Ep 149: How to Time Contractions and Why it is Helpful

In this episode, Dr. Shannon and Doula Rachael discuss labor contractions. They explain what contractions are, how to differentiate between Braxton Hicks and real contractions, and how to time contractions. They also discuss the importance of understanding the physiological changes during labor contractions and the significance of visualization and changing the narrative around contractions.

Takeaways

• Understanding the difference between Braxton Hicks and real contractions
• Knowing how to time contractions and when to head to your birth location (if not birthing at home)
• Recognizing the physiological changes during labor contractions
• Using visualization and changing the narrative to empower the birthing experience

Chapters

00:00 Empowering Birth, Navigating Labor Contractions and Home Labor Preparation

04:23 Understanding Contractions and Changing the Narrative

05:14 Physiological Changes During Labor Contractions

08:33 Differentiating Between Braxton Hicks and Real Contractions

23:50 When to Go to the Hospital or Call the Midwife

29:02 Visualization and Flipping the Script

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Chapters

• 25:20 [Ad] Modem Futura
• 26:07 (Cont.) Ep 149: How to Time Contractions and Why it is Helpful

Transcript

Dr. Shannon (00:02.009)
Hello, this is the Aligned Birth Podcast. You have both hosts here today. I am Dr. Shannon and Dula Rachel is here as well. And our birthy topic for this time around is, we're gonna title it, Empowering Birth, Navigating Labor Contractions and Home Labor Preparation. The goal for this one is to know,

how to count a labor contraction, like understanding what a contraction is, what it feels like, and then a little bit of the difference of like you hear about Braxton Hicks and a little bit of false labor. So how to differentiate between the two and then how to count the contractions because that's going to give you insight into how labor is progressing. If you are going to the hospital, when do you need to go? If you are laboring at home, when do you need to call the midwife? When do you call the doula?

all of those fun things. I feel like I'm gonna learn some today because it's the counting labor contractors. When you count, when does it start, when does it end? I am excited to learn a bit today. So welcome, Rachel.

Rachael Hutchins (01:18.152)
Hi Dr. Shannon, very excited for our conversation today. I think this is an important one that can help people in a very, very like bite -sized way of learning how to simply understand what a contraction is and how to track it so that you can hopefully labor at home more confidently until you're ready to go to the hospital if you're doing that or if you're birthing at home that you just have that confidence to kind of do your thing at home until it's time for your providers to join you because we really want to keep...

you know, stress to a minimum in early labor. So like understanding what's happening can help you feel more at ease during that time. So that's kind of the big why behind us having this conversation.

Dr. Shannon (01:56.225)
Mm -hmm because and we've done this before we'll probably mention again later We have an episode episode 124 on how to labor at home as long as possible So that goes a little bit more in depth into like why do you want to labor at home as long as possible? Especially if obviously if you're planning to to leave the home and go birth somewhere else whether it be a birth center or the hospital because if you can get to the hospital a little bit more

progressed into your labor and birth then there's the potential of not having as many interventions which can lead to the potential of having a more satisfying birth experience. There's there's that so that's what we're really talking about that one but this again to now how do we count those contractions? What is a labor contraction? What is a contraction and you know, we've done episodes to we've called them different names. Oh, I feel like I saw something recently. I

Rachael Hutchins (02:49.958)
Mm -hmm.

Dr. Shannon (02:53.145)
Oh no, no, no, I shared that, okay. God, what did they call it? I'm gonna have to look it up because it was something I shared on social media. It was so funny because it was these two women, they were across the street and they were yelling at each other, not like angrily but just talking because they were across the street. And this one woman, she was like, oh, you had your baby. And the other one was like, yeah, because she wasn't pregnant anymore. And they were like, yeah, that was a real thing. Like talking about pregnancy and then talking about postpartum. And then,

Yeah, why do they call them contractions? And they came up with something funny. And now I can't think of what it was called, but it was great. Now I have to go find it. I don't know what it was, but they called it something besides contractions. I just, yeah, anyways. Anyways, we're gonna talk about contractions on the show. Yes. No, they were making fun of like the pain aspect, you know? So like it should have been called and I don't know, something funny. Yeah, oh man. But yeah, so.

Rachael Hutchins (03:27.304)
Oh no, now you have to go, we have to find out what that is.

