Precipitous Labor: An Editorial

I used to be terrified of childbirth and actually burst into tears when I discovered I was pregnant with my first child because I realized I would have to give birth. Due to suffering with vulvodynia the medical staff advised me to have an epidural so after my daughter was born I still didn’t really know what birth felt like.

After a forced episiotomy and complications that ensued, I didn’t want another hospital birth but was told I had to because of the vulvodynia. With my second daughter I had another epidural and the third, a TENS machine that I later found out wasn’t working because they hadn't realized the pads had come off my back!

So childbirth didn’t really get my vote of approval and when I found out I was expecting my fourth child, I was dreading the whole experience. Through her birth, I discovered that childbirth is not always painful and doesn’t have to take hours, either.

On the day of her birth I took my older daughter to toddler group and then I stopped at a sandwich shop to buy lunch. After I had eaten the sandwich, I started to feel nauseas and mistakenly thought my food must have been "off". I mentioned this to my husband who told me to sleep it off and said it was normal for a nearly 9-month pregnant woman to feel bad. He went to a DIY store to buy shelving units and I did as he suggested and fell asleep for two hours.

When I woke up at 4 p.m. I needed to go to the toilet urgently so I went and sat there waiting, but nothing happened. I also noticed I was spotting slightly. I was irritated. First I felt sick, then I was constipated and now I was bleeding!

I phoned my husband, who was still shopping, and told him about my symptoms. He said it was probably because the doctor had examined me the day before and was not at all gentle. He said she was probably "too rough" and that would account for the spotting. I accepted this as a likely possibility and wasn’t worried about the baby because she was moving and active.

I went downstairs and had two mild contractions, no worse than period pain, so I called him back again and told him that we might be having a baby. He reminded me I was 39 weeks and we’d never had an early one and told me to see if I got anymore and then phone him back. I had another so I called back only a couple of minutes later. As I was explaining this to him, my water broke in a tidal wave gush and I shrieked from the shock of it and nearly dropped the phone.

What happened next I will never forget. I realized in a sudden moment of clarity that the constipation I felt was in fact the baby’s head. I told him my water had broken and I needed to push. He laughed at me, I’m sure he thought I was over-dramatizing. After all, women don’t have babies instantly, do they? And they certainly don’t have painless labor.

Three more "period" cramps later, one minor push and her head was born, with no pain whatsoever. I was still on the phone so I told him I had delivered her head and I didn’t know what to do because my jeans were still on. I was scared she would suffocate. He erupted into panic like the dads do in the movies and just kept shouting "Oh my God," and "You’re kidding!" down the phone at me.

I told him, calm as a cucumber, that no, I would not kid about a thing like that, and there was definitely a head there! After he had finished panicking, he told me to take my jeans off.

"I can’t , can I?", I said, irritated, "I’m on the phone!"

That was a stupid thing to say but I guess no one knows how they are going to react until it happens to them. How he responded was equally as hilarious. He said, “Well, put the phone down, have her and then call me back!”

I did as he said. I put the phone down, gave one more push, then she literally fell out of me onto the rug, screaming with the indignity of it. I picked her up with one arm and dialed her dad with the other arm, shouting, “She’s here! Can you hear her cry!?!”

When I looked at the clock it said 4:25 p.m. It had only taken me 25 minutes from the start of contractions to birth, and there had only been six painless contractions. I couldn’t believe it. All he said for the next week was, "Oh my God."

I never believed in painless birth but my daughter showed me it was possible. I later found out when I was trying to understand how I could have a painless birth that many other women have had similar experiences and some doctors, such as Grantly Dick-Read, M.D., have written books about the phenomenon of painless childbirth. He routinely handed out chloroform to women in labor and in the 1920’s, one woman refused it. He watched her give birth naturally with no pain. When he asked her why she didn’t feel pain, her reply was, “It didn't hurt. It wasn't meant to, was it, doctor?"

