Bradley Class #5 - First Stage Labor

This class focused on how our body works during labor, what to expect during vaginal exams, practice contractions, and an overview of what happens during labor.

Early first stage labor brings on excitement and wondering if this is it, but not sure.  Women tend to get anxious.  Might have bloody show, urinate frequently, have a runny nose, or several bowel movements.  Contractions are around 10 minutes apart, peak around 30 seconds, and last for 45 to 60 seconds total.  Keep busy and don't become too excited.  Walking helps to open the inlet of the pelvis. 

First stage labor comes with acceptance and knowing that this is definitely it.   Women try different positions to find what works best.  May be hungry.  May be able to move and talk during contractions, which are becoming stronger and more frequent.  Mom needs support and reassurance, and she shouldn't be separated from her coach from this point on.  Conserving energy is important.

Late first stage labor brings seriousness and a "do not disturb" attitude.  Moms lose modesty, and the clothes start to come off.  May need to lie down and appear to be sleeping.  May no longer be hungry.  Contractions are more intense.  It's hard work.  Relaxation is the key.

Moms and coaches can talk to care providers about how many vaginal exams they do during labor.  Some doctors actually recommend against having vaginal exams routinely and/or if the bag of waters has broken.

What vaginal exams measure:

• Dialation of the cervix (up to 10cm)
• Presentation (i.e. position)
• Effacement of the cervix (i.e. thinning around baby's head, from 0% to 100%)
• Station (i.e. position of the baby's head relative to the ischial spines)

 The dirty about vaginal exams:

• Invasive and uncomfortable
• Can expose vaginal area to bacteria, risk of infection
• Practitioners use fingers to measure dialation
• Two practitioners can get different results
• Can be depressing for mom (i.e. not as far along as hoped, etc.)
• Can lead to false information (guestamations)

Babies should be in a head-down position facing your back (Occiput Anterior).  We talked about various ways to turn a breech baby:

•  Stay in a "cat" position with chest down toward ground for a few minutes a day.
• http://spinningbabies.com
• External version (manually turn baby, typically unsuccessful)