Rachael Hutchins (03:36.36)
Something that was funny. Well, so I like to refer to them as expansions, but I don't think that's what they probably said.

Rachael Hutchins (03:47.464)
Yeah, they should call it something else. Yeah. Yeah. I...

Dr. Shannon (03:52.025)
There's power in your words, so maybe you change the word.

Rachael Hutchins (03:55.88)
Yeah, contraction just insinuates stress and tension and we were always talking about releasing stress and tension in labor and we need our body to open and so contraction just found sounds restrictive. So when I talk about contractions, I'm like, it is actually an expansion of your body, not a contraction, but the uterus is contracting, but you're with that contraction. It's facilitating so much. And so.

Dr. Shannon (04:04.057)
Hmm.

Dr. Shannon (04:09.753)
Mm -hmm.

Dr. Shannon (04:15.161)
I like that.

Dr. Shannon (04:23.191)
Mm -hmm.

Rachael Hutchins (04:23.624)
When we talk about labor and birth, we like to talk about it in a way that's enlightening and empowering and like, oh, like that's a different, like a flip of the script way to look at it. So we can embrace it and not fear it. Cause if you're pregnant and you're choosing to give birth, like you want this. So we want to find ways we can see it as a positive thing that's happening. You know, especially when you're anticipating labor, all you want is like for labor to start and your baby to be here. But then like everything in between, you're kind of like, you want to skim over that.

Dr. Shannon (04:32.279)
Mm -hmm.

Dr. Shannon (04:51.991)
Yeah.

Rachael Hutchins (04:52.168)
But you need all of that in order to get your baby here. And so I do love talking about this conversation, especially understanding just like what's happening within the body. But like starting simple, like what is a labor contraction? So that's that rhythmic tightening and relaxing of the uterine muscles signaling the progression of labor. And so some physiological changes are.

during this time, your body is starting to produce more oxytocin, which is your love hormone, that's your bonding hormone, that's like when you feel safe, connected, private, comfortable, maybe dimly lit, like all of that is gonna like help release oxytocin and it's released in your brain and then it's a feedback loop between your uterus and your brain and you have oxytocin stores on your uterus so they build up over time so when you start having contractions early in labor,

They're usually for most people pretty mild. They kind of feel like menstrual cramps or maybe low back pain, depending on where you're feeling them. And they start low and then they build up. And by the time you're well progressed into labor, it's like the whole abdomen is tightening and contracting versus just like the low achy feeling. But even in those early parts where you're just feeling maybe a little bit of a cramp and they're...

Dr. Shannon (06:06.551)
Mm -hmm.

Rachael Hutchins (06:11.592)
really sporadic, not very consistent, spread out, not intensifying over time. It's still producing oxytocin. It's kind of priming the body for labor. And so you might have this off and on for some time before labor kicks over into full -on labor. Or you might have those types of contractions that then quickly lead into more intense progressive contractions. And so...

We have oxytocin playing on the uterus causing it to contract. The uterus is a muscle made up of a ton of fibers going a bunch of different directions. So they go diagonally, they go up and down, like it's just covered in these smooth muscles that...

Dr. Shannon (06:50.989)
Mm -hmm.

Dr. Shannon (06:55.833)
And it's an involuntary muscle though. So it's not like your bicep where you're like, oh, I'm going to do that. Like you can't be like, ah, contract uterus. Like it's the same thing with your digestive tract. Ah, do something, small intestine, you know? Like, yeah, there's that. Yeah.

Rachael Hutchins (07:00.046)
Right. Strengthen it. Yeah, that's right.

Right. Involuntary muscles. Right. And so when, so that muscle is contracting and tightening and shortening. Um, and when it does that, so at the bottom of your, sorry, at the bottom of your uterus is your cervix. And I encourage you to look at a diagram. So if you don't understand where things are in your body, um, but you have your uterus and that's where the baby is. That's where the placenta is. And then at the bottom of your uterus is your cervix.

Dr. Shannon (07:26.913)
Yes.

