Think back to junior high health class, when they made you watch a birth video. You’re smart enough to know that the video probably didn’t cover the whole labor process. From what I remember, though, the video my class watched just covered the second-to-last stage of labor.
You might be skeptical about that “second-to-last” thing. You saw the part where the baby popped out. Then you stop to think. Wait a second. There are different stages of labor?
Yep. Not only that, but one of them has at least two phases (with the second phase having two parts). As a birth partner, you need to understand what you’ll need to do to be supportive during each stage, phase, and part. Please understand that this describes a typical labor, and every labor is different. This also describes a full-term labor–pre-term labor warrants a call to your doctor.
In the case of any contradiction between what’s written here and what a doctor says, believe the doctor.
Stage 1 – Early and Active Labor
This is the longest stage of labor. It begins with early labor.
Phase One – Early Labor
The first phase of the first stage of labor starts when “real” (not Braxton-Hicks contractions) become regular.
Your first step is to keep calm and relax. Sometimes, regular contractions stop. There’s (usually) no need to rush to the hospital until contractions are regular and close together. “5-1-1” is the usual rule: contractions 5 minutes apart, lasting 1 minute, over a 1-hour duration.
If contractions start becoming more regular, you can start timing contractions and getting your last-minute packing done. Besides that, you and mom-to-be can continue with normal activities. You can go for a walk, do light household chores, hang out and do things you enjoy–anything that’s comfortable for her, that you both enjoy, and that helps pass the time until you’re sure it’s really labor.
During this time, make sure she gets food and rest. She’ll need energy for the rest of labor.
Once it’s time, calmly head to the hospital with everything you’ll need.
Phase Two – Active Labor
Active labor is the phase in which contractions get stronger and more frequent, and possibly more painful. It’s not time for pushing yet.
During active labor, which is usually surprisingly uneventful, mother-in-progress needs your attention, understanding, and help. She might need comfort or a distraction. She needs to keep hydrated.
If she needs comfort, you can try comfort techniques or simply helping her move around. Gentle physical contact (holding hands, slow dancing, etc) can be reassuring and comforting.
If she needs a distraction, find something she likes: music, board or card games, a good book (you might want to read the book to her–your voice might be helpful).
It’s okay to ask her what she wants or needs every so often. Don’t be annoying and ask too often. Feel free to suggest something in particular if you think she needs it.
Phase Two, Part Two – Transition
Transition is the last part of active labor. It usually begins at 7 or 8 cm dilated.
Transition is also rough on everyone. It’s usually the hardest, most intense part of labor. Contractions are even longer and more frequent–in fact, they can even overlap or double-peak.
If you are paying attention, you will notice transition starting. There are a variety of possible physical and psychological signs. Generally speaking, her body is going crazy, she’s tired, and her brain is trying to keep everything together.
She needs all the help you can give. Since each transition is different (even from one pregnancy to the next for the same woman), it’s up to you to pay careful attention to her and do your best to get her through it. You need to be strong for her, but gentle and soft at the same time. Keep rational, but keep a loving focus on her. Stay with her through all of transition.
The best encouragement I can give you is this: transition won’t last long (usually about 30-45 minutes).
Stage 2 – Pushing and Birthing
Stage two is the stage where the mother pushes the baby out into the world. This is the part that is usually shown in birthing videos.
If you are paying attention, you should notice when transition ends and Stage 2 begins. She will be calmer, but tired. Depending on how things have gone so far, she may perk up, or she may just want to be done. Neither is “right”; be prepared for either.
During pushing, you need to encourage her, be a voice she can rely on, and help her (say, by helping hold a leg) as needed.
Encouragement is different than coaching. Reassure her she’s doing a good job. Acknowledge the work she’s already done and how tired she is. Remind her that the baby is almost here. You’re not her coach–you’re her birth partner, and you need to encourage her through this stage.
If the messy part of birth makes you queasy or offends you, stay where you won’t see it. There will be a lot of mess. Deal with any issues you have with the mess quietly, and make sure you don’t end up passing out or getting sick. You need to be physically and mentally there to help.
At the end of this stage, the baby emerges and…
Stage 3 – Placenta
…labor is almost but not quite done. Really, the hard part is done. The medical team will clean up baby and hand him/her over to you and the new mother. That’s where you’ll both be focused during this stage.
The placenta, non-technically speaking, is a thing that looks like a slab of liver that was very important to keeping Baby alive for the past nine months. Now that Baby has been born, the placenta wants to wave good-bye and set off on its own new adventures.
While the new mother is snuggling Baby, she will have a few more (usually mild) contractions. The medical team will do whatever they do with the placenta. Your focus can be on Baby and being excited that labor is over.