I think fundamentally, he knows that I'm capable. He knows that I know the tools. So his way of supporting me was holding space. But actually, I started to feel that I needed something more. And so I said to him, on this next contraction, can you try and coach me? Can you remind me to breathe? Can you remind me to soften my shoulders? I was like, I need you to coach me I want to see how it feels so the next contraction came in and he started verbally coaching me and saying things like breathe in deeply you can do this and just kind of rotating all these various things and after that contraction went I said to him don't stop do not stop talking this was just what I needed I needed his voice as an anchor
Poppy:
[1:08:51] I had my birthing tracks on and I had this voice. I could feel now I'm on top of this now. This is what I needed. So contractions are coming. My husband's coaching me. I now feel like we are a team. This is it. Like this is happening.
Poppy:
[1:09:06] So I'm lying on the side and a super strong contraction comes in and I can feel like like kind of really this uterus is going for it. And then suddenly I'm like, I need to get into that pool. I could feel things are changing. So I get into the pool and I remember just dropping my whole shoulders. I've got my hands over the pool like this. And I just knew that
Poppy:
[1:09:33] That that was the end of that part of labor. I knew I had done the work and I experienced this all-consuming sense of calm. That was it. The transition was over and I knew my baby was going to come and I knew I was entering pushing stage. And it was just like this peace washing over me and this knowing that this is it. I can do this. And I remember saying to my husband, I think I'm experiencing the rest and be thankful. Do you remember I told you that stage in labor where things all calm down before pushing and I've got my eyes closing and I'm literally fucking narrating this shit? My husband's like, you don't need to tell me, just experience it. Enjoy the peace. That's what I'm saying, but you can't take the doula out of the doula, right? So I'm literally narrating, I'm like, narrating what stage of the room is. And I'm so glad he told me, just experience it. You don't need to tell me. So I'm like, thank you. Thank you. Breathing. Contractions have now spaced out and I know and I'm like, this is it.
Poppy:
[1:10:48] And then eventually a contraction comes in and it changed in intensity. I could feel that it was coming from the top of my uterus. And now my body was trying to push this baby out.
Poppy:
[1:10:59] And at this point, I did start to experience some fear because we're alone. And no matter how much you have planned, there is a little bit of fear there. Because you are carrying the weight of responsibility in a way that you're not when you have healthcare professionals around. You can, they can take some of that away from you. So this kind of, you know, made me wake up a little bit. And I remember thinking to myself, in order for this birth to be safe, I need to listen to my body. I was worried about the baby's position. And so I knew the only way forward was for me to listen to my body with what position to get into and what the hell to do here.
Poppy:
[1:11:47] And I remember saying to my husband, do you think I should stay in this position or should I move? And he said, you should listen to your body. I can't tell you. And I remember feeling a bit disappointed because I wanted him to just tell me. But also it was a rude awakening that no one was here to save me. You need to listen to your body. So the contraction started to come in again and my body was telling me to push with it. So I start pushing and I'm going like this and then I reach out my hands like this and I'm just pushing, pushing, pushing with the contraction and I can feel my baby coming down and the contraction fades away and I'm breathing in between. Contraction builds up quite quickly again and I start to push push push and I can hear my husband in the background saying breathe breathe because he could hear me holding my breath and I had my hands out like this and I was going like this whether or not that was a good thing I was just following my body and my body wanted to hold my breath and my body wanted to I wanted to actively push with this and then I could feel the baby's head coming out I could feel the crowning and the stinging. And then I naturally switched into-
Poppy:
[1:13:04] And I could feel the head emerging, emerging, emerging. And then I could feel the head come out fully. And my husband at this point is looking down in the water and he's looking really mighty confused about what he's seeing, but I needed to zone him out. And then he's saying things like, you can do this, you're doing amazing. And I just say to him, shh, while I push. He was following my previous instructions not to stop talking because I said, don't stop talking. So he was listening to that. And now at this point, I wanted to stop, stop, because I need to focus. But interestingly, he didn't stop. And I think that was partly to do with his nervousness. You know, we're both in this alone. Something's come out of me. He didn't look quite sure about what it was. So then I'm waiting for the next contraction. I have my head back at this point, just breathing, breathing, kind of going, oh, I feel like, you know,
Poppy:
[1:13:57] just, oh, just realizing what the fuck's going on here. Like oh I could hear him chattering in the background and I was trying to zone him out at this point and then on this next contraction I could feel that the baby was coming but it wasn't quite coming and so instinctively I just lifted my leg up and kind of had it on the on the side of the pool and then I could feel a pop and then another pop and then I just went
Poppy:
[1:14:23] Like that and then pushed and then i just hear tom going baby's here baby's here and the baby comes out into the water and i could see hair balls immediately we didn't know we didn't know it's a boy and then i just remember saying pick him up pick him up and then my husband tries to scoop and then and then i remember kicking into gear thinking no i want to actually i want to pick him up And then, and then I pick him off and I bring him to my chest. My husband comes around this side and he's like helping me hold him at this point. And I'm like, oh my gosh, like we did it. And I'm like, wow, I can't hear him crying at this point. So again, my adrenaline starts kicking in and I start rubbing his back and I say to my husband, get a towel, stimulation. He gets this towel and I start rubbing his back and I could see in his face that he's alert and his eyes are kind of just looking around.