Rachael Hutchins (07:36.646)
And your cervix starts out kind of cone shaped, kind of longer, a couple inches or an inch or something like that maybe, and thick and firm and pointing towards your tailbone versus like pointing toward the front of your body. And with contractions, so cervix is at the bottom of the uterus. The uterus is these involuntary muscles. And when they're contracting, they're pulling up and therefore it...

it's causing change of the cervix. Every time you have a contraction it is pulling up on the cervix and that over time helps it soften and thin and dilate and then strong uterine contractions help move your baby down and out. So it's helping facilitate all of that but in early labor how you can kind of think about it when you're having those contractions and maybe it's going slower especially for first time birthing people like it takes time.

So like I just described it in this very like do do do way, but your cervix needs to soften hours or days. And this is typically a time of labor that is more manageable. These contractions are more spaced out. So your, your uterus is having this rhythmic tensing and releasing tensing and releasing. And that's a really important thing to know too, because if you think of like one big contraction or like you're going to be in this intense discomfort,

Dr. Shannon (08:37.945)
Like, taking hours. Yeah.

Dr. Shannon (08:46.593)
Mm -hmm.

Dr. Shannon (08:53.911)
Mm -hmm.

Rachael Hutchins (09:02.458)
infinitely that's very intimidating but know that it it tenses and then it relaxes and you get a break and like for the most part of labor for at least like early labor and active labor it is like two -thirds relaxation and one -third intensity like that's the kind of like you're contracting it's intense but then you get a break so that intermittent type of pattern makes it doable so i want you to like people to like visualize that

Dr. Shannon (09:08.761)
Mm -hmm.

Dr. Shannon (09:23.255)
Mm -hmm.

Rachael Hutchins (09:31.47)
And so we understand the uterus is helping cause change to the cervix. And so the difference between Braxton Hicks contractions, and like we'll call them real contractions just for lack of better terms, but a contraction is a contraction. Like if you're feeling it, you're feeling it. If it's uncomfortable, it's uncomfortable. Braxton Hicks doesn't cause change to the cervix. So a Braxton Hicks contraction is

Dr. Shannon (09:38.871)
Mm -hmm.

Dr. Shannon (09:51.001)
Yeah, it's just that tightening. Mm Yeah.

Rachael Hutchins (10:00.816)
tightening of the entire belly for like 20 seconds, 30 seconds, maybe longer, kind of takes your breath away. It's like a really, really tight hug. And they're very sporadic. They might only happen for a period of time and then they stop. And they don't like progress or get closer over time. They don't form a pattern. But really that, yeah.

Dr. Shannon (10:23.065)
That's the big thing, the pattern, I feel like. Or if you go to take a bath or something like that and they stop, that tends to be more of the Brax and Hicks, correct? Like it's more of when, like if you were stressed or dehydrated, sometimes moms will be like that and they'll have the contractions. It's like, oh, if you go to a place and you're calm and you rest and then they stop, then it's kind of like, okay, we know that that was triggering them as well. So.

Rachael Hutchins (10:38.216)
Right.

Rachael Hutchins (10:46.376)
Yep, that's always our first response. If someone feels like they're having Braxton, they can always describe it. We'll be like, okay, it kind of sounds like Braxton. We don't ever like, it's not discounting anything. It's like, well, it sounds like Braxton Hicks, but, and then usually it's like, well, I worked in the yard today. I had a 12 hour shift at the hospital. I was with my kids at a birthday party for four hours and I haven't had any water or whatever. Like, and then we're like, okay, so here's your, here's what we're gonna recommend. You're gonna drink a big thing of electrolytes.

Dr. Shannon (10:55.681)
No.

Dr. Shannon (11:00.311)
Mm -hmm.

Dr. Shannon (11:05.591)
Mm -hmm.

Rachael Hutchins (11:12.36)
You're going to go get in the tub, a warm epsom salt bath. You're going to drink more water when you're done and you're going to put your feet up and maybe go to bed early. Like you got it's a signal to the body of like, let's just take a beat. And so we that's what we encourage. And then when things calm down, it's like, okay, cool. That's, you know, just carry on as normal and then wash and repeat. Cause some people just have them more regularly than others. And with subsequent pregnancies, like a lot of second and third and fourth time moms,

Dr. Shannon (11:19.393)
Mm -hmm.

Yeah, and that aspect of it, yeah.

Dr. Shannon (11:30.145)
Yeah.

Dr. Shannon (11:34.103)
Mm -hmm. Mm -hmm.

