You Know It As Stalled Labor, But Emotional Dystocia Is Not Talked About Enough
When Angel,* a mom from Minnesota, headed to the hospital on New Year’s Eve to be induced with her son, she had no idea what to really expect. After receiving medications to start her contractions, her water broke and she started dilating faster than expected. She was told enthusiastically by the medical staff that she may be having the first baby of the new year. “At that point, I was dilated to five,” she explains to Romper, “It was like [my son] heard this too and at that point, I stalled out. The medical team decided to start Pitocin, but no more progress was made, even at the max dose. I never did dilate past 5 [centimeters].” Finally, after 36 hours of labor, she was wheeled in to have a c-section. She was unaware at the time, but her experience possibly fitted descriptions of what birth advocates term "emotional dystocia."
The female stress response affects childbirth; whereas we see more of a “fight or flight” response in men, women tend to cope by forming a social support and nurturing others, a tactic dubbed "tend and befriend."
When we can’t cope with the stress of labor, and stress hormones rise, you can see contractions stop or stall — this is emotional dystocia (a birth obstructed or made difficult due to emotional factors). You may know of it as a “stalled labor,” but may not be aware of the connection to your stress response or emotional experience.
The birth process is less about what’s in your head and more about connecting to your body.
“I feel that women these days are privy to a vast amount of information,” Latham Thomas, women’s wellness expert, bestselling author of Own Your Glow, and founder of Mama Glow, explains to Romper, “There is such a thing as too much education and sometimes people can be really brainy about things instead of realizing that the birth process is less about what’s in your head and more about connecting to your body.”
Angel endured years of infertility before finally becoming pregnant with her son. As multiple doses of Pitocin were being infused into her, and as the internal monitors were placed inside her showed she was still having strong contractions, her cervix stubbornly remained dilated to 5 centimeters.
“They told me I might have that baby after midnight and have a New Year’s Day baby — [there was] that pressure, and then all of a sudden, it stops just before midnight," she recalls. "The strangest part about that is it really didn’t bother me. I was frustrated, but it also meant I was going to be pregnant for a little bit longer. When you have wanted it for so long, you don’t want it to be over, and then I have everyone else saying, OK, you need to have this baby right now.” She laughs, “Maybe I’m not ready to have it right now!”
There’s poking and prodding by medical staff, there’s all kinds of things that people say not even meaning to.
Part of Thomas’s job as a doula is to pin down a woman’s emotional needs, identifying places where there have been trauma or stressors, even during the pregnancy journey. “It doesn’t have to be abuse that’s happened in childhood,” she explains, “there’s poking and prodding by medical staff, there’s all kinds of things that people say not even meaning to when you are sensitive, that can show up when you are at a critical point of labor.”
She stresses three conditions a woman has to have in order to produce the hormone (oxytocin) that progresses labor: safety, security, and a sense of privacy.
“These are the same conditions it takes for us to get pregnant to begin with,” she says, “When you’re having sex with your partner, you’re probably not doing it with bright lights on, and loud music. You probably have dim lighting, cushy sheets. These kind of conditions are the same conditions that make a safe space for labor.”
Once someone tells you your labor is slowing, or you aren’t progressing, your safety bubble breaks, and your body essentially shuts down, potentially producing stress hormones like adrenaline or boosting levels of beta-endorphin, the body's natural pain relief response, high enough to slow oxytocin production.
“When you’re up against the challenge of having to be a super-heroine and push your baby out in record time, your body isn’t governing the flow of its own hormones. Basically your hormone system is being hijacked,” explains Thomas.
No one knows that better than Sarah,* a mother from North Carolina, who had a bad experience with the doctor who delivered her first child. Pregnant with her second, she left for the hospital having strong, regular contractions. Her nurse asked if she’d like her water broken, and Sarah asked her who the doctor on call was. It turned out to be the same doctor from several years ago, the one she never wanted to work with again.
“I absolutely declined having [my waters] broken,” she explains to Romper, “I looked at the nurse and told her I wasn’t having this baby any time soon if that man was involved. The nurse sort of giggled at me and it was fairly quickly that my contractions just stopped. She offered to break my water again, and I told her I would be leaving as soon as I was free to leave. She giggled again, and after two hours of no contractions, the nurse checked me and my cervix was now closed up tight."
If a laboring mother doesn’t feel safe and connected with her baby, her labor and delivery can absolutely go south.
Sarah went home that day and her baby was born a week later. This time though, she says it was with a supportive and encouraging staff within the same hospital.
“I believe that our mental strength or weaknesses can hold in a baby and that natural tendency hearkens back to our primitive days when it was stupid to have a baby while surrounded by saber tooth tigers. If a laboring mother doesn’t feel safe and connected with her baby, her labor and delivery can absolutely go south. Labor is as primitive as it gets,” Sarah adds.
We as humans all have our own traumas and issues. What doulas like Thomas do is not just find out what they are, but help laboring women move past those traumas, ideally before labor even starts. Having the conversation of where certain fears lie and discussing your beliefs around pregnancy and birth can give a doula a heads up that a woman may have certain during birth that she must work through.
Providing an environment where a women feels safe, secure and has a sense of privacy is key, and sometimes in the hospital women need to create that space for themselves. Dimming overhead lights, playing soft music, and practicing mindfulness techniques are all great ideas to get you mentally in the zone. One client of Thomas's couldn't feel safe or deliver her baby until she got into a closet.
“I often have moms recite, or we will write together some affirmations or a letter to the baby and have her listen back to them to calm her,” says Thomas, “A lot of the time anxiety can just take over and mindfulness is a great way to help.”
Telling yourself, even if you’re feeling rushed, 'This takes time and I am just trusting my body' can help you stay calm.
She recommends working out some of those affirmations with your support person in advance because so much of the time we just hear, “You’re doing great” when really, what we need is for someone to tell us “You’re safe here. You’ve been able to get through so much and you will get through this too.”
Once a labor has stalled out, there are some great non-medicated ways to get it going again. Whether you are working with a doula or not, self-talk is important, says Thomas. Telling yourself, even if you’re feeling rushed, “This takes time and I am just trusting my body” can help you stay calm.
She also recommends that if nothing is happening with the baby to ask for another two hours to get your head back in the game, to not pressure yourself. Turn on music, have someone rub your feet. “Touch can increase the production of oxytocin, the hormone that governs birth and increases contractions and can help move things along,” she explains.
Using a breast pump to stimulate your nipples or requesting an enema may seem unconventional, but both of these along with touch will naturally move the process along and the enema will clear out some space for the baby to descend. Use your imagination on that one, but they are tactics Thomas swears by.
You may not even be aware that a vibrator can be a great tool to kickstart labor again. “Even though it doesn’t feel like it, labor is essentially a big orgasm in the body,” says Thomas, “One way to shunt labor pain is to use a vibrator because the pain and pleasure pathways run alongside each other but not over. If you’re experiencing pleasure, you can’t experience pain at the same time, and vice versa. A lot of people will be intimate and kiss, but arousal can increase contractions and decrease pain.”
Most births are exactly what women have wanted. But when women come up against something during labor, they have to know it’s not their fault, ever. It’s how our system is set up. Women can’t maneuver in ways they need to have a desirable experience.
“It’s not set up that way,” Thomas says, “We really need to advocate for ourselves. We need to find support in whatever shape or form that looks like."
*Asked to be identified by their first name only.