Labor Partner’s Summary

Below is a short and quick summary that guides the labor partner to the right management of the various situations that come with labor from the very beginning to the end of the fourth stage of labor.

Warm-Up
State Before Labor Begins
What Is Going On?
  • Lightening
  • Increased frequency of Braxton-Hicks contractions
  • Early effacement and dilation.
  • Increased vaginal discharge.
  • leveling off or loss of weight.
How Is She Feeling?
  • Excited: a sense of anticipation.
  • Depressed.
  • Difficulty sleeping; very tired.
  • Spurt of energy.
What Should She Do?
  • Simplify the housekeeping.
  • Pack suitcases and Lamaze bag.
  • Conserve energy; take naps.
  • Pre-register at the hospital; take a tour.
  • Practice exercises, relaxation, and breathing daily.
How Can I Help?
  • Assist her with the household chores.
  • Encourage her to rest.
  • Provide diversion—for example, take her on walks, take her out to eat.
  • Help her practice relaxation and breathing.

First Stage
State Beginning of Labor
What Is Going On?
  • Contractions.
  • Loss of the mucous plug.
  • Leaking or rupture of the membranes.
  • Frequent bowel movements.
How Is She Feeling?
  • Excited.
  • Apprehensive.
  • Talkative.
What Should She Do?
  • If it is nighttime, try to sleep.
  • If it is daytime, continue normal activities,
  • Take a walk.
  • Take a shower; wash hair; shave legs.
  • Eat carbohydrates; drink juice.
How Can I Help?
  • Time the contractions.
  • Reassure her of her readiness for labor.
  • Call the baby sitter.
  • If it is nighttime, encourage her to sleep; sleep yourself.
State Early Labor
What Is Going On?
  • Contractions from 5 to 20 minutes apart, lasting from 30 to 60 seconds,

    becoming longer, stronger and more frequent.

  • Effacement and dilation from 0 to 4 centimeters.
How Is She Feeling?
  • Confident.
  • Sociable.
What Should She Do?
  • Relax with the contractions.
  • Begin slow paced breathing if necessary.
  • Stay in an upright position as much as possible.
  • Empty bladder every hour.
  • Call caregiver.
  • Drink sweetened liquids, eat light snacks.
How Can I Help?
  • Time and record the contractions.
  • Remind her to relax; use touch relaxation.
  • Encourage and praise her.
  • Help her with the breathing pattern if necessary.
  • Encourage her to walk.
  • Remind her to urinate.
  • Use distractions—for example, play cards or games with her, take her outside to the park.
State Active Labor
What Is Going On?
  • Contractions from 2 to 4 minutes apart, lasting from 45 to 60 seconds,

    with greater intensity and longer peaks.

  • Dilation from 4 to 8 centimeters, with more effacement.
How Is She Feeling?
  • Anxious.
  • Apprehensive; doubts her ability to handle labor.
  • Serious mood; birth-oriented.
  • Attention turned inward.
  • Quiet.
What Should She Do?
  • Continue Relaxation and breathing.
  • Use a focal point.
  • Do effleurage.
  • Relax in a tub or shower.
  • Change position frequently.
  • Continue to urinate hourly.
  • Drink liquids.
  • Adjust pillows for comfort.
  • Go to the hospital or birth center.
How Can I Help?
  • When walking with her, stop and support her body during contractions.
  • Administer massages or back rubs.
  • Give her a cool washcloth for her face.
  • Give her ice chips pr Popsicles to suck on.
  • Offer her cold liquids if allowed.
  • Remind her to change position and to urinate.
  • Keep her informed of her progress.
  • Encourage her to relax and help her to do the breathing pattern.
  • If her breathing seems ineffective, suggest changing the pattern.
  • Watch for signs of transition.
State Transition
What Is Going On?
  • Contractions from 1 1/2 to 2 minutes apart, lasting from 60 to 90 seconds, extremely strong and erratic, possibly with more than one peak.
  • Dilation from 8 to 10 centimeters.
How Is She Feeling?
  • Panicky; wants to give up.
  • Irritable.
  • Does not want to be touched.
  • Forgetful; disoriented; amnesic.
  • Rectal pressure; premature urge to push.
  • Nausea; vomiting.
  • Alternating between feeling hot and cold.
  • Trembling legs.
What Should She Do?
  • Remember that this phase is intense but short.
  • Take the contractions one at a time.
  • Change breathing patterns as needed.
  • Eliminate the relaxing breath if the contraction peaks immediately.
  • Blow with a premature urge to push.
  • Use slow paced breathing in between contractions.
How Can I Help?
  • Do not leave her for any reason.
  • Remind her that the labor is almost over—the baby is coming.
  • Praise her lavishly for her efforts.
  • Communicate with the medical staff.
  • Keep her calm; do not argue with her.
  • Apply counterpressure to her back.
  • Call the nurse if she feels the urge to push.
  • Breathe with her; have her mimic you.
  • Help her catch the contractions at the start.
  • Help her relax between contractions.
  • Be positive!

Second Stage
State Birth of the Baby
What Is Going On?
  • Contractions from 3 to 5 minutes apart, lasting from 60 to 75 seconds, with an urge to push at the peak. Effacement and dilation complete.
  • Baby is moving down the birth canal.
  • Head is crowning.
  • Delivery of the head, the shoulders, and then the rest of the body.
How Is She Feeling?
  • Strong urge to push.
  • Relieved to be able to push.
  • Renewed energy level.
  • Great deal of rectal pressure.
  • Burning, splitting sensation.
  • Sociable again between contractions.
What Should She Do?
  • Assume a comfortable pushing position.
  • Use the most comfortable pushing technique.
  • Push only when feeling the urge.
  • Pant or blow as the head is delivered.
  • Relax the perineum.
  • Keep eyes open.
How Can I Help?
  • Help her assume a comfortable position for pushing.
  • If she is holding her breath, count to 6 to pace her pushing.
  • Make sue she lets a little air out before holding her breath.
  • Remind her to relax her bottom; check her face for relaxation.
  • Coach her to pant or blow as the head is delivered.
  • Remind her to keep her eyes open.
  • Be sure she can see the birth in the mirror.
  • Take pictures as the baby is born.

Third Stage
State Delivery of the Placenta
What Is Going On?
  • Mild uterine contractions.
  • Separation and expulsion of the placenta.
How Is She Feeling?
  • Exhilarated.
  • Fatigued.
What Should She Do?
  • Push with the contractions as instructed.
  • Hold and soothe the new baby.
  • Initiate breastfeeding.
  • Use a breathing pattern if necessary.
How Can I Help?
  • Take pictures of the mother and baby.
  • Hold the baby.

Fourth Stage
State Bonding and Recovery
What Is Going On?
  • Perineal repair if necessary.
  • Identification procedures for the baby.
  • Intermittent uterine contractions.
  • Checking of the mother’s physical status.
  • Possible removal of the baby to the nursery after bonding.
How Is She Feeling?
  • Emotionally high.
  • Proud.
  • Happy.
  • Tired.
  • Motherly.
  • Hungry and thirsty.
What Should She Do?
  • Examine, caress, nurse, and talk to the baby.
  • Make eye contact with the baby.
  • Take pictures of the father and baby.
  • Massage the fundus of the uterus.
  • Eat and drink.
How Can I Help?
  • Share in bonding with the baby.
  • Take more pictures.
  • Make telephone calls.