A doula trainer’s love-hate (seriously-mixed-feelings) relationship with contraction timers
I’ve been a doula long enough to remember contraction timing sheets. They had a thin left-side column to record the time that each contraction happened, another thin column to note how long it lasted, and a longer column to the right to make any notes about that particular contraction. We’d jot down a few contractions now and then, to get a sense of where things were with the labor, and then we’d abandon the sheet for awhile – until something had changed.
When I start to talk with my childbirth education students or doula trainees about timing contractions, invariably someone excitedly says:
"There are apps for that!"
For sure, there are apps.
So first the love. Contraction timing apps allow families to use technology to track their contractions. Like paper, they can (theoretically) be used intermittently. That is all the love.
And now for the, well, if not the hate, my seriously mixed feelings about contraction timer apps.
Contraction apps take you out of labor land.
Labor goes best when the hormones of labor are working well. And the hormones of labor are optimized when people get out of their heads and fully into the primal space that we call “labor land.” Too much thinking and analyzing can reduce oxytocin, and slow down or complicate your labor. We want you in a state of flow, and thinking about timing each and every contraction is not a helpful way to get there.
Someone’s pushing buttons instead of paying full attention to you.
If someone else is timing the contractions for you, they aren’t giving you their best. Whether it’s your partner or your doula, they are thinking about when to press that button on their phone at the beginning and end of every contraction. I’d rather those people be giving you their full attention and presence, ready to support you in exactly the way you need at each moment, and not so much focused on when to hit that button. It can be surprisingly tough to tell exactly when a contraction begins and ends, and even if you’re not bothering the person in labor to fill you in, you are using a fair amount of brain space to do this. (Doulas, I know you are good at multitasking, but the next time you’re truly, fully present with someone in labor, think about how different that is compared to when you’re also timing. Even for the best multitaskers, divided attention is still divided. The energy you’re putting out is different — and remember that oxytocin is contagious, our calm can boost our clients’ calm.)
You’ll see everything else on your smart phone too.
You know how easy it is to be lured away by the siren song of a favorite app, or to be drawn into a text that’s coming in. How about 40 texts from people who are just sooooo excited and want to know what’s happening and is the baby here yet? Maybe you should just take a quick peek at Instagram, maybe it will help sooth you (nope, it will likely just take your focus external instead of internal, where it should be for great labor progress). If you’re on your phone, you’re accessible to everyone, and everything is accessible to you. That’s not great for labor, whether you’re the one giving birth or offering support.
You might believe this is the most important info about your labor.
When I arrive at births as a doula, sometimes the birth partner (often a dad who happens to be an engineer or accountant) wants to scroll me through a long list of every contraction that their partner has had over the last many hours. I nod approvingly and try to look very impressed, smiling at all the little changes they want to point out. (“See this big one she had here?”) But really, what I want to take note of when I arrive is how hard my client is working. What are the sounds like? How’s her demeanor between contractions? Is the parent dropping to their knees as the force of the contraction makes major change, or is it more like breathing lightly through mild surges? That tells me so much more than a contraction timer — usually the way someone looks and sounds is everything I need to know, with contraction timing as an added side note.
It could yell at you to go to the hospital at the wrong time.
First of all, not everyone is having a hospital birth. Second, timing is an unreliable indicator of where someone is in labor and therefore, of when they should go to the hospital or birth center, or when they should ask their midwife to come for a home birth. I know people like the precision of timing rules. “Come in when the contractions are 3-1-1 for a first baby, or 5-1-1 for a second or later baby.” That is, come in when the contractions are five minutes apart, at least a minute long, for at least an hour. But someone can be having contractions that are five minutes apart but feel like strong menstrual cramps. There’s no reason that person needs to be at the hospital, but their contraction timer might be flashing and blinking and yelling in all caps that it’s time to go. On the flip side, I’ve seen clients with contraction that are seven minutes apart but completely rocking their world, and clearly bringing that baby very close. They need to be at their birth place, but the timer hasn’t even suggested it yet. On either side of the error here, you could wind up at the hospital and just a centimeter dilated, or you could wind up with a roadside baby. A doula is a better bet for reliably gauging where you are in labor, and a great childbirth class should have educated you on the signposts of active labor.
So what's a family in labor to do?
I recently saw a ridiculous wearable contraction monitor device being marketed to normal, healthy moms as a great way to track where they are in labor at home. This is not the answer to the contraction app dilemma. The last thing we need in normal birth is more technology. “Shoes off. Feet Up. Contractions Monitored.” Sound appealing? A little further down the page, they explain that the monitor works best when you’re sitting or laying down. In labor, it’s actually best to stay moving and grooving, to open the pelvis and to use gravity to help bring the baby down. No. Just no. Resist the siren song of this technology. It’s the wrong direction for healthy, low-risk birth.
Timing contractions can give you some helpful information about where you are in labor. And if you want to use an app, that can be a fun and easy way to track things. I totally understand that for some people, having more information makes them feel more relaxed and at ease. But if you do opt for a contraction timing app, use it wisely. Here are my suggestions:
- Use it for a few contractions, here and there, when something about the labor pattern seems to have changed. Then put it away and just focus on the labor.
- Try to find the simplest app you can, and if possible turn off any function that tells you when to go to the hospital.
- Don't give the contraction app power over your labor. Go internal, listen to your intuition and follow your body — not the technology. The app is a minor tool, but your body is the driver. You know more than you might think about exactly where you are in labor.
What do you think? Did you use a contraction timer in your own labor, or if you are a birth doula, do you use them in your role? How do you use it mindfully? What camp are you in — love, hate or seriously mixed feelings? Leave a comment below, we'd love to hear your thoughts.
I agree with every word of this! As an experienced doula, I rarely use a contraction timing app, and caution clients about them for the same reasons. Often when I find myself using one, it means that there is an irregular contraction pattern, and we should be helping mom move in ways that make room for baby to shift. But I find it difficult to use it regularly because I am paying attention to her demeanor!