Keeping Labor Low Risk PDF Print E-mail
Written by Laura Maxson LM   


Many parents-to-be spend the entire pregnancy reading books, attending classes, and otherwise preparing for an all-natural, drug-free labor. For others, planning for labor is more like, “I’m going to get the epidural” as books are skimmed and classes are skipped. 


Reliance on the epidural as a labor plan can fall short, especially when coupled with The American College of Obstetricians and Gynecologists’ (ACOG) 2017 recommendations to minimize routine interventions in low-risk births. One of these recommendations is that a person is not admitted to the hospital until in active labor – meaning the cervix is dilated to six centimeters. Early labor used to be considered four centimeters. Families used to stay home until the labor pattern just started to kick up a notch, somewhere between 3 and 4 centimeters, then head off to the hospital. Influences such as bright lights, new people, and lots of questions could easily disrupt a labor that was just getting established. By six centimeters, however, labor should be fairly well established and not as vulnerable to the changes in environment that happen when moving from home to the hospital.


The active labor designation change from 4 centimeters to 6 might mean less chance of labor stalling out when admitted to the hospital, but it also means there will be additional hours to labor at home. With more than half of labor’s 10 centimeters slated to take place at home, even those planning an epidural should have some good labor coping skills in place. 


Selecting a childbirth education class with a focus in labor coping (as opposed to just learning what to expect once you arrive at the hospital) is a must. Prenatal yoga classes can be a great place to learn how to relax the body and let go the mind. The stories and experiences shared by other parents in classes and groups can be a bonus in childbirth preparation. 


Another of the ACOG recommendations is for continuous labor support. Unfortunately, this highly effective care is not routinely provided by the hospital. Labor and delivery nurses can’t be expected to provide this care as they have way too many responsibilities that pull them away. While this continuous care can come from family or friends, hiring a birth doula is the clear choice. A birth doula brings a multitude of ideas and techniques for labor support at home and the hospital. A birth doula will also be familiar with routine practices, especially those that are included in the ACOG recommendations, such as skipping the continuous fetal monitoring in favor of the nurse listening with a Doppler intermittently during labor, being upright and active in labor, and much more. 


Birth doulas generally meet with parents prenatally and can help parents formulate questions for their care providers, and make a birth plan that addresses their preferences and desires for labor and birth. While OBs and midwives should be on board with the 2017 recommendations, it is always good to double check, which confirms consumer understanding and demand for implementing these changes as well. Not all care providers, nursing staff and/or hospital policy makers are as committed to the ACOG recommendations as others may be.


March brings two events to help parents navigate planning for labor, birth and postpartum. Meet the Doulas on Saturday, March 10 is specifically for parents to meet birth and postpartum doulas and learn about their services. Then Saturday, March 24 brings a full afternoon of activities. Families can meet other parents, explore options for care, and learn about community resources around birth and parenting at Bellies, Birth and Babies Spring event.


At Bellies, Birth and Babies from 2-5 pm, Parents can choose to attend workshops on a variety of topics: 


      "Mother-Friendly” Birth Choices: Advocating for Your Choices

      Your Changing Body: Supporting for the Aches & Pains of Pregnancy and Postpartum

      Pain with a Purpose: Coping with the Intensity of Labor

      "Sleeping Like a Baby": Expectations vs Reality


Families will be able to shop for maternity and nursing wear, lactation and diapering supplies, and baby/child toys and other items. A wide variety of birth related service providers will be on hand to answer individual questions and share information. The community resource area will help parents connect with local programs and services. Santa Cruz baby wearing groups will provide both a fashion show and a parent/baby wearing dance demonstration. Womb Song will be on hand to entertain, and Luma’s massage therapists will be providing some mini-massages. Door prizes and goodie bags offer some really fun items and services!


Laura Maxson, LM, CPM, the mother of three grown children, has been working with pregnant and breastfeeding women for over 30 years. Currently she is the executive director of Birth Network of Santa Cruz County and has a homebirth midwifery practice. Contact her at This e-mail address is being protected from spambots. You need JavaScript enabled to view it or This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


New Professional Recommendations to Limit Labor and Birth Interventions



Birth Network of Santa Cruz County 



Register for Meet the Doulas – Mar 10



Register for Bellies, Birth and Babies  - March 24




Last Updated on Friday, 02 March 2018 22:47
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