What is Going On?

While birth is a complex and intricate process, it is also the most normal and simple process. Birth is the moment when an individual changes irrevocably, and a new life’s story begins. Birth can happen in many places, such as a hospital, birth center, or home. It can even happen in places that were not intended, such as a public spot or in a car. Labor has patterns that the skilled and experienced provider can track and therefore make some prediction as to when birth will occur, but labor can also change quickly and unpredictably. Although frustrating, this is why many care providers tell pregnant people there’s no saying what or when birth will happen. Labor and birth is largely affected by several variables, including the laboring person’s body, their psyche, and their environment. The baby’s hormones and position in the pelvis play a role as well.

Labor begins when the hormones of pregnancy begin to shift. Hormones such as progesterone decrease and other hormones, such as estrogen, begin to increase. The hormones circulate throughout the laboring person’s and baby’s body, creating feedback loops and a cascade of hormones to start and continue labor.1

The symptom most perceived by the laboring person is contractions. Contractions are the rhythmic and intense contraction -- or flexing-- of the muscles of the uterus. At the beginning of labor these muscles’ contractions are uncoordinated. The muscles of the entire uterus are not quite working together yet, and the contractions are often too weak and short to cause the second symptom of labor: cervical change.2 The cervix, the opening to the uterus, changes it’s consistency from hard to soft, changes its dilation --widening from 0 to 10 cm, and length-- from about 2 cm to very thin. As the labor continues and intensifies, the muscles become better coordinated, and the contractions strengthen, last longer, and cause cervical change.3

During labor, the care provider will likely need to check the cervix to assess labor progress. This progress is measured in 5 ways - the dilation of the cervix (0-10 cm), the effacement (or thinning) of the cervix (0-100%), the consistency of the cervix (hard-soft), and the position of the cervix (towards the back v. towards the pussy*).  The provider will also check how high the baby’s head is in the pelvis, or how low into the vagina -- that’s called the station. Each of these measures combined can give information as to how labor is moving along and how close to delivery the person is.4

In order for a baby to be born through the vagina, the contractions must be strong, last 60 to 90 seconds, and be continuous. Also, the cervix must dilate to 10 cm, be 100% effaced, soft, and facing the pussy*. When these conditions are met, the baby can descend through the pelvis, from the uterus, through the cervix, through the vagina, and out. The baby completes a series of movements, called the cardinal movements, in order to find the right fit and pathway out.5

Labor and birth feels differently to different people. For some it is frightening and a hardship to overcome, for others it may feel joyful. Some individuals report that their experience giving birth was orgasmic, as described in Ina May Gaskin’s work “Ina May’s Guide to Childbirth.”1 However, aspiring to an “ideal” birth experience can sometimes be harmful to the birthing person, and may cause a sense of failure if they do not achieve that “ideal” labor and birth. In conclusion, no matter the type of birth that a person experiences (i.e unmedicated, with an epidural, at home, in the hospital, cesarean section) research is finding that the most important part of helping a birthing person feel satisfied with their birth is feeling informed, respected, and supported by their care team.6

There is no “right” way to deliver a baby. Research shows that delivery through the pussy* is better for the delivering person (less risk of infection, trauma, and higher success rate of breastfeeding) and has benefits for the baby as well (i.e. decreased risk of respiratory distress, and improved immune system).7 However, when a baby needs to be born through the abdomen for the safety of the mother and baby, it is what is best. The path to parenthood is unique to the individual and there is no shame in how one becomes a family.

How Can I Take Care of My Pussy*?

Perhaps the best way to take of your pussy* in preparation for giving birth, is by using your mind and heart. Research shows that creating a birth plan, a manifesto of desires and wants during labor and birth, can help the delivering person feel more satisfied with their experience.8,9

Moreover, that research revealed that the person’s satisfaction was tied to the provider respecting and attempting to fulfill those wishes. Historically, maternity providers who deliver in hospitals were known for providing paternalistic care, in which they made recommendations and provided little alternatives. This type of care stripped patients of their right to be involved in their own healthcare and decision making. Luckily, due to cultural changes, advocacy groups, and research, many maternity care providers are following models of care, such as the midwifery model, to empower their patients to have more say about how the process goes.10 Therefore, it is important for pregnant individuals to find a pregnancy provider that values their autonomy and perspective, and that they feel comfortable and safe with.

There are many providers available, such as Nurse Midwives, Licensed Midwives, and Obstetrician-Gynecologists.  Obstetricians-Gynecologists, or OB-GYNs, are doctors who have graduated from a medical school, and then received further training in pregnancy, birth, and gynecology. They can provide pregnancy care to anyone and are specialists in high risk pregnancies. Midwifery is a specialty in womyn’s health and pregnancy that has a deep and rich history. Because of this history, there are different types of midwives around the world. What makes a midwife different from another, such as a Nurse Midwife versus a Licensed Midwife, comes down to the type of education they received and what certification and licensing they can apply for. For example, in the US, Licensed Midwives receive a Masters in midwifery, and often specialize in pregnancy and birth and practice out of hospital. In comparison, Nurse Midwives receive a Masters or Doctorate in nursing, with a specialty in midwifery. In many states, Nurse Midwives are licensed as Nurse Practitioners. Nurse Midwives provide gynecologic care, as well as pregnancy and birth care. Nurse Midwives can practice out of hospital, but are most often seen working in hospitals as part of a team that includes OB-GYNs. Shopping around and having a meet-and-greet appointment prenatally may help the person or family to find the right team to help bring their baby into the world.

Author’s Dedication: To all the families and beautiful babes who let me catch, thank you for allowing me to meet you on your birth day.