How to Advocate for Time in Birth for a Better Experience on Your Own Terms
This week on the blog, I’m going to talk all about how to advocate for time and how you can use it as a tool for a better birth.
We live in a world where there is incredible pressure to measure, quantify, and time every aspect of pregnancy and birth. In this article, I’m going to unpack how time impacts the pregnancy and birth experience in our current culture. You’ll also learn some strategies to help you advocate for time in birth.
A Brief History of Time…
The idea of talking about time as it relates to pregnancy and birth is so interesting. The vast majority of human civilization has been spent using natural landmarks and seasonal routines to measure the passage of time. It is only in the very current era of humanity that we see such a focus on time as a numerical formula for how and when things are supposed to happen.
In the 1700’s, the age of reason began to usher in an importance of science, numbers, and measurements. The enlightenment moved us closer to this place as well. Then, we moved into the industrial revolution which centered upon quantifying human production as a means of furthering society. This eventually moved humanity away from its traditional agrarian or rural based culture and into a fast-paced, urban, productivity focused lifestyle.
Becoming an Advocate for Time in a Patriarchal System
Also in history, we have the deep trauma associated with the persecution of midwifery. This is especially notable as the black midwives of the south were persecuted, discriminated against, and no longer supported in their ability to serve their community. Many of the birth practices traditionally used during this time were stolen and erased within the medical culture.
This is the result of the push to bring birthing people into hospitals to birth with doctors outside of their community rather than their local, community-based family midwives. This sets us up to have an incredibly racist, patriarchal, and misogynistic birth culture in which the human body is put on a clock and expected to comply with the rules of people in power.
That Damn Friedman’s Curve…
In the 1950’s, Dr. Friedman developed what came to be called Friedman’s Curve. This is essentially a graph that charts how long average labor should take. It looks at how quickly a parent should dilate and birth their baby based on averages taken at the time.
If a labor was taking longer than expected based on this curve, it was diagnosed as failure to progress. This has led to an incredible amount of cesarean births as a result of the failure to progress label. This study was conducted using information from 500 births, and 96% of the parents were under sedation.
This was done in the twilight sleep era, where it was standard to sedate birthing people in the hospital (often very heavily to erase memory of their experience). The standard was to then cut an episiotomy and use forceps to deliver a baby.
What Does Friedman’s Curve Say?
Friedman found that the length of time to get from 0-4cm was 8.6 hours. Then they dilated an average of 3cm per hour until they hit 9cm. It slowed between 9-10 slightly. The average time to get from 4cm-10cm was 4.9 hours. The average length of pushing was one hour.
Advocate for Time in Pregnancy: Brain Wave Changes
So, now we are living in the year 2021, where every aspect of standard medical care in pregnancy is calculated, measured, quantified, and timed. Also, we still follow the inaccurate science of due dates as if it were infallible.
From the day you pee on a stick, you’re thinking “how many days post ovulation am I? When’s my due date? What’s my HCG? What’s my progesterone level? How many weeks and days am I?” And I am not saying anything negative at all about this, but my personal experience and support experience tells me that this is how our brain is programmed to think.
Brain Wave Changes
Something amazing happens in pregnancy, alongside growing a baby. In pregnancy, our brain waves change. I have a whole podcast episode where I talk about the brain wave changes in pregnancy and birth so I won’t reiterate that whole story.
Have you ever wondered where the term “pregnancy brain” comes from? This is because you’re not living in your every day reality as much. Pregnancy is experienced in alpha brain waves. It’s the realm of the heart, emotions, the senses, and creativity. You move from those super fast beta brain waves of ordinary reality and into a more heart-based experience.
If you’re pregnant now, or have had a baby before, you probably also have experienced time a little differently. In the alpha state, time becomes a more subjective experience. Have you ever done a creative project where you’re really in the flow state and you totally lose track of time? That’s the alpha brain wave state.
