What it is

There are two kinds of electronic monitors, external and internal. An external monitor can be used early in labour and is sometimes used during pregnancy to check the baby’s well-being. The internal monitor is slightly more accurate. You will have belts strapped around your body and a tiny electrode will be clipped on to the baby’s head. Your contractions and the baby’s heartbeat are recorded on a printout (partogram). There is also a video screen that records the contractions and heartbeats as visible waves, punctuated by flashing lights.

During a contraction blood flow to the placenta is reduced for a few seconds, and your baby`s heart rate will dip. This is quite normal and the heart rate returns to baseline when the contraction passes. If the return to base­line is delayed, your baby may be distressed and action can be taken early to protect his well-being. The latest type of EFM, known as telemetry, uses radio waves and allows you to walk around because the baby’s monitor is attached to a transmitter strapped to your thigh. The older equipment confines you to a bed or chair.

How it is done

Your waters bag are broken when the cervix is about 5-6 cm {2-TA in) dilated and the electrode is applied to your baby’s head. In addition to the baby’s monitor, which picks up his heartbeat, a second monitor is placed between your baby and the uterine wall to measure the pressure and contractions

Positions

Walking around, leaning against your partner or the wall, and rocking your pelvis will probably feel much more comfortable than lying on your back in bed. There are also certain positions that you will find more comfortable than others, because these will relieve the pressure on your back.

Massage

This is a wonderful way of getting reassurance from your partner while relieving discomfort, whether you’re lying, standing or squatting. It can be particularly relieving if you have backache during labour, which most women do, or if you suffer from a backache labour.

TENS

(Trans-cutaneous Electrical Nerve Stimulation) Pain impulses conducted by nerves are blocked by an electric current, which also stimulates the production of endorphins. A battery-powered stimulator is connected by wires to electrodes that are placed on either side of the spine. You then use a handset to regulate the amount of stimulation and thus pain relief that you receive.

Visualizing

Creating images in your mind can be a very effective way of calming fear and reducing pain. As your contraction begins, imagine something that you find particularly soothing, for example, warm, bright sunshine. Contractions in the first stage are opening the cervix and you may find it helpful to think of the image of a bud of your favorite flower opening slowly, petal by petal. Thoughts of waves are also very comforting, the flow of the waves matching each contraction as it increases in intensity, peaks and dies away.

Water

Lying in warm water can be very relaxing and soothing because the water renders you virtually weightless and this brings relief between contractions. For these reasons, birthing pools are used by some mothers under supervision.

Sounds

You can help to diffuse the pain and anxiety of your labour by vocalizing in the way you feel is most helpful. Sighing, moaning, groaning and grunting are all ways of releasing tension, and you shouldn’t be inhibited, or worry about disturbing others.

Many women find that listening to music is very effective. Your birth assistant can play different pieces on a cassette recorder depending on how you are feeling.

Hypnosis

This isn’t something that you should try on a whim, since you need to respond to hypnosis very easily. Women who can go into a deep trance have been able to have a forceps delivery, stitches or Caesarean without feeling pain. A period of practice sessions is advisable, so that both you and your hypnotist are completely familiar with what you have to do during the birth.

Acupuncture

You should only opt for this method if you have already found that it can relieve pain in other situations. In addition, your acupuncturist must be familiar with labour and delivery. This may not stop you feeling any pain at all, but it will certainly reduce it, and also helps prevent nausea.

UNDERSTANDING YOUR ROLE

Like many partners, you may be nervous or worry about feeling squeamish, or being inadequate at offering sufficient support. You can help combat this by prepar­ing yourself in advance. It s important that you know as much as possible so that you can effectively help the mother meet the physical and emotional demands of labour. At the antenatal classes there will be demonstra­tions to describe the onset of labour and the effect of contractions, and you will be taught techniques for helping her relax.

If it’s going to be a hospital birth, visit the labour and delivery rooms with her and introduce yourself to her hospital attendants so you wont feel like an outside when the time comes. If the birth is to be at home, find out what will be expected of you.

HOW TO HELP DURING LABOUR

You may have a very active role throughout the labour and birth, but sometimes your presence is all the mother needs. Make sure you are familiar with her birth plan and any alternative version. You need to be aware of her wishes in order to speak on her behalf during labour if necessary.

Use your intuition

You need to judge the situation, observing your partner’s moods and fitting in. Alternatively, she may need a great deal of verbal or physical encour­agement, or to be distracted by music or talking.

Provide emotional support

Stay as intimate as possible using loving words, and keep your movements slow, quiet and steady. Always be positive: offer praise, never criticism. If she wants to hear your voice, constantly tell her how well she is doing (how far dilated), suggest how she can relax herself, tell her what other people such as the midwife are doing to help her, and what will soon happen.

Also, help her to see how much she has achieved already – its easy for her to be overwhelmed by how far she thinks she has to go. Massage and stroke her slowly, but if she just wants to hold your hand, you can offer encouragement by using facial expressions and lots of eye contact.

Combat fatigue

Before labour, remind her to rest as much as possible, particularly if she seems to spend a lot of energy cleaning during the “nesting” period. If she has a long, tiring labour, try to help her relax between contractions to conserve her energy for the second stage. If she’s not feeling nauseous, provide her with as much refreshment as she wants (see also p. 32). She will probably find that having her face wiped is very soothing.

Help her cope with pain

It’s hard to see someone you care about in pain, but try not to reveal your anxiety because she may become discouraged. On the other hand, don’t discredit her suffering. Don’t let her feel embarrassed about expressing her discomfort – encourage her to be as uninhibited as possible. Try not to be upset if she becomes critical or aggressive – this often happens when the pain is very intense.

Assist with breathing

You will probably have practiced this during antenatal classes, but allow her to follow her own rhythm. If she seems to lose control, slowly guide her through the pattern until she can carry on alone. Be prepared to adapt – very few people follow exactly what they practiced at antenatal classes.