Monday, July 20, 2009

Prodromal Precipitous Birth

Gloria Lemay has a post regarding a prodromal precipitous birth today. Though neither word is used in her post, they are both good descriptions of what went on. (Notice the mom mentioning she's been "doing this for weeks," then promptly giving birth within an hour of assuring Gloria that she's not having the baby.)

"What's that," You say? Can that be possible for the same birth to be described as both unusually long (prodromal) and very short (precipitous)? Yes! I've had two of them. My midwife charts my labors as two hours long, since for the births she has attended, that is when I have called her to come--when things have gotten so intense there is NO DOUBT we are not turning back this time: the baby is coming today. If I had more textbook labors (where close, strong, long and regular contractions didn't show up until birth day), I would be calling her much sooner.
The fact is that oftentimes in prodromal labor, a woman has been doing what she considers "the same thing" for so long that she may not realize the subtle changes (or there may not be any to notice) that have kicked her into active labor (not to mention that active labor can also stall and re-start hours and days later). It is in the nature of some prodromal births (where there is gradual and very subtle change) to not realize how close one is to delivery. This is the ultimate "frog in the pot of water" labor. By the time she realizes she really is having this baby, she's pretty much done.

If this interests and intrigues you, here's another post from another midwife in which she uses the term "precipitous" to describe one woman's 25-hour labor. It may be unusual, but this kind of labor does happen!

7 comments:

  1. Hi, Sarah!

    Back in July, you left a comment on my blog about prodromal labor; and I've been meaning to get back to you, but you know how it goes with a new baby in the house... ;)

    Anyway, I find this blog of yours really interesting; and this notion of prodromal labor intrigues me. As I had written before, I had lots and lots of contractions in the days leading up to Shav's birth and was left wondering if labor was really beginning--"real" labor, that is. But when labor really did begin, it only took 3 hours and 19 minutes from start to finish. I guess my experience fits in with what you've described here.

    Anyway, I just wanted to check back in with you; and I hope things are going well for you! :)

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  2. My first baby was a 4 hour start to finnish homebirth that was very painful. my second baby was a week late, i was 5 cm dilated for five days with a long prodromal labor weak contractions starting and stopping. then when i finally gave up on my homebirth and decided to head to the hospital for a "wiff of pit". My labor kicked into gear as i was getting ready and my baby was born 15 min later on my bedroom floor in the caul. very precipitous. I felt no real pain until that last 15 min when my body went from 5cm- to 10cm and transitioned and delivered

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  3. Oh, prior to this blog I was unfamiliar with the terms prodromal and precipitous. However, I am going on 43 weeks (6th blessing) and have had "false labor" for the past month! All my births have been precipitous.
    Thanks for broadening my vocabulary, sure does make it much easier to explain.

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  4. Tribalmama, I hope you come back to say whether your upcoming birth ends up precipitous as well as having been prodromal! I do think they can go together in subsequent pregnancies, but it (like anything in labor) cannot be counted upon. Thanks for commenting (and you too, Anonymous!). I love to hear other mom's experiences.

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  5. Hi,

    This describes my labor pattern too. My first was a 10 hour labor but the contractions never got stronger, longer, or closer together - they started 2-4 minutes apart, irregular, completely manageable, and stayed that way. I had two transition contractions and then started pushing. I just barely made it to the hospital as I left when I was already pushing.

    My second I had a lot more prodromal labor. Usually there were only occasional contractions but a couple times they started out with the whole 2-4 minute thing just like that first time. The first time this happened I went in because I wanted to get the antibiotics started (GBS+). But I didn't progress (I was at 4 cm/80% effaced for the last month) and they sent me home. So when contractions started again I was at a total loss as to when to go in. I ended up just staying home (we had originally planned a home birth before I knew I was GBS+ so this was not as big a deal as it sounds). The time it really happened (2 weeks after the false alarm), the piddly irregular contractions went on for two hours and then the amniotic sac sprung a leak, at which point I got ready to go in. Nope, too late. 35 minutes after that my son was born (in the caul) and my husband caught.

    Prodromal precipitous is as good a name as any I guess. I'm actually glad to have something to call it, other than "I'm weird." My mom had this same labor pattern as well. She didn't know she was in labor with me until she got checked at a routine doc's appt and she was 9 cm. As soon as they broke her water, out I came.

    One question for you or anyone who knows: Do you suppose the cervical check at the hospital could have stalled out my labor, and if I had just stayed home the first time, I would have had a baby the next morning? I wonder about that.

    Thanks for the article.

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  6. Thanks for commenting, Mel! I love the "I'm weird" classification--I can SO relate to that when explaining my birth experiences!

    As to the question about whether or not the cervical check was what stalled-out your labor, in my experience, start-and-stop labor is simply what my body does in the weeks (and even months) leading up to the big day. And though it is true that labor (even active labor) can stop as a result of seemingly innocuous things like a cervical check or an abrasive nurse, family member or provider, I tend to believe that for many prodromal labors, the body stops because it was just a warm-up: it wasn't going to finish the job in the first place--just practice a little!

    Have you had people suggest to you that your labor stalled because of the cervical check? I have found that many birth educators, doulas and providers believe that if labor stops or stalls, it always means there's a fear issue or something internal to the mother's thoughts and emotions that is holding up labor. Though this can certainly be the case for some labors, it is not true for all labors. Some women's bodies just work that way. She may be relaxed and welcoming of labor and the baby, yet the contractions may still peter out, for the simple reason that it's it's not time yet.

    My personal thought, and one I've seen play out is that a woman in your situation *can* stay home (or even go in to the hospital) and do all kinds of things to get labor going, and she may indeed prolong the laboring episode, keep the contractions coming and possibly even cause them to be stronger, but all that may still lead to a stalled-out labor, with an exhausted mama to boot!

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  7. Hey, thanks for responding! Nobody has really suggested it to me, except myself. :) I had heard that things like that can stall out labor. The reason I think it may have is because it was SO similar to how things felt with my first labor and the way that started. I definitely expected things to progress, but after I went to the hospital, they did not. And the cervical check was very uncomfortable, even as far as cervical checks go. But I guess we will never know for sure! If I have another kid, I will have to see what happens that time!

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