Time in Pregnancy
This is why pregnancy can feel like the longest and yet the shortest time in life. The days are long and the weeks are short. It calls you into your emotions and senses and you experience the present time in a different way.
You can also compare this to the brain changes that happen if you use cannabis. It puts you into the alpha brain wave state – the realm of the senses and the heart – and you can easily lose track of time in this place. What’s the difference between 20 minutes and two hours? Who knows! Children also live in the alpha state. Did you ever notice how they seem to live in their own time? This is why! They’re in the present. They’re in alpha.
Also, this tends to ramp up at the very end of pregnancy. It coincides with all those amazing hormones that drive the labor process. As you move through the deep theta and delta waves of the birth process, time becomes completely warped and irrelevant.
If you’ve had a baby before, then you know that your perception of time is totally altered. What feels like hours may only be 30 minutes. So, it really doesn’t matter what the clock says. You’re just basking in the cosmic consciousness of birth as your body is doing exactly what it needs to be doing.
Advocate for Time as a Natural State
Our bodies have always existed on a natural timetable. Sometimes, this is called horticultural time. It’s nature time. No matter how much we try to escape it, we’re animals. The body doesn’t read the clock. There’s no oven-timer that’s going to pop off and say, “we’re done here!”
Our childbirth care system exists in beta brain or technocratic time. It’s all about hard science, numbers, measurements, and timing. Every aspect of our experience is timed, measured, and quantified – even when there isn’t good evidence to support using these tools (such as continuous fetal monitoring, for example).
How to Advocate for Time When Faced with an Induction of Labor
The importance of time begins to play into the experience of birth in our culture as you approach your due date. The majority of people birthing in the childbirth care system are scheduled for an induction by 41 weeks of pregnancy, if not sooner. Often times, these inductions are scheduled starting at 39 weeks, just because that number means your baby must be done.
Of course, there are certainly important medical reasons for an induction of labor and it is a truly lifesaving intervention and I am so thankful that we have this tool available for families that really need it.
But as a doula, what I see is that the vast majority of people offered inductions at 39-40 weeks don’t really want one. I especially hear coercive language such as, “The schedule is booked for next week, but we can get you on the schedule tonight!” If someone really needs an induction, how can you deny them care because of a full schedule? I hear this statement used all the time, and I can’t possibly believe that this is true so often.
Advocating for more time, in the absence of medical necessity, is one of the greatest tools you can use for a better birth.
How to Advocate for Time When You’re Approaching Your Due Date
There are many ways you can advocate for time if you’re faced with an induction because you’re nearing your due date.
Firstly, you can read my last blog post and ask for your bishop score. This gives you information about your body’s readiness to go into labor and tells you how likely an induction is to lead to a vaginal birth. Essentially, if you’ve got a thick and closed cervix with a baby high in your pelvis, there’s a much lower likelihood that a medical induction will lead to a vaginal birth.
If your body isn’t ready for labor, you can simply use that information to make a decision. You always have the right to decline an induction if you don’t want one and if you don’t feel ready. Also, you can advocate for more time to wait for labor to begin on its own.
Stay Home in Early Labor: Advocate for Time to Labor on Your Own Terms
Another way to advocate for time as a tool is to stay home as long as possible in labor. Firstly, it is safe for the vast majority of birthing people to stay home until active labor begins. This means that you can stay home until you reach about 6cm dilation, with contractions 3-4 minutes apart lasting about 1 minute long for at least an hour.
So many first time parents worry that they’re going to wait too long to go to the hospital. What I often see is that early labor begins and the parents get anxious and after a short while they go in to the hospital.
Firstly, this is problematic because as soon as you are admitted to the hospital, you’re put on the clock. The staff has an expectation that you’re going to birth your baby according to their standard time allowed for a laboring patient. Secondly, they might not be following Friedman’s curve exactly, but they’re following their own standard of care and expectations for how long labor should take. If your labor doesn’t follow their standard for progress, they will suggest using Pitocin to speed up your labor.
