birth.com.au Labour Support Guide - Set printer to 'landscape' in your page settings.

What's happening to the woman's body	What the woman may feel	What you can do	What the partner/support people can do
LAST WEEKS & PRELABOUR Baby's head heavy in the pelvis Lightening ?baby's head engages Muscles relax under influence of hormones Cervix begins to thin, soften and starts to open to around 2-3 centimetres	Backache and / or sore thighs Period pain or cramping Waters may break (call caregiver) Possibly a Mucous 'show' Bursts of energy Chatty and excited or introspective Change in bowels - constipation or diarrhoea Heavy pelvic pressure Vomiting or nausea Nesting instinct - exited or scared Mild to moderate regular or irregular contractions	Swim, walk, rest or sleep Carry on as normal Keep eating and drinking Arrange to have a massage Try to resist telling everyone. It can still take many hours or days yet! Relax and enjoy it! Remember it is just the beginning Pack bag for hospital Baths, showers, heat packs	Massage Organise an evening out or a candlelit dinner for 2 Hire videos Check route to hospital, petrol in car, capsule fitted Cuddles ?talk about how you both are feeling Prepare to take time off work Organise last minute preparations Organise siblings Take a photo Rest if she doesn't need you
MOVING INTO EARLY PHASE OF 1st STAGE Contractions become closer more regular and intensify Cervix opens up to about 3-4 centimetres Contractions last from 45-60 seconds long now. Baby's head moves further into the pelvis	Contractions increase in length and intensity 'Show' ?mucus plug, or vaginal discharge can be clear, pink or bright red Membranes may rupture - check for any green or brown discolouration (call caregiver) Exited, impatient, talkative Need to be upright or move Needing to use deeper breaths during the contractions now	Contact caregiver, prepare to leave (2nd or subsequent babies) Pelvic rocking Keep eating if you feel like it Drink after each or every other contraction Watch for regularity in contractions Think about this new person coming into your life Visualise the cervix thinning and opening Go for a walk Take a shower or use heat packs	Call caregiver and take her to birthplace (2nd / subsequent babies) Encourage relaxation Burn Aromatherapy oils (ask first) Massage-use acupressure points Encourage walking, light snacks and drinks, eat yourself 'Bodycheck' between contractions remind her to relax her body Remind her to empty bladder Hot / Cold packs Tie her hair back Love and encouragement Take a photo
ACTIVE PHASE / ESTABLISHED 1st STAGE Cervix opening up from 4 to 7- 8cm dilation Contractions stronger, longer and closer together Baby's head moving lower	Contractions need all of your attention May become restless or sleepy Needing to breathe and work with them now. Not that interested in conversation Focus turns inward Membranes may rupture "Show" with blood may come Dependent on your companion Starting to feel you need to be at your birthplace or caregiver with you Thinking about Pain relief	Contact your caregiver, prepare to leave (first babies) Empty your bladder before you go & every 2 hours Drink, suck ice or lollies after every contraction Breathe with open relaxed jaw and throat After every contraction breathe in and release that contraction Pelvic rocking Listen to your body ?go with it Think of, and talk to your baby! Change positions frequently Get on 'all fours' for backache Shower or bath needed now Heat packs	Call her caregiver and take her to her birthplace (first babies) Breathe with her, remind her to take the breath deep into her body. Eye contact if she looks lost Hot packs to lower back and abdomen. Rub back with warm oil (rub between your hands to warm) Foot and shoulder massage 'Bodycheck' after every contraction, make sure she relaxes her body Offer her fluids after each or every other contraction Remind her to urinate every 2 hours Suggest and physically help her into other positions Stay calm and look after yourself

