Class 5 Summary Sheet

Communications - mom and coach write down (separately) where mom tenses first, where she likes to be touched, and where she does not like to be touched

First Stage Labor, How Your Body Works

  1. Preparing for labor- contractions become more frequent and stronger, blood volume increases about 50% in a healthy, well-fed mother; you can lose a lot of blood during birth and be okay.

Hyaluronidase and relaxin are produced by the mother’s body to help soften the cartilage in the pelvis and give elasticity to the ligaments. This allow the pelvis to have more give during birth. Cervix begins to soften and thin out (efface). You will likely lose your mucous plug (which was sealing the cervix).

  1. Early First Stage Labor- mothers are usually still hungry; low blood sugar can interfere with the effective work of contractions. Mothers are usually still thirsty. Dehydration can reduce energy output by 30% and interfere with effective distribution of hormones. Loose stools are often a sign of early labor. Mother may lose her mucous plug if she hasn’t already lost it. The mucous plug will be bloody and thick.
  2. During active first stage labor mom will likely still be thirsty, but not hungry. Mom will have a continued loss of modesty. Mom’s body will continue to dilate and efface. Mom needs to make sure she urinates frequently. The cervix may not  be able to dilate efficiently if the bladder is full.
  3. Natural alignment plateau - Contractions may continue, but dilation may slow or stop. There may be reasons other than those listed that could include psychological reasons. If mom has experienced sexual trauma in the past, this could especially be a big reason. Mom will likely have felt as though she lost control in the sexual trauma, and sometimes the same feeling is evoked when mom  is labor. Mom may need food or water. Mom may be exhausted and her body may need to rest. Mom may need to let go of any fear. Mom’s pelvis could be opening up more. Baby’s head may need more time to mold. Baby’s lungs may need more surfactant. Baby may need more time accepting that he/she is being born.

Four Things Measured in Vaginal Exams

  1. Dilation
  2. Presentation
  3. Effacement of the cervix - measured in 0, 25, 50, 75, and 100%
  4. Station of the baby

First Stage Practice

-The Bradley Method teaches natural abdominal breathing because it

a) saves energy - chest breathing wastes a tremendous amount of energy

b) avoids hyperventilation - hyperventilation can be very dangerous in labor and we want to avoid it. Chest breathing can lead to hyperventilation

c) Relaxation works better - The Bradley Method has found that altered breathing patterns are not necessary and relaxation techniques work better

d) Chest breathing causes tension - tension causes pain and pain causes fear and fear causes more chest breathing

e) Most people are already doing it - 

Look through how to time a contraction and the mother’s and father’s checklist for contractions at the bottom of page 37.

Review the Overview of Labor and Birth chart on page 38 and 39.

If you are hiring a doula or if you are going to have a sister or mom in the room, page 40 has some helpful hints.

Study Helps

  1. A well nourished body has better stamina.
  2. Tailor sitting will help the uterus come forward. Pelvic rocking can help the baby be in a good position and help with general discomfort. Regular physical exercise has helped tone your muscles for the athletic event of labor.
  3. Being calm and relaxed helps the progression of labor and helps mom save energy.
  4. Adrenaline will slow the progression of first stage labor. 
  5. Fear of the unknown or the birth process or stress about anything can cause the production of adrenaline.
  6. If you are lying on your back or are in a way that prevents your uterus from moving forward you are working against gravity and this could cause pain.
  7. Pressures on the descending head are equalized. When the bag of waters is broken, increased molding of the head occurs and could cause a corresponding decrease in fetal heartrate.
  8. Medication can slow down first stage labor.
  9. Dehydration can reduce energy output and interfere with efficient distribution of hormones that are necessary for labor. 
  10. If you familiarize yourself with these, it will cause less stress when you arrive at your birth place

Labor Rehearsal 

Please take some time to practice through some pretend contractions. Mom and dad need to remember their checklist.

Check position - Make sure that mom is in a comfortable position. Does she need extra pillows? Is it too hot, too cold? Is the light right? Are the right people there? Is mom practicing sleep imitation?

Check relaxation - Stroking - coach should practice stroking. Coach’s hands may get tired from lots of massage, but usually stroking for lots of hours can be more manageable. Coach needs to make sure that they only use stroking in one direction, away from the body. If coach goes back and forth with his hand, it will likely be annoying for mom. Coach can use the flats of his/her hands or fingers or fingernails. Coach can say something like “let it goo” as the hand moves. Coach and mom should imagine the tension leaving her body as the stroking occurs. Coach needs to use a low, slow voice. 

Rubbing the back - Using the flats of the hands the coach can make light stokes on the upper, lower or middle back. Moving from the shoulders down to the lower back is usually the most comforting. A fist against the low coccyx can feel good. Placing both hands on the hips and squeezing can also feel good for mom. It also helps open the outlet of the pelvis.

Simulate a contraction - While doing practice labor rehearsals, coach can simulate a contraction by squeezing mom’s arm, and increasing the intensity of the squeeze at 30 seconds, and then decrease pressure. Alternatively, mom may hold an ice cube during the contraction, and practice relaxation through the discomfort of the coldness.

Guide her breathing - It may not be effective to tell mom to slow down her breathing. It may be effective to breathe with her, but possibly a little slower than what she is doing. Don’t breathe in her face, though. You can place your hand on her abdomen to remind her to make it rise and fall.

Timing contractions - Coach will need to time the contractions at the beginning of labor. It is helpful to download an app on your phone for this.

Talk to mom during the contractions  - Dr. Bradley says that coach should whisper the gobbly gook that got mom and coach into this position in the first place. Coach should practice using positive visualizations as well. This could be a special place you guys have been together or somewhere you would like to go together.