Coping Tips for Each Stage of Labor

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Stages of Labor

Woman having labor pains
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The first stage of labor is what we generally think of as labor. Within this stage, you will find three phases, what to expect physically from each stage, as well as coping suggestions.

Labor is broken down into three main stages:

Early Labor

This phase of the first stage is where you will spend the most time. This is characterized by contractions that are regular but not be very close together or last very long. The contractions maybe ten minutes apart and last only thirty to forty-five seconds. This is a very comfortable stage of labor for most women and a chance to ease into labor.

Active Labor

As the contractions become more intense you will move into active labor. Here the contractions are regular and are coming closer together and lasting longer. They may be three-five minutes apart and last up to sixty seconds. This is the serious phase, where mom gets down to work and really uses many of her coping techniques.

Transition 

The hardest, but the shortest phase of the first stage of labor. Transition is what television births are all about. These contractions are stronger and longer and finish dilating the cervix. The usually last 90-120 seconds with breaks of about as long in between. Generally, this phase only lasts for thirty minutes to two hours.

Many people will try to tell you how many centimeters you should be dilated in each phase. This is not the only way of defining the stages of labor. You can be exhibiting transition-like contractions and only be four-five centimeters, but still really close to having the baby. It's important to remember that very few women will be dilated one centimeter, two centimeters, three centimeters, etc. Many women will jump in dilation. And some will even have stories of being four centimeters dilated and then be completely dilated within a few minutes. So it's more important to pay attention to the intensity of the contractions and how they are coming than what the cervix is doing for most women.

Early Labor

This phase of the first stage is where you will spend the most time. This is characterized by contractions that are regular but not be very close together or last very long. The contractions maybe ten minutes apart and last only thirty-forty-five seconds. This is a very comfortable stage of labor for most women and a chance to ease into labor.

Early labor is usually a time of fun. You may actually spend quite a bit of it wondering if this is really labor. Other women sleep through these light contractions or go about their day without really noticing a difference.

What You Might Be Feeling

Behavior & Attitude

Generally, you'll be excited in this phase of labor. After all your baby will be here soon, the end of pregnancy is near and you're moving on to the next phase of parenting. Some women will be nervous, not knowing what will happen once labor gets more intense.

Partners tend to be a bit more panicked during this phase. This is the last chance to get everything done. They wonder if they will know how to support you in labor. The good news is that when the women are calm, the partners panic, and when the women are panicked, the partners are calm.

Ways to Cope

You really probably won't need a lot of physical support or coaching for this stage of labor. Your best bet is going to be ignoring the contractions as long as you can. If you feel up to it continue your day as planned. Many women choose to go on to work or finish whatever they had planned.

The keys to managing this phase effectively are to alternate rest with activity. Don't forget to keep up your fluids and to eat to comfort.

Here are some suggestions of things to do in labor:

  • Take a walk
  • Finish packing your bags
  • Write a letter to baby
  • Sit in baby's room and relax
  • Go to the movies
  • Rent a funny video
  • Have date night and go to dinner

What Your Partner Might Do:

  • Keep her company, if she wants it
  • Encourage her to move around
  • Massage her back to promote relaxation
  • Time some contractions
  • Praise her
  • See if there are last minute things you can do to help

Ways to Spend Early Labor

Active Labor

As the contractions become more intense you will move into active labor. Here the contractions are regular and are coming closer together and lasting longer. They may be three-five minutes apart and last up to sixty seconds. This is the serious phase, where mom gets down to work and really uses many of her coping techniques.

What You Might Be Feeling

  • Contractions that are closer together and require your attention
  • Need for support
  • Tuning in to the contractions
  • Less interest in eating/drinking

Behavior & Attitude

As you become more serious with each contraction, relaxation will be important. Tuning out distraction and creating a positive environment to birth in will be important. You may feel the desire to be with someone whether or not you feel like having them touch you. Not wanting to be alone is something often spoken of.

Ways to Cope

Here are some suggestions of things to do:

  • Change positions frequently
  • Take a walk
  • Take a bath or shower
  • Rock in a rocking chair
  • Do pelvic tilts (great for backaches)
  • Concentrate on relaxing
  • Use visualization

What Your Partner Might Do

  • Keep her company, if she wants it
  • Remind her to drink and go to the bathroom
  • Encourage her to move around
  • Massage her back to promote relaxation and comfort
  • Protect her environment (keep it darker and quieter)
  • Praise her
  • Call the practitioner for advice on going to the hospital or birth center
  • Call your doula
  • For a home birth, be sure your supplies are readily available

Calling Your Practitioner

Many doctors and midwives will tell you when you need to call or will be available for you by phone during the earlier parts of labor. Have the phone numbers handy and some general information available prior to calling. Generally, they will want to know the length of the contractions, how far apart they are and if the water bag has broken or not.

