Four Menaces of Labor

Since a number of my friends (not just I!) will be having babies over the next few weeks, I thought I'd post some notes I took when I was pregnant with Nikita. The information is from Childbirth without Fear by Grantly Dick-Read, a fascinating book about childbirth.

When	Reason/Expression	What to do
1. First stage of Labor: Cervix is about halfway dilated (5 cm)	Woman panics because it has taken many hours to reach this stage.	· Reassure woman that she is doing well. · Explain that the cervix will dilate much quicker.
2. Transition: Final dilation of the cervix	Acute backache in the sacrum or lower end of spine.	· Tell woman that the backache is TEMPORARY, will last only 9-12 contractions. · Remind her to breathe slowly and deeply to stay relaxed. · Relieve backache by firm rubbing or hard pressure on sacrum.
3. Second stage of Labor: Baby has reached the floor of the pelvis.	The woman desires “to escape” or says she has “had enough” because she feels resistance in the birth path.	· Remind woman that she is doing well. · Tell woman that at the next contraction, she should concentrate and push firmly. Doing this will distend pelvic floor and passage will be much easier.
4. Crowning: Baby is now visible, stretching out the vulva.	Vulva is burning; woman may contract her pelvic muscles because she feels like she is about to burst or tear.	· Reassure woman that she will not burst. · Remind woman to relax pelvic muscles and to NOT push. The baby will come out very soon, and the vulva will feel anesthetized as it stretches out even more. · Tell woman to breathe in and out rapidly during contractions.