Prodromal Labor:  The Story of an Undiagnosed Mother

The Journey Begins

I was absolutely elated to be welcoming our first child.  Everyone had told me to make a birth plan, and for some reason, I did not feel the need, thinking that whatever occurred organically was the order in which the birth should take place.  I had very simple plans:  I would birth naturally, with no epidural or induction, and with my doula and my husband by my side, we would welcome my son into the world.  I had read enough about birth, taken my child labor class, and I felt well prepared.  I was not interested in over-educating myself, because I felt like instinct should play a part.  I know now that even if I had read every book I could get my hands on, I still would never have learned about prodromal labor, what it was, or how to recognize it.  It was a condition I would experience during the births of both of my children, and yet, the term was one I would not learn for almost two more years.

It was December 2008, and I started labor slowly.  Over the course of the day, my contractions progressed to be about 15 to 20 minutes apart, coming in strong groups, then calming.  By the following afternoon, about 24 hours later, contractions were about 12 minutes apart.  I waited for them to come closer together, and my doula came by to check on me.  I was only 1cm dilated, so we waited for another day until they reached five minutes apart.  I was completely shocked at the intensity of the contractions.  What was odd was that they would get close together, then slow again after a few hours. The pattern didn’t resemble anything I had been told to monitor when determining true labor.  I tried to keep relaxed as I felt my body pressing down on itself, seemingly trying to turn my insides out.  I have an extremely high tolerance for pain, but this was unlike any pain I had ever felt.  I was grateful that we had reached this moment, and that labor had finally begun.

We headed for the hospital and were met by my doctor, who I liked very much.  I was excited for him to assess the situation.  None of us could believe it when he said I was only 1cm dilated.  I told him I had been in labor for almost three days and asked how this could be!  He was stumped. Told me sometimes it happens this way. Offer #1 for an epidural came (there would be many more, from every hospital staff person with whom I spoke).  I adamantly declined.  He said that, at times like this, he can speed up labor by reaching in and manually stretching me open, but tended to only do this under an epidural since it was extremely painful.  I told him to do it anyway.  I did not want any drugs.  The pain was surreal.  But we were on our way.  My contractions continued, and the nurses put a monitor around my belly to make sure the baby was okay.  Several hours later, my doctor returned to check on my progress.

I was still at 1cm!  I absolutely could not believe it.  I was really hungry!  And frustrated.  And baffled, as was my doctor.  He said all we could do was wait.  I was about to begin day four of labor.  He suggested that perhaps we throw Pitocin into the mix to speed contractions.  At this point my contractions had been three to four minutes apart, during which I would bury my head into my husbands chest and he would rub his hands down my spine, trying to lessen the intensity.  I had no idea how bringing the contractions closer together would make me feel, but at this point I was willing to cooperate and see where it took us, since nothing seemed to be working.

My doula gently advised me to wait, telling me that sometimes one intervention could lead to another (meaning a potential c-section).  I heeded her words, but hours later opted out of desperation to try the Pitocin, bringing my contractions 60 to 90 seconds apart, with each lasting at least 30 seconds.   I continued that way for about five hours, and by 11pm, I collapsed in tears on the bed.  I was so tired, and I felt I couldn’t do it anymore. I was trying to be a hero, but for whom?  My goal ultimately was to deliver a healthy baby.  My body, it seemed, was retaliating. I had not planned on turning my fate over to the doctor, though here I was with my own course of action yielding no result.

I remember it like it was yesterday, even though it has been four and half years.  My doula again urged me to wait a bit longer before making any decisions.  Eventually, though, I buckled under the strain of so many days without sleep and pain that, even now, I cannot find words to describe.

