Before Labor: Learn as much as you can, come to class!

• Attend Childbirth Education classes…Preferably with Birthing Basics, LLC!  Here you’ll learn how to best support your partner—what comfort measures are the most helpful and what comfort measures you can implement in each phase of  labor!  Also, attend as many of the supplementary classes (Breastfeeding, Infant CPR, and Infant Care) as possible so you can feel confident in caring for your little one!
• Ask questions at your physician’s/midwife’s office and in your childbirth class.
• Read and review information on labor and birth.
• After you’ve taken a Childbirth Class, spend time with your partner to help complete a birth plan and then review it with your physician/midwife and doula.  Make copies for you to take with you to the hospital so that the staff there will know your heart’s desire for your birth day!

Remember: Make a Plan “A”, Plan “B” and “Plan C”, for the big day!

Be familiar with signs of labor:

• The contractions are usually at regular intervals increasing in frequency, intensity, and length. (They become longer, stronger and closer together.)  When they start getting regular, start timing them!
• Mucous plug (bloody show) is not very significant and there is no need to call the physician/midwife or go to the hospital.
• If you think that your  membranes  ruptured or started to leak, make a note of Time, Amount, Color, and Odor. ( Remember: T.A.C.O. .) Contact your physician/midwife as some prefer to see you and others may ask you to go to the hospital.
• Pack your bags and do as much as you can during the last month. Make a list of things you may need to add at the last minute. Review the list “What to Bring to the Hospital.”
• Install the car seat; have it inspected and ready to take your baby home.

Early Labor: Be patient!

• Promote rest and relaxation (put class information to good use ).
• Provide a quiet, calm atmosphere: use massage, music, and warm water shower/bath to promote relaxation.  (Remind her to “drink fluids, take a shower and lie down” when contractions begin…)
• Between rest and quiet time, go on with your life. Go shopping, walking, or visit friends.
• Try to relax and stay patient. This is your time to check for gas in car and to be sure you have packed those things you wish to bring to the hospital.

Active Labor: Be supportive!

• Encourage her to listen to her body, move around, and change positions. (REMEMBER the “Gate Control Theory”…20-30 minutes, then MOVE!)
• Often, women find it helpful when the support person times the contractions. It can help her keep her perspective. Time from the beginning of one contraction to the beginning of the next, noting how long the contractions last.  Keeping a record of the duration of contractions may help determine changes in the labor pattern.  Try counting off 15-second intervals during a contraction if it helps her.
• Start COMFORT MEASURES.
• Breathe with her if she is having trouble concentrating. Slow, deep, easy breathing usually works best for most women. Remind her of useful breathing techniques: cleansing breath, sighing, moaning. Don’t insist she breathe a certain way if she doesn’t find it helpful. Let her find her own rhythm and follow her cues.
• Hot & Cold Packs often help.  Remember “THE ZONES”.
• Hydrotherapy- shower or a bath, either or can help her relax with contractions.
• Start swaying- Rock in a rocking chair, roll on a birthing ball, get in hands and knees position. Slow dance, lean and get those hips rocking, swaying and circling.
• Light/Medium Touch- Massage the shoulders, back, hips, hands and feet.
• Remind her to drink clear fluids in-between contractions.

Call your physician or midwife:

• If membranes rupture (usually 10-15% of all labors), it is important to call soon, especially if she is Group B Strep positive.
• If a first-time mom is having contractions at regular five-minute intervals or less (requiring total concentration) and she can’t walk or talk through them any longer, they’ll usually last a minute!  Remember the 5-1-1!
• If she has had a baby before and contractions are “feeling like labor” do not wait at home until a strong active labor pattern is established. This labor may progress much more quickly than the last labor.
• If she has vaginal bleeding, a headache, fever or decreased fetal movement.

At the Hospital:

• Once at the hospital, review your birth plan with your nurse.
• The nurse will help you locate and become familiar with things you both may find useful during labor: Jacuzzi bathtub/shower, emesis basin, washcloths, ice chips, rocking chair, birthing ball, extra pillows, extra blankets, tape and/or CD player.
• Create a peaceful environment, making her as comfortable as possible. Try dimming the lights, playing music, adjusting the bed.
• Explore the maternity unit, if she feels like walking.
• Remember, women in active labor don’t always tell you what they need. Watch for twitching, wriggling, frowns, grimaces, or curled toes. Try massage, stroking, suggest a warm shower or tub. She may lick dry lips, push hair back from her face, and rub her own back. Follow her cues.
• Be positive. Encourage and praise her efforts. Keep up her spirits but do not minimize her difficulty. Acknowledge that what she is experiencing is painful and intense, then remind her of the progress she is making.
• Continue to appear relaxed yourself. Keep your voice calm and soothing. Remember, neither one of you has to control labor: let the birth happen.

Transition- Be encouraging!

• Give encouragement, praise, reassurance, and love. Remember that labor is a healthy (normal) process.
• Review your handouts: Know the signs and symptoms of transition and what you can do to help. Your nurse will be there to help and offer suggestions.
• Don’t give up on your ideas just because they don’t always work the first time. Repetition can be helpful. Even if you lose her attention during a contraction, firm and confident suggestions can help to regain the connection.
• A paced- breathing or verbalized “AHHHhhhhh” breathing  may be helpful. Quiet, slow breathing may not provide enough concentration at this time in labor.
• Blowing may be needed if she begins to push and has not recently been checked for dilation. The nurse will help you. (She made need to blow through a few contractions if she has the urge to push. The provider or nurse will check to be sure it is time to begin pushing.)
• Do not panic!  Remember, this is usually the most difficult phase of birth, it’s an emotional time and physically challenging.  Endorphins usually kick in at this point, so if she rests in-between contractions…Great!

Second Stage of Labor: Bearing down

• Ask nurse for warm compresses and mirror, if they aren’t in the room.
• Review two types of bearing down. The nurse will help guide you both.

1. Spontaneous bearing down

• Remind her to listen to her body and let the contraction guide her as to position and technique. Pushes when she can no longer resist the urge to push.
• Bear down while holding breath or release air by grunting, groaning, making noise.
• The focus is moving the baby down, up, and out.

2. Directed bearing down. To be used:

• With anesthesia. Count only to 6.
• If there is not progress in the first hour with spontaneous pushing after position changes (squatting, supported squat, toilet, hands and knees, side, standing).
• If there is fetal distress and she needs to deliver right away.

Remind her:

• To go with her body’s urges.  Change positions while pushing, lie on her side, squat, sit on the toilet, get on her hands & knees, sit up, and sometimes, lying flat and curling with her legs bent can really help if the baby is in an “OP” position.
• Relax the perineum (pelvic floor muscles).
• Making noise is okay, vaginal bloody show at this point is normal, feeling like pooping and sometimes actual pooping may occur while pushing and that’s okay too.
• To open her eyes and look in the mirror.
• To touch the baby’s head if she wishes.
• To blow if the physician/midwife asks her to stop pushing.

You may wish to remind the physician/midwife of any special requests you may have discussed earlier, such as helping to catch (deliver) the baby, discovering the gender of the baby yourself, a delay in cutting the cord until it stops pulsating, and skin-to-skin to facilitate bonding and breastfeeding.