This table is a summary of all the signs of first stage labor. One can tell where a woman is in labor by the emotions she’s expressing, by the physiological signs, and by the contractions and their pattern. First stage labor is a lot of work for the laboring mom. First stage labor is also a lot of work for her coach or partner. Look at this table of first stage labor and you will know what is normal in first stage labor and how you can smooth her way with all your mad coaching skills!
Discuss with your care provider before labor begins when reviewing your BIRTH PLAN. You may have medical issues or conditions that require you to go sooner according to your doctor/midwife’s instructions. Always remember to ask BRAIN questions:
Benefits
Risks
Alternatives
Intuition
(do)Nothing
At the bottom of this table are recommended reading and DVD’s to watch so you can be the best coach possible and the pregnant woman can understand what is normal in first stage labor.
FIRST STAGE LABOR
| PHASE OF FIRST STAGE LABOR | FIRST STAGE PHYSIOLOGY | FIRST STAGE CONTRACTIONS | FIRST STAGE EMOTIONS | HOW TO HELP HER |
|---|---|---|---|---|
| 3 PHASES OF FIRST STAGE | Possible PHYSIOLOGICAL SIGNS | Possible CONTRACTIONS | Possible EMOTIONAL SIGNPOSTS | COACHING |
| PRE-LABOR | Dropping/Descent Low backache Frequent urination Cramps Swelling Bursts of energy Increased vaginal discharge Leaking water Runny stools like diarrhea | Pre-labor contractions are irregular | Excitement Impatience Anxious Confident Lack of confidence | Reassure and encourage her Practice relaxation exercises Practice different positions Don’t let her tire herself, Make her rest, eat, relax, Ignore her labor Care for her Talk about the baby |
| EARLY LABOR | Baby’s head or presenting part descends lower into pelvis Mucous plug/bloody show Possible leaking or rupture of membranes | Contractions follow a pattern: stronger, longer, closer together Contractions may feel like strong menstrual cramps, or they may start in back and radiate to the front Contractions are intensified by: movement, change of position, walking | Excited Anxious Able to putter around. Desire to stay home. Apprehensive Can carry on a conversation. Can go unnoticed “How will I cope/ feel?” | If you can ignore this part of labor, do so! Make sure the laboring woman does these 5 things: Sleep/rest Eat Drink Walk Take a bath or shower FIX HER SOMETHING TO EAT AND DRINK. WALK WITH HER. ENCOURAGE HER TO URINATE EVERY HOUR. GIVE HER A MASSAGE. DRAW HER A BATH OR A SHOWER. PRAISE, ENCOURAGE HER, (STAY CALM YOU HAVE A LONG WAY TO GO). |
| ACTIVE LABOR WHEN TO GO TO YOUR BIRTH PLACE? | Cervix is completely effaced 100% Baby’s head descends, bulging, breaking membranes, pressing on pelvic floor Endorphins are released Dilate from 5-8 cm Backache, Deep pelvic pressure | Contractions accelerate 3-5 minutes apart, 60 seconds long WHEN TO GO TO YOUR BIRTH PLACE? | The intensity of these contractions MAY TAKE HER BY SURPRISE! Take heart, the rest of labor is likely to be more productive. Very serious, cannot be distracted during a contraction. Turns inward. Touchy, irritable, quiet. She doesn’t have time or energy to explain: uses short sentences, snaps at you. She is less aware of her surroundingsLoss of inhibitions. | GET SERIOUS ABOUT SMOOTHING HER WAY! Give her fluids. Walk with her. Have her rest: in the bath/shower, in bed, on toilet. Have her empty her bladder. Talk, touch her through a contraction. PRAISE HER, PRAISE HER, PRAISE HER! IF YOU ARE FREAKING OUT-GO TO YOUR BREATH and calm yourself down. If you are tempted to go to your birth place, get in the tub or shower. Fix her something light to eat-easily digested. Encourage her to vocalize through each contraction. If she is offered drugs (pitocin, or Epidural) get in the shower with her-for at least 1/2 hour/try 30 minute rule. It will give her body a chance to do more productive work. |
| TRANSITION | Shortest, most intense phase Backache Bowel pressure Hot & cold flashes Shaking, nausea, belching Vomiting Aching thighs Pulling, stretching deep within pelvis Cervix dilates from 8-10 cm Baby’s head squeezes through the cervix into the birth canal The presenting part (head) puts pressure on the rectum, pelvis, back,can feel like a bowel movement This pressure causes endorphins to be released. | This can last 15-90 minutes on average. Your contractions may be: 60-90 seconds long, 2-3 minutes apart. May slow down. May come one on top of another with no rest in between. May double peak relentless. | Self-doubt “I can’t do this anymore”. Confused Overwhelmed Hostile to birth partner. Unaware of her surroundings. Needs to yell, scream, bellow, moan, groan. She may let it all hang out! She may turn inward, quiet, introspective. Critical, snaps Cries. Wants to give up!!! Asks for drugs. (worst time to get an epidural cause you're almost done). | She will probably want to stay in one position, but it’s better if she moves. Keep her side-lying or in a resting position between contractions Give ice chips, juice, teaspoon honey, popsicles, lollipops Remind her this is the shortest and most productive phase. Remind her she’ll be holding the baby soon. Don’t panic, coach, it is the hardest part but she is capable of handling it-TELL HER SO! Tell her to turn inward to find her strength. Encourage her praise her. Remind her this is about the baby. Be patient with her, use words: surrender, release, let go, open. Be patient with labor. Ask everyone else to leave the room, if possible. Wipe her face and neck. Get in the shower or bath. Empty bladder. Breath and vocalize. |
Want to know more about what is normal in labor and birth? Want to know how to help, encourage, and coach a woman in labor? Read these books and watch at least one of these DVD’s:
