Labor Practice Scenarios - How Will You Cope?

A helpful way to prepare for labor and birth is to imagine different scenarios and prepare how you might react and respond in those situations. Read through each of the following labor scenarios, paying close attention to the details of time, dilation, and what's going on. After each description, answer what you think is going on (ie, is it early labor, active labor, pushing, etc.), and brainstorm ideas on how you would cope and what you might do in that situation. Then, read the suggestions for each scenario (in italics) to confirm or add to your ideas. 

This exercise is taught in several Lamaze childbirth classes after students learn about the different stages of labor, their signs, and techniques and choices for coping. If you find yourself wanting to know more about labor and birth after reading through these scenarios, find a Lamaze class near you and sign up! You'll get all you need to feel confident and prepared for labor and birth. Lamaze Certified Childbirth Educators (LCCE) are currently teaching interactive virtual classes to help families stay safe and healthy in the midst of the pandemic. You won't be disappointed!

Practice Labor Scenarios

• 5 a.m., unknown dilation. You and your partner are at home, asleep. You wake up to go to the bathroom, then go back to bed. You're up again at 5:15 a.m. for another bathroom trip and things feel different. You can't go back to sleep and you notice a backache. 

>What might be going on? What would you do to cope?

This could signal the beginning of early labor. Or it could just be practice labor. It's too early to tell for sure -- it's the "wait and see" phase. See if contractions come, organize, and begin to form a pattern. Getting sleep and/or rest is the best thing you can do in early labor, so try as much as possible to take it easy and rest up. 

• 8 a.m., dilation unknown. Contractions have been coming every 20 minutes since 5:35 a.m. but they are very mild and require only a little bit of effort to find comfort. 

>What might be going on? What would you do to cope?

This could be early labor, though contractions are still quite far apart. If the pattern stays consistent for at least an hour, it's likely early labor. Continue to preserve your energy for later on in labor. You could also take a walk, which can help spur on labor. If you're giving birth outside your home, take this time to finish gathering any supplies/packing bags, etc. in between contractions. Coping during this stage may involve stopping to breathe, sitting down, or bending over to rest on a counter/chair. You will likely still be able to talk through contractions. 

• 12 p.m., dilation unknown. Contractions are coming every 4, then 6, then 4, then 6 minutes apart. You are feeling some back pressure and you must really concentrate and breathe with focus to get through contractions.

>What might be going on? What would you do to cope?

Your contractions are starting to organize -- they're getting longer and stronger and closer together. This is most likely early labor, moving toward active labor. Listen to your instincts and cope with contractions in ways that feel best to you -- moving your body, focused, long slow breathing, rocking back and forth, etc. Ask your support person/partner to apply pressure to your back or hips for relief. 

• 3 p.m., 5 cm dilated. Contractions are occurring every 3 minutes. You just arrived in a room at the hospital and the nurse checked your cervix. Your partner is parking the car and taking a long time! You are in your hospital room alone and contractions require a lot of focus. You feel like you've been at this for a long time, so you're disappointed to hear that you're only half way there. 

>What might be going on? What would you do to cope?

6 cm is considered the start of "active labor," which is great news because you're already actively working to cope with your contractions! It's normal to feel disappointed that your dilation doesn't match where you "feel" you are in labor, but remember that dilation is just one way to measure the progress of labor. There's no magic formula for how long labor will take based on your dilation. Once in the hospital, stay up and out of bed as much as possible in order to cope with contractions and find comfort. Laying on your back, for most people, is the most uncomfortable way to experience a contraction. Most medical assessments and procedures can be performed while you are sitting up or even standing. 

• 5 p.m., 5 cm dilated. Contractions have really slowed down. You are starting to worry that your cervix will never dilate past 5 cm.

>What might be going on? What would you do to cope?

It's common for labor to slow down or "stall" after arriving at the hospital. Your hormones need to be reassured that your change in environment is safe in order for you to relax and continue laboring. Be patient if you're experiencing a short stall or slow down. Once you've settled in, your labor will likely pick back up. You can try walking around to help progress your labor. 

• 6:00 p.m., 6 cm dilated. After some time in the shower, you are sitting in a rocking chair and feeling much better. A hospital anesthesiologist peeks in and asks if you would like an epidural.

>What might be going on? What would you do to cope?

Labor is moving forward. Getting into a shower is a great way to find comfort while in labor. Sometimes a shower can even help bring on stronger and more regular contractions, helping to move labor along. Sitting in a rocking chair or on a birth/exercise ball is also a good way to deal with contractions -- the rocking motion helps you find a rhythm to more easily cope. If you feel like you're coping well with contractions, you may not want an epidural. It's ok to tell your care providers you would like to wait and see. 

• 8:30 p.m., 7-8 cm dilated. Your legs begin shaking uncontrollably. You complain of nausea and say that you CANNOT do this anymore. “I can’t...I can’t...I can’t!”

>What might be going on? What would you do to cope?

This is most likely transition -- the last few centimeters dilation before you are ready to push. Physically, this part of labor can be the most intense. It's important to have hands-on support from your team during this part of labor. Many people find comfort in using short, more rapid-paced rhythmic breathing, as well as locking eyes with their partner or doula to help get through each contraction. Remember to take small sips of water/drink in between contractions to stay hydrated, and to try and fully rest/relax in between each contraction. 

• 9:30 p.m., unknown dilation. Both of you are alone in the birthing room. At the peak of a contraction, you feel pressure and call out, “The baby’s coming! Now!”

>What might be going on? What would you do to cope?

If you feel the urge to push, it may be time to push! The pressure and urge to push is typically an unmistakable and unavoidable feeling. It's also described as feeling like you have to poop. Many people feel relief when they are finally able to work with their contractions by pushing. If you are simply feeling a lot of pressure but no urge to push, it could be baby is moving into position, but you are not ready yet to start actively pushing. Often, people benefit from "laboring down" once they hit 10 cm -- a period of waiting (up to around an hour) while baby drops further into position before actively pushing. 

• 11:00 p.m., 10 cm dilated. After 45 minutes of pushing in the semi-sitting position, you are discouraged and say, “I can’t push anymore. My back hurts too much!”

>What might be going on? What would you do to cope?

Pushing is hard work! It helps to try pushing in different positions, especially if you're experiencing pain in your back. It may be that baby needs to rotate more, or it may be that baby is "sunny side up" (face up), which is common, but can cause increased back pain and difficulty pushing. Getting on your knees, hands-and-knees, squatting, or pushing on your side are all different options that can help assist your pushing efforts.