Guide to Laboring at Home as Long as Possible

February 15, 2022

As a doula and childbirth educator, I often get asked, “What tips do you have to help me labor at home as long as possible before going to the hospital?” This is one of the BIGGEST reasons couples hire a doula and take a childbirth class. We discuss this topic more in-depth during my classes and during our prenatal appointments, but I want to share a few of these tips with you.

 


 

How to Labor at Home as Long as Possible:

Why should you labor at home?

Before we dive into the “How”, let’s talk about the “Why”.

  1. Oxytocin: Oxytocin is what is considered to be the love hormone and it is also the hormone that causes contractions. Being in a place, such as your home, where you feel loved and comfortable will not only help you stay relaxed it will help your labor progress easier and faster. The farther along a woman is in labor when she goes to the hospital the less likely her labor will slow down. If a woman can wait until she is in a really good active labor pattern before going to the hospital, odds are that her labor will continue to progress and the release of oxytocin will continue.

  2. Less Pitocin: In my experience as a doula, women who labor at home well into the active stage of labor are less likely to need Pitocin to strengthen or augment their labor.

  3. Unmedicated Birth: Women who labor at home are more likely to have medicated births. Meaning, they are less likely to have synthetic drugs or an epidural to deal with the pains of labor. Most of the time this is because she has learned to cope with the contractions at home and she will continue coping with them when she is admitted to the hospital. I like to call this “being in the zone”. She is focused and can push through.

  4. Coping with Pain: There is something about being able to labor at home that helps women cope with pain better. I believe it is because they are in the comfort of their home where there is less fear and a better sense of peace. There are fewer distractions, bright lights, and questions being asked. Women tend to be able to cope with the pains of labor easier at home.

  5. VBAC: If you are planning on having a VBAC (vaginal birth after a cesarean) is recommended by midwives that you are labor at home as long as possible. VBAC patients are monitored more closely and are more likely to have interventions, which unfortunately increase the chances of a repeat c-section. With the help and support of a doula, laboring at home as long as possible is the KEY component for having a successful VBAC.

This leads me to a VERY important point…. It is important that you listen to your body and go to the hospital if you ever feel that something is not right or that contractions are stronger than you can handle.

If you are laboring at home as long as possible because you are fearful of the hospital and/or the staff- you are laboring at home for the wrong reasons. Always base your decisions on loving yourself and your baby! Don’t base them on fear. If for some reason you feel uncomfortable or don’t trust your care provider or their team, or the hospital, choose a new one! It is NEVER TOO LATE!!

 


 

Tips for Arriving at the Hospital During Transition

If you are going and planning of laboring at home as long as possible before heading to the hospital, odds are your goal is to arrive when you are during active labor or in early transition. The following are some tips to help you be prepared to make this transition easier.

  1. Take a Childbirth Class: Taking a childbirth class will help educate you on the different stages of labor and what to expect. This is key information to know if you plan on laboring at home as long as possible. You will learn about coping skills or techniques, how to support a laboring mom, the process of labor and so much more. Taking a childbirth class will give you a good solid foundation and understanding of the labor and birth process.

  2. Hire a Doula: Hiring a doula is a fantastic way to help you successfully labor at home longer. Doulas have attended many births and supported many women through labor. They know what signs to look for and have been trained to help women to feel as comfortable as possible during labor.
    There have been times when clients have called me unsure if they should go to the hospital or not. Most of the time by speaking to my clients on the phone I can gauge how strong their contractions are. I have also been called to clients’ homes and within 5 minutes or less, I am able to see how things are going and help my clients determine if it is time to go to the hospital or not.

  3. Being Prepared: Having things ready to go in advance is another way to help ease the stress of going to the hospital. Having your hospital bag packed and ready to go a few weeks or so before your due date is a good idea. Your partner can always grab last-minute things like phone chargers, wallets, pillows, towels to sit on in the car, etc., while mom is laboring inside the home. When the decision to go to the hospital is made, everyone should be able to get in the care and go within a couple of minutes.

