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The Stages of Labor

Information about the stages of labor at Providence Health and Services in Washington.Before labor: Learn as much as you can

  • Read about pregnancy, childbirth and newborns
  • Attend as many of the family education classes as possible
  • Ask questions in class and at your physician's or midwife's office
  • Read and reread the information on labor and birth
  • Complete a birth plan and review it with your instructor and your physician or midwife
  • Choose some names for the baby

Be familiar with the signs of labor:

  • The contractions are usually regular, increasing in frequency strength and length. If this is the mother's first baby and she isn't sure this is labor, help her with a distraction. When active labor is under way, there will be little question in her mind.
  • Mucous plug or bloody show should not be worrisome, and there is no need to call the physician or midwife or go to the hospital. Be pleased that something is happening.
  • If her bag of water breaks or starts to leak, make a note of time, amount, color and odor. Ask your physician or midwife for instructions during a regular office visit; some physicians and midwives prefer to see you, others may ask you to go to the hospital.
  • Pack your bags and prepare as much as you can during the last month. Make a list of things you need to add at the last minute. Review the list What to Bring to the Hospital.
  • Have a car seat ready to take your baby home.

Early labor: Stay patient!

  • Rest and relaxation are important (Put class information to good use).
  • Provide a quiet, calm atmosphere; use massage, music and warm water baths as directed.
  • Between rest and quiet time, go on with your life. Go shopping, walking or visit friends. Don't try to make things happen.
  • Try to stay patient. We guarantee she will not stay pregnant forever!

Active labor: Be supportive

  • Help her keep a perspective by timing her contractions. Time from the beginning of one contraction to the beginning of the next. Keeping a record of the contractions may help determine changes in the labor pattern.
  • Try counting during a contraction if it helps her.
  • Breathe with her if she is having trouble concentrating.
  • Listen to her and encourage her efforts.
  • Call the hospital:
    • If her bag of water breaks (usually 10-15 percent of all labors).
    • 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.
    • If she has had a baby before and contractions are "feeling like labor;" do not wait until a strong active labor pattern is established. This labor may progress much more quickly than the last labor.
  • Go over your birth plan with your nurse.
  • Ask the nurse to help you locate: emesis basin, washcloths, ice chips, birthing ball, extra pillows and extra blankets.
  • Make yourself as comfortable as possible by dimming the lights, playing music, adjusting the bed and walking around with mom.
  • Continue helping her to relax. Watch for twitching, wriggling, frowns, grimaces or curled toes. Neither of you need to control labor; let the birth happen.

Transition: When the going gets tough

  • Encourage, praise, reassure and love. Remember that labor is a healthy process.
  • Review the Take Charge Routine and Transition sections. Know the signs and symptoms of transition and what you can do to help. Your nurse will be there to help.
  • 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 regain the connection.
  • Shallow, more rapid breathing may be helpful. Quiet, slow breathing is best for relaxation, but 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.
  • Do not panic! She is okay.

Second stage of labor: Bearing down

  • Review two types of bearing down:
    • Spontaneous
    • Directed. To be used a) with anesthesia; b) if there is not progress in the first hour with spontaneous pushing after position changes (squatting, supported squat, toilet, hands and knees, side standing); c) if there is fetal distress and she needs to deliver right away.
  • Remind her to:
    • Go with her body's urges
    • Relax the perineum (pelvic floor muscles)
    • Make noises if she likes
    • Open her eyes and look in the mirror if she wants
    • Touch the baby's head if she wishes
    • Blow if the physician or midwife asks her to stop pushing
  • Remind the physician or midwife of any special requests you may have discussed earlier, such as discovering the sex of the baby yourself, and cutting the cord.