What to expect when you're expecting (155 page)

Keep your eye on the prize: That bundle of joy will soon be arriving in your arms.

When you’re a full 10 cm dilated, you’ll be moved to the delivery room, if you aren’t already there. Or, if you’re in a birthing bed, the foot of the bed will simply be removed to prepare for delivery.

For the Coach: What You Can Do.
Again, the doula, if one is present, can share these comforting techniques with you:

If your laboring spouse has an epidural or other kind of pain relief, ask her if she needs another dose. Transition can be quite painful, and if her epidural is wearing off, she won’t be a happy camper. If it is, let the nurses or the practitioner know. If mom’s continuing unmedicated, she’ll need you more now than ever (read on).

Be there, but give her space if she seems to want it. Often, women in transition don’t like being touched—but, as always, take your cues from her. Abdominal massage may be especially offensive now, though counterpressure applied to the small of her back may continue to provide some relief for back pain. Be prepared to back off—even from her back—as directed.

Don’t waste words. Now’s not the time for small talk, and probably not for jokes, either. Offer quiet comfort, and help her with instructions that are brief and direct.

Offer lots of encouragement, unless she prefers you to keep quiet. At this moment, eye contact or touch may communicate more expressively than words.

Breathe with her through every contraction if it seems to help her through them.

Help her rest and relax between contractions, touching her abdomen lightly to show her when a contraction is over. Remind her to use slow, rhythmic breathing in between contractions, if she can.

If her contractions seem to be getting closer and/or she feels the urge to push—and she hasn’t been examined recently—let the nurse or practitioner know. She may be fully dilated.

Offer her ice chips or a sip of water frequently, and mop her brow with a cool damp cloth often. If she’s chilly, offer her a blanket or a pair of socks.

Stay focused on the payoff you’re both about to get. It’s been a long haul, but it won’t be long before the pushing begins—and that anticipated bundle arrives in your arms.

Up until this point, your active participation in the birth of your child has been negligible. Though you’ve definitely taken the brunt of the abuse in the proceedings, your cervix and uterus (and baby) have done most of the work. But now that dilation is complete, your help is needed to push the baby the remainder of the way through the birth canal and out. Pushing and delivery generally take between half an hour and an hour, but can sometimes be accomplished in 10 (or even fewer) short minutes or in 2, 3, or even more very long hours.

The contractions of the second stage are usually more regular than the contractions of transition. They are still about 60 to 90 seconds in duration but sometimes further apart (usually about 2 to 5 minutes) and possibly less painful, though sometimes they are more intense. There now should be a well-defined rest period between them, though you may still have trouble recognizing the onset of each contraction.

Common in the second stage (though you’ll definitely feel a lot less—and you may not feel anything at all—if you’ve had an epidural):

Pain with the contractions, though possibly not as much