By midnight, I asked for an epidural.  At four am, my doctor came back to check me.  I was 2 cm.  He suggested we schedule a c-section for 6 am.  I was so exhausted.  My spirits, despite everything, were still high.  I was so optimistic, still making jokes and trying to be lighthearted in the face of what secretly had been my worst fear.  My doctor would be going home at 8 am, he told me.  I could hold out, or he could deliver the baby via c-section at 6am.  I asked him if we could wait and check again at the time of surgery, hoping that if I progressed, we would hold off.  He agreed that this was a good plan.  At 6 am, however, my status was the same.  We prepared for surgery.  I remember I was shaking so much, teeth chattering, and I could barely talk; like a shivering child just out of the bathtub.  I don’t know if I was scared, or cold, or…what.

My husband and I held hands during the surgery.  Tears streamed down our faces during the immeasurable joy of meeting our beautiful, perfect little Oliver for the very first time.  I was still shaking.  They closed me up, and I held our son.  We had our baby, and that was all I cared about.  I thanked G-d and felt everything was right in the world.  I didn’t care that I’d had a c-section, because I had our son in my arms. As I nursed him and kissed his tiny little mouth, I felt like the most fortunate person in the world.

I still never knew that what I had experienced was prodromal labor.  No one told me.  Everyone seemed amazed to hear I’d had such a lengthy effort.  But not even my doctor addressed in my follow-up appointment that what I had experienced had a name, not to mention that there was a positive way to navigate around it should it reoccur.  Never mind, I thought at the time; I had no reason to be ungrateful.  I was blessed.

The Second Time Around

Fourteen months later, I became pregnant with our second child.  After my first appointment with my OB, where he casually said, “When you have your c-section…” instead of “if,” I knew I had to find someone else to deliver the baby.  I was not having another c-section.  It was 2010, and VBACs were still so much less common than just following precedent.  I interviewed a number of midwives and eventually settled upon the midwives at Mt. Auburn Hospital in Cambridge, MA.  What really sold me was when they said, “Western doctors go to medical school and read a thick book that has a small section in it devoted to what can go right.  Midwives go to school and learn from thick book that is all about what can go right, with just a small part about what can go wrong.  It shapes our perspective and keeps us focused on the positive, beautiful experience of child birth.”  Perfect.

When I went into labor, I was fully prepared.  Apart from wanting a successful VBAC, my birth plan, as it had been the first time, was flexible.  This time, I decided that if my pain became intense, I would have an epidural.  Simple.  I wanted to be happy and strong to welcome my daughter.  I felt good about knowing this.  I went into labor a day after my due date, even though the contractions were still 10-12 minutes apart.  They continued to get closer, but not close enough; about every 7-8 minutes for hours, then further apart, then close again.  I went to bed, hopeful, only to wake up with the same status and same pattern.  I went through the day this way, and by evening, I called my midwife as the familiarity of this situation hit me.  Suddenly I feared a repeat of my four-day labor from my son’s birth.

My midwife advised me to have a glass of wine, then lie with my backside in the air, knees to chest, to slow my labor.  This was around 7pm.  I obliged, but by 11pm, the intensity of the contractions brought me back to memories of my previous labor.  They were coming closer together, but somehow I knew I was not dilating.  At 11pm, I called again, worried, knowing my contractions were only yielding pain.

I told her, panicked, that this was alarmingly like my previous labor.  I begged her for any insight she could provide that might explain how a person could labor for so long and yield no result.  I was heading into day three of unbelievable contractions, and I needed any kind of hope, wisdom and motivation she was willing to share with me.

Prodomal Labor

It was at this point that I heard the term prodromal labor for the very first time.  One definition I found describes it as:  An early phase of labor that does not progress in a normal pattern: contractions do not increase in intensity and cervical dilatation is minimal.  Yes, sort of.  What my midwife said was that, for whatever reason—and often due to the fact that women spend more time sitting these days than they used to—the uterus tilts in a way that can put us into unproductive labor.  She told me we needed to get my labor to stop so that my body could reset.  How?  Somehow I needed to get rest.  At best, I should try and sleep.  At worst, I could go to the hospital and they could give me narcotics to force me to sleep, which would stop the labor and allow it to come on when my body was truly ready.  It seemed fine in theory, but I was waking up every 5-7 minutes in sheer pain.  Sleeping wasn’t really happening.

