As doulas, one of the first questions we ask parents in a prenatal visit is, “What are your personal goals for this labor and delivery?” We ask both parents because this will help us know how we can best help them.
The most common answer we get is laboring at home as long as possible.
Today we want to talk about what laboring at home looks like and how it can be more comfortable than a hospital or birth center. Most importantly, you’ll learn some tips on how to do it safely and know the right time to go in.
If this is one of your desires and you’d like to learn more, stick with us, and make an informed decision.
Why labor at home?
Laboring at home is something that a lot of people desire. The question is, WHY?
When it comes to giving birth, there is typically a VBAC birth plan of some sort, which can be adapted into a home birth plan. Depending on your provider and your birth location, labor can proceed in different ways. In most cases, your provider will communicate in advance what they want you to do when labor begins.
When you envision your birth, you have an opportunity to decide what is most important to you and what goals you would like to achieve. Below are common birth goals and reasons why people consider laboring at home as long as possible.
Unmedicated birth (or waiting until it’s absolutely necessary)
Labor can get tiring and can be hard. When there is an anesthesiologist down the hall, and things are getting tough, it’s tempting to reconsider all your plans for an unmedicated birth.
It’s harder to want to continue unmedicated if you are tired, labor is getting more difficult, and it’s getting harder to cope.
Laboring at home as long as possible can help you stay in the groove in a place where you are most comfortable. At home, with a supportive partner or doula, you can try other options to ease the sensations you are feeling.
Avoid interventions
It is common to have interventions come into play during labor and delivery. If a laboring parent arrives at a hospital and contractions haven’t started, they’ve stopped, or they are not consistent, there is a higher chance of the staff suggesting interventions.
Options such as Pitocin, foley catheter, and even breaking the waters can be offered to help get labor going quicker.
Although sometimes interventions are required, there are drawbacks to using them unnecessarily. Speeding up labor with interventions can bring on more intense and even synthetic contractions, causing it to become harder to cope with labor.
Pitocin, a synthetic version of the hormone oxytocin, is one of the most common interventions to induce labor and move it along more quickly. Oxytocin is naturally released in our bodies when we are in labor, and there are ways you can encourage your body to create more of it. When we labor somewhere comfortable, with emotional support and minimal stress, oxytocin has a better chance of working to your benefit to help labor progress naturally.
It is normal to get very excited when labor begins. I mean, it is exciting, right? That moment you have been waiting for is here, and you want to do all you can to speed it up.
Sometimes we get excited too early, because the contractions may be close together. We rush to the hospital or birth center. However, if we have not progressed much, we may be sent home or offered to be “induced.” This can be frustrating.
If you are home, and your labor has started but not yet turned a corner, there are a few ways you can encourage it before you go to the hospital. For example, you could go for a walk, or use breast stimulation with hands or a breast pump to release your natural oxytocin.
The ability to eat freely during labor
If you have had a friend or family member who has had a baby, you may be aware that a laboring person is often discouraged from eating during labor — especially if they have an epidural.
I will just be honest with you right now. I DON’T GET THAT! And I am not sure if I ever will.
Restriction of food is one of the reasons I personally didn’t want to labor at a hospital again. I remember being in labor for 18 hours and not being allowed anything but ice chips. I was shaky, weak, and didn’t feel like I had the energy to reach 10 cm dilation and then push a baby out.
Rebecca Dekker of Evidence Based birth shared a study in sports nutrition showing that taking in carbohydrates during exercise improves performance and avoids fatigue. Although there is not much evidence about what the laboring body needs, I can’t help but wonder what would happen to cesarean rates if fatigued moms were able to eat as needed.
Eating during active labor can be super hard to do. While I was in labor with my VBA2C baby, I was contracting for 42 hours — it was exhausting. I was losing energy quickly and had my amazing team remind me to eat and drink. Although I wasn’t able to eat a whole meal, I was grateful that they were there to help me get some nutrients in and keep going.
Fear of the hospital
Hospitals are big and can feel scary for some, especially if you have previously experienced birth trauma in a hospital setting. It is so important to feel safe and comfortable when you are in labor.
We as birthing parents and supporters, are in a vulnerable spot while we labor. Feeling comfort can change the way we view our labor and cope during labor overall.
Many parents have told us that they feel that a hospital is a place to be treated for a medical concern or problem. And giving birth should not be viewed as a medical concern or procedure — most births can happen naturally without medical interventions. With that said, some situations that may cause concern. We are grateful for hospitals, especially when there is a reason that C-section is necessary.
Our bodies are incredible, and they are smart. If we are uncomfortable or stressed, our bodies typically respond by going into fight or flight mode. This can stop labor. Laboring at home as long as possible where you are most comfortable helps avoid this.
With this said, I would like to mention that sometimes laboring at home seems like a desirable idea, but feels less comfortable once labor begins. If your intuition causes you to doubt your choice to stay home, follow it.
Don’t hesitate to go to your final birthing location.
I have seen labor slow down, and also pick up after arriving at a hospital or birth center. Sometimes the parent felt more comfortable once staff was nearby, allowing things to progress naturally.
Labor positions and freedom of movement
One of the biggest benefits of laboring at home is being able to move and do what you want. During labor, it can be extremely difficult not to be able to move how your body is telling you to move or go where you want.