Rachael Hutchins (11:41.23)
experience Braxton Hicks sooner and more frequently. Don't know the reason behind that, but that is we hear that a lot with our moms who've given birth before. But yeah, how you kind of already said it, but how you know the difference of Braxton Hicks and actual contractions is that the Braxton Hicks don't, or the contractions don't stop. Like they progressively, yeah, they progressively get closer or longer in duration.

Dr. Shannon (11:47.191)
Mm -hmm.

Mm -hmm.

Dr. Shannon (12:02.393)
If you rest and those type of things, like it's no, it's still going.

Rachael Hutchins (12:11.336)
stronger in intensity and closer together and then they don't stop. We even say that like even if you're experiencing like what seems like probably real contractions but they're still in a stop and start pattern it's sort of the best approach is to ignore it until you can't. So if your body is doing this start and stop it's like until they don't stop try to ignore it and of course support yourself in that time with rest and hydration and gentle movement and activity and you know.

Dr. Shannon (12:16.129)
Mm -hmm.

Dr. Shannon (12:26.359)
Mm -hmm.

Rachael Hutchins (12:39.336)
We want to do all the things that support oxytocin and relaxation and all of that, but really just try to carry on as normal best you can. And then when they don't stop, that's how you know, they start forming a pattern, they start getting longer, stronger, closer together. And then, you know, it's like, and we like to see you get acquainted with labor pretty quickly. Like once it's happening, I, okay, I get it now. But then everything leading up to that feels very ambiguous. Even what I'm saying now feels I'm sure to those who haven't done it before, it feels ambiguous.

Dr. Shannon (12:43.767)
Mm -hmm.

Mm -hmm.

Mm -hmm.

Dr. Shannon (12:55.339)
Mm -hmm.

Dr. Shannon (13:06.337)
Mm -hmm.

Rachael Hutchins (13:09.266)
So just like to sort of share a little bit about how labor contractions, what they are, how they work, and how to identify them. And we kind of have already said it. That was our next point was like how to identify it, but you know, pattern, long or short or close together.

Dr. Shannon (13:21.463)
Mm -hmm.

And there's, I remember the, and too sometimes I'm sure clients call you and then you can kind of, and we've talked about this before, like hearing their voice. If they're talking through it and they're managing it, like you can tell a difference in the voice between early labor versus like, oh yeah, we're progressing, you know? There's that aspect. And I know I've shared before, but I...

Rachael Hutchins (13:39.6)
Mm -hmm. Mm -hmm.

Dr. Shannon (13:49.273)
was pregnant with my second and it was we were at the holiday party because he was born close to Christmas. I remember sitting there talking to a one of the male supervisors. I'm very pregnant. I actually gave birth the next day. So I think I was right at like 40 weeks or when I was very, very pregnant. I had just eaten the eggplant parmesan because I was on the menu and I was like, sweet, I eat eggplant parmesan. I'm gonna pick that.

Rachael Hutchins (14:08.712)
Mm -hmm

Rachael Hutchins (14:13.608)
There you go, it worked.

Dr. Shannon (14:16.057)
And I remember sitting there and having a conversation with him and I like gripped the table because I would have such intense contractions. And so I'd like squeeze the table and I would just nod at what he was saying. And I was like, this man is so clueless. I'm like, I am literally, I don't know what you're saying. We're trying to have this conversation. And as we were gripping the table and then being like, ah, and then they go away and just kind of, it was interesting to feel that progression of like, oh, that's very strong and intense, a little bit regular to it.

Rachael Hutchins (14:32.264)
You

Dr. Shannon (14:45.837)
You know, I just remember that. That was fun. Yeah. I just remember that. Yeah, it was fun.

Rachael Hutchins (14:46.44)
And then like you feel it let go, you feel it build up and you, and then you're, it starts, you get real familiar with it real fast. Once it starts happening. That's super cool. And then you're just like rocking on like, yeah.

Dr. Shannon (14:57.611)
Uh -huh, uh -huh, yeah. I was like, oh, okay, I can manage this. But yeah, this is the beginning, but I remember that, yeah, that was just fun. I know, it's like, here we go, I'm gonna have this conversation.

But then I had him last and then I had him the next morning.

