Class 2 Topics Stages & Phases of Labor 2nd Stage Labor/Pushing - - PDF document

5/15/2020 1 Welcome! Childbirth Preparation 4 Week Series Week 2

Class 2 Topics

• Stages & Phases of Labor
• 2nd Stage Labor/Pushing
• Labor positions
• Birth Video
• Coping Skills

Your Hospital Stay

• Arrival at Hospital
• Please wear a face covering when you arrive at the hospital
• All patients and visitors entering the hospital are screened for any

signs of illness

• Triage
• No support person allowed, support person will be called when

patient is admitted to L&D

• Labor and Delivery
• One support person only (ok to leave and re-enter)
• Support person will be screened once per day on entering hospital

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Covid-19 Testing

• Covid-19 testing
• Scheduled surgical patients will have COVID-19 test at their

physician’s office prior to being admitted.

• Laboring patient will be tested when admitted
• Nasal Swab, patient can do the test, nurse will observe
• Swab both nostrils, rotate swab 5 times in each nostril
• Covid-19 positive
• No support person allowed
• We need healthy caregiver at home to care for the baby

Stages of Labor

4th Stage

Recovery & breastfeeding

3rd Stage

Delivery of the placenta

1st Stage

Cervix thins and opens

2nd Stage

Pushing and birth

First Stage Phases

Every labor is unique. The length of your labor may be different!

Transition

30 minutes-2 hours

Active Labor

3-5 hours

Early Labor

6-12+ hours

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1st Stage: Early Labor

5-30 min apart 30-45 sec

Emotions:

Happy, Excited, Some anxiety

Cervical Dilation: 0-6 cm

Contractions

6 cm

Time (in minutes) Strength Early Labor 1:47

Early Labor Activities

• Rest or sleep
• Diversions (music, TV, cards)
• Eat lightly
• Drink fluids
• Take a walk
• Shower or bath (call caregiver first if you

think your bag of waters is broken!)

1st Stage: Active Labor

Active Labor 2:33

Emotions:

Serious, Focused

Contractions

Cervical Dilation: 6-8 cm

45-60 sec 3-5 min apart

8 cm

Time (in minutes) Strength

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Active Labor Activities

• Shower
• Massage
• Diversions (music, TV, cards)
• Upright positions like the birthing ball
• Breathing & relaxation techniques
• Ice chips
• Take a walk if not medicated

1st Stage: Transition

Transition 1:33

Emotions:

Frustrated, Dependent

Contractions

Cervical Dilation: 8-10 cm

60-90 sec 1-3 min apart

10 cm

Time (in minutes) Strength

Transition Labor Activities

• Diversions
• Upright positions
• Breathing techniques
• Ice chips
• Shower if not medicated
• Eye contact
• Firm, simple directions

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Fetal Descent 2nd Stage

Pushing & Bony Plates 1:40

Contractions (there may be a resting period before contractions restart) Emotions:

Happy, Relieved, Exhausted 60-90 sec 3-5 min apart

Time (in minutes) Strength

Pushing Positions

Pushing Positions 1:38

Hands-and-knees Squatting Birth Stool Side-lying

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Breathing During Pushing

• Breathe in a way that feels good during pushing
• Try a controlled exhale as you push, instead of holding

your breath

• You will push 3-4 times per contraction for about 6-8

seconds each time

Birth

Birth video begins with crowning 2:12

Birth reactions vary

Brandy’s Birth Story

Join the couple at home and in the hospital.

Watch the story, then discuss:

• Did you see anything in this birth story that you

want to use in your own experience?

• Did you see anything that surprised you?

Brandy’s Birth Story 13 minutes

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Skin-to-Skin Contact

Healthy infants should be placed and remain in direct skin-to-skin contact with their mothers immediately after delivery until the first feeding is accomplished.

American Academy of Pediatrics Policy Statement on Breastfeeding (2005)

3rd Stage

• The placenta detaches

from the uterine wall 5- 20 minutes after birth

• You may feel a mild

contraction as it detaches

• Your healthcare provider

will examine the placenta to make sure that it comes out in one complete piece

Placenta 0:20 (no audio)

You’ll push out the placenta

4th Stage

• The 4th stage of labor is the

first few hours after birth

• Your uterus continues to

contract and shrinks to about the size of a cantaloupe

• Holding your baby skin to skin

and feeding him within the first hour after birth helps long- term breastfeeding and milk production, and helps your uterus contract to its usual size

4th Stage 0:54

This baby’s first feeding occurs during the 4th stage

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Any questions? Pushing Practice and Labor Positions are next!

Stages of Labor Review Tips for Labor Partners

Birth Companions 0:49

• Suggest a variety of

comfort measures (try one at a time)

• Rest when you can
• Nourish yourself
• Be the link between

medical staff and Mom

• Don’t take things personally

Find what works best for Mom

Tips for Long Labor

• Rest if you can
• Change positions
• Change the atmosphere or environment
• Stay hydrated and nourished
• Support people may need a break;

consider a back-up

• Try new techniques

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Tips for Back Labor

Back Labor 0:38

Counterpressure Heat or Cold Packs Double Hip Squeeze

Breathing Patterns

Slow Breathing

Click pattern to play 45 second exercise

Paced Breathing

Click pattern to play 45 second exercise

Patterned Breathing

Click pattern to play 45 second exercise

Labor Positions

• Help a baby descend

and turn into a more

• ptimal position

for birth

• Cause more efficient

contractions

• Reduce the pain of

contractions

• Help mom actively

participate in her labor

• Provide a change of pace

This upright position allows the baby to move

Labor Positions 2:07

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Labor Positions

Side-lying Forward-leaning Hands-and-knees Sitting

Labor Positions

Squatting Lunging Slow Dancing

Fitness Ball

Fitness Ball 0:52

Sitting Forward-leaning Peanut ball between legs

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