When should I go to the hospital - Why as a Virtual Doula I don't recommend contraction timers!

Did you know only around 60% of women go into labor spontaneously?

The number is probably less than this, around 40% of labors are induced, so 40% of women don't have to put this into practice!

But most women express that they would prefer to go into labor naturally and this is usually one of the first questions they have!

A virtual doulas guide to active labor

The medicalization of childbirth has led to the definition of the 'stages' of labor.

There is evidence that if you attend the hospital before you are in active' labor, you have a higher likelihood of labor augmentation with oxytocin, epidural, and needing a cesarean.

This is probably because the longer you are in hospital, the more interventions you are offered.

The NHS defines active labor as 4cm dilated and you are having regular contractions (3 contractions in 10 minutes).

But at home, you can't give yourself a cervical exam (not that it tells you anything about how long it will be until the baby arrives - but that is another post for another day!).

What you can do is time contractions - so let's take a look at that!

Contraction timers and apps

As we have embraced technology, you'd think as a virtual doula I would recommend a nifty contraction timer, but this is where you might be shocked!

A lot of companies including hypnobirthing companies have developed Apps with built-in algorithms that alert you when you have met the (3 in 10) threshold, this seems like a great idea, right?

Some even have built-in positive affirmations, symptom trackers, and relaxation tracks.

How a contraction app contributed to sabotaging my first birth.

I downloaded the App developed by the hypnobirthing course I had done, it seemed great.

When contractions started I went on a walk with my husband, every time I got a contraction, I pulled the phone out of my pocket, hit start, and then hit stop when it was over, eventually I just kept the phone in my hand.

When things got more intense, I put on my TENs machine, now I had two buttons to press, my contraction times and the Boost button.

Quite quickly the App told me I was in active labor, the color changed and a little symbol appeared!

My husband called the hospital, and they spoke to me, they said they thought I should stay at home a little longer - I know now they were listening to how I coped with the contractions whilst I was on the phone, I could talk, I was rational and therefore their clinical decision was that I was not yet in active labor.

So we waited, but the App kept flashing, and we were worried about leaving it too long I was still timing all the contractions, and I felt flustered, and frustrated when the contractions seemed to space out, eventually we decided to go into the hospital anyway!

I was 3 cm and so began the cascade of intervention.

Looking back, I was not in active labor, I was coping well with contractions, I could talk through some of them and some of them were pretty short and/or far apart.

Crucially - I did not feel like I needed more support, I just thought I needed to go in because the App told me it was time!

How using an App can impact early labor.

Every time you get your phone out, you take yourself out of 'the zone'.

You are placing your focus externally not internally,

You are relying on technology to tell you when you need additional support, not listening to your body and your instincts.

You are paying attention to the timing and length of your contractions, not how they feel and how you are coping with them.

Seeing the times listed in front of you can feel frustrating if they are not getting closer together or longer, you could start second-guessing yourself!

What I suggest instead as your virtual doula!

When your contractions start, ignore them whilst you can, carry on with everyday life, rest, sleep, and conserve energy!

Once you can't carry out tasks during contractions you should start to take your focus inward, concentrate on getting through each contraction, and then relax between them, using your breathing and relaxation techniques.

When you feel like the contractions are regular, you aren't getting much space between them and perhaps you would like some additional support, now is the time to ring the midwife.

Now... here is the kicker, the hospital is going to ask for the timings of your contractions...

This is why I recommend your partner use a stopwatch to time a few of your contractions when they feel that they are getting regular and Intense, they shouldn't tell you they have started doing this, it's for information only!

They should avoid downloading an App though as if they see the 'Active labor' alarm they are going to start influencing the decision to go into the hospital.