Prodomal (meaning precursor) labor, also known as false labor is something that many Moms experience. Prodromal labor contractions are stronger than Braxton-Hicks contractions. They can be quite strong, similar to active labor, however prodromal contractions do not increase in intensity or frequency. While it is considered more common for third and subsequent births, it does happen with first and second births.

Take advantage of it! Prodromal labor is a great chance to practice:

• relaxing through a contraction
• ignoring contractions
• coping techniques so you can learn which ones might be the most helpful
• going about your day while your uterus does its thing
• eating  and drinking during labor
• the mindset you will need for labor

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Things to know about prodromal labor

• you can't force prodromal labor to become active labor
• it lets the uterus practice and strengthen for active labor
• it can help the cervix to move into an anterior or more forward position
• it can help the cervix to efface or thin
• it doesn't tell us when labor will start or when baby will be born
• it might help baby settle into a good position for birth

While it can be frustrating to have contractions that hang around for hours without turning into labor, it's not wasted work. It's a sign that the body is preparing for labor. It's one step closer to meeting your baby and that is a good thing. 

When labor has done its work and dilation is complete, pushing is the next phase to get baby born.

While you wouldn't think of pushing as a topic with differing opinions, it is. Do you start pushing as soon as dilation is complete? Do you wait until the fetal ejection reflex kicks in and your body is pushing? Is coached pushing the best? Do you hold your breath while pushing? Do you add effort to your body's pushing? How long should you push? These are just a few of the questions that have differing answers. Adding to the confusion is that there is no one correct answer that applies to every birth. 

I've been at births where Mom is told she's completed dilation so now she needs to push. I've been at births where Mom has completed dilation and takes a nap before pushing. I've been at births where Mom is complete, but needs a good snack before she has the energy to push. I've been at births where Mom has the urge to push, but is only at 5 or 6 cm dilation. I've also been at births where Mom has the urge to push but is told she has an anterior lip. The urge to push does not always mean it's time to push. 

In the home birth setting, I prefer for clients to wait for the fetal ejection reflex. I feel this leads to more effective pushing which means less time pushing. Sometimes this may mean there's a "rest and be thankful" phase where labor appears to slow down. I think this resting phase is beneficial to let Mom build up some energy for pushing. I also think it's a perfectly normal part of physiological birth.  

Sometimes in a home birth setting, a Mom will need some coaching to direct pushing where it needs to go.  I watch for this and will offer coaching if I think it is going to be beneficial. I am not a fan of asking a client to hold their breath while I slowly count to 10 . Sometimes holding breath for a few seconds while pushing can help with understanding of where to direct pushing efforts. I prefer Mom to breath as the body needs to make sure there is plenty of oxygen going to baby. If I coach a client with pushing, usually after a few pushes they need encouragement more than coaching. 

As baby starts to crown, I will remind clients not to add any effort to pushing in order to protect tissues. This also lets baby have time to adjust and do what they need to do tonavigate the pelvis. It can be perfectly normal for a pause between head being born and the rest of the birth. This pause lets baby turn his or her shoulders so they can come through the pelvis. 

I trust birth so I do not feel pushing has to be managed. I do not feel that pushing has to be rushed. I want to allow the time both Mom and baby need to work together in the pushing phase to have a safe, healthy birth.