EARLY LABOUR:
Ideas for coping and Optimal Foetal Positioning

In the UK, birth is a normal event in everyday life and is facilitated and supported by midwives, the lead-professional for women with a healthy pregnancy.

Labour and birth is a normal, physiological process and for many women this process may take many hours – particularly with a first baby.

‘Early’ or ‘latent’ labour is a phase of labour that may last many hours; evidence shows that the best place for a woman to spend most of her labour is at home (and evidence also shows that giving birth at home is just as safe as hospital) and staying at home gives your body the best chance possible to ‘establish’ in labour and reduces the likelihood of obstetric intervention (Lauzon & Hodnett, 2003).

What can I do to help myself?

Some women find the following suggestions helpful for managing with early labour:

• Ignore labour - for as long as possible. If it’s the real deal, you will soon know!
• Rest – where possible give your body the chance to rest, saving your energy and resources for when contractions become more intense
• Eat and Drink – if you are thirsty, drink; if you are hungry, eat. This will keep your body hydrated and provides the extra energy required for labour. Eat foods that are carbohydrate based such as bread, potatoes, bananas, pasta, oats, Jaffa Cakes – or anything that takes your fancy! Listen to your body.

• Self-help – warm baths can provide excellent pain relief and it is safe to take paracetamol in pregnancy. Some women find distraction very helpful and use this time to finish off those last jobs around the home!

What else can affect the ‘early labour’?

Anecdotally, midwives know that the position of your baby can affect the length of labour and the way your baby is born.

If your baby is in a POSTERIOR or ‘Back-to-Back’ position (your midwife can tell you this by feeling your abdomen, or your may notice most of the weight of the baby in your right side and feel lots of kicks out to your left), then the ‘latent phase’ of labour can last many hours more than usual, and most women experience the majority of labour pains in their back. This can make labour very uncomfortable and some women may find labour harder to manage.

The ‘Optimal Foetal Position’ (OFP) for your baby to enter the pelvis is in an ANTERIOR position – with your baby looking towards your spine (you will be feeling lots of kicks in the right side of your body).

Although there have been few studies focusing on the position of a baby in respect to labour, midwives and women’s anecdotal experiences find that where the baby is in an anterior position, you are more likely to have a shorter and easier labour and Sutton & Scott (1996) write extensively about this.

If you baby is in a POSTERIOR position, you can help your baby by:

• Staying upright – kneel or lean forward
• Keep mobile – walk around and change position
• Alter the level of your hips e.g. raise one foot onto a step or kneel on one knee
• Side lying – if you are feeling tired and need to rest, try lying on your left side, well supported by cushions.

All of these may help to turn your baby into an OFP.

How long shall I stay at home?

The longer you can stay at home, the less likely you are to need obstetric input and the more likely you are to achieve a normal, straightforward birth.

As labour progresses and becomes more ‘established’, contractions will become strong and long and regular: increasing in strength and length and frequency. You are the best judge of when you may want additional midwifery support, but as a guide women who can not hold a conversation, are having to really ‘focus’ on working with their bodies during powerful ‘surges’ (contractions) and who are no longer smiling are normally in established labour!

You can telephone the labour ward and speak to a midwife again for further advice at any time.

Remember: labour and birth is hard work, is normal and can often last many hours.

Angela Horler, RM

References:

Lauzon L, Hodnett E. Labour assessment programs to delay admission to labour wards. Cochrane Database of Systematic Reviews 2001, Issue 3. Art. No.: CD000936. DOI: 10.1002/14651858.CD000936.

Sutton J., Scott P. (1996) Understanding and Teaching Optimal Foetal Positioning. Tauranga, New Zealand