Poppy:
[1:15:21] And then I start speaking to him saying, hey, you're here, you're here. And then eventually I hear and I was just like oh
Poppy:
[1:15:32] We did it we did this and I say to my husband we did this we did this together we did this and I'm flinging my head back and I'm like we did this and he's kissing my neck and all around me and it was just this feeling of like relief holding baby and he's now crying and then eventually he stops crying and he's just alert looking around and And then I can hear my husband in the background just saying, I think we should call the paramedics. I think we need someone here.
Poppy:
[1:16:05] And I remember saying to him, do it. Just do what you need to do. And we reflected later on. And he had said that in that moment, he felt a huge sense of responsibility for us, having his wife and his now son and him. How is he meant to assess blood loss? how is he meant to know truly if this baby's okay he wanted some reassurance and in our preparation the meetings that we'd had to talk about this birth he had made it clear that he was comfortable with an unassisted birth but for him he really needed to know someone was on the way for afterwards that was where his his cutoff was and I was happy with that too we're not we're not you know I would have loved to have had a midwife there holding my hand through my birth it wasn't possible for us so for us you know i was happy to have that reassurance um So he's calling the midwives. And at this point, I thought I'm going to phone my midwife friend to get her on video and just check her, get her to help me assess the blood loss in the pool. So I phone my friend, midwife, Vic, and she's like, hey, baby. I'm like, baby here.
Poppy:
[1:17:16] So I'm like, can you just let me know, does this look okay? Does this blood look okay? And she's like, look, I can't, really can't clinically assess you right now over video, but it looks okay. And obviously I could tell she was kind of wanting to, you know, she didn't want to say something that wasn't true. She was struggling to see, you know, as a midwife, it would be very hard to fully confirm that everything was okay without seeing in person. So I quickly wanted to say goodbye and phone my midwife, my doula friend. And so I said, thank you. Thank you. Okay. Bye. And then I phoned Kiki Hansard. And I was like, Kiki. And she was like, congratulations.
Poppy:
[1:17:52] So if we go okay here. And she's like, looks amazing. She's like, I don't know, does the blood look okay? She's like, fabulous. Like, you know, she's obviously doesn't have that same thing as a midwife where she felt quite confident to let him know. So meanwhile, in the background, I can hear this paramedic on loudspeak. So I say goodbye to Kiki, I'm holding baby. And I can hear the paramedic in the background. And he's like, where's your wife? And my husband's like, she's in the pool. And he's like, what pool? So I can hear in these like, is the baby breathing? You know, and already I'm like, right, okay. I need to kick into gear right now and recognize what's happening. Paramedics are coming to the house. I know these paramedics are coming with paramedic energy. And so they should. That's their job. That's their remit. And so I need to make sure that I'm protecting my oxytocin bubble because I need to birth the placenta. And that was kind of my next mission was that I needed to birth the placenta safely. And at the moment, there was a bit of a risk here in that the energy of the paramedics coming in could actually send me into an adrenaline state. And then quite quickly, actually, the paramedics arrive. I can't remember the exact timestamp, but it was fast. Here in the UK, you know, the response times are really quick. So I'm in that room over there. There's glass windows. And I just see four paramedics coming in with their rucksacks and their stuff and their kit and their full, you know, attire.
Poppy:
[1:19:18] And I could see the whole scene was like, right, we're here. We're here. We need to check things. Okay. So they open the door.
