Episode 14: The Six Signs of Progress in Labor

What are the six signs of progress in labor in the linear/medical birth model? 

Often, in the birth room, birthing people, their birth partners and labor support people, and the medical care providers are all looking for 'progress' in labor. But what does that even mean? Well first off, progress in labor is so much more than just cervical dilation.  

I originally recorded the core of this video for a different purpose. I recorded this as part of what I thought would be the first module and lesson in the full Brave Journey Birth Preparation Program. However, since then, I've completely reworked the order I'm introducing concepts in the full course program, and I'm going to re-record these concepts in order to introduce them in the proper order. So I decided to divide the Module up into chunks and offer them as free weekly videos, with new introductions giving some context. This week's video discusses the six signs of progress in labor. Next week we'll be discussing Prodromal Labor, then the stages and phases of labor including Early, Active, Transition & Pushing in the weeks following.

See you next week!

FULL TRANSCRIPT:

Welcome to episode 14 of the free weekly Brave Journey, birth preparation videos. This week, I'm sharing another video that I originally recorded for another purpose. I'm just recording this, this introduction at a different time. And what I did is I recorded a, what I thought would be a lesson for my full Brave Journey Birth Preparation Program, the paid program. And I have since decided to completely rework the way I'm introducing concepts and the way that I'm introducing, um, and organizing materials within the full, Brave Journey Birth Preparation curriculum, the program. So I'm going to end up rerecording all of these videos, these concepts in order to connect the dots properly with the way I'm introducing concepts.

So the topic today is the six signs of progress in labor. It's about the physiology of labor. And the reason this is important is because often, in the birth room, the birthing person anxious to hear that there has been progress. The birth partner is often anxious to hear that there has been progress. And the medical care providers are having to document progress because in most medical care facilities, most hospitals, there's an expected amount of time "allowed". Um, that's a loaded word and I'm not going to get into it here. But there's a certain amount of time that the medical care providers expect a birthing person to be at a certain stage of their labor before they want to see "progress". So it's important to understand as a birthing person, it's important to understand as a birth partner and a labor support person that there's a lot more that goes into progress in labor than just cervical dilation.

And so I'm going to talk about this in the video that you are about to watch. So without further ado, this is the video on the six signs of labor. Oh. And one note. In this video, I do mention things like "in this lesson, we're talking about this" and "in future lessons, we're going to talk about hormones of labor" and just know that it's because I originally recorded it to be in the full curriculum. I'm not using it for that. I'm offering it as a free, brave journey, weekly video. But if you hear me referencing lessons and lesson concepts, that's because it's concepts that will be offered in the full program, the full curriculum. Okay. Without further ado here it is.

Progress in labor is so much more than just the cervix opening. You may have heard birth stories from friends and family, or just generally in the ether, just in the world where people tell their birth story based on cervical dilation.

And they'll say things like then we went to the hospital and we checked in and I was six centimeters dilated and blah, blah, blah, blah, blah . So these centimeters dilation are between one and 10 centimeters, but that is just one of many different methods of identifying progress in labor.

There are actually six. And I believe it's really important for birthing people to go in knowing all six signs of labor progress in order to understand just how, if the cervical dilation doesn't seem like it's happening as quickly as they think it should be happening, that they'll know that all these others signs of labor are happening. That you'll know that if your cervical dilation is not the number that you want it to be, you think it should be more dilated than it is that there's all these other signs that your body and the baby's body are getting ready for birth.

So the mechanics of contractions are complex. With each, if this is the uterus, and this is the cervix, the uterus and the cervix, the each contraction is not only pushing down. Here. Let's get a little, we'll get a little baby doll. So this baby is in the uterus and here's the cervix. With each contraction, the baby is getting a little bit of pressure. Pushing on their body and pushing them down into that cervix. The cervix is the mouth of the uterus.

