Labor Support Checklist

Before Labor: Learn as much as you can

• Attend Childbirth Education classes.
• Attend as many of the supplementary classes (Breastfeeding, Infant CPR, and Infant Care) as possible.
• Ask questions at your physician’s/midwife’s office and in your childbirth class.
• Read and review information on labor and birth.
• Complete a birth plan and review with your childbirth instructor and physician/midwife.

Be familiar with signs of labor

• The contractions are usually at regular intervals increasing in frequency, intensity, and length. (They become longer, stronger and closer together.)
• Mucous plug (bloody show) is not very significant and there is no need to call the physician/midwife or go to the hospital.
• If membranes rupture or start to leak, make a note of time, amount, color, and odor. Contact your physician/midwife as some prefer to see you and others may ask you to go to the hospital.
• Pack your bags and do as much as you can during the last month. Make a list of things you may need to add at the last minute. Review the list “What to Bring to the Hospital.”
• Install the car seat; have it inspected and ready to take your baby home.

Early Labor: Stay patient!

• Promote rest and relaxation (put class information to good use).
• Provide a quiet, calm atmosphere: use massage, music, and warm water shower/bath to promote relaxation.
• Between rest and quiet time, go on with your life. Go shopping, walking, or visit friends.
• Try to relax and stay patient. This is your time to check for gas in car and to be sure you have packed those things you wish to bring to the hospital.

Active Labor: Be supportive

• Encourage her to listen to her body, move around, and change positions.
• Some women find it helpful when the support person times the contractions. It can help her keep her perspective. Time from the beginning of one contraction to the beginning of the next. Keeping a record of the duration of contractions may help determine changes in the labor pattern. Try counting off 15-second intervals during a contraction if it helps her.
• Breathe with her if she is having trouble concentrating. Slow, deep, easy breathing usually works best for most women. Remind her of useful breathing techniques: cleansing breath, sighing, moaning. Don’t insist she breathe a certain way if she doesn’t find it helpful. Let her find her own rhythm and follow her cues.

Call your physician or midwife

• If membranes rupture (usually 10-15% of all labors), it is important to call soon, especially if she is Group B Strep positive.
• If a first-time mom is having contractions at regular five-minute intervals or less (requiring total concentration) and she can’t walk or talk through them any longer.
• If she has had a baby before and contractions are “feeling like labor” do not wait at home until a strong active labor pattern is established. This labor may progress much more quickly than the last labor.
• If she has vaginal bleeding.

At the Hospital

• Once at the hospital, review your birth plan with your nurse.
• The nurse will help you locate and become familiar with things you both may find useful during labor: Jacuzzi bathtub/shower, emesis basin, washcloths, ice chips, rocking chair, birthing ball, extra pillows, extra blankets, tape and/or CD player.
• Create a peaceful environment, making her as comfortable as possible. Try dimming the lights, playing music, adjusting the bed.
• Explore the maternity unit, if she feels like walking.
• Remember, women in active labor don’t always tell you what they need. Watch for twitching, wriggling, frowns, grimaces, or curled toes. Try massage, stroking, suggest a warm shower or tub. She may lick dry lips, push hair back from her face, and rub her own back. Follow her cues.
• Be positive. Encourage and praise her efforts. Keep up her spirits but do not minimize her difficulty. Acknowledge that what she is experiencing is painful and intense, then remind her of the progress she is making.
• Continue to appear relaxed yourself. Keep your voice calm and soothing. Remember neither one of you has to control labor: let the birth happen.

Transition: When the going gets tough

• Give encouragement, praise, reassurance, and love. Remember that labor is a healthy (normal) process.
• Review your handouts: Know the signs and symptoms of transition and what you can do to help. Your nurse will be there to help and offer suggestions.
• Don’t give up on your ideas just because they don’t always work the first time. Repetition can be helpful. Even if you lose her attention during a contraction, firm and confident suggestions can help to regain the connection.
• Shallow, more rapid breathing may be helpful. Quiet, slow breathing may not provide enough concentration at this time in labor.
• Blowing may be needed if she begins to push and has not recently been checked for dilation. The nurse will help you. (She made need to blow through a few contractions if she has the urge to push. The provider or nurse will check to be sure it is time to begin pushing.)
• Do not panic!

Second Stage of Labor: Bearing down

• Ask nurse for warm compresses and mirror, if they aren’t in the room.
• Review two types of bearing down. The nurse will help guide you both.
  1. Spontaneous bearing down
     • Remind her to listen to her body and let the contraction guide her as to position and technique. Pushes when she can no longer resist the urge to push.
     • Bear down while holding breath or release air by grunting, groaning, making noise.
     • The focus is moving the baby down, up, and out.
  2. Directed bearing down. To be used:
     • With anesthesia.
     • If there is not progress in the first hour with spontaneous pushing after position changes (squatting, supported squat, toilet, hands and knees, side, standing).
     • If there is fetal distress and she needs to deliver right away.

Remind her:

• To go with her body’s urges.
• Relax the perineum (pelvic floor muscles).
• Making noise is okay.
• To open her eyes and look in the mirror.
• To touch the baby’s head if she wishes.
• To blow if the physician/midwife asks her to stop pushing.

You may wish to remind the physician/midwife of any special requests you may have discussed earlier, such as helping to catch (deliver) the baby, discovering the gender of the baby yourself, and cutting the cord.