Poppy:
[1:19:24] And they're like, right. Like, hi, mom. You okay? Has baby been breathing yes so um straight away they were like look we need to get you out of the pool because we need to assess you we're not qualified to assess you whilst you're in the pool so I start getting up we we had um towels with the baby so I'm kind of holding holding him up um and they say is he still attached to you I say yes I want to make sure that the blood's transferred across so already I can kind of see that they're sensing that I'm someone that has a bit of a plan here like I'm not going to just submit to everything that they say um and then so I so I get on the bed and then the male paramedic said uh because your placenta hasn't come out yet we need to look at transferring you in
Poppy:
[1:20:10] So I'm on the bed, I'm holding the baby and I look at him and I say, look, I know that you need to tick your boxes and that's fine, but I'm going to decline that and I'm staying here because this is where I'm going to be able to get the placenta out safely. I'm going to need time and I need to just be with my baby and I will get this placenta out. Don't worry. And he was just like, okay, mom, sure. So they they had checked the baby's uh temperature and they they i could tell they weren't really believing me that he had cried so like are you sure he's cried he looks really chilled and i'm like it's a physiological birth this baby's chilled so then they insisted on kind of rubbing him just to hear his cry which i was fine about they were doing their thing so they come over and do a bit of a rub and then he cries obviously and they're like right fine tick that's fine so they they They checked his temperature and he was a little bit lower than what they were happy with. So they said, look, we want to put him in this warmer, this little bag thing. And I was happy with that. So they put him in the warmer and I was still able to breastfeed him. And then I said to them, could you give me some space now? I want to work on getting this placenta out. I was experiencing really strong after contractions, really mighty strong after contractions. And to be honest, at this point, I wasn't interested in using hypnobirthing. I'd done my progeneral labor for a week. I'd done 15 hours of labor. Get me the gas and air. I was keen at this point. Do they carry it? They carry it.
Mel:
[1:21:36] Okay.
Poppy:
[1:21:38] Yeah, yeah, yeah. So that was a touch. so so um but actually i forgot to mention before i said to my husband i was like maybe i need some coaching through these contractions and he was like oh you're doing amazing but so half-assed like yeah you're you're doing a great great great amazing and then i was like right this is not working you're not gonna help me through these i can't really be bothered get me the gas and air so i said could you bring in the canister of gas and air they gave it to me so i'm on the bed got my baby in this bag breastfeeding him gas and air in one hand and i say to tom i was like put some tunes on let's make this a vibe upbeat music at this point i'm having the gas in there during the arse contractions and i'm actually vocalizing at this point because these felt a lot stronger than the actual birth which was interesting so i'm vocalizing into the gas in there like and then breastfeeding and out of the corner of my eye i can see all the paramedics just outside it was a beautiful sunny day we've got this patio with a with a table and they're all out there like nattering away so I'm there with my backs out with the gas and air like baby in the bag like breastfeeding and I'm just like I need these people to get out of my vision because this is like I've got people waiting for me to do this and this is adding pressure so I said to my husband just open the door a little bit I was like guys do you mind going into the house make yourself a cup of tea make yourself comfortable I just really need some privacy here to get the placenta out and they were like, sure, is that okay? So they went into the house.
Poppy:
[1:23:06] Now I'm like, right, this is it. I'm going to be able to get this placenta out. So this continues for like an hour. The lady comes back in and she's like, is the placenta out yet? And I said, look, I haven't tried to push it out. But basically, Mel, my game plan was that I wanted to make sure that I was giving my body the best chance to get the placenta out. And I knew that if I'd gone to try and push it out and it wasn't out, then they would start applying pressure. So I had a bit of a strategy here that I was just going to continue. And then eventually i wanted to make sure that it would be out last time with olivia's birth it took two and a half hours so i knew that it could take time
Poppy:
[1:23:47] So um i just said just give me a little bit more time i promise i'll get it out then she went back into the house um and another hour had passed and then they they were getting a bit tetchy because uh they basically couldn't essentially discharge us um without this placenta out so they phoned the midwives and the midwife was now available so the mid two midwives came yeah two midwives came and they were lovely like just the right energy that I needed um they came into the room and the midwife was like look like let's just go and see if we can get this to center out let's see if we can push it out so she laid the little bucket thing in the toilet and so I waddled over I gave the baby to my husband and I waddled over to the toilet and I sat down I shut the door and at this point I still have the gas and air and I'm going for it in this little bit high state.