At 1am, we headed to the hospital.  There were no rooms available, so we waited until a nurse finally checked and told me I was 1 or 2 cm dilated.  Each contraction hurt SOOOO much!  I burrowed into my husband, and he did his best to soothe me.  I knew I wasn’t supposed to wince or tense with the pain, that I should go with it and ride the wave, but I simply could not withstand the intensity.  I wish, in retrospect, that I could say it had been doable, though to this day, I don’t know if I could have endured much more.

By 3am, I had an epidural, and I finally slept.  When I awoke at 8am, my body had restarted, and I was in legitimate labor.  My midwives came together to help me birth our sweet baby Penny, and she was born at 12:30pm.  Everyone cheered for Penny, and for our group success with the VBAC.  I felt hugely triumphant and SO very happy.

Looking back, there are a few things I know.  If I had been made aware of what prodromal labor is, I am certain that I would have understood how to pace myself.  I am a runner.  I have run sprints, and I have run marathons, and it is all about the mind.  You just have to know what distance lies ahead.  Because none of the videos I had watched and none of the books—not to mention my birth classes or weekly OB appointments!—had mentioned this remote possibility, it was impossible for me to envision a positive, let alone finite, outcome.  I thought I was defunct. I know now I was, and am, perfectly fine.  My body was just doing what some bodies do.  This was information that would have helped me so much.

If someone had simply said to me, “Danielle, this is prodromal labor.  It feels real, but you need to zoom out and see the bigger picture.  The pain will be really tough, but it will go away, during which time you will need to rest to gain strength for when it returns.  It’s a pattern, but you can handle it, because it WILL end.  It WILL result in labor, and you WILL be okay.” I needed someone to tell me that.  Instead, I tensed up amidst a lack of knowledge and eventual worry.

I am still incredulous that no one ever brought up this possibility.  How had my original OB never even known about this?!  Had he known but just not thought of it?  I don’t know. Frankly, it seems irresponsible to me.  My doctor didn’t tell me about something that other women experience whose criteria applied to my situation, and that makes me uneasy.  I am, above all else, grateful that my two babies reached their destination!  I’m also grateful I can tell others that prodromal labor is not insurmountable, and that with the right support and awareness, giving birth will absolutely be as beautiful as you had hoped.  Probably more.

Resources

Update as of 6/14/14 – a must-read post on cervical scar tissue, one cause of prodomal labor: http://thedoulaguide.blogspot.com/2012/12/cervical-scar-tissue-cause-of.html?m=1

Here are some links to other helpful information and stories about prodromal labor:

http://spinningbabies.com/more-info/in-labor/362-starter-broken-when-early-labor-lingers-or-starts-and-stops

http://thechroniclesofbubs.blogspot.com/2012/06/andrews-birth-story-week-of-prodromal.html

http://belladolcebirths.blogspot.com/2012/01/prodromal-labor-what-is-it.html

Here’s a great one:

http://www.nmfrogblog.blogspot.com/2010/01/prodromal-labor-from-doulas-perspective.html

Did you experience Prodomal Labor? Please share your words of wisdom with our readers.

**********************************************************************************************************

Danielle_bioDB Gottesman, a stay-at-home mother, Pilates instructor, and [dormant] artist with a formal marketing background, fills her days observing and relearning the world through the eyes of her wise and generous two-year-old and four-year-old.  She is in the throes of parenting toddlers and wonders constantly what adventures lie ahead for her and her lovely, silly, sweet little family.

