midwife's muse

False labour? What\'s in a name?

On Saturday I worked a shift at our local birth centre. I love it there, very laid back, woman-centred, what I think midwifery is all about.  I took over the care of a lady, C, having her first baby. She had come in in the early hours of the morning and gone home again as it was very early on in labour. She had returned at 7 in the morning as her contractions were coming every 3 - 4 minutes and her waters had broken. When she was examined things had really not altered from six hours earlier. She had her TEN's on, and started using gas and air. Later on she had a chamomile and lavender bath. I took over her care just after lunch. I went in and chatted to her, her partner and her sister. All during this time C was marching on the spot, a common movement when a woman's having a contraction, if this was a contraction it was going on for ages. Eventually I asked her why she was marching? To get the contractions going, was the response. It was obvious that the contractions had slowed right down so I made the suggestion that they all went home again. They didn't feel happy with that idea, and the sister gave me a look. Okay then, how about going out for a walk? Find some steps and try stomping up and down them. That idea was taken up on. Off they went. Just 10 minutes later they returned. Whats up? Have the contractions returned? No. She, they, were exhausted. Awake all night, hadn't slept for over twenty-four hours. At the Birth Centre we have a relaxation room, bean sofas, coloured lights, aromatherapy burners, soft music. I suggested they go in there and relax. C was worried about lying down, it will stop labour. I felt that it was more important that she recoup some energy as it was obvious things were not really going to get going for a while yet. I popped my head round the door 20 minutes later, all asleep. When they woke up we had another chat. I said that I felt that going home was the best option now. The 'contractions' were only coming every half-hour and they were so short that they couldn't have been doing anything. I said that I saw no indication to do another examination as Mum and baby were okay, but that if C wanted me to I would. Then came the telling comment - 'No. Don't examine me if you don't have to, that was more painful than contractions.' I knew then that I had made the right decision. If a woman is having useful contractions there is no way an internal examination is more painful. Painful, sometimes, but contractions are worse. Hurrah, everyone was in agreement, go home, have a sleep, eat some high energy foods, try to relax, don't sit there waiting for a contraction. I went outside to write up the notes and out came C's sister. " Was that false labour then? You can tell me, I'm a medical student". Ah, that explained the odd looks she had been giving me. I responded that I didn't think that was it, just a long latent phase. She said she hadn't read anything about that, only about false labour and false alarms. I don't like those terms, it almost belittles the womans experience. To her those pains are terrible, she truly believes that she is in labour. Most of the time she is, but really, really early on. This is the time when, if she was busy doing housework/gardening or caring for another child, she would dismiss them as ferocious Braxton Hicks. Anyway, I would rather that a woman came in to us, was reasurred, and went home, than was too frightened to phone in case we thought she was crying wolf.

5.4.04 11:52