If you're having a home birth your practitioner may come over earlier to check on you and make calls back and forth until you're ready for them to come for the birth.

Getting to the Hospital in Labor

If you are not planning a home birth, you will probably go to the hospital or birth center towards the end of this stage or early into the next stage. Prior planning on the route, special considerations for the time of day or road closings will make this an easier trip. Many women will also feel better with a few pillows in the car. Some people may be concerned about the water breaking during the trip or leaking if it has already broken. A towel can be placed on the seat to catch any fluid or mom can wear a maxi-pad.

Know where to park, where to enter and if you need to alert anyone that you're coming or if you should just show up. Also knowing the routines like whether you'll go straight into a room for the birth or if you will be required to stay in a triage area to assess your labor first will help make a more smooth transition to the place of birth.

A word to the wise about driving: go slowly and safely. If you're concerned that she's having the baby pull over, do not try to speed and endanger yourself. She will probably be very uncomfortable in the car, and every bump will increase her discomfort. Do what you can to make it a safe and comfortable car trip.

Advice for getting to the hospital?

Transition

The hardest, but the shortest phase of the first stage of labor. Transition is what television births are all about. These contractions are stronger and longer and finish dilating the cervix. The usually last 90-120 seconds with breaks of about as long in between. Generally, this phase only lasts for thirty minutes to two hours.

What You Might Be Feeling

  • Contractions that are longer and more intense
  • Need for support
  • Hot flashes
  • Burping or belching
  • Trembling
  • Low pressure as the baby continues to descend
  • Your water may break
  • Loss of modesty
  • Loss of appetite

Behavior & Attitude

This is the hardest and shortest part of labor. This is where it gets really intense. Many women will respond with phrases like "I can't do this." What she really needs during this part is intense coaching and companionship.

Ways to Cope

Here are some suggestions of things to do:

  • Change positions frequently
  • Take one contraction at a time
  • Take a bath or shower
  • Rock in a rocking chair
  • Do pelvic tilts (great for backaches)
  • Concentrate on relaxing
  • Use visualization
  • Use your rest periods effectively
  • Stay focused on the goal

What Your Partner Might Do:

  • Cool rags for her face and neck
  • Change temperature in the room if possible
  • Encourage her and remind her that this is the short part, soon she will be pushing
  • Keep her company, if she wants it
  • Remind her to drink and go to the bathroom
  • Encourage her to move around
  • Massage her back to promote relaxation and comfort
  • Protect her environment (keep it darker and quieter)
  • Praise her

What To Do If She Wants To Push

Sometimes as the pressure increases because the baby is moving down, the mother will express the desire or need to push, even when the cervix is not completely dilated.

There are two schools of thought on this: One is that as long as she feels the urge pushing will help finish the dilation process. The other is that all pushing prior to complete dilation will cause swelling of the cervix and delay the process. Some women push when they felt like it at seven centimeters and have the cervix quickly disappear. Sometimes at nine centimeters women who felt like pushing have had their cervix swell. The best advice is to have someone monitor your cervix while you try a few test pushes. Sometimes small pushes at the peak of each contraction, enough to deal with the urge but not enough to cause swelling, are best.

If you are instructed to not push here are some tips:

  • Have mom lift her chin in the air
  • Have her pant loudly
  • Don't let her hold her breath
  • Have her imagine a balloon or feather above her face that she is trying to blow away from her face.

Being a Good Coach

Laboring women need help. They need someone who will know what their preferences are for everything in labor and help them achieve their goals. As her coach you have a distinct advantage over everyone else there: you know her best! Your job is to be supportive of her, enthusiastic, and committed to her.

Practicing relaxation and positioning will make you feel more comfortable with the material.

Remember to enjoy the birth and take care of yourself as well. Pack yourself snacks, go to the bathroom when possible (Try not to leave her alone.), and protect your back while doing labor positions. Remember wearing yourself down won't help her in the long run!

The positions that you choose in labor will help or hinder your progress. One of the worst things you can do is to get into bed and stay there.

Remember the hormone relaxin, this is where relaxin is very good! Laying in bed will actually flatten parts of your pelvis and make it less mobile. This makes it harder to make room for baby. By moving around you allow your pelvis more mobility and greater flexibility to allow the baby to descend into your pelvis.

Depending on the position of the baby and your comfort level here are some good positions to try in labor:

These are by no means an exhaustive list of positions for labor and birth. Be flexible and try a variety of positions in labor, some will feel better than others.

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