  4. Timing Contractions: One of the best ways to know when to go to the hospital is timing your contractions. If you are unsure or don’t know how to time contractions there are many great apps you can download that will do all the hard work for you. Some of my favorites are Full Term and Contraction Timer. When using these apps all you have to do is push start when the contraction starts and stop with it eases up. The app will do all the calculating for you.
    Time Between Contractions: The first thing you need to look for when timing contractions is the time between them. Contractions are measured from the start of one to the start of the next. If you are wanting to labor at home as long as possible consider waiting till your contractions are 4 minutes apart.
    Length of Contractions: Another thing to keep in mind is how long contractions are lasing. In early labor contractions typically last about 30 seconds. During active labor contractions last about a minute. During transition contractions last about 90 seconds or longer. When your contractions are around 4 minutes apart and lasting for about 60 seconds or longer it might be time to head to the hospital.
    4-1-1: To put this all together, when your contractions are 4 minutes apart, lasting for 1 minute, for 1 hour– you might want to go to the hospital. This is what I call the “4-1-1 Rule”.

  5. Mom’s Mood and Deminer Between Contractions: Sometimes, when contractions are 4 minutes apart, it may not be time to head to the hospital. One way to determine this is to pay attention to mom’s mood and deminer between contractions. Normally, during active labor contractions, mom is working really hard to cope, breathe, etc., but between contractions, she is in a good mood, talkative, and generally her normal self. However, if her mood changes BETWEEN contractions that is when it is time to pay attention.

    Here are some things to look for BETWEEN contractions that might indicate it’s time to go to the hospital:

    She closes her eyes and goes within, even when not having a contraction.

    Stops talking to family, friends, or the birth team even between contractions.

    Annoyed when people are talking or noises even between contractions.

    Becomes irritable, agitated, and easily bothered even between contractions.

    If her contractions are close together AND her mood between contractions has shifted, it’s time to go to the hospital.

  6. Movement of Mom: Paying attention to how fast or slow mom is moving during labor is also a good indication of when to go to the hospital. In my experience, when a mom is progressing through labor she tends to move slower the closer she gets to transition and the pushing stage.

  7. Focused and Checked Out: If you are in labor and you are able to continue texting and staying connected with friends and family or on social media, it is most likely not time to head to the hospital. When things start getting more intense, you will not have the ability and/or brainpower to stay connected. You will become focused completely on the task of hand-having a baby.

  8. Trying to Stop or Slow Labor: If you are unsure of when to go to the hospital, try to see if you can slow or stop your labor. If you can, is it definitely not time to go to the hospital. You can try doing this by drinking a glass of water, taking a bath or shower, napping, or even going for a walk. If you find that your contractions stay the same or become stronger, then you are in labor and it is important for you to watch for the other signs we have talked about.

  9. Signs of Transition: There are some distinct symptoms or signs of transitions to look for:
    Long contractions lasting around 90 seconds
    Contractions are getting closer together, around 2-3 minutes apart
    ”Double peaking” during a contraction
    Due to “double peaking” you are not getting a break between contractions
    Hot and sweaty
    Cold and shaky
    Nausea/Vomiting
    Crying
    Can’t get comfortable
    Contractions increase when changing positions
    Afraid to move/change positions
    Looking for a way out
    Water breaking
    Discouraged or wanting to give up
    Irrational thoughts or behavior
    Asking for pain medication

  10. You’ll know: There have been many times that I get a phone call asking me to come to a client’s home while they are in labor to help determine if it is time to go to the hospital. While on my drive to their home I get another call saying that they decided to go in because it became obvious that it was time to go. They just knew!
    If you have a gut feeling it is time to go to the hospital…by all means GO!

Tips From Your Doula

It is important to pay attention to how you are feeling during labor. If at any point you feel like you need to go to the hospital do not hesitate. Trust your instincts!! Take a childbirth class so you can better understand and be aware of signs to look for. Hire a doula!!! They are pretty darn amazing if you ask me.

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