Poppy:
[1:24:41] And then I start doing the hypnobirthing down breathing. I'm like, and I can feel it just there. And then it comes out along with a relief, such a relief along with a gush of blood and the biggest we I've ever done in my life.
Mel:
[1:24:58] The biggest we. That could have been what held it up.
Poppy:
[1:25:01] Maybe.
Mel:
[1:25:03] Sometimes if there's a full bladder there, it can be tricky to get things out of your uterus.
Poppy:
[1:25:07] Yeah.
Mel:
[1:25:08] Yeah.
Poppy:
[1:25:09] So the biggest we ever. and then I looked down I was like damn that looks like a lot of blood and and that looks like you know so I I warned her I was like I've just done a really big weed don't worry it's not I in my head I was just like I don't want anyone worrying about to like blood loss or this I knew things were fine so she was like absolutely fine yeah then I then I put a pad on um and then I was like wow like this is this is truly it like the the birth is complete like I'm safe baby's safe and I'm just thinking right okay I need to just get all these people out the house now and just wind things down so take baby go back into the house and they were like do you need us to make you tea do you need us to tuck you up in bed and they were just being so kind and and really caring um and I said no uh thank you so much but you know we're all done here no like congratulations you did it like it's amazing and I actually thought to myself you know women go through so much during labor and I don't really feel like there's enough of a congratulations and there's enough of like acknowledgement it's so easy to just say happy birthday to the baby and say you know and no I don't really feel like no one really looks you in the eye and says you just did that no yeah congratulations and I felt like I kind of got that from those midwives which felt really um amazing
Poppy:
[1:26:33] And then I went into the downstairs bedroom and my husband bought me this flask of honey decaf tea, which was delicious. And had baby on my chest, making sure he was warm.
Poppy:
[1:26:46] And yeah, I was just in this bubble of like, wow, like we did this, we did this together. And I couldn't believe it. We did that. Yeah.
Mel:
[1:26:55] Amazing.
Poppy:
[1:26:56] Thing yeah a big thing for me is with during my pregnancy this third pregnancy was very different to my previous two um I had experienced extreme emotions uh extreme lows um you know some days I'd wake up and literally just be stood at the the island making porridge for the girls and then just start crying um a lot of emotions really uh and and my husband was quite finding it difficult to know what to do with me. And I felt throughout that pregnancy, I'd built so much inner resourcing because I realized that, you know, I told my midwife about it. I told Tom, I spoke to friends, but I really could feel that no one fully understood what I was going through. And I stopped expecting people to, I stopped expecting my husband to understand this extreme hormonal weather.
Poppy:
[1:27:49] And I just started to build inner resourcing and build positive self-talk. And all of that work I'd done over pregnancy was available to me during that seven, eight hours laboring alone. It was available to me in that pool, realizing that no one else could do it. And I really realized having had three pregnancies and three births, how for me, and this is my perspective and not everyone will resonate but I feel that there is something deeply you do it alone like you you fundamentally have to labor and experience the physical side
Poppy:
[1:28:27] Alone it's you your your body and your baby obviously but fundamentally it boils down to that inner strength and and and that resourcing and my husband was there for me during the labor his voice was my anchor I had the oxytocin bubble but fundamentally it was me that had to get through it and and having had that pregnancy was really an amazing learning experience for being my own anchor and really kind of having that. And can I also just add that, you know, that applies to getting through the intensity of labor, getting through the transition, getting through the physicality of the laboring experience. But I think it very much applies to when birth doesn't go to plan, when you are having an unwanted cesarean or an unwanted intervention, or when you have to transfer in those moments I truly believe is when hypnobirthing breathing techniques and mindset come into handy even more than when you're going through the physical sensations and that's why um I I'm so passionate really with helping women prepare for all types of birth and this is something I've really been thinking about a lot um deeply is is like
Poppy:
[1:29:41] Really not being too attached to a certain kind of outcome. Because I think especially people who follow you, Mel, and follow me, and who devour your podcast, are women who are doing everything to try and set the wheels in motion for the birth that they want. And the downside of that is the risk is, is that when it doesn't go to plan it, or if it slightly deviates, you instill this sense of shame and guilt. And my goodness, what a bad way to begin motherhood. And I think the real learning is actually trying to use your tools to navigate any scenario and leaving your birth experience with a sense of empowerment, regardless of what happens, I think is so important, isn't it?