It is all one thing. And the cervix is the mouth of the uterus with each contraction, also, not only is it pressing at the top, but the uterus, because it's all one thing, is pulling up on the cervix. So cervical softening, thinning, and dilating all happens partly because through the mechanics of the contraction, pulling up, pulling open that cervix with each contraction.

So there are complex hormonal processes that are happening all throughout labor. We have an entire full lesson on the hormones of labor and the ways that they impact labor and labor progress for the purposes of this lesson, just know that all these complex hormones are present and they're impacting the laboring person's mind. They're impacting the birthing person's body, contractions. They're impacting the strength and frequency of contractions. The hormones are also bathing the cervix, and inviting softening in the cervix and opening in the cervix. So there's the mechanics, there's the physical contractions, there's the hormones, all of this complex interaction that's happening during labor. 

So rather than just dilation as the only sign of labor progress amongst all of this complexity, there are actually six signs and the six signs are

One, the cervix moves forward. Two, the cervix is ripening. And we'll talk about these each. Three, the cervix is shortening and thinning. Four, the baby is descending. Five, the baby is rotating. And Six, the cervix is opening.

So first, the last few weeks of pregnancy, early labor, the cervix begins to move forward. This is a sign of labor, impending labor.

The cervix also ripens. So in the final weeks of pregnancy, the final days of pregnancy, all through early and active labor, the cervix begins soften. So during pregnancy, the cervix, if you were to touch, it would feel more like the tip of your nose. By the time labor is active and rocking and rolling, the cervix will be softened. Ripened is the medical word they'll often use in the hospitals. And , if you stick your finger in the inside of your cheek, that's what it feels like. So if you feel in there compared to the tip of your nose, this is happening through the final weeks, hours, Days of pregnancy, the change of the cervix from like the tip of the nose to the, to the cheek. So if it's softening, it's ripening that as a sign of progress in labor.

Cervix shortening and thinning is called effacement. When cervical checks take place in medical care facilities -hospitals, birth centers, home births- they will, the midwife or a doctor or nurse will give an effacement assessment.

It's a percentage. Usually they'll say like 20% effaced, 75% effaced, or 100% effaced. The cervix through pregnancy is thick and long, and it begins to slowly soften. It gets super ripe and squishy like the inside of your cheek. And then it thins to the point where it's as thin as the rest of the uterus and then the thinning, the effacement, allows for dilation.

So the cervix opening and dilating one centimeter to 10 centimeters is the final sign of not the final. It is another additional sign of progress and labor. There's often the most emphasis placed on cervical dilation, but all of this is happening.

In addition, the baby is descending and the baby is rotating the other two signs of progress in labor. So there's a whole other, in addition to the birthing person's body, there's a whole nother human being that is going through the birthing process. And that's the infant. So station is how high is the baby in the pelvis? The progress and labor will be the baby descending into, well, let's get the baby in optimal position here.

The baby is descending into the pelvis, down to where they begin to emerge from the vagina.

The baby is also rotating. So the baby has to go through a whole sequence of movements. They're called the cardinal movements.

Imagine this is the baby's head and this is the baby moving through with the vaginal canal. The baby has to make this path all the way out to being born. And This twisting turning process is so complex. It's such a long few inches. And if you can think of that, when you're in labor, staying upright and moving, it can help to think of moving with the baby and inviting them baby to find those important rotations as they move their way out.

So those are the six signs of progress in labor. 

Okay, that concludes the video for this week, the episode 14 and next week, I'm going to take another chunk from what was going to be a part of the full curriculum that I'm no longer going to use these videos. And the next chunk I will be talking about for the next weekly video will be prodromal labor, which is a, sometimes it's considered part of early labor.

It's a discussion on the stages and phases of labor. So over the next few weeks, we'll go through prodromal labor, early labor, active labor, and transition, pushing, et cetera. So thank you so much for watching. Thank you for your support, please comment and let me know what you're thinking. Send me an email.

[email protected].

The conversations with pregnant and expecting people always bring me great joy. So please reach out. I'd love to hear from you. Thank you for watching and I'll see you next week.