Rachael Hutchins (15:12.072)
Oh my goodness.

Rachael Hutchins (15:16.616)
That's so cool. That's so cool. Yeah. With mine, my first, my contractions came on like in the late afternoon. They stopped. I went to bed. I was like, okay, I guess it's not. And then woke up with like very strong, very evident like contractions. Um, like there was no like questioning it cause we, I support a lot of clients who like, it's this, am I, am I in labor? Am I starting? And again, we just have to reiterate until this.

Dr. Shannon (15:36.407)
Mm -hmm.

Dr. Shannon (15:40.577)
Mm -hmm. Mm -hmm.

Rachael Hutchins (15:46.376)
Carry on as normal, ignore it until you can't, your body will, you will know, you will know when it's time. And that's for me, like I was having in the evening time, these like, I don't know. And then when I woke up, I was like, absolutely, these are contractions, no question about it. And then with my second, I had like contractions and some like bloody show, like in the early morning on a Saturday.

And I was like, I was anticipating things to kind of pick up and we were going to be like game on. I like called everybody, got my birth team on deck and it was a full 24 hours later, um, before I had my baby and I had on and off contractions all day. I thought baby was coming like that morning before just by, I was like, I'm having all these symptoms. It's time like, and then I basically had on and off contractions all day.

Dr. Shannon (16:31.289)
24 hours.

Dr. Shannon (16:36.665)
Yeah, yeah.

Rachael Hutchins (16:43.752)
for like a 24 hour, for like a not 24, like 12 hour period. And I went out to dinner with my mom and dad and my husband and my younger son and had a glass of wine. And then things were really quiet. And I went to bed and then woke up at like 2 a .m. with very strong, very evident contractions. But so like that day I had, it was a mental like Olympics I was doing in my head to not get too worked up.

Dr. Shannon (17:08.281)
Uh huh.

Rachael Hutchins (17:09.992)
Like, okay, I knew I was having contractions, but they hadn't like shown that pattern and that like that progression. So I just had to kind of, we went to the store, went for a walk, took a nap. Like I did all the things, but it's not easy. That's not easy. But being out to dinner and in labor is funny. People look at me crazy when I give them as a, give that as a recommendation. And I'm like, you can totally do it. No one will really know. Like for the most part. So.

Dr. Shannon (17:24.333)
All the things. Yeah. No, exactly. Exactly. It's not easy.

Yes.

Dr. Shannon (17:35.029)
Uh huh. Yeah. Now. Yeah. It's doable. Exactly. Exactly.

Rachael Hutchins (17:40.262)
Distract yourself. Yeah. So how to time a contraction.

Hold on one second.

Rachael Hutchins (18:03.72)
There we go, sorry about that. So how to time a contraction. You know, I think this is important to know for the birthing person, for their spouse or husband or whoever's gonna be supporting them in those early, you know, early time of labor. So how to time a contraction. I mean, there are lots of apps out there you can use, but I still think it's important to know how it's timed and measured regardless of if you're using an app.

Dr. Shannon (18:33.505)
Mm -hmm.

Rachael Hutchins (18:33.692)
So a contraction begins when you feel the tightening or the hardening of your uterus and it ends when the uterus relaxes So you'll feel this as like a slow build and that's the like when you feel it coming on That's the start of the contraction and then when it has stopped and you feel like your uterus has has let up Then that's the end of the contraction. So that's the length of the contraction. So start of the intensity to the

Dr. Shannon (18:51.543)
Mm -hmm.

Dr. Shannon (18:57.113)
Yeah.

Rachael Hutchins (19:00.846)
end of the intensity that's the length of your contraction so those might in the beginning might be 20 30 seconds building up to 45 55 seconds and building up to 60 to 90 seconds being the length and then if you can imagine your contraction as like a bell curve on a graph

Dr. Shannon (19:21.985)
Mm -hmm. That's exactly. Yeah. Mm -hmm.

Rachael Hutchins (19:22.536)
it's a slow build, right? And then at the very top is the most intense. So you're not in like level 10 for the whole time.

Dr. Shannon (19:30.009)
It's not like bing and straight over, not like a mountaintop. It's like a, yeah, that's a little bell. Okay. Mm -hmm. Mm -hmm.

