We need to rethink linear time in the birth space
Linear time is the idea that time is sequential, always pushing forward and never back. This subjectivity may be considered normal, but if we look at time from the perspective of various non-western cultures, this is not necessarily the case.
The concept of strict linear time served a political and social purpose during European, specifically British, colonisation. A central belief in the colonial project was that the greatness of a civilization was based on its ability to conquest and transcend nature. Of course, several pre-colonial societies had been existing and thrived as civilisations living in harmony with nature. In fact, many indigenous cultures understand time as an intersection of environmental shifts, including rhythms of the sun, moon, sea, skies, plants, animals, and peoples. These non-Eurocentric understandings of time stray away from the now conventional, pervasive linear versions into a more curved, cyclical form.
Cyclical time may feel like a very abstract concept, but a very tangible example of this is hormonal cycles, namely menstrual cycles which tend to follow a monthly rhythm and are influenced by a range of physiological and environmental influences.
Another facet of linear time is that it is a finite resource that ultimately runs out. On the other hand, cyclical time is infinite, constantly renewing itself. Within the labour ward setting, time is a finite resource that is essentially ‘running out' the moment you walk through the hospital doors. As birth workers, we tend to advise our clients who are having hospital births to stay at home for as long as possible, as it delays setting off the ‘ticking clock’.
Many birthing people have recalled being told by their midwives that if their waters break and surges (a less medical word for contractions) haven’t started within 24 hours, it is necessary to medically induce labour. This is sometimes referred to as being ‘on the clock’. Some will have heard a different cut-off time of 48, 12, or even 6 hours after and some have had midwives telling them to induce labour as soon as possible after waters have broken. The reason for this is that it is believed that the baby’s environment has now become more susceptible to infection, so induction is done as a precautionary measure to avoid a detrimental outcome to the baby, even though the chances of infection are slim (there is a 2% risk of infection to baby for those who wait for labour to start on its own).
Dilation is commonly believed to follow a linear trajectory from 0cm (closed) to 10 cm (fully dilated). However, it is now known that dilation doesn't follow a stringent linear model, increasing by regular increments as time goes on, but rather follows its own unique pattern, influenced by a range of biological and environmental factors. Examples of biological factors include oxytocin levels and pelvic positioning, whereas environmental factors could be room temperature, lighting, and who else is in the room. Midwives tend to rely on pelvic exams (also known as vaginal exams or VEs) to assess where a birthing person is in their labour. However, there is growing awareness of the many downsides to pelvic exams, which only show a snapshot in time, rather than the true picture. Birthworkers have used the phrase ‘the cervix is not a crystal ball’, to emphasise that although fascinating, they cannot accurately predict the past or the future.
While discrete stages of labour can be useful for the birthing person and their birth team, allowing them to work towards a goal of pushing out a baby, these stages vary for every person with some people finding that they progress very quickly from one stage to another whilst others may spend longer. Terms such as ‘stalled labour’, ‘prolonged' or ‘failure to progress’ medicalise instances where dilation, pain levels or surges do not follow the stringent linear path. In reality, there is no normal or abnormal progression of labour, but rather a spectrum of patterns and experiences with no two being the same. Furthermore, a break from surges could be a good thing, giving the birthing person time to rest. Birthing people may find that they experience a pause during their labour which can be a sign that the cervix has fully dilated and the baby is ready to descend through the birth canal and make their arrival. Midwives sometimes refer to this part as the ‘rest now and be thankful later’ stage.
When thinking in linear time, we often focus on discrete variables. During birth these variables tend to be the surges, measuring their frequency, intensity and duration. However, what is paid less attention to, is the time in between surges when the labouring person can let go and prepare for what is yet to come. Calculations have suggested that birthing people only experience surges for 23% of their labour. This means that on average, birthing people are experiencing no surges for 77% of their labour. By preparing not only for how to manage surges, but also thinking about what to do in these periods in between, the birthing person can receive the patience, understanding and safety they need to give birth throughout.
Having explored the detrimental impact of linear time in the birth space, how can birthing people go about reconnecting with a more cyclical understanding of time?
Start by being patient with yourself so that you don’t feel disheartened by how birth is progressing. Whether labor accelerates, stalls or reverses, this is the body responding to its own cues and environmental shifts. It is so important to acknowledge this, so that you can work with their birth team to adapt to the circumstances as needed.
Connect with your bodily rhythms, in particular the breath. Notice how the breath changes at different stages of labour whether it is a conscious or unconscious decision.
Connect with your environment. Curating your surroundings so that you feel safe is pivotal in getting the oxytocin flowing and powering every surge. Consider which environments heavily restrict and impose their own timeframes onto you and those that adapt to the timing of your body.
Reframe language used by medical professionals which are based on a heavily linear understanding of time to one that is more malleable. For instance using affirmations such as ‘my labour is unique and is following its own rhythm’.
Hire a birthworker who is in tune with your needs and will be beside you to advocate for your wishes.
Relevant Links
What Is The Real Risk Of Infection After Waters Break? | BellyBelly
