Wouldn’t it be amazing if we had a crystal ball that told us exactly when we would go into labor and exactly where we were throughout the duration of labor?? We may not have a crystal ball, but there are a lot of clues that could help us better understand where you are in labor!
6 Ways to Tell Labor Progress!
The most common way to assess if there has been change in labor is with a cervical exam. But, cervical exams can be uncomfortable or even painful, especially during labor. And cervical exams are not a great way to predict labor onset, and progress, as it is just a moment in time.
How can we assess labor progress without a cervical exam?
- Temperament changes
- Movement pattern changes
- Sensation changes
- Contraction Pattern
- Bloody Show
*Labor Progress*
1. Cervical Checks
Cervical checks can be the easier way to tell where you currently are in during labor, but not necessarily a predictor of labor onset or how labor will go. Cervical checks or exams are done digitally inside your vagina to assess your cervix. It is important to remember that these checks are subjective, as each provider may assess a certain dilation, effacement, or station slightly different from the other. It can be helpful to have the same provider do cervical checks each time, as they may have a better gauge on progress from check to check.
But, cervical checks are an invasive exam; they may not be comfortable or can be painful; and there is an increase risk of infection with each check, especially if your water is ruptured.
So, let’s explore some external signs of labor progress so we can limit internal exams, if that is your desire.
*Labor Progress*
2. Temperament
Your temperament during labor can be a huge clue to where you are in your labor timeline!
We break down the labor timeline in more depth in our childbirth education courses.
Please remember that these are general guidelines as to how labor may feel temperament wise. You are an individual, so experiences may vary!
*Labor Progress*
Early Labor: Usually able to talk and move freely both during and in between contractions. Generally unaffected by being in labor but may be excited or anxious! You are still very present mentally in the space. This is usually around 0-3cm.
Early Active Labor: Usually not able to talk or move as freely during contractions, may start needing support to make it through a contraction. But, mentally returns to the space between contractions. Able to hold a conversation and engage with your environment in between, and maybe even during contractions. This is usually around 3-5cm.
Active Labor: This is where a big temperament shift happens! You are no longer mentally present in the space both during and in between contractions, you are in your own world.
You need support during contractions and are generally resting or tuned out in between contractions. You can be pulled back into the space if someone asks you a lot of questions, but it is challenging to focus. This is usually 6-8cm+
Transition: This is the final phase of the first stage of labor, and can be filled with a lot of confusion and anxiety, or a sudden lack of confidence.
When you ask the laboring person what they want to do, they may reply with “I don’t know,” which can be unusual if they had previously been making decisions and adjusting throughout intuitively.
They may begin to ask for help or say they can’t do it anymore, or they don’t know how long they can do this. This phase is usually the shortest and may end with spontaneous bearing down. This phase is usually 8-10cm, with bearing down usually meaning complete or 10cm.
3. Movement Patterns
Each level of the pelvis opens in a different way. We tend to intuitively create space in the level that baby is in, so movement patterns can be a clue as to where baby is in the pelvis! Movement patterns are not necessarily tied to a specific dilation or early/active labor.
If baby is in the top of the pelvis, or still trying to engage, you may find movements patterns are very front to back and squatty.
If baby is in the midpelvis, you may find movement patterns are swaying or sideways.
If baby is in the outlet, you may feel a lot of pressure in the perineum or rectum + back to a front to back movement pattern and quarter squats.
*Labor Progress*
4. Sensations
You may notice that where you feel contractions shifts as labor progresses. It may start in one point, then shift lower or from the back to the front.
These are all signs that something is happening, so paying attention to where you feel contractions can be helpful! You may also notice that contractions feel more intense or strong, as labor progresses!
For me in my own labors, I find that I start my labor feeling contractions more in my lower abdomen, and then towards the end I feel a lot of sensation in my outer hips and upper thighs.
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5. Contraction Pattern
Contractions will get longer and closer together as labor continues to progress. In active labor, contractions maybe every 2-3 minutes lasting for a full minute.
You can pay attention to how frequently and how long your contractions are; a contraction timer can be helpful in keeping track, but it can also be distracting for you and your partner to keep track of this method too.
You will notice that they get closer together, and feel longer.
*Labor Progress*
6. Bloody Show
The cervix is really vascular, so it bleeds easily. As the cervix changes, there will be more bloody show. This can be similar to bloody mucus but should not be gushing or running out of you. You should not be soaking pads with blood. If you are concerned about any bleeding, please contact your provider!
Labor progress can be assessed by a cervical exam, but there are a lot of external signs of labor progress that we can use to tell where you are at in your birth journey! If you notice that a lot of these external signs are staying the same, a cervical check could be helpful to assess if change has been made or not. Some folks don’t seem to be any different externally but are making tons of change internally! You may also just need more time!! Patience is huge during labor.
We are helping to break down those options in our online, self-paced childbirth education courses.
Learn more in our 1-Day Childbirth Education Course offered both in-person and virtually! See our upcoming schedule here!