A Guide for Expecting Parents



A Guide for Expecting Parents

LABOR REVIEW & GUIDE - Stage 1

Prelude to Labor
Stage 1: Effacement (%) and Dilation (centimeters) of Cervix
Stage 2: Birth of the Baby
Stage 3: Expulsion of the Placenta
Stage 4: First Hours After the Birth of Your Baby
Special Problems Related to the Birthing Process

Stage 1: Effacement (%) and Dilation (centimeters of Cervix)
Begins with the onset of true labor and ends with the complete effacement (100%) and dilation (10 centimeters) of cervix.

Stage of Labor	Mother's Feelings	Mother's Activity	Coach
Onset of Labor • Contractions that increase in intensity, frequency, and duration • Progressive effacement and dilation of the cervix	• Excitement (“This is it!”) • Apprehension/anxiety (“I’m not ready for this.”)	• Relaxation • Usual activity with frequent rests • May have clear liquids but no solid food • Change position for comfort • Empty bladder regularly REMEMBER: Be flexible—each labor is unique.	• Time contractions: • Intensity: mild, moderate, or strong • Frequency: beginning of one contraction to beginning of next contraction • Duration: beginning of one contraction to the end of same contraction • Company/support • Calm reassurance • Rest and eat • Make sure mother is ready to go to the hospital • Make final arrangements for siblings
Early Phase Work: • Effacement • Dilatation 0–4% Contractions: (ranges) • Intensity: mild/moderate • Frequency: regular, 5–10 minutes apart • Duration: 30–45 seconds long Possible Signs: • Increased bloody show • Membranes continue to “leak” if ruptured • Possible back pain REMEMBER: This phase is usually the easiest but longest part of labor	• Excited • Confident • Comfortable • Talkative • In control	• Relaxation • Focal point • Effleurage/massage • Begin breathing patterns when necessary • Music • Change position frequently • Empty bladder regularly • Enter hospital as directed • Keep calm Hospital Admission • Interview • Vaginal check • Fetal heart tones • Buffalo cap • Fetal monitor • Enema (only if necessary)	• Time contractions • Help with relaxation through touch and words • Company/support • Encouragement/praise • Monitor breathing: keep it slow and even • Drive carefully to hospital
Active Phase Work: • Dilatation 4–8 centimeters Contractions: (ranges) • Intensity: strong • Frequency: regular, 2–5 minutes apart • Duration: 45–60 seconds long Possible signs: • Bloody show continues to be heavy • Difficulty in maintaining relaxation • Possible nausea/vomiting, increased perspiration or chilling, and trembling of legs as transition nears • May become tired	• Intense, serious mood • Very absorbed and busy • Tired • Begins to doubt own ability to remain in control	• Relaxation • Focal point • Effleurage/massage • Breathing patterns • Music • Change position frequently • Empty bladder regularly • Remain very alert!	• Positioning • Extra pillows • Back rubs and massage • Ice chips • Cold washcloth for face and neck • Sour lollipop • Help minimize distractions around mother
Transition Work: • Dilation 8-10 centimeters Contractions: (ranges) • Erratic and often having more than one peak • Intensity: very intense • Frequency: 2–3 minutes apart • Duration: 60-90 seconds long Possible signs: • Pressure sensations in rectum • Urge to push • Nausea/vomiting • Hiccups • Belching • Chills and/or profuse sweating • Trembling of extremities • Sensitivity to touch • Difficluty in maintaining relaxation and breathing patterns • Increased fatigue, drowsy between contractons • Increased bloody show Remember: This phase is usually very intense but short!	• Discouraged • Overwhelmed • Irritable • Confused/forgetful • Feelings of despair: “I can’t go on!”... “I’m losing control!” • Restless	• Relaxation • Focal point: maximum concentration needed • Breathing patterns • Music • Do not push until completely dilated • For a premature urge to push: replace the blow with a grunt in shallow chest breathing • Relax between contractions as much as possible • Change position for comfort	• Encourage! Praise! • Stay with mother • Firm directions and support • Monitor breathing: • Keep it in a controlled pattern and breathe with mother if necessary • Be alert for hyperventilation and correct breathing as necessary • Help with relaxation through touch and words • Physical comfort measures • Keep mother informed of progress • Remind mother that baby is almost here • Alert nurse if mother is having the urge to push