 

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17 thoughts on “Prodromal Labor:  The Story of an Undiagnosed Mother”

  1. Birth like sex is a primitive brain activity as this is where the hormone oxytocin comes from! Thinking, speech vision etc, all the cerebral brain activities interfere with the flow of oxytocin!
    I recommend you read Michel Odent’s “Functions of the Orgasms”, Sarah Buckley’s “Gentle Birth gentle mothering” and other hormone informed writers. Also seek maternity carers who understand about the interplay of all birth hormones, as well as labour in an environment that supports the flow of the labour hormones, then you also get endorphins going which will negate the need of an epidural or other artificial drugs. Then birth is life’s greatest high!!

  2. I just went through 4 days of what I found out was predromal labor. It was the most intense and painful experience of my life. 4 days of contractions being 2-7 min apart, so intensely painful I could only moan through them to keep from loosing my mind. 4 days and 4 trips to the hospital later and only being 3 cm I begged for an epidural and induction with pitocin

  3. Thank you for sharing! I have actually taken off work since July 15th because I have thought I was going into labor nearly every night. Contractions start any where from 9 to 11 pm and last through most of the night. Fortunately, I can sleep through some of the night and my husband has taken off work to take care of our 2 year old in the morning. With all of the contractions all week I am discouraged that I am still at 3 cm, which I was at last week. I am resting a lot and walking a lot trying to get this going! The contractions all week are exhausting and make your body very tired! I appreciate you sharing your birth story. Most people do not talk about prodromal labor.

  4. I appreciate having other women’s experiences to read about. I am a prodromal laborer pregnant and ready to deliver my 5th child. I am currently experiencing (at least) day 4 (but more likely into week 2) of tiring, maddening prodromal labor. For the past week and a half I have used a glass of wine in the evening to calm my contractions so I can sleep (at the suggestion of a friend who is a midwife). It wasn’t until my last pregnancy that I knew it had a name- my friend was a “midwife-in-training” at the time and shared that valuable nugget with me. Because of insurance coverage I still visit a regular OB with mostly conventional practices and deliver at a hospital. It took me a couple babies to understand that what I had experienced was prodromal labor. Hospitals and doctors do not readily talk about it, instead they seem expect all labors and births to fit into charts and graphs. When they don’t seem to be measuring up, outside measures of induction and birth are usually employed. It saddens me that prodromal labor is often passed off as “false labor”, because it is SO MUCH WORK. Child #1 was born following a car accident. I was having regular contractions but they weren’t able to keep her on the monitor, so out of caution and fear they broke my water to do an internal monitor. My plan all along had been natural birth. This birth resulted in hours of excruciating labor, administration of pitocin and eventually I caved to an epidural. Child #2 was “induced” one week early. I had thinned and effaced naturally and had been walking around at 2+cm for 2 weeks. He came quickly, but with pitocin I went ahead with an epidural again. By Child #3 I was determined to have a natural birth. I am a really active person, exercising throughout pregnancy etc. This is when I learned that my exercise could help things progress…and that my prodromal contractions WERE actually doing something (turning the uterus forward, thinning/ effacing). I discovered that in effect my body labors the first stage over a period of days or weeks…fun (cue sarcastic rimshot). So I danced then walked and walked. Eventually my body progressed far enough for them to decide to break my water, which seems to get things going further in most cases. My natural and totally unmedicated delivery was successful! #4 came earlier (according to EDD) but the labor was longer. When I had labored for a couple weeks prodromally without any progress past 2cm, stripping of membranes, using evening primrose oil and lots more walking seemed to help me along. Once admitted into the hospital contractions continued without much progress. At 4cm my water was broken. No one could believe it, but my contractions actually backed down. I pleaded with the nurse to call my Dr. and get permission for me to walk instead of administering pitocin (which was advised). Luckily my Dr. knows I know my body, and was willing to oblige. I walked, and within an hour our daughter was born.
    And so, being proactive is the plan for me starting today. Last night was a little better sleep than the previous night, my husband is home cleaning and “nesting” for me, my mom is here from out of town to watch the kids, and the weather is a little cooler. Today I finally feel ready to start walking this baby out…hopefully he cooperates! One positive I try and focus on during these slow suspenseful days is that my body is building endurance and knows how to handle labor. Contractions feel pretty much this way right up until transition, and that period goes swiftly for me. I think that is largely due to the preparation of prodromal labor. Blessing ladies!

