2nd Stage Labor

Resting Phase

Doula's Role

• Reminds her what the resting phase is
• Encourages her to rest & relax
• Prepares her for pushing
• Encourages her partner to remind the nurse of her preferences for 2nd stage
• Suggest position change if it goes on too long

Descending

Rotating

Molding

What's the doula's role?

doula's role

• Encourages the mother through each contraction
• Makes her comfortable between them
• She encourages mother to relax her pelvic floor, loose jaw = loose bottom
• Gets her cool wash clothes and ice chips
• She suggests position changes as needed

Squat Bar

On Knees

Side Lying

Directed Pushing

tug-of-war

What could you suggest?

crowning

• Baby’s head remains visible at perineum
• Stretches vagina & perineum to their max AKA "Ring of Fire"
• Tissues may tear☹
• May want to educate on perineal massage at prenatal visits

head is crowning

mom catching her own baby

Baby born in the caul

in the caul

now what do I do?

Doulas Role during crowning

• Encourages her to listen to HCP when NOT to push & may pant with her
• Helps mother get baby skin to skin
• Within minutes of birth the mother’s CA levels start to decline & allow oxytocin levels to be unopposed
• Steps back & lets family rejoice together
• She may take pictures or videos

3rd stage of labor

what's happening?

• Her uterus cramps
• Placenta separates from wall of uterus & is expelled
• The umbilical cord is clamped & cut (baby’s first intervention)
• What emotions might mother be feeling?

How can doula support her?

• Supports mother while nurse massages uterus
• Reminds parents to talk or sing to baby
• Stays w/mother if partner has to go w/baby
• Assists mother with breastfeeding
• Takes photos and/or videos
• Points out baby’s abilities feeding cues alert to parents voices calm when close to parents

Fun Facts about the placenta

• The genetic “map” for the placenta is actually written on the fathers DNA!
• The genetic makeup of the placenta is identical to the baby! Unless there is an identical twin, this is the only other thing that will ever have the same exact DNA!
• Though mom and babies blood doesn’t mix, fetal DNA still ends up in the mom’s blood stream!

cord clamping

• In the womb the placenta fulfills the functions of lungs, kidney, gut, skin & liver for baby
• Blood flow to these organs is minimal until baby takes it’s first breath
• The reservoir of blood in the cord & placenta provides additional blood necessary for these systems
• Early clamping deprives baby of 54-160mL of blood, which is almost half of baby’s total blood volume at birthDelayed cord clamping reduces the risk of anemia by 15% at 2 - 3 months
• Delayed cord clamping reduces the risk of anemia by 15% at 2 - 3 months

Let's try some positions!