Rachael Hutchins (19:33.992)
Right. It's a gradual build and then it rolls over and then it starts to fade away. And I like to always touch on like, if you can see those, like the beginning of the contraction and the end is points where you can really still kind of release tension and be in a, like a very open surrender state and then do what you got to do at the peak of the contraction. It's going to serve you really well. So as soon as you start feeling it wash away, you're, you're like relaxing your body, doing your breath work, you know,

Dr. Shannon (19:55.895)
Mm -hmm.

Rachael Hutchins (20:03.942)
releasing the tension and we like to melt like butter or ragdoll. The sooner you can tap into that on the downside of your contraction, the better. So.

Dr. Shannon (20:12.185)
And that's the duration, correct? Like that's how long the duration of the contraction. Mm -hmm. Mm -hmm.

Rachael Hutchins (20:15.496)
That's the length of the contraction itself or the duration of the contraction. Yeah. Um, and then the length between contractions. So we've given you like the length of the contraction and then the length between contraction is from the start of the contraction of the one contraction to the start of the next contraction. So that's the length between contractions. It's, uh, it, cause some people and understandably so think that it's from the end.

Dr. Shannon (20:27.457)
Mm -hmm.

Dr. Shannon (20:36.631)
Okay.

Rachael Hutchins (20:45.8)
of a contraction to the start of the next contraction and it's from the beginning of each. And that's going to give you your time between.

Dr. Shannon (20:46.713)
Right. Yeah. Mm -hmm. I feel like that's the same thing with nursing. When you, like, how long, when do you start the thing? It's like when they started nursing, then they end it, and it's like, nope, it's the next time when they start, and I'm like, oh my god. Uh -huh, uh -huh. So now it's exactly, so it's the start to the start. Mm -hmm.

Rachael Hutchins (21:01.288)
Right, because the end is very unclear. Well, because the end is hard to put a point in. And so the start is very clear. And that's why standing with breastfeeding, you know, when you start and then maybe they're like just nibbling or, or not really eating as much at the end. So it's hard to really define when it ended. And so same thing. That's why you do it from start to start, but it is confusing. Um, and so that is like an early labor. You might have.

Dr. Shannon (21:15.883)
Mm -hmm.

Dr. Shannon (21:19.993)
Yeah.

Dr. Shannon (21:24.395)
Mm -hmm.

Rachael Hutchins (21:29.83)
20 -30 minutes between contractions right and at that point I do not want you timing them. Like if you are having them and you're not able to be like yeah they're coming regularly I personally and professionally as a dual don't think you should be timing them until it's very clear that they're they're coming more than a few and 30 minutes. Does that make sense?

Dr. Shannon (21:32.631)
Mm -hmm.

Dr. Shannon (21:38.551)
Mm -hmm.

Dr. Shannon (21:49.409)
Hmm.

Dr. Shannon (21:55.489)
Mm -hmm. No, that makes sense. Yeah.

Rachael Hutchins (21:57.696)
Because if you get too focused on timing them, you're too much in it. And we want, I want you distracted, self -care, relaxed, doing your thing. Remember, ignore it till you can't. And so if you're timing them, then you're very much focused on what's happening. So if they're over 30 minutes apart, you do not need to be timing them. And so then as it feels like they're notably maybe getting more intense,

Dr. Shannon (21:59.705)
You're too focused. Mm -hmm. Mm -hmm.

Dr. Shannon (22:07.425)
Mm -hmm. Mm -hmm.

Rachael Hutchins (22:26.12)
and longer, maybe close together, then start timing them. And you can use an app. You can use like the stopwatch on your phone. You could simply use a pad and paper. What I love about the apps is that it does the math for you. So you're able to see it calculates average duration and average length between contractions. So after you've done it for 30 minutes or an hour, it'll give you a good idea about where you're at.

Dr. Shannon (22:42.549)
Yeah.

Dr. Shannon (22:52.313)
Your data.

Rachael Hutchins (22:54.536)
I like the apps. There are lots out there, so just do your research and I don't think you need to pay for one by any means, but definitely that is an option. And so once you feel like they're getting close together and it's hard to ignore them, then time them for a period of like 30 minutes to an hour just to get an idea. And then even at that point, I would stop timing because you're just trying to get like an idea about where you're at. You don't need to...

keep obsessively timing. So you can see, okay have things progressed? Like are we getting close to that marker of when we think we want to kind of head to the hospital or call our midwife or whatever? This is a great conversation to have with your care provider about based on your circumstances and needs and preferences about when is a good time to go to the hospital or if you're doing the home birth when is a good time to have the midwife come.

