The Natural Alignment Plateau phrase was first used by Marjie Hathaway, who is an independent childbirth educator and author of several books, as well as a practitioner trainer for the Bradley Childbirth Method.
She highlighted that it is not uncommon for women to get to a point in their labour where their cervix stops dilating. This usually happens before transition, but it can happen at any time, but it doesn’t mean that the cervix is broken or has failed.
A woman can be progressing at that expected 1cm per hour (according to the outdated medical text books on Friedman’s Curve, which is definitely now proven to be obsolete) and frequent vaginal exams that are performed to assess progress. But what happens when suddenly it’s noticed that she has stalled at 7cm after several more vaginal exams – and the woman and her partner notice the energy changing in the birth suite? There seems to be an air of urgency now and concern that this mum is now not doing what “she’s supposed to” according to the text books.
Read more about Friedman’s Curve by going to the Evidence Based Birth website:
Her cervix is slacking off and now progress has come to a halt when she was doing so well according to her care providers, and everyone in the room had been synchronising their watches and predicting the time this baby would be born based on that hourly 1cm progression sticking to plan. Now look what the cervix has done – just gone and ruined everything.
That energy is not wasted on the mum who hears the whispers, recognises the conditioning language of “failure to progress” and now there is a shift in focussing more on an “interventional birth” rather than a “let’s step back and leave mum alone to focus, trust and breathe” birth.
As a Hypnobirthing Australia Practitioner and Doula, I have been at births where the mum has been told that her cervix is not dilating and she has opted to wait and see, rest, sleep, and perhaps work out what is conflicting her mind. Sometimes letting in fears and doubts can have an effect on her hormonal physiology, and that is a big part of that synchronicity for cervical dilation.
Birth is not just about the cervix. We know that a woman can go from 6cm to fully dilated and birthing her baby in an hour.
I also know of a mum arriving at hospital to be told she was only 1cm dilated and should go home, particularly because she was a first time mum, so she probably had 12 to 24 hours before active labour. Well, that mum birthed her baby within an hour after getting back into a peaceful zone, bouncing on her ball and blocking out distractions. She knew her baby was really close, and she declined to go home and was put into an assessment room to “wait it out” but she didn’t have long to wait at all. Was the mum super excited at how fast the birth went? No she was not because she felt fearful. Was the mum feeling this birth was the best it could be? No definitely not, as she was traumatised that nobody would listen to her and what she felt was going on with her body. Did the mum feel safe and supported? Absolutely not.
Having care providers speak in a way that leads a woman to believe her body is no longer working can affect that balance – internally the body is working, and that doesn’t mean that the cervix is failing. As Dr Sara Wickham points out “the cervix has done its job of keeping baby in, now it is the job of the fundus to get the baby out.”
Women are being coerced and convinced by the care providers that their labour needs to be sped up, augmented either by rupturing the membranes and / or with “synthetic oxytocin” via a drip.
It is so important that women understand that they may experience plateau’s, so this is a natural bonus – use this time to sleep, recharge, reboot and prime the brain with positive affirmations and encouragement. In other countries they have changed active labour to 6cm, rather than 4cm, so why hasn’t Australia done the same, which would enable women a lot more time to get to “active labour” and therefore less stress? Many women are being labelled with “failure to progress” before they are actually in active labour.
In fact a large study by Jun Zang in 2013 identified that before 6cms, many first time mothers and even multips went long periods without any dilation.
Vaginal exams and other medical evaluations to determine the progress of labour are unreliable – even if the care provider is highly trained and experienced. Stop and consider that the labour could be progressing in a way that is spot on for that woman and her baby. If baby is happy and mum is happy then adopt a “wait and see” approach.
There is evidence that a plateau in labour is normal and healthy and most times this results in “failure to wait” by care providers. Progress is invisible on the outside but on the inside there are so many levels, functions and systems working and interweaving to facilitate progress – we can’t know every facet of labour and birth because every women is unique – no two bodies or babies are the same and even more profound is that no two minds are the same.
