You wake up in the middle of the night with your belly clenched and feeling like its made of iron. It relaxes, you drift back to sleep, and then—BAM—there’s that tightness again. Are you in labor? Should you call your doula?
If you can go back to sleep between contractions, then definitely sleep. Toward the end of your pregnancy, you can experience contractions long before you are in labor. Don’t think of these as “false labor,” though! Your body is initiating the changes that lead to labor, and these early contractions are doing some of that preliminary work.
Think of it like road construction. It starts with all those orange barrels appearing at the roadside. They might be there a few days before any real work begins. Early labor pains are like those orange barrels: they tell you things are getting ready. And what you need most in these final days is rest, so sleep if you can.
But what if you can’t go back to sleep? What if those pains keep you awake? It’s easy to get excited about labor and head to the hospital to get checked out. And they may admit you because you’re dilated a couple centimeters. But that puts you on the hospital’s clock. And if labor isn’t well-established yet, you may find nurses suggesting Pitocin after only a few hours for “failure to progress.”
Which brings us back to when to call your doula. And the answer is, make her your first call. Just talking to you will give her a good idea of how your labor is progressing. She will assess whether it’s time for her to come to your home, whether she should meet you at the hospital, or whether you can relax just a little longer—whether construction has started or it’s just orange barrels.
More than that, though, you want your doula with you from early in active labor. Because that’s when you will learn the “labor dance”—what works, what doesn’t. What is comforting, what is irritating. What in your labor plan still matters to you and what you no longer want. Maybe you couldn’t wait to get in that bathtub full of water but now want absolutely nothing to do with being wet. Or you brought four different aromatherapy blends only to get nauseated by any scent. You aren’t alone in changing. Whole playlists get discarded for silence. Specially brought snacks are banished in favor of saltine crackers. You just won’t know until you are there.
Early active labor is when your doula learns what kind of touch you find comforting and what sets your teeth on edge. One mom wanted me to just stroke her forehead for hours, because that reminded her of her grandmother soothing her when she was sick. Another can’t stand to have her face touched.
Your doula will try different things and ask for feedback. Be honest—you won’t hurt her feelings if you say, “No, I don’t like that.” She will store the winners away to use through the course of labor and discard the losers. It’s great to establish this baseline early in labor when things are mellow, so having the doula there early on will help you all work as a team.
By the way, if the most comforting thing suddenly becomes unbearable after a few hours, speak up! Even if you can only yell, “Stop that!” your doula will understand and switch tactics. Don’t silently endure something
that no longer helps because it feels like you would have to explain yourself—she will adjust without hesitation.
Doulas help the most when they are part of the team from early on. Developing your rhythm before “labor brain” really sets in means that your relationship will feel instinctual by the time you really need it. So make that call!