General rule of thumb is a 5 -1 -1 pattern. So that's where contractions, now you've learned about the length between contractions, the length of the contraction. Right. So the 5 -1 -1 is a rule of thumb that your doctor might throw out or you might learn about, but it's a good measurement of where you're at in labor. It can be, right? General rule of thumb. It's when contractions are five minutes apart.

Dr. Shannon (23:56.481)
Mm -hmm.

Dr. Shannon (24:01.113)
And we know frequency, right, the duration and then with frequency how often they are. So yes, now, what does that mean?

Rachael Hutchins (24:20.488)
that's the length between contractions, they are lasting for at least one minute and they are doing that for at least one hour. So that's your 5 -1 -1. So that's a good indicator. So that whole like contractions are now at least a minute and they've been doing that for an hour and they've been coming in that interval. That's a good indicator that you are in labor. Like you're in this rhythmic pattern that doesn't appear to be

Dr. Shannon (24:31.065)
Mm -hmm.

Dr. Shannon (24:45.857)
Mm -hmm.

Rachael Hutchins (24:49.512)
stopping or slowing and it's, but have to be always very careful because everyone like can be different. Like you might be further along in labor and never achieve that five one one. Um, you might be very, very sporadic in your contraction pattern and get to transition. Um, so again, general rule of thumb, always trust your body. If things feel like they are getting much stronger and intense, like that's like, you want to be talking to your, your care provider, your birth team about like where you're at.

Dr. Shannon (24:55.479)
Mm -hmm.

Dr. Shannon (25:01.537)
Mm -hmm.

Dr. Shannon (25:18.743)
Mm -hmm.

Rachael Hutchins (25:19.528)
This is a benefit to having a doula. I mean, I'm a birth doula, so I'm partial, but we're in communication with our clients early on. So like from that very first contraction, we're checking in with them, asking about what they're feeling, seeing how they're doing, giving them things to do, distraction techniques, relaxation techniques, like, you know, and then checking in every couple of hours. So we're along that journey. So like if you're, you know, just for example, if you're getting birth in a hospital, typically for your...

provider at that hospital, you're not in communication with them until you're like headed that way. I mean, you could be if you wanted, but we're like, we're very much available. We're like on the phone. We want to hear how you're breathing. We want to hear how you're coping. And so since we're along that journey with you, we're able to kind of see that progression and be able to help. Like we don't tell you when to go to the hospital at all, but like be able to help you be like, okay, it sounds like things are progressing. It sounds like you're breathing different. You're more inward. You're...

Dr. Shannon (25:50.935)
Mm -hmm.

Dr. Shannon (25:58.617)
Right.

Rachael Hutchins (26:14.876)
you know, less talkative, like all these signals to us that are like, okay, plus that pattern, that 411 or something like that is a good like, okay, maybe it's time to go. So, you know, documenting your contractions that way, being in contact with your birth support team, whether you have a doula or not, or your midwife or doctor at the hospital, just have any like changes happening of like, hey,

My contractions are going and they are getting stronger and longer. They may not tell you to come to the hospital. Hopefully they tell you to stay at home until it feels like things have progressed, but they're going to affirm you and be like, okay, it sounds like you're in labor. Just drink some water, take it easy and let us know if anything changes, but still give them that update. Let them know so they can kind of be along that journey with you. Um, and then, um, note, of course, if your water breaks during any of this time, you want to let your provider know.

Dr. Shannon (27:04.247)
Mm -hmm. That's what I was about to say. Yeah.

Rachael Hutchins (27:07.72)
If you're having like a bloody show or anything like that, that's like mucousy tinged. It's blood tinged mucus, vaginal discharge that you might have. You might have it before labor begins, but you might have more of it as labor is going along. Anything like that or any concerns you have. Of course, always reach out to your birth support team, your provider specifically. But yeah, that's a little bit about kind of how to time a contraction.

Dr. Shannon (27:10.561)
Mm -hmm.

