As most of you know, I teach a 10-week course on natural childbirth. The first night of class, the number one question is, "When do we go to the hospital?" Line-upon-line here. We don't hit that until Class 5!
Over the years, I've learned that this question is really asking, "When can the professionals take over?" It usually is asked by a dad-to-be. It's interesting to watch these expectant parents learn and grow. Education and information is unbelievably empowering! Several years ago, I was teaching "emergency" (ie. unattended) childbirth. By the time we get to that point, we've spent countless hours together, watched more than a dozen birth videos, and everyone has a very good idea of what normal childbirth involves and what to do -- or not do! I asked this particular father-to-be how he felt about the possibility of this happening. I should preface his answer with the fact that he didn't speak to me until Class 5 and was totally depending on his mother-in-law to help his wife at the birth. He despised that he was forced into attending this class. So, when asked this question, I was amazed at his cool reply: "On the one hand, totally terrified, but on the other -- bring it on!" I should also mention that the mother-in-law didn't make it to the birth and they were only at the hospital for 22 minutes before the baby was born!
The answer to the question "When do we go to the hospital?" often changes as you get more information. Let's back up for a minute. You know how I feel about hiring a doula. Do it. Who are the people you are inviting to your birth? A sister? Mom? Mother-in-law? Other children? Your best friend? Do you call them all the minute you have your first "real" contraction? Of course not.
There is nothing like being pregnant with your first baby. Not that the other pregnancies and labors aren't exciting, but they are undeniably different. You've done it before. You have distractions now that you didn't have the first time around. Regardless of what baby number this is, enjoy early labor with your spouse. I love early labor! Get into a rhythm together. Figure out what works, what doesn't. Practice different positions. Nap. Eat. See a movie. Enjoy this time together.
Everyone's labor is different. You may have several hours of early labor -- this week I had a mom that did this for several days! -- or it may not exist at all. You may jump right into active labor and need your doula right away. There is no way to know beforehand.
But let's assume that you do have early labor -- you are contracting regularly but are able to talk, walk, or sleep during and/or between contractions. If your husband is sleeping, and it's 2:00 a.m., let him keep sleeping. A lot of moms don't like it when I say that. Here's the thing -- yes, labor is exhausting, but it's also exhausting for your birth team. This often doesn't get a lot of sympathy from moms, but if your labor is on the longer side, you are going to need your birth team to be able to step it up, and they may not be able to if they are utterly exhausted. If you don't need his help, let him keep sleeping. You'll both be glad later. You may find yourself enjoying those early contractions, just you and the baby.
As things progressively get harder -- and you feel like you need some extra help -- think about who you want to reign in. Maybe it's your sister or mom or maybe it is your doula. Whoever it is, be sure that you are ready for the help. And perhaps even more importantly, be sure they will be a positive influence on your labor. For example, the mom who is freaking out that you didn't go to the hospital with the first contraction or the minute your water broke may not be the best person to be with you and your husband. She may not be someone you want at your birth at all! In the end, if you don't need help yet, you may feel like a watched pot, which won't be good for your labor.
There's not a set time that is right for all couples. I hate it when couples are told to head to the hospital when contractions are 5 minutes apart lasting 60 seconds. You could do that for hours! It's really hard to explain, but there will come a time in your labor that you will know who you need. With my 2nd baby, I had no early labor and wanted my friend there immediately. It was a very fast labor. But with my 3rd and 4th babies, no one was there until about an hour before the birth, including our midwives. But I knew when I needed them.
Again, it's hard to explain, but there will be an urgency felt to be with your birth team as labor progresses, whether you are in the hospital or at home. This will be different for each woman. Some women feel this urgency earlier than others. This is their emotional relaxation -- how they feel about where they are giving birth, who is there, are their wishes being honored? I remember with my first homebirth -- 3rd baby -- the minute the midwife walked through the door, I felt like crying. I felt such a release. She wasn't there more than an hour and my baby was born. My body held back until my birth team was in place.
I often think of it as involving people according to their skill set: my mom was needed because I needed help with the other kids (1st called). She cleaned up, made food, changed sheets -- a good one to have around! Anyone else helping out with the kids was next. They'd usually help my mom too. One of these people was usually on video duty. As labor progressed, if I had a doula or doula-friend, they'd be called in to help me and David. Your chiropractor is also a great person to call in for a period of time. Eventually, you'll want someone to catch the baby, so either calling your midwife or heading to the hospital will be necessary! You'll know when this time is. You'll be very serious, eyes closed, not talking or smiling. Some women will be sounding out contractions and others won't make a peep. Either is fine. One is not better than the other.
My ultimate answer to the question "When do we go to the hospital?" Alright, here it is. There will come a point when she (talking to dad because mom won't remember this or be thinking logically) will not want to walk anymore. She will still get up and go to the bathroom when you encourage it, but she doesn't want to. She has to wait till the end of a contraction to get up and she will move quickly so she doesn't get caught standing up during a contraction. Contractions are stronger and longer when she stands up. Still willing to move, but not wanting to. This is usually a good time to mosey on down to your birth place or call in your midwife. Labor is very well established at this point.
Most of all, enjoy your labor. Choose your birth team carefully and reign them in as you need them. So many women wish for a fast labor, not understanding how hard a fast labor is -- just to get it over with. A longer labor is not a bad thing. Like I always say, labor and birth serve as a bridge between pregnancy and becoming this baby's mother and father. Enjoy it. These hours are unlike any in your whole life.
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