What's happening to the woman's body	What the woman may feel	What you can do	What the partner/support people can do
MOVING INTO THE END OF 1ST STAGE / TRANSITION Cervix opens from 7-8 to 10cms or fully dilated. Contractions very strong, close together 1- 2 minutes apart or back to back with little to no rest between Contractions lasting mostly 60-70 seconds long.	"Panicky" Leg cramps and shaking Nausea and / or vomiting Need to open your bowels Heavy bloodstained 'show' Hot and perspiring or cold and shivery Pressure in the lower back Feelings of being out of control 'Not wanting to do this anymore' Pressure in your bottom as your baby's head moves lower Needing to make more noise and possibly some grunting noises Wanting this baby born now Asking for pain relief, perhaps not really wanting it if you are nearly there difficulty staying in the "here and now"	Try to keep focused and calm, if you need to release sounds then let it go Know it's all right to feel out of control Eye contact with partner or eyes closed to focus Get into the bath or the shower Sip fluids regularly Relax- know your baby is arriving soon. Cry and complain Try to remember that you will probably not find a comfortable position Trust your body, the process is normal	Eye to eye contact if she needs and wants it Allow her to be noisy and out of control, reassure her this is good Be quiet if she finds talking annoying Encourage her to stay in the 'here and now' let go of 'how long?' Maintain tranquillity around her Breathe with her Tell her to release sounds if she needs to Stay close and stay calm Let her direct you Thigh or shoulder massage if she wants to be touched Cold washer or spray to face Offer fluids or ice chips Be open and flexible to her needs
THE RESTING AND PUSHING PHASES OF 2nd STAGE Cervix fully dilated Baby descends and rotates in the pelvis Contractions 5 or more minutes apart, Urge to push No urge to push (resting phase) Your baby moves out of the uterus, through the pelvis and down the vagina Pushing for 20 minutes to 2 hours Baby's head crowns Birth of the baby	Baby moving down the birth canal Urge to push or No urge to push ?rest and wait Pushing - cannot resist the urge Possibly need direction to help push May open bowels Towards the end of 2nd stage the head is seen with pushing and moves back when the contraction finishes Feeling frustrated - remember it is better that your baby takes time, so your body can stretch with the head coming out The top of the baby's head is clearly visible and does not move back now, the perineum is stretched to the maximum Burning and stretching as baby's head crowns You pant the head out You wait for your baby to rotate around so the shoulders can emerge, top shoulder out and body follows You may feel awe, numb, relief, love, exhaustion, shock, quietness, disbelief all that and more!	Go with your body ?push only when you have a contraction to avoid exhaustion Relax between pushes. Drink between the contractions Let gravity assist you and your baby try upright positions, eg. Standing, squatting Get on all fours if the baby is coming too fast Get into the bath or shower Let your vagina open - you're doing well! When you feel the stinging, burning sensations pant, pant your baby's head out to help avoid tearing Touch your baby's head as it emerges Enjoy the feeling of bliss when your baby enters your arms Feel relieved you have done it!	Physical support ?help with positioning Help her into the bath Organise a mirror if she wants one Tell her when you can see the baby's head. Help her to feel the baby's head. Eye contact ?pant with her! Encourage her to relax the pelvic floor and 'let go' If she says, "it's stinging/burning" tell her the baby is coming! Wipe her brow it is hard work Offer drinks between contractions. Tell her how wonderful she is Be in awe of a labouring and birthing woman Help 'catch the baby' if it is appropriate and she doesn't need you to hold her Cry Take photos if she wants them Cut the cord if appropriate
THIRD STAGE The uterus contracts the placenta separates and comes down and out the vagina Delivery of placenta ?usually within 5 to 30 minutes Probably an injection of Syntocinon, as the baby is being born to speed up delivery of the placenta and control the bleeding	Mild contractions or cramping after pains Some bleeding Sore bottom and perineum Not wanting to be touched or moved for a while Lengthening of the umbilical cord Heaviness in pelvis Relief, joy shock that your baby is finally here	Upright position to help placenta come away Give gentle pushes,with a contraction or cramping Put baby to the breast if you both feel like it Hot cup of tea or drink Take some mild pain tablets or use heat packs	Offer warm drinks and something to eat Assist her into a position to help birth placenta Once placenta comes away, help her to be comfortable to feed the baby Take photos Make phone calls Help her into the shower when she is ready Feel relief and joy

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