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Onset of spontaneous labour

What happens

One or a combination of the following:

• 'A show'
• Waters break or leak
• Regular contractions felt as a low abdominal discomfort, backache, aches in tops of thighs or across buttocks, period like pain / cramp or similar.

Helping yourself

• If the show has more than a streak of fresh blood ring your Midwife.
• If the waters break and the water is clear but there are no contractions let the Midwife know within 8 hours (yes - that means at breakfast time!).  Tell her straight away if the water is green - even at 3 in the morning.
• Time the contractions.  Ring when the contractions have got to the point that she has advised you to contact her.  (We do not need to know about irregular contractions at 3 o'clock in the morning!!)

Relaxation / positions

• Use calm breathing to help you to relax.
• Use this phase to relax fully and get into the rhythm of relaxing with the contraction, focusing during and breathing it away., while it is easy to do so.
• Keep in touch with what your body is doing.  Visualise your cervix being taken up and starting to stretch open over your baby's head.

Partner's help / needs

• Check final preparations.  Lists may help.
• Maintain a calm and unhurried atmosphere as possible.
• Suggest a light activity to avoid a boring wait.  Cards, a board game, video, walk on the beach, massage... let her choose!
• Make sure that pets are fed and watered and that the answer phone is on.

Early first stage

What is happening

• The cervix is being thinned, softened and stretched open by the powerful muscles of the uterus. The upper part of the uterus pushes the baby down as it becomes thicker during labour, the lower part relaxes allowing the cervix to stretch open.
• The baby starts to be ‘compacted’ and descends further into the pelvic cavity.

Helping yourself

• At night time, rest. If you are too excited to rest or cannot get comfortable, get up, have a warm drink and then relax in a comfortable position or take a hot water bottle / wheat pack back to bed with you. In the daytime, continue light activity.
• Unless you have been told otherwise, eat easily digested snacks, such as ;- toast and Vegemite, yoghurts, fruit, salads, tuna fish, chicken, muesli bars, bowls of cereal and milk. Do not have very sugary drinks such as Lucozade or Powerade. The ISOTONIC balanced types like Horleys Isotonic sports drink, Gastrolyte from the Chemist, or plain water is great!
• A bath or shower can be relaxing.

Relaxation / positions

The uterus works best in an upright position. However, if it is night time STAY IN BED! Bear in mind that if you are in proper labour, whatever position you are in, your labour will continue. Rest is much more important at this stage than adopting upright positions, you will find that your energy is needed later and you will be pleased that you have dozed in between contractions and have had some rest.

Partner’s help / needs

• Be positive. She may be very frightened.
• Be affectionate - unless she finds that irritating. Tell her how much you love her, be her friend and supporter, encourage her, it can appear daunting at the start of labour.
• Help her to remain cheerful by chatting in between contractions unless she would rather rest.
• Remind her of relaxation techniques that you have practised together.

As the first stage progresses.

What happens

• The contractions become stronger, and perhaps closer together. They may last for longer too.
• If you feel like it, you may still be pottering around at home normally. IF you have not already contacted your midwife now is the time to do it! She may chat on the phone to assess your progress and she may want you to come so she can listen to babies heartbeat. She may visit you at home or may arrange to meet you at the hospital too.
• When the Midwife arrives she will feel your uterus, listen to baby’s heartbeat and decide whether it is the right time to examine you internally. If your contractions are not regular she should leave you well alone unless she has any concerns.

Helping yourself

• Being up and about is likely to feel better and to help this stage pass more quickly, but be guided by your own preferences.
• An upright position is more efficient and less painful for most people.
• Do not leave for hospital until the Midwife says that it is indicated; hormonally women labour better in their own surroundings and establish in labour quicker.
• When / if you travel to the hospital try to maintain the most upright position that you can for the journey, pillows or cushions may help to support your back. Keep practising your relaxed, rhythmic breathing.

Relaxation / positions

See attached sheet.

Partner’s help / needs

• Remind her to empty her bladder every 2 hours.
• Remind her to relax, help her with changes of position, supporting her if necessary.
• Wear cool clothes for the hospital and take food for yourself.
• Make sure that you have a chair to sit on.
• Keep yourself as relaxed as possible. Seeing your partner in pain is never easy....bear in mind that it is a normal pain and that with your positive approach and support she will find it easier to cope with.
• Be prepared to act as her "communication centre", telephoning the Midwife, family, birth supporters etc. If she wants to be incommunicado..............let her be!