Dr. Shannon (27:16.055)
Mm -hmm.

Rachael Hutchins (27:38.12)
Um, and yeah, I'm looking at my notes.

Dr. Shannon (27:38.135)
Mm -hmm.

Dr. Shannon (27:44.921)
No, I think that, I mean, that was, yeah, that was everything that we really wanted to chat about with it, you know, understanding. I think that's important to know though, understanding how are they timed and what does that mean and that like aspect of like the 5 -1 -1 and then a little bit too of what's happening with the contractions. That can really help because then you can use some maybe visualization things if that's something that you want to do for pain coping where you can look at like, okay, this is what's happening with my body. I use this with patients, just everybody who, not necessarily,

Rachael Hutchins (27:57.51)
Mm -hmm. Mm -hmm.

Dr. Shannon (28:14.841)
pregnant because if they've got muscle imbalance somewhere, so a lot of times it's between the rhomboids, it's right between the shoulder blades in the back, that's where our posture tends to like crap out and then our shoulders come forward. So when I have people with shoulder blades up, back and down, I touch them back there and I say, I want you to envision this is what these muscles look like, this is where they are, this is where you are pulling your shoulder blades back. So that same thing can be done with labor and birth with the contractions. Like you can picture, I don't know, in my mind now,

Rachael Hutchins (28:26.216)
You

Rachael Hutchins (28:31.014)
Ehh

Dr. Shannon (28:43.865)
It's like, I see this like little uterus because they're so cute, like cute shaped. And then it has this little smiley face and it's just smiling. And I was just like, getting stronger, you know? It's like building muscle and it's getting stronger and then contract. So like you can visualize things like that as it goes on. And maybe that can help too.

Rachael Hutchins (29:02.376)
Yeah, we had a client who did very strong visualizations during labor and had ended up having a very fast, smooth labor. But she said every contraction she had, like she counted down, I think from like a hundred or something like that. And she envisioned she would breathe and she'd give that contraction like a number and then she would exhale and she visualized her contraction like thinning or her cervix thinning.

Dr. Shannon (29:27.383)
Mm -hmm. Mm -hmm.

Rachael Hutchins (29:28.232)
with every contraction, she kind of counted down and in her mind she's like, I'm not doing anything or think worrying about anything until I get to zero or like she just was so focused on the breath work and the counting and visualizing her certain and I was and it felt it really was it was like, did you have some magical powers? Cause everything went like really fast. But I mean, there's a number of variations there. I love a good visualization. I love the idea of with every contraction, it's an expansion.

Dr. Shannon (29:35.929)
Mm -hmm. Mm -hmm. That's cool. Yeah.

Dr. Shannon (29:47.897)
Yeah, really smoothly. So that's fun. Yeah.

Rachael Hutchins (29:57.832)
with every contraction, your cervix is doing that thinning and softening and dilating and then baby's moving down with every contraction. So if we can see that contraction is purposeful and helping get you to the end goal, it's less like you don't have to resist it so much. So I love a good flip of the script, a good visualization and good like, how am I seeing this?

Dr. Shannon (29:58.199)
Mm -hmm.

Dr. Shannon (30:14.137)
Yeah, I think that's, yeah. Because that contraction word can have like negative connotations with it. And if you're only really focusing on the contraction, like the squeezing aspect of it and the intensity aspect of it, that's like engaging. I like the aspect of understanding, well, what else is happening with the contraction? It's working on the cervix. So then yes, can you visualize that? Because that's like opening and expanding and doing what needs to rather than focusing on the like, ah, like aspect of it.

Rachael Hutchins (30:28.584)
Right. The pain.

Rachael Hutchins (30:42.824)
Right? Yep.

Dr. Shannon (30:43.673)
No, I think that's great. That would have been great to know. 14 years ago, 11 years ago. That's okay though, that's okay. But yeah, this is great. I thoroughly enjoyed the episode. I hope that this brings a little bit of peace to those who are getting ready to have a baby so you can understand a little bit more about what's going on.

Rachael Hutchins (30:47.408)
helpful tip, a little hindsight. Yeah.

Dr. Shannon (31:13.145)
with your body and how it's doing what it's supposed to be doing and then ways that you can support that as well. So again, thanks for listening and we'll see you next week.