When you believe that something is starting to move along, give your doula and your midwife/doctor a call. Let them know what you are experiencing. Are you having contractions? How long are the contractions lasting? How far apart are your contractions? When did they start? Did your water break? Giving us as much details will give us the best idea on where you are at in your labor.
Try to labor at home on your own as much as possible. Let this be your time to be intimate with your partner. Soon you will have a room full of people and it can feel like everyone is involved. Enjoy this time together before calling in your troops. Laboring at home as long as you can, can also decrease your chances of needing interventions. Some providers will put you on a time clock once you have arrived and may want to help you speed things along. You may also be sent home if you arrived "too early" and haven't progressed enough. Plus, you are going to be more comfortable in your own home. You have access to everything you need and all your personal comforts.
Call your Doula, then your Doctor/Midwife. You aren't necessarily calling them into your birth, but just giving them a heads up on what is happening. Your doula may be able to provide suggestions over the phone on some comfort techniques. This also gives her a heads up that she may be heading into a birth later on and she can make arrangements with work, kids, and transportation. You do not need to call your OB or Midwife until you are heading to the hospital/birth center. Your doula will give you some insight on when to call your doctor/midwife and when to go in. Some policies say that they will always tell you to come in, as a precaution. But this can lead to unnecessary interventions. Always follow your gut!
You don't need an audience. Calling everyone into your labor before you really need the support, can make you have stage freight. Too many people watching can make you feel pressured to move this along faster than it is. This can lead to performance anxiety and can prolong your labor. Don't invite too many people. You won't need everyone assisting you and it can feel crowded. Once people start to run out of things to do, they may just end up sitting and waiting, which can also cause more pressure. Don't be afraid to send people home if it becomes too much. Only invite people who will be able to help you through this. Don't feel obligated to invite anyone who may add more stress or discomfort. You will still want to get as far into your labor as possible before calling in your birth team, helping them reserve their strength for when you will need them the most.
Rest, eat, drink, repeat! Exhaustion is labor's enemy number one. When labor begins, try and get as much sleep as you can. It sounds silly but your body will need it! Keep eating and drinking even though you may not have an appetite. Ignore the contractions until you can no longer ignore them. Pack snacks for labor like honey sticks and fruit for energy. Keep in mind, what goes in, usually ends up coming back up in labor. So be mindful of what you eat! Foods that provide energy are key.
Riding the contraction wave. "You will feel your contraction coming before it's really there - this is the time to take your first deep cleansing breath. Get on top of your contraction before it gets on top of you and ride the wave rather than letting it crash over you. This first deep breath helps you do this. From there, work mentally, from the head down to release any tension in the forehead, jaw, tongue, shoulders and down the spine. Always from top to bottom (because we want baby to move down, not up). If you have a partner, they should be scanning your body for areas of tension and gently bringing your awareness to that place in your body so you can consciously release it. The idea here is to make sure that each area of your body is loose and not taking energy and productivity away from the job your uterus and cervix are trying to do. Allow all the tension to be THERE - not in your face/back/hips. A relaxed face, loose hips and breathing mama tells me that she is allowing herself to open up to the process of birth. This is all you can hope for for any mama" (Crowning Lotus).
Open Communication Keep your doula updated as things progress. Let her know how far apart your contractions are and as anything new changes. When you hit a wall where you just don't know if you can continue, let your doula know it is time to come in. She can help you with new positions and new ideas to help handle the contractions. "You will need to listen to your intuition here. Are things simply getting more intense, or are you closing in on giving birth. Often times a doula will listen to a contraction or two over the phone and make a fairly accurate assessment of where you are at through your breathing pattern and any sounds you might be making. She will inform you of this assessment and will then make a suggestion or ask you what you would like to do. Sometimes, more often than not, there are 2-3 walls you will move through in labor" (Crowning Lotus). Once she's arrived, she can help you contact your OB/ Midwife and they will let you know if they think you should head in or if you need to labor at home for a little bit longer or if your doula hears you on the phone, she can suggest heading in and she will meet you there.
Things to watch for "These are signs that you may be closer to transition from the first stage of labor to the second stage of labor (pushing). These are all reasons to begin to consider calling in your team and/or going to the hospital/birth center.
Shaking - Sometimes when you are nearing the transition phase (from first stage labor to second stage/pushing) you begin to shake and tremble.
Nausea - Along with transition, you may begin to feel nauseous and even begin to vomit or burp a lot.
Pressure - Towards the end of labor you will progressively feel more and more rectal and vaginal pressure as your baby moves further and further down. You may even be convinced that you have to poop (and sometimes, you do), however, it's often times the baby who is making you feel that way. This is a good indication that you are moving towards transition.
Involuntary "pushes" - the "urge to push" everyone talks about can be easily compared to what it's like to vomit. When throwing up, there is no stopping it - it's coming and your stomach is involuntarily retching it up and out of your body. Essentially, this happens with the urge to push your baby out as well. Your abdomen will begin to heave and you may begin to grunt and push along with it. This is definitely time to get where you are going to be to give birth.
"I can't do this anymore" - These are often the "famous last words" of women as they move into transition" (Crowning Lotus).
All of this aside, I will come in whenever YOU need me to come in. Don't ever feel like you are calling me in too early. I am here for YOU! I can meet you at your home or at the hospital/birth center. Whatever it is that you need. You are not weak for needing me "early". Birth is scary. And I'm here to help make it a little less scary. With that all being said, DO call me when you are ready. I DO want to be at your birth. Notifying me too late when things are getting started and keeping me posted, will almost always guarantee that I won't make it. Communication is key.
I will also give you this form to keep on your refrigerator as a simple reminder for when things get going.