Wait For Solid Active Labor
Firstly, waiting until active labor begins is a great way to use time to support your experience. At home, you can let things flow at their own pace in your comfort zone. You can relax, build your oxytocin, and avoid the pressure of other people’s expectations.
If you’re having an extremely long and exhausting early labor stage and you need support, you could certainly choose to go in to the hospital. Also, even if you do choose to go in to the hospital and you’re not at the 6cm point, you can go home and wait! You’re not a prisoner – and you have the right to go home if you want to because you’re not in active labor.
How to Be An Advocate for Time in Active Labor
Once you’re in active labor and at your birth place, there are so many ways that you can advocate for the tincture of time.
One scenario that arises is cervical exams. You have the right to decline any exam you don’t want. If you are offered an exam and you don’t want that information at the moment, you can always say something like… “We’d like to wait an hour before checking for progress.”
One of my favorite phrases to use sounds like this…
“Thank you so much for your concern. It’s important to us to have as little disruption as possible in labor. We’d like to wait an hour.”
You can advocate for time when being offered labor augmentation such as Pitocin as well, if you don’t want it.
If there is a stall in labor, and you’re okay with continuing on your own, you can always advocate for more time to make a decision about an intervention.
You can say, “We’d like to wait an hour and see how labor progresses.” You could also say, “We’d like to try a few different labor positions before making a choice.”
Be Aware of Provider Convenience
Be aware that you may be offered certain choices simply because of provider convenience. This sounds like being offered Pitocin before there’s a shift change. It also sounds like being offered an epidural earlier than you want one. You might be told it’s “the only time the anesthesiologist might be free,” or simply being offered a cervical exam because it’s the start of a shift change.
Advocate for the tincture of time. You are the center of the spiral. You don’t have to accept or decide on anything until you are ready.
And if it were truly an emergency situation, you will absolutely know because the entire tone and affect of the room will change and you will instinctively know it is an emergency.
Examples of How to Advocate for Time: A Few Stories
As a doula, I see the tincture of time as one of the most effective tools for a better birth.
Allowing Labor to Progress
For example, just this week I was supporting a family and they were experiencing a very long early labor. They were handing it beautifully and didn’t urgently want to do anything. Right at about 6cm, progress stalled a little bit. They were offered Pitocin many times and put it off. We simply asked for more time to make a decision.
I had to take a lunch and breastmilk pumping break for a few minutes and the family asked the nurse to wait to make a decision until I got back. Within a few minutes of me returning, my client’s water broke which ushered in the rest of the labor process and she birthed her baby within a few hours – no Pitocin needed. So advocating for time can be really incredibly powerful. In the absence of medical necessity, don’t let anyone rush you or put you on their time table.
Trying one more position…
In another experience, I had a client with a very long labor. She had an epidural, and progress was slow. Her team seemed very impatient and quick to suggest a cesarean birth. We said we were going to try one more position to try to get the baby to turn and move down. I helped her get into a left side-lying position. Her belly was pointed to the floor with her leg up on a peanut ball. I call it a “left side roll over” position – I have no idea if this actually has a name. Anyway, it worked perfectly and within about 30 minutes she was pushing her baby into this world – no cesarean needed.
If you don’t know what to do and you’re not ready to make a decision, advocate for time. If there’s no medical urgency or emergency happening, I would question anyone who rushes you or tries to coerce you into making a decision that you aren’t ready for.
ATTENTION EXPECTING PARENTS
Looking to give birth with gentle loving awareness…
I have an amazing in-person workshop that I am hosting in Rochester, NY. I’m hosting the Blissful Birth Masterclass on August 15th at 10am. In this workshop, you’ll learn my 3 proven strategies for a confident, peaceful, and comfortable birth. You’ll learn amazing relaxation and connection strategies to help you build a comfort ritual for birth – no matter where your birth journey leads.