Perhaps that plateau is to prepare the woman for the transition into motherhood – the change of dynamic in her relationship with her partner, outside influences and so much more. If the woman has another child, perhaps there is conflict about the change in being a mum to another little person, and maybe feeling she may not having enough love for both.
Your baby is instinctively doing things during labour as well, so maybe they need this lull in dilation to initiate their own progress while they are preparing to enter this new world and learn to survive. Perhaps they need to get into a better position, which is what the title suggests – that plateau so baby becomes more aligned in the pelvis for an easier transition down the birth canal. They may need to manoeuvre themselves around a bit more gently without the pressure of contractions, or perhaps they have been experiencing some intensity with contractions, so it is an opportunity for them to rest too, so if they are happy, let them be.
What can you do during The Natural Alignment Plateau?
- Have a sleep – world-renowned birth expert Sheila Kitzinger (sadly now deceased) encouraged women to have a sleep to give themselves every chance of restoring energy before things ramp up again;
- Move around, change positions and even go for a walk, get some fresh air and enjoy being outdoors, particularly if you have been stuck in a birth suite for a while – you are not a prisoner after all;
- Eat and drink to ensure that you stay hydrated and you prevent ketosis;
- Take a look at your birthing environment – are the lights turned off, the blinds closed, and does it feel safe and comfortable in your birthing space – the same as a mother cat would look for when she was preparing to birth her kittens – a quiet, dark and undisturbed space away from interruptions;
- Get into the shower or the bath and allow yourself to relax and recharge;
- Put on some music and dance – dance like nobody is watching while you swing those hips and do drop squats. Here is one of my most favourite videos of Obstetrician Fernando Guedes da Cunha in Brazil who encourages all his labouring women to dance.
- Nipple or clitoral stimulation – you know I love talking about orgasms in my classes and this releases oxytocin – you can’t birth your baby without oxytocin so why not get the real stuff happening rather than the synthetic oxytocin
- Acupressure can help with relaxation while also stimulating the hormones for labour and birth – oxytocin and endorphins. Dr Kate Levett has compiled some educational videos for parents to learn the acupressure points that can be used and what they do.
- Massage can also help to relax the mind, body and emotions, while releasing endorphins, which will also help to increase the release of oxytocin – that wonderful labouring hormone cracks a mention again and is what is needed to get labour active;
- Hugging or cuddling with your partner can help you to feel calm and relaxed but more importantly safe. Even watching funny movies and laughter releases endorphins and oxytocin.
- Fear release hypnosis can help to release any blocks that have invaded the space in your mind. Take some time out to lie down, put on a fear release track and be guided to release those fears and doubts while at the same time feeling encouraged, which can be incredibly beneficial. At Hypnobirthing Australia™ we have a beautiful fear release track that you can purchase:
These are just a few ideas that may help during The Natural Alignment Plateau but please do take some time out to rest, recover and reboot for when you really need that stored energy to roar your baby out.
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My name is Vicki Hobbs and I am a Childbirth Educator (Back to Basics Birthing), Hypnobirthing Australia Practitioner, Certified VBAC Educator, Remedial Massage Therapist specialising in Pregnancy & Postpartum Massage, Birth & Postpartum Doula, Certified Placenta Encapsulator, Hypnotherapist, Aromatherapist, Reiki Practitioner and Life Coach. I am a serial workshopper and learner, so that I keep up to date with new research and information so that I can provide you with up to date resources. My focus has always been on the mind, the body and the emotions and how they all need to be in balance for harmony. You can subscribe to my newsletter by adding your details in the box on the right-hand side and when you do I will send you a free relaxation meditation to help you feel calm and relaxed. I am based in the northern suburbs of Perth and can be contacted by email at [email protected] or phone (08) 9303 9111 or click here to go back to my Resources Page for more great articles and information.