Suggestions for Labor Partners

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	WHAT'S GOING ON?	HOW IS SHE FEELING?	WHAT SHOULD SHE DO?	HOW CAN I HELP HER?

Before Labor Begins: 3 to 4 weeks before due date	Lightening Increased frequency of Braxton-Hicks contractions Early effacement and dilation Increased vaginal discharge Leveling off or loss of weight (1-3 lbs.)	Excited, sense of anticipation Depressed Has difficulty sleeping - very tired Has spurt of energy	Simplify housekeeping Pack suitcase and Lamaze bag Conserve energy - take naps Preregister at hospital, if not done already Practice exercises, relaxation, and breathing techniques DAILY	Assist with housekeeping chores Encourage her to rest Provide diversion - take walks, eat out, etc. Practice relaxation and breathing techniques with her

Beginning of Labor	She may experience any or all of the following: contractions loss of mucus plug leaking or rupture of membranes bowel movements	Excited Apprehensive Talkative	Try to sleep if at night Continue normal daytime activities Take a walk Take a shower, wash hair, shave legs Eat a light meal	Time contractions Reassure her (of her readiness for labor) Call babysitter If at night, encourage her to sleep and sleep yourself Eat a good meal

Early Phase	Effacement and dilation of the cervix from 0-3 centimeters Contractions 5-20 min. apart, lasting 30-45 sec. Becoming longer, stronger and more frequent	Confident Sociable	Relax with contractions Begin slow paced breathing if necessary Assume upright position as much as possible Alternate being up with short rest periods Empty bladder every hour Call physician or midwife Drink plenty of fluids Eat lightly as tolerated	Time and record contractions Remind her to relax, use touch relaxation Give encourage-ment, praise her Help her with her breathing, if necessary Offer fluids frequently Prepare for trip to hospital Encourage walking and position changes Remind her to urinate Use distractions - play cards, games, go to a movie

Active Phase	Dilation from 4-7 centimeters with more effacement Contractions 2-4 minutes apart, lasting 45-60 sec. with greater intensity and longer peaks	Anxious Apprehensive - doubts ability to handle labor Serious mood - birth oriented Attention turned inward Not talkative	Continue relaxation and breathing techniques Use focal point Do effleurage as desired Change position frequently Continue to urinate hourly Adjust pillows for comfort Go to the hospital or birth center Drink fluids frequently(sports drinks are recommended)	If walking, support her body during contractions Assist with effleurage or offer lots of massage, stroking and counter pressure, especially on her back if it feels comfortable to her Protect your back while massaging by positioning yourself close and lean into her body as you massage Provide cool wash cloth for face Give ice chips (if available) or wet wash cloth to suck on Offer fluids frequently Remind her to change positions and urinate Keep her informed of her progress Cue relaxation Rest when she rests Encourage relaxation and assist with breathing If breathing seems ineffective, suggest changing pattern (make sure breathing is rhythmic) Watch for signs of transition Keep up your energy by snacking on food brought from home

Transition	Dilation from 7-10 centimeters Contractions 1-1/2 to 2 min. apart, lasting 60-90 sec, extremely long and erratic, possibly with more than one peak	She may experience one or more of the following: Panicky, feels like giving up Irritable Desires not to be touched Forgetful, disoriented Rectal pressure, premature urge to push Nausea/vomiting Alternating hot/cold feeling Trembling of the legs	Remember this phase is intense but SHORT Take one contraction at a time Change breathing technique as needed Eliminate cleansing breath if contraction peaks immediately Blow with premature urge to push Use slow-paced breathing between contractions	Do not leave her for any reason! Remind her it is transition-LABOR IS ALMOST OVER-baby is coming-she can do it Praise her lavishly for her efforts Do not be offended by remarks Screen out annoying disturbances Keep conversation to a minimum Communicate with medical staff, keep calm, do not argue Apply back pressure Call nurse if urge to push is felt Breathe with her-have her mimic you Help her catch contractions at start Help her relax between contractions Be Positive!

Pushing and Birth	Dilation complete Baby moves down the birth canal Head crowns Delivery of head, shoulders, and then rest of body Contractions 3-5 min. apart, lasting 60-75 sec.	Has strong urge to push Relieved to be able to push Renewed energy level Feels great deal of pressure Burning, splitting sensation Is sociable again between contractions	Assume a comfortable pushing position Use most comfortable pushing technique Push only when feeling the urge Pant or blow as the head is delivered Relax perineum Keep eyes open	Help her assume a comfortable position for pushing (support neck and shoulders or legs while pushing) Remind her to relax her bottom, check her face for relaxation Coach her to pant or blow as head is delivered Remind her to keep her eyes open Be sure she can see in the mirror Take pictures as baby is born

Delivery of Placenta	Mild uterine contractions Separation and expulsion of placenta	Exhilarated Possibly fatigued	Push with contractions as instructed Hold and soothe your new baby skin to skin Initiate breastfeeding Use breathing techniques if necessary	Take pictures of mother and baby Hold baby skin to skin

Bonding and Recovey	Perineal repair if episiotomy was done or the perineum tore Identification procedures for baby Begin breastfeeding and bonding with baby Intermittent uterine contractions Checking of mother's physical status	Exhilarated Possibly fatigued Hungry and thirsty	Have skin to skin contact, examine, caress, nurse and talk to baby Make eye contact with baby Take pictures of father and baby Massage fundus of uterus Eat and drink	Share in bonding with baby Take more pictures Make telephone calls

Labor and Delivery

Suggestions for Labor Partners