  5. Thanks for sharing. I’m experiencing this kind of labor right now I’m 38+6 and hoping for a vbac. I know now not to show up at the hospital unless my water breaks or in unbareable pain

    1. This article resonated so much with me, particularly how you said it would have been more tolerable if only you’d known what was going on. I figured it out after a night of so-called medical rest ( which didn’t work at all) – I went online and in between very strong contractions that would not get closer than 6 minutes apart, i researched what could possibly be happening. Even when I found out, it seemed none of the midwives had ever heard about it. I had had cryosurgery and a d & c and my cervix was scarred and not dilating. It irritates me so much when people say prodromal labor is not true labor. It’s as painful as progressing labor but far more challenging because you’re so confused and scared. Sad that I had to figure this all out on my own. I’m almost 38 weeks with my second and I’m glad to read your article… Not thrilled that it could happen again, but if it does I will be ready for it, and educate everyone around me about it, too.

  6. I would encourage other women to also explore the possibility of scars on the cervix, which can result in contractions that seem like hard active labor but with minimal dilation. So many women have undergone gynecological procedures that can result in scarring. Here is an introduction to the topic — you can follow the links within the article and Google the subject to find out more:
    http://thedoulaguide.blogspot.com/2012/12/cervical-scar-tissue-cause-of.html

    Sincerely, Ananda

  7. I am so glad to have found this blog entry! I went through nearly the exact same thing with my first baby. I was given morphine after being in this ‘false’ labor for 2 days. After I slept for awhile, it did reset my body and I finally went into active labor but it was I felt like such a failure because I had all these friends who had their babies in <4 hours. Reading your story will hopefully help me to be more mentally prepared for the next time around. Thank you so much.

  8. WOW! Thanks so much for sharing this information. I actually starting crying when I read your words of encouragement at the end. My first pregnancy I experienced pre-term labor at 33 weeks (3.5 cm dilated and 50% effaced) and was put on bed rest and Procardia until 36 weeks. After being released from bed rest and medicine a week passed with no contractions or cervical changes so I figured we would make it to 40 weeks. However, exactly a day after hitting 37 weeks my water broke and normal, by-the-book contractions started shortly after and were a steady 5 minutes apart and slowly got closer together until delivery. My daughter was born 7 hours later. This pregnancy I was fully prepared to deal with preterm labor again which we did at almost the exact time at 33 weeks. I was 2.5 cm dilated and 50% effaced. Two days later I was put on bed rest and Procardia when my doctor examined me and I was 4 cm dilated and 70% effaced even though I wasn’t feeling any contractions. This time, I started having very severe contractions 48 hours after stopping the medication. These contractions felt EXACTLY the same as they did when I was in labor the first time and I have not felt anything like them before or since. What was different was they were anywhere from 2 to 5 to 8 minutes apart and some were 30 seconds long and others were 1 min 30 seconds long. When we went to the hospital 3 hours later though there was no cervical change even after another 2 hours of monitoring the contractions. I couldn’t believe these contractions were so painful and weren’t doing anything even after 5 hours. They sent me home and told me to take some Tylenol. WHAT?!?! The past two days since then I’ve been experiencing painless to slightly painful contractions ranging from 2 minutes apart to 20 minutes apart. I am now 5 cm dilated and 80% effaced so they seem to be doing something even though they are irregular, but not doing enough fast enough to be considered ‘active labor’. These past few weeks have been such an emotional roller coaster and I’ve been so confused about what ‘active labor’ will feel like now. I may not be experiencing prodromal labor since I am progressing (albiet very slowly), but it’s comforting to know that others experience unusual births and I’m not going crazy.

