The Pause

I recently got to witness the most beautiful, powerful freebirth. It was in incredibly humbling experience to be present during such an incredibly transformative event.  

But it also got me thinking - about several things. Firstly, and this is not the topic of this blog post, its no wonder that our induction rate, our instrumental delivery rate are so high because we have simply forgotten how to wait for birth and respect the wondrous hormonal processes that must occur in order for us to birth our babies in the the world.

Secondly, there was one very distinct aspect of this birth process that reminded me so much of my own first two births and births I've subsequently attended as a birth keeper. The pause.

When labour is discussed in public - in antenatal classes - on social media - and in popular culture. It is talked about as though its a linear process, one that gathers momentum and then keeps ascending (or descending - depending on how you view the process of labour) that once it starts, it keeps on rolling (like a train picking up speed).  

But all too often I see a pause. Not just the pause that is often caused by the necessity for many parents of getting in the car and travelling to their place of birth, but pauses that in medical terms are usually considered a "stall" in labour.  These pauses/ stalls are treated as problematic. Something needs to be done to "restart" labour. Medical professionals (midwives/ obstetricians) will be reaching for synthetic oxytocin drips at this point.

Birth workers (doulas/ birth keepers) can be just as guilty of trying to interfere though. We reach for clary sage (or some other form of "natural" intervention like acupressure, or biomechanics techniques). 

But what I've often wondered is - what is the reason for the pause? And if these pauses can be seen so often in the birth process - is it in fact a natural part of the process. A means for mother/parent and child to rest and recalibrate? 

I've seen pauses occur after very intensely grouped surges that don't form a linear pattern - what might be considered a labour dystocia. A series of surges that are perhaps enabling the baby to find a more beneficial position for birth. The body and baby work hard to find that position and then rest. Labour seems to have stopped. Midwives begin rustling paperwork and hunting in cupboards and muttering under their breath about what to do to "get things going". 

I've seen pauses occur in long labours. Particularly in first time parents where they've labour steadily over days and nights (usually more intensely at night). They need time to rest and recalibrate before the final part of the process where they will need those final reserves of energy to make it through the final stage and meet their baby. 

And I've seen pauses occur in fast labours as well. 

Now there has been research done into these pauses, stalls, plateaus that occur so often in labour that concludes, "Physiological plateaus may be an essential mechanism of self-regulation of the mother-infant dyad, facilitating feto-maternal adaptation and preventing maternal and fetal distress during labor and birth." 

https://onlinelibrary.wiley.com/doi/10.1111/birt.12607