That encounter changed his life and he became the father of the natural childbirth movement.

I realized that what I thought was an oddity was actually normal. After all, we don’t often see animals suffer for hours and hours when they give birth. Almost five years later, I gave birth to my son in a planned home birth with no drugs, no pain and only one hour and 45 minutes of "period" cramp before he arrived, all 9 pounds, 1 ounce of him. I didn’t experience pain, only an intense pressure as his birth neared.

Precipitous Labor

The medical term for what happened to me is called precipitous labor, that is, a labor and birth that lasts less than three hours from start to finish. Sometimes a very fast labor can cause intense pain, but in my case and others I have heard about, there was no pain or minimal pain.

Women who are more likely to have precipitous labor include:

• Young women
• Women who have had several children before
• Women with a high tolerance of pain (they may not feel contractions and not realize they are in labor until the delivery)
• Women with cervical weakness.

What to Do in the Event of Fast Birth

Firstly, remember to phone the midwife or doctor! I didn’t because I didn’t remember. I was so caught up in trying to get my husband to come home, I didn’t think about it. He eventually phoned them and I was attended one hour after delivery.

Even if you are planning a home birth, pack a bag with baby clothes and diapers in it so you know where everything is after you have given birth.

Kneeling on all fours can slow the descent of the baby’s head and minimize the risk of tearing. Lying on your back can make labor hurt due to pressure on your back and pelvis.

If you think you might want pain relief, hire a TENS machine as you can stick the pads to your back at home and the tiny electrical impulses mask contraction pain and increase your endorphins. You could also have acetaminophen or codeine if you want post-birth pain relief. Check with your doctor if you are breastfeeding.
Use plastic sheeting such as a shower curtain to kneel on so you don’t spoil the carpet.

Drink plenty of water as this reduces the chance of low blood pressure/shock after birth.

After the baby’s head is born, feel round the neck to make sure the cord isn’t round the neck. If it is, gently lift the cord over the baby’s head or loosen it.

Don’t attempt to cut the cord. If you leave it attached, it provides oxygen for the baby for 15-20 minutes after delivery, even if his breathing is poor. After this time, the cord dies and can be severed. By that time, a medical professional should be with you.

If the baby is slow to breathe, dial 911 for instructions on how to help your baby. You can also rub his chest with a towel to encourage him to breathe.

If the baby is choking on fluids, use a towel or blanket to wipe his nose and mouth clear. If you are planning a home birth, buy a bulb syringe just in case you are on your own when the baby is born. This is to suction his mouth out and they are available from home birth and midwifery supply online stores.

After you have delivered the placenta, press down firmly on your abdomen to help stop heavy bleeding.

Make sure your baby is warm while you wait for medical help.

You can nurse the baby straight away. The baby will nurse better and maintain his body temperature better if he is skin-to-skin with you.

Above all, enjoy your new baby!

Sources:

The American College of Nurse-Midwives, Giving Birth’ in Place’: A Guide to Emergency Preparedness for Childbirth. Web. 31 August 2011. http://www.midwife.org/siteFiles/education/giving_birth_in_place.pdf

Precipitous Labor/Delivery or Unplanned/Out-of-Hospital Delivery, Nurse Review. Web. 31 August 2011.
http://www.scribd.com/doc/2761925/NurseReviewOrg-Precipitous-labor

Childbirth Classes and Techniques: The Teachings of Grantly Dick-Read. Childbirth without Fear, Pregnancy Today. Web. 31 August 2011. http://www.pregnancytoday.com/articles/birth-methods-and-philosophies/childbirth-without-fear-1924/

Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/. She is author of the book, 'Breast Milk: A Natural Immunisation,' and co-author of an educational resource on disabled parenting. She is a mother of five who practised drug-free home birth, delayed cord clamping, full term breast feeding, co-sleeping, home schooling and flexi schooling and is an advocate of raising children on organic food

Reviewed Sept 1, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith

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