What is Established Labour? - Also known as First Stage encompassing Transition.

First stage Wave

Note the direction of the wave as it draws the womb upwards, opening the cervix as it simultaneously encourages your babe to nestle down, helping the cervix to bloom in her own way.

Come unto me, all you that labour and are heavy laden, and I will give you rest.                                                    Mt 11:28

• What is happening for Mum & Babe

• The cervix is thinning and opening (effacing and dilating) from 4cm-10cm (full dilation).
• The uterus is drawing back and pulling up.
• The pelvic ligaments are softening and opening.
• Contractions (waves, rushes, surges of energy) are increasing in intensity, longer, and closer together.
• The waters may or may not break in a gush or a slow continuous hindleak.
• Baby is nesting down and putting good pressure on the cervix helping it to thin and open. Babe is also turning in preparation to move down the birth canal.

• What is a first stage rush like

• Varying experiences depending on ability to SURRENDER to the process.
• Typically a WAVE of sensation – builds to a peak and then subsides. Lasts between 30-90 seconds. Regular pattern generally getting longer and closer together.
• May experience a tightening sensation.
• A contraction is not one continuous sensation. There should be breaks in between.
• Some women may feel it in their thighs, back, belly, pelvis, and/or bottom.
• Nausea or vomiting may occur.
• A constant loss of fluid is a normal occurrence, particularly if there is a hindleak.

• For support people – how might mum be feeling

• Varies according to ability to relax and SURRENDER – women have reported feeling any of the following; blissed out/lucid/centred but also as if they were off on a different planet, anxious, scared, terrified, impatient, frustrated, overwhelmed, angry, want to withdraw or be by themselves (particularly toward and during transition), excited, exhausted, vulnerable, out of control, thirsty, backache, very hot, want to give up, expanded.

• Support for First Stage

• Remember that like pre-labour, it is important to pace yourself. REST BETWEEN CONTRACTIONS.
• Massage
• Position change every hour or if mum starts to get tired.
• Keep up fluids.
• Heat packs
• Toilet every hour
• Lots of encouragement
• Bath/shower
• Aromatherapy/herbal teas
• Lights low, soft music
• Visualization – tell yourself, ‘see’ what is happening in your body – your cervix is opening like a flower.
• Walking, dancing, stomping feet, holding onto support and rocking.
• Breathing and vocalizing 
• Hypnobirthing CD’s.

• NB: For support people remember to respect the woman’s space and the rhythm of her labour by not asking her in depth questions, particularly during a contraction. Our primary goal is to help her maintain her focus and hold the space for where she needs to be to get this very special job done.

Tell me about Transition…

• Transition marks the time between the first stage of the cervix opening to the second stage of pushing your baby out. It is the time where the characteristics of the contractions change. 

• Rushes have reached maximum intensity and last b/w 1 ½ - 2 minutes and are closer together, may be a slight urge to push with a feeling like you need to do a poo. Sometimes before this occurs there may be a pause in contractions as their character changes.

• Mum may feel like she wants to be alone, will probably not want to be touched (as in massage) or she may feel very scared and want to give up.  She may even feel like throwing up.  Mindful encouragement is very important at this stage. Other support measures include sponging brow, being calm and reassuring, helping her get into position if she wants to change. It is very important at this stage for support people to be non-judgmental and non-invasive (ie: leave your own fears/issues outside the birth space and don’t try to rescue the woman from a situation that is normal)

Tip:  A note about breathing…………………………when you start to feel the wave begin take 2 deep breaths and as you let the second breathe out vocalize deep and low, feel it coming from your root, deep in your belly….match your breathing to the wave and then when it subsides take 2 more deep breaths to let it go completely. This helps to bring oxygen to your uterus and to your baby which in turn helps you to relax…..remember one breath for you one for the babe, beginning and end of the wave….great for helping you to focus and go inward. (Thanks to Renee Adair for this tip)