Sweet Beginnings Overview of Labor and Birth

Stage / Emotional Signs / Behavior / Physical Signs / Contractions / Sensations / Needs
Early First Stage / First emotional signpost: Excitement
“maybe this is it!...But then I’m not sure.” / “PutsyPutsy” Anxiously talking, walking, smiling. Walking is important. Many mothers feel restless and need to walk. She may or may not want to move or talk during contractions. May be hungry. / She may have bloody show (mucous plug, spotting of blood tinged mucous or mucous discharge), runny nose, several bowel movements, need to urinate frequently. / Generally 10 minutes apart or less, lasting 45-60 seconds and becoming progressively stronger and closer together. Generally they do not space out from changing activities. / Strong contractions that peak about 30 seconds. Possible pressure or cramping feeling. It generally feels better to walk around and keep busy. She may notice many changes in her body during this time. / Keep busy and don’t become too excited. This may or may not be actual labor. Have someone with you. Eat if hungry, drink often, get some rest if possible. Take a walk, a bath/shower.
First Stage / Acceptance
“This is it.”
Confident and committed. “This is a lot of work, but I can do it.” / Tries various positions and techniques to find out what works best and is most comfortable to her. Walking is still important. Looks as if she is working hard but usually prefers to keep busy between contractions. / May be hungry, depending on how long the labor has been. May be able to talk and/or move during contractions, but it is an effort. She feels many changes occurring in her body and is settling into a pattern. / Contractions are becoming stronger and more frequent. Generally five minutes aprt or less lasting around 60 seconds. / Increasing pressure and fullness in pelvis, backache, cramping feeling across lower back or as menstrual cramps. May feel stretching in pelvis with sore pubic bone. Pelvic rocks may help. / Support and reassurance. She should not be separated from her partner from now on. Freedom of movement, plenty of space and fresh air are important. Timing contractions may help.
Late First Stage (active) / Second emotional signpost Seriousness
The do—not-disturb” and “get to work” attitude / Losing modesty. May still need to walk, but uses slow deliberate movements. May need to lie down. Appearance of sleep, deeply concentrating. May like sitting on the toilet. / No longer hungry. No longer talkative, even between contractions. She may be sweating, bag of waters may break, she becomes uncomfortable if disturbed, tenses up, or needs to urinates. / Intense and close, sometimes one on top of other. Generally (but not always) follows a regular pattern and lasts 60 seconds or more. May put pressure on bladder causing need to urinate during contractions. / Hard work, intense, almost overwhelming, you lose track of time, you must concentrate on staying relaxed, tensing up causes pain. Tremendous pressure in pelvis. Feels good to completely relax between contractions and to rest. / Dim lights, comfortable temperature, freedom to move around, peaceful environment, drink and go the the bathroom often. It is important to “give in” and allow the labor to take over.
Transition4 / Third emotional signpost:
Self doubt
“This is so hard. I’m so tired. I can’t take anymore. I give up.”
Surrender / Confused, unsure, scared, nervous, self-doubt, may move around a lot, may give up, may yell at you, may be handling things fine. / May be sweaty, shaky, hot then cold, nauseous, may vomit, burp, have cold feet. Bag of waters may break if it hasn’t yet. / May become irregular, may double peak, may come one on top of another, may stop completely for a while. / Sensations change greatly often causing panic, disbelief and fear. You may feel the baby shifting into alignment with pelvis, a lot of pressure down low. This may be the hardest part / Reassurance, encouragement, explain what is going on, various relaxation and comfort measure techniques. Take one contraction at a time. Avoid drugs, the hardest and shortest part of labor is over.
Second Stage / Calmness and determination. Desire to complete the task. ‘I want to hold my baby.” / No longer modest. Either gradually or suddenly gets the urge to push. Usually more alert and may become more talkative between contractions. May be very tired and might sleep between contractions. / Mucous discharge and some bloody discharge, bag of waters may break if it hasn’t already. She seems to have gotten a second wind. Tissues at the perineum are stretching, may be swollen. / Change to expulsive type. May ease into stage by only pushing at peaks or get a sudden urge to push. Usually more time between contractions now. / Wait for overwhelming need to push down. Feels better to push and hurts if you don’t. Feels sort of like having a huge bowel movement. Most mothers feel a stretching and burning feeling which builds to a tremendous release when the baby is born. / Encouragement and freedom to choose best position. May need a quick lesson in how to push. Everyone do as mother asks. Give her ice chips or water help her to relax between contractions.

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