Updated: Feb 25, 2021
I often see inconsistent patterns of contractions in folks who are labouring - mostly during their first labour. I usually pick up on it in early labour, but sometimes it can shift when active labour begins. This is often an indication that baby is in slight malpositioning, preventing baby from descending into the pelvis and therefore dilating the cervix at a desirable rate.
In order for the cervix to dilate consistently and smoothly, it needs pressure from the baby's head. If the baby has their head tilted to one side (acynclytic), or the baby's entire body is positioned with their back toward your back (posterior), the crown of their head cannot press on the cervix, nor come through the pelvis with ease.
One position to help with this is a side lunge with the labouring persons leg on a stool or chair. This helps the pelvis open and tilt side to side to help baby wiggle down. Rock in and out of the position throughout an entire contraction. Stay here for a few and switch to the other side. Another option for this is to walk with one foot up on a curb or climb up and down some stairs sideways.
Your doula will have a watchful eye and be ready with lots of ideas, tips, and tricks for you to try in these cases, but it's important for you to be willing to work with your labour if need be! Relaxation and softening of all the muscles in the body is valuable and important during labour, however, sometimes the stillness that relaxation brings can slow things down. Remember to bring in some deep, gentle, flowing movement into your contractions and if you are unsure, your doula will be able guide you in your focus for your individual labour and situation.