Table of Contents
Preface 8
Acknowledgments 13
How to Use this Book 16
A Note To Doulas 18
Part 1 Before the Birth 19
1 The Last Weeks of Pregnancy 20
What Kind of Birth Partner Will You Be 21
Getting Ready for Labor 23
Preparing for Life with the Baby 51
On to the Next Step … 59
Part 2 Labor and Birth 60
2 Getting into Labor 62
The Difference Between Prelabor and Labor 63
How Long Will Labor Last? 66
Signs of Labor 67
If the Bag of Waters Breaks Before Labor Begins 71
"False" Labor, or Prelabor 72
Labor Progresses in Six Ways 74
Timing Contractions 77
3 Moving Through the Stages of Labor 81
Compare Labor to Running a Marathon 82
Prelabor 85
The Dilation, First, Stage 90
Early Labor 92
Getting into Active Labor (3 to 5 Centimeters Dilation) 99
Active Labor 102
Transition 109
The Birthing, Second, Stage 116
The Resting Phase 117
The Descent Phase 121
The Crowning and Birth Phase 127
The Placental, Third, Stage 131
The Recovery and Bonding, Fourth, Stage 135
Normal Labor-in a Nutshell 138
4 Comfort Measures for Labor 143
Pain versus Suffering 144
The Three Rs: Relaxation, Rhythm, and Ritual 147
Self-Help Comfort Measures 153
Comfort Aids and Devices 176
Comforting Techniques 187
Taking Care of Yourself 197
Checklist of Comfort Measures for Labor 198
5 Strategies for Challenging Variations in Normal Labor 201
The Take-Charge Routine 202
On-the-Spot Coaching (When You Have Had No Childbirth Classes) 206
The Very Rapid Labor 207
The Emergency Delivery 209
When Labor Must Start (Labor-Stimulating Measures) 212
The Slow-to-Start Labor 216
Slow Progress in Active Labor and the Birthing Stage-with or without Back Pain 221
When the Birthing Person Must Labor in Bed 224
A Breech Baby 226
A Previous Disappointing or Traumatic Birth Experience 231
Incompatibility with the Nurse or Caregiver 233
Part 3 The Medical Side of Childbirth 236
Key Questions for Informed Decision-Making 237
6 Tests, Technologies, Interventions, and Procedures 239
Late-Pregnancy Tests 240
Essential Observations During Labor 243
Conditions Influencing the Use of intervention Daring Labor 245
Common Obstetric Interventions 246
7 Complications in Late Pregnancy, Labor, or Afterward 270
Complications for the Pregnant Person 272
Complications with Labor Progress 285
Complications with the Fetus 290
Complications in the Placental Stage 295
Complications with the Newborn 297
After It Is All Over 303
8 Medications for Pain During Labor 304
Management of Normal Labor without Pain Medications 305
What You Both Need to Know About Pain Medications 307
Know How the Birthing Person Feels About Using Pain Medications 326
9 Cesarean Birth and Vaginal Birth After Cesarean 340
Know the Nonmedical Reasons for Cesarean Birth and Factors to Consider 341
Know the Medical Reasons for Cesarean Birth 343
Know What to Expect During Cesarean Birth 346
Your Role During and After a Cesarean Birth 353
Vaginal Birth After Cesarean (VBAC) and Trial of Labor after Cesarean (TOLAC) 356
Part 4 After the Birth 363
10 The First Days Postpartum 364
The First Few Hours 364
The First Few Days for the Baby 376
The First Few Days for the Birthing Parent 382
Homecoming 387
After a Home Birth 388
Getting Help and Advice 389
Postpartum Emotions 390
What About Your Feelings 392
Practical Matters at Home 394
11 Getting Started with Feeding Your Baby 400
Reasons for Breast-Feeding/Chest-Feeding 401
Getting Off to a Good Start 403
How to Offer Support Related to Infant Feeding Early Concerns 405
When to Give the Baby a Bottle 414
Once Breast-Feeding/Chest-Feeding Is Established 416
Parting Words 417
Recommended Resources 418
Index 428