Laboring at home, you walk around the block, walk up and down the stairs, rest in your bed, couch, tub, floor, or anywhere that seems desirable. You can assume the most comfortable and natural position to deliver your baby.
At the hospital, you may be restricted to your room. If there are interventions, you may be restricted to staying in or near the bed to maintain the IV connection.
For VBAC, you are likely to be required to have continuous monitoring during labor. That means you would be hooked up to both a baby heart monitor and a contraction monitor. Labor can increase sensitivity, so having these monitors and restrictions can be tough.
There are many reasons to labor at home. Our biggest message to you is to do what you feel is best for you and what you are most comfortable with.
As you know, we talk a LOT about following and honoring your pregnancy intuition. It won’t lead you astray. If your goal is to labor at home as long as possible and then something changes, you may no longer feel comfortable. Don’t hesitate to change your plan.
If there is anything pregnancy and labor has taught us along the way, it’s that plans sometimes change and it’s okay.
Tips for laboring at home
As doulas, our job is to help birthing parents manage labor — either at home or any birth location they choose. We’ve learned and practiced many of these techniques with our clients and our own birth experiences.
Here are our best tips to make laboring at home more comfortable, safe, and successful.
1. Take a birthing class
Honestly, whether you plan to labor at home for as long as possible or not, I highly recommend taking a birthing course.
These courses are crucial for gaining knowledge about labor and delivery, as well as the pregnancy and postpartum parts of your journey. There are many to choose from. Our favorites are Hypnobirthing and the VBAC Prep course.
2. Use technology
We are so lucky these days when it comes to technology. There are many apps you can get on your phone to track contractions, log how you are feeling, track kick counts, and more.
Laboring at home can be nerve-wracking when you are unsure when to go to the hospital. Having an idea of what your contractions are doing, in addition to how you are feeling, can help you know when it’s time to head to your final birthing location.
One of my favorite apps is called Full Term.
3. Hire a doula
What is a doula, anyway?
A doula is someone who can come and help you labor at home by providing support to you and your birthing partner. They can offer counter pressures, rebozo techniques, help with siblings, and even allow your partner to rest, knowing that you are in good hands.
In addition to all of these amazing supports doulas can offer, they will also be able to help you know when it’s a good time to go to the hospital. This can ease the stress of wondering if you will get there too soon or too late.
Check out our directory to find a VBAC supportive doula near you.
4. Rest
Resting is one of the hardest things to do during labor. I spoke a little about this above, but it is easy to get super excited and want to speed things up or get things going.
I can’t stress enough to try your hardest to rest as much as you can. Early labor can be slow. Overdoing it before labor gets stronger can leave a tired team by the time active labor begins.
Resting allows your body to do what it needs to do. Trust your body and baby and know that it will happen.
5. Move
Moving is one of the best ways to not only help labor move along but also to help with coping.
Your baby is moving into the perfect position and coming down through the pelvis. Movement creates space in the pelvis and allows your baby to find the best spot possible to come down and out.
Laboring at home as long as possible also allows you the freedom to visit your chiropractor. When I was in labor, I received two adjustments from my chiropractor. To this day, I swear that is the reason that my baby was so low and ready to come out when I reached 10 cm. The adjustments helped my pelvis and sacrum re-align.
If you are interested in learning more, check out our article all about chiropractic care for pregnancy and VBAC.
6. Stay hydrated and fuelled
Prepare with snacks and lots of options for hydration. Coconut water, sports drinks, protein shakes, and smoothies are all great ways to hydrate and fuel for labor.
Nutrients that are beneficial during pregnancy are also wonderful during labor. High protein, healthy carbohydrate foods, and natural sugar for fuel.
7. Have a plan with your provider
Discuss how your provider would like to communicate. For example, are they willing to give you their number so you can message them with updates?
If you are having a VBAC, make sure you have a supportive provider and you have discussed your plans well in advance.
TOLAC (Trial of Labor after Cesarean) in a hospital will more than likely “require” continuous monitoring. Movement is really helpful in labor, and monitors can restrict your range of motion.
8. Learn the signs
Last but not least, it is important to know what signs to look for when it comes to uterine rupture or something else being wrong. We encourage education so much when preparing to give birth, and knowing these facts will bring comfort in laboring at home.
One of the biggest concerns for health care providers is not being able to monitor the baby for heart decelerations — one of the first signs of potential uterine rupture.
Some people choose to purchase a handheld doppler to check the baby’s heart rate while laboring at home. We suggest you discuss this with your provider or be sure to educate yourself in what is normal and what’s not if you go this route.
There are also less dire complications that can arise, such as scar tissue on the cervix causing labor to stall.
Learn all the facts about VBAC, so you can feel prepared and confident about your decisions.
Getting ready to labor at home for a VBAC
Laboring at home with a VBAC has great benefits.
During my labor, it was wonderful being able to climb into my own bed with my own pillows to rest and labor where I felt comfortable. It was lovely having my husband beside me, helping me feel safe and increasing my oxytocin.
While you are home, follow your intuition. If something doesn’t feel right, maybe it’s time to move locations.
If you’re ready to learn more, we offer an online self-paced VBAC Prep Course that covers uterine rupture signs and much more.
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VBAC Facts: The Real Truth About VBAC