  9. I went through 3 days of stop-start contractions and felt mentally, physically and emotionally exhausted when I finally went into labour – I had also lost a lot of my confidence in being able to give birth. On the third night (the contractions lasted about 6 hours and went again by morning), I ended up having a glass of wine and giving myself a stern talking to as I just didn’t feel like I could face another false start and my third sleepless night. I rang a midwife who was really unhelpful and the hospital looked at me like I was an idiot and said ‘go home you’re not in labour’ …but it was real pain! By the time I finally got to the hospital I was 8cm so I think I had been dilating over the 3 days just very slowly but no medical professionals took me seriously which when I look back was heartbreaking. By the time I got to the hospital I was exhausted and also very relieved to be in a medical space – so much so my contractions stopped. In the end after pushing for an hour and getting nowhere I had an epidural and a forceps delivery to a 9.5lbs baby! (she was 2 weeks overdue – is this related?) If it is happening to you I would recommend demanding a safe sleeping pill to get rest and make sure you eat and keep your strength up and relax I was so sure it was labour every time I got so tired – by the third day I just told myself I’d ignore it and carry on with my normal day which sort of helped til the pain started again. Also don’t let anyone tell you it’s not labour or make you feel like you can;t handle pain! This needs to be talked about especially for first time mums I can’t believe it’s not more widely discussed – it can’t be that unusual!

  10. For all those of you who are passionately spreading the word about Prodomal Labor, we’ve just added a must-read post to the resources section above, linked here for your convenience. http://thedoulaguide.blogspot.com/2012/12/cervical-scar-tissue-cause-of.html?m=1

    Thanks so much for sharing your stories! DB has read all of them, and while she’s had some technical difficulties responding, she appreciates the outpouring of love and has deep compassion for your stories.

  11. Oh my god, thank you so much for this. This is happening to me right now. Contractions started on my due date and became very intense, coming in clusters, 6 minutes apart, then 5, then 9, then 7, on and on. They never became regular but were soooo painful. All I could do was rock and shake and moan, trying and failing to relax my body. After 24 hours of this I finally thought it might be time to go to the hospital, but was sent home at 3cm dilated. By 4am I called my midwife sobbing. At that point I had been awake for almost 48 hours and could not sleep due to contractions coming on every 7-10 minutes.

    I ended up spending the night in the hospital with iv fluids and a morphine drip. Even the morphine didn’t do more than just take the edge off the contractions, but I did manage to sleep for about four hours. Now I am home again, and feel much better (I think dehydration has played a significant role in this ordeal). Contractions are still happening every 10 minutes but they are significantly less painful.

    3cm still, but the baby’s head is finally beginning to engage, and I’m hopeful that something more positive will happen in the next couple of days. It has been SO AFFIRMING to hear that other people experienced these extremely painful contractions in prodromal labor because it has made me feel like I am just a total wuss who won’t be capable of a natural childbirth. (also that the midwife doesn’t believe me regarding the strength of the contractions as she keeps warning me that real contractions will be unimaginably worse). Although I new about prodromal labor, I had always heard it described as “mild”, “contractions don’t intensify”, “just ignore the contractions”. Trust me, these were NOT POSSIBLE to ignore. I don’t know what will come, but I am so much more hopeful now. Thank you!

  12. This is me right now! 2nd baby, going for a VBAC and having 3 days/nights of some very serious pain and I have a high pain tolerance as well. But this has me wanting to climb the walls. I’m currently 1cm and 60% e-face. The lack of sleep is so much fun on the emotions and yeah, praying baby girl comes soon!!

  13. Thanks for this! I’m currently doing the prodromol labour thing right now with baby #4 – I don’t recall doing it with any previous baby, but boy it’s sure different this time! The lack of sleep is my biggest beef right now, it makes it hard to cope with the discomfort/pain and caring for 3 other children.

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