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The Natural Alignment Plateau – stop blaming the cervix!

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A woman can be progressing at that expected 1cm per hour (according to the outdated medical textbooks on Friedman’s Curve, which is definitely now proven to be obsolete) and frequent vaginal exams that are performed to assess progress.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 textbooks.

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Read more about Friedman’s Curve by going to the Evidence Based Birth website:

https://evidencebasedbirth.com/friedmans-curve-and-failure-to-progress-a-leading-cause-of-unplanned-c-sections/

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 Childbirth Educator 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.”

 

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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 plateaus, 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.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3660040/

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 woman 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 have 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 maneuver 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.

A study released in May 2024 by midwife Marina Weckend and her co-authors highlighted the existence of natural pauses (physiological plateaus) during childbirth which can last a few minutes or several hours, which then leads to interventions, instrumental birth or caesarean section. If more care providers understood this and changed the way they worked, we could see a lot less interventions, and a whole lot more better birthing experiences.

“Midwives’ unique holistic philosophy has a direct positive impact on birth outcomes for mothers and babies, as it challenges narrow definitions of normality and adapts flexibly to women’s individual labour patterns – including patterns with physiological plateaus.”

To read the study CLICK HERE

You can also listen to one of the researchers Marina Weckend discussing this study on The Great Birth Rebellion podcast:

CLICK HERE

This brilliant group of midwives have just launched a whole website dedicated to Physiological Plateaus, if you would like to read more: https://childbirthresearch.com/

 

Vicki Hobbs, Doula Training Academy, Natural alignment plateau, labour plateau, Back to Basics Birthing, labour stalling, cervix, Sara Wickham, Marina Weckend, Clare Davison, midwife, hospital birth, failure to progress,

What can you do during the Natural Alignment Plateau?

https://jme.bmj.com/content/medethics/4/3/119.full.pdf

https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-1871-5

https://vickihobbs.com/can-i-eat-and-drink-during-labour/

https://www.pregnancy.com.au/out-of-the-laboratory-back-to-the-darkened-room/

https://evidencebasedbirth.com/water-immersion-during-labor-for-pain-relief/

https://www.youtube.com/watch?v=S7kVwX5y5fY

https://vickihobbs.com/keep-out-orgasm-in-progress/

https://drkatelevett.com/video-resources-acupressure-for-labour

https://evidencebasedbirth.com/massage-for-pain-relief-during-labor/

https://www.livescience.com/42198-what-is-oxytocin.html

CLICK HERE

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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If you would like more information about Childbirth and Hypnobirthing classes in Perth, please go to my website
CLICK HERE 

 

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    About Vicki Hobbs

    My name is Vicki Hobbs and I am a Childbirth Educator (Back to Basics Birthing), Hypnobirthing 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.

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