Training of Roma Health Mediators in Reproductive Health

the mother breathe more easily, but she may need to urinate more often because of
pressure on the bladder. (In the first birth, these signs can appear up to 4 weeks before
delivery.)
‣ What are the signs of labor?
• Loss of mucus plug
• Blood with mucous comes out of the vagina.
• A gush of water comes out of the vagina (rupture of amniotic sac or “bag of
water” breaks)
• Increased pelvic pressure and painful regular contractions of the womb, every 20
minutes or less.
Pregnant women should be advised to go to the hospital as soon as possible if any of
these signs of labor appear.
Explain the term ‘labor’ and describe the three stages of normal labor:.
• Labor is the process by which a woman delivers her baby into the world.
• The first stage of labor starts with regular contractions of the womb, which become
stronger and stronger and the intervals between contractions become less. The baby is
pushed downwards with each contraction and thus pressure is applied regularly on the
cervix (mouth of the uterus or womb) so that it opens up and finally the baby moves
down into the vagina (birth canal) and the mother feels she has to push. Usually labor
lasts 10 to 20 hours or more when it is the mother's first birth, and from 7 to 10 hours
in a woman who has already had the first baby. This varies a lot.
During the first stage of labor, the mother should not try to hurry the birth. It is
natural for this stage to go slowly. The mother should not try to push or bear down.
She should change positions often or get up and walk about from time to time. She
should not lie flat on her back for a long time.
If the mother is frightened or in great pain, she needs to take deep, slow, regular
breaths during each contraction, and breathe normally between them. This will help
control the pain and calm her. Reassure the mother that the strong pains are normal
and that they help to push her baby out.
• The second stage, in which the child is born, lasts from the dropping of the baby into
the vagina (birth canal) until the baby passes through the vagina and goes out from
the mother’s body. Sometimes this begins when the bag of water breaks. It is often
easier than the first stage and usually does not take longer than 1 hour. During the
contractions the mother bears down (pushes) with all her strength. Between
contractions, she may seem very tired and half-asleep.
• The third stage begins when the baby has been born and lasts until the placenta
(afterbirth) comes out. Usually, the placenta is detached from the wall of the uterus
and comes out by itself 5 minutes to an hour after the baby. The uterus contracts
further to minimize blood-flow and becomes tight.
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RFHI/JSI Romania Training of RHMs in Reproductive Health Session 6: Pregnancy