Prefer to listen? Find the accompanying podcast episode on the Unschooled Homebirth podcast, Episode 13, wherever you get your podcasts!

When it comes to waiting for baby, caring for your newborn or raising a toddler, patience is a virtue. To cultivate that virtue, we are going to meander through the complexity of patience as it relates to waiting for your due date, going past your due date as well as how to get better at having patience, and some tips to help you know whether what you need is more patience or action.

When Is Your Baby Going To Get Here!?

As you near the end of your pregnancy, it is inevitable that people will start asking you about your due date and when your baby is going to come, as if you can see into the future, or start recommending inductions. We have all heard stories of post-date labors that were induced, or a stalled labor that needed to be augmented with Pitocin, or oxytocin, to speed things along. And most women who undergo inductions or augmentations believe it is for the health of their baby, but how do you know if that is true for you? How do you know if what you need is patience or action, like an induction?

The Flaws of Prenatal Research Studies

It seems almost every week an article shows up in my inbox reinforcing the benefits of induction, some arguing for 39 weeks, while others are looking at post-term induction around 41 weeks. In fact a recent study in Sweden published in the British Medical Journal1, stopped the study early because they were finding a high enough significance in inducing at 41 weeks that they felt it was safer to end the study and induce any woman who's pregnancy goes over 41 weeks rather than keep a control group of expectant management to 42 weeks. 

Further, with the publication of the ARRIVE study in February 2018, which announced that induction of labor at 39 weeks reduced c-section rates, although it is important to note that it was not found to impact the rates of serious complications for babies, you might find yourself wondering if induction really is the best course of action for you and your baby?

With all this information, it's hard to make decisions given the current state of prenatal research and guidelines that we have out there today. Statistics are not actually as reflective of reality as the research would like us to believe. The reason is that we don't know anything about the health of the women or the babies in these studies or the choices they are making in their pregnancy and birth because nothing about the onset of labor is black and white.

That leads to the question, if all women are supposed to be birthing babies at exactly 40 weeks, why does nature have variability? Why doesn't it always start on time.

Looking Deeper

I have looked far and deep into this subject, because it is one of the leading causes of regret and dissatisfaction in birth, and regret and dissatisfaction in birth is what I want you to avoid! So after studying back hundreds of years into the history of birth, and working with hundreds of prenatal clients, I will share the keys to patience in birth and doing everything in your power to encourage your labor to start on time.

First, because my approach is all about increasing awareness of birth through all kinds of perspectives, angles and experiences, I want to share some passages from the Chinese Treatise on Childbirth by Ye Feng. Though some of Ye Feng's perspectives dismiss the effort that labor can require in many cases, he does a great service to those under his care by focusing on keeping them healthy during pregnancy so by the time they arrive at the time of birth, their body is prepared for labor and has the endurance needed to experience an efficient and safe labor.

Ye Feng says: "Seeing that man is the most intelligent being in creation, how can we suppose that he should be inferior to other created beings; now other things are produced without difficulty; hence herbs and plants bud in their proper season, and the chicken leaves its shell at the appointed time, what occasion is there for any aid being given? These processes are entirely spontaneous, and the application of force is in no case called for; why then should the human species alone be an exception to this rule?"

He goes on to write: "Some ask, if these things be so, how can there be in the world any such thing as a difficult labor? Sometimes these things will happen, either because the mother is exhausted, and the nourishment of the womb not sufficient, and the blood and subtle fluid not supplied abundantly; or the woman has been sick."

So that brings us to the keys for doing everything possible to have a timely and efficient labor so you can relax knowing that your labor will start when it is supposed to start, and if reason exists to induce or augment your labor, you still have done everything possible to be prepared for a healthy birth, even if circumstances arise for which you decide it's time for an intervention.

The Keys to a Timely & Efficient Labor

Your health, physical, mental and emotional is the biggest factor influencing the timeliness of the onset of your labor. That's right, it’s as simple as assessing your own health, which means, the onset of your labor and birth are now much more in your control.

So that's great news, but I know, you need this broken down a little more, just stick with me, there's a little bit of winding around to get to the goal.

Whether or not you and your body are ready to endure the intensity of labor is dependent upon your overall health. If your health is weak in any area, your body will be in a state of too much stress for it to feel safe to go into labor.

The Marathon of Birth

Physically, your body needs to be able to endure the physical and mental process of labor, so you need to be rested and well nourished. Think of your labor as a marathon, and actually a marathon is considered to be a similar amount of exertion as going through labor and birth. In order to complete a marathon, you need to be rested, you need to be eating enough proteins, healthy fats and lots of mineral rich foods, and you need to be preparing your mindset for the race. If you follow this formula, you are much more likely to start the race strong and be able to finish when you've undergone the right training.

However, if you are not getting enough sleep or not enough nutrient dense foods, your muscles and cardiovascular system may underperform. You will go to the race and maybe you will finish, but it will be slow and difficult, maybe you will have to walk for part of it or maybe you will stop part way through and not finish at all. This is the equivalent to a labor that doesn't start or that starts but doesn't build up enough intensity, as happens in a stalled labor or prodromal labor, where contractions start, but they don't ever build up to full labor, which is exhausting if it continues for days or even weeks. The same things applies for cervical dilation that stops before 10 cm, these are all signs that the laboring woman has not had the opportunity to restore and recharge her strength before labor. 

What does this have to do with patience?

If you are flourishing in your pregnancy - eating the right nourishing foods, getting enough rest, managing stress and feeling confident about your upcoming birth, then it is likely your baby and your placenta are experiencing the same level of health, and you only need to have the patience to meet your little one when he or she is ripe and ready. Instead of promoting labor, sometimes the best medicine is to promote patience while focusing on truly nourishing health.

The last thing I want to bring to this discussion is a quote from a Japanese Doctor, Dr Tadashi Yoshimura, who wrote Joyous Childbirth Changes the World. He was an obstetrician with a very unique clinic where he saw around a 5% cesarean delivery rate, compared to the 33% average of US hospitals, this is startlingly low, in a good way. He said his secret was keeping women and their babies healthy during pregnancy and giving the laboring mom enough time in a peaceful environment to allow her and her baby to do the work of labor, eating when she needs to, sleeping when she needs to and being in a place where she is completely respected.

"Weak contractions mean the conditions are not yet perfect for birthing. All you have to do is wait until they are right."

"The mechanism of birthing is amazingly delicate and mysterious. If the baby is big, it takes longer to come out. Even if the baby is small, a tight birth canal might impede smooth delivery. Whether the contractions are weak or strong reflects each woman's condition."

This sums up exactly what we have been talking about here.

Dr Yoshimura goes on to say, "It is so precise and miraculous that, although I am a doctor, I cannot help thinking it is an act of God. If we leave birthing to Nature, or God, babies are born at the proper time. That is the truth of childbirth."

I hope you enjoyed that bit from an amazingly insightful doctor who helped so many women bring their babies into the world peacefully and fulfilled with a sense of accomplishment.

Our takeaway for today is that the key to patience is to nourish your body and mind in a way that creates the best conditions possible to support a timely birth. Eat well, sleep well and create as peaceful and calm an environment as you can.

People will continue to ask you about your due date or recommend you think about inducing and the articles and studies that try to portray that inducing at 39 or 40 or 41 weeks will continue to show up in our inboxes, but you can rest assured that you are doing everything you can to support a healthy pregnancy and baby and have a healthy, natural birth at the time intended by nature.

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1 BMJ 2019;367:l6131 http://dx.doi.org/10.1136/bmj.l6131