Mel:
[1:30:27] The other thing is the thing that makes a birth great is not that everything went to plan, because we can't really control the events of your birth. There's an element, there's little bits and pieces that you have control over, but there's a lot that you don't have control over, like the unavailability of your midwives, right? That could have been a massive turning point. When women describe a great birth, it's usually because they, in any, however it turned out, they were respected and cared for and they had what they needed and they could make decisions and they felt autonomous and in control. It wasn't so much about the outcome because even women who had unplanned caesarean sections, I've had clients describe their births as incredible, even though they were planning a home birth. But they transferred into hospital and had a cesarean. They're like, it was so good. But that's because they had every opportunity to make their own decisions, that they felt like everything that happened was actually necessary and that they chose, even though it wasn't the original intention.
Poppy:
[1:31:38] It's interesting because my birth with Olivia, my second birth, which on video, on paper, looked perfect. But actually i look back on that birth with with pain because of how intense it was and i i made some mistakes in the way that i prepared um i kind of got led down a path with the pain-free birth ideology and sort of convinced myself that i could somehow dissolve pain how silly of me um but like i speak to my husband and he he still struggles to understand why i felt that birth wasn't extremely positive in terms of the internal experience because I was fighting. I wasn't prepared. I felt everything was so intense and it felt so hard. But on paper, it went to plan. I had a home birth. I was in a pool. But actually, it's so much about the internal experience, isn't it?
Mel:
[1:32:34] Absolutely. And so much about the expectations. I know a woman who, went into labor, labor progressed really quickly she she got to hospital the baby came out her and her baby were fine yet again on paper all the statistics like whoa this is just, a woman's body birthing efficiently, She was devastated. She said, it's not what I wanted. I didn't want to feel it. I wanted an epidural. I wanted to not feel anything. Instead, I felt everything. And you're like, whoa, for one woman, this is a dream birth. And for another, it's their absolute nightmare. And so it's- So interesting. It's so interesting. You know, our expectations and our hopes and our dreams about the birth, you know, if they're not met, we can feel so robbed or so disappointed or so traumatized. Yes, yes. And it's part of the growth. It's part of the growth of matrescence as well to be doing these hard things and going, what? I need to reflect and think and how does this change us as people, as women and as mothers with our birth experiences? I mean, we could talk forever.
Poppy:
[1:33:46] Yeah, part two maybe. Yeah.
Mel:
[1:33:49] Thank you so much because your baby's now what 12 weeks.
Poppy:
[1:33:54] Yeah oh my gosh april the 13th i remember we were meant to be doing this podcast earlier thank god we didn't i was in the right state um so yeah no no it's three months or so
Mel:
[1:34:05] Yeah yes amazing are there any final thoughts you'd like to leave us with puppy as you reflect back on your story or anything that you learned that you think another woman could benefit from?
Poppy:
[1:34:17] I would honestly say trust your body. And let your body guide you because it's constantly giving you information especially when you're pregnant I feel like your body is so communicative and trust that you are designed for birth and in most cases that process works well and in the minority of cases it doesn't and we are thankful to have help but trust your body to kind of lead you and listen to it yeah and that's a process that I think needs to be practiced over pregnancy because we're not used to listening to our bodies and so just tuning in and committing to a meditation practice commit to your breathing practice these tools so that when you're in labor you are merely stepping back into a state that you had been in during your pregnancy you're not scrambling around trying to remember technique you have been there you are just going back into that calm internal state beautiful
Mel:
[1:35:17] Oh my goodness Thank you so much for sharing your journey, Poppy. I know women who are listening, particularly the ones who maybe they've come to this episode and they are in the throes of prodromal, long prodromal labor. I feel like you've given us a glimmer of hope and some really helpful strategies that women can use. Thank you so much again for being with us, Poppy, on the Great Birth Rebellion podcast.
Poppy:
[1:35:40] Love your podcast. I'll be here anytime. Just let me know when. So good. Incredible. Frothing for an episode.
Mel:
[1:35:49] To get access to the resources for each podcast episode join the mailing list at melanie the midwife.com and to support the work of this podcast wear the rebellion in the form of clothing and other merch at the great birth rebellion.com follow me, mel @melaniethemidwife on socials and the show @thegreatbirthrebellion, all the details are in the show notes.
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