Hyperstimulation: When there's no gap in contractions
I wanted to share a post here after some brilliant conversations happening over in the Birth-Ed Members Facebook group, which have been really enlightening for many and answered a lot of questions!
Hyperstimulation refers to the uterus over contracting in labour. So rather than getting breaks in between contractions, they come one right after another.
The gaps in between contractions in a normally unfolding labour are actually AS important as the contractions themselves for several reasons.
Obviously first off, the gaps give us opportunity to rest. No rest is going to seriously affect our ability to cope with the sensations we are feeling, it can be near impossible to get comfortable and epidural use is much more likely if the uterus is hyperstimulating; bringing with it the risks associated with epidural use.
Secondly, the gaps in between are actually when baby makes much of their progress during the first stage of labour. During a contraction the muscles draw UP and during the rests, baby settles deeper into the pelvis.
Finally, when the uterine muscles contract, it’s squeezing baby and placenta pretty hard! There’s a natural dip in a baby’s heart rate as this happens. But when the uterus relaxes, the placenta refills with blood, baby’s heart rate swiftly returns to normal.. UNLESS the uterus doesn’t stop contracting.. in which case it can make labour harder for baby to cope with.
There are a few reasons why hyperstimulation can happen- firstly, induction of labour, particularly using hormonal methods such as the pessary or syntocinon drip. The uterus over responds to the synthetic hormones it is being exposed to and because the feedback mechanism that our bodies use in a spontaneous labour is disrupted, we struggle to regulate the hormones or know how to respond.
Hyperstimulation can also occur in a labour that starts spontaneously, and if it does- it’s usually a clue that baby might be in a suboptimal position and your body is working hard to move them. Often, if we are left undisturbed, this will move/rotate the baby effectively and the contractions will eventually return to a more manageable pattern on their own. Other times it doesn’t seem to rectify on its own, maybe because we feel inhibited for some reason (bright lights? Strangers?) and unable to lean into what it is asking of us, or if the malposition is caused by a physical pelvic imbalance that doesn’t release with instinctive movement alone (eg previous injury or muscle tightness).
Not sure if things rings true for you birth story?
Other things that you may have experienced alongside this might have been-
Unbearable pain (impossible to find any comfortable position at all)
Severe back, pelvic or thigh pain
A very long labour or a labour that took a long time to ‘get going’ or make measurable ‘progress’
Double peaking contractions
Ending with an episiotomy, instrumental birth or caesarean.
Mollie O’Brien and I discuss malposition in depth in our podcast episode on ‘Labour Dystocia’ if you want some more answers!