Timing Contractions Is Not Always As Simple As It Sounds
What the coach should know
One of the important jobs of the birth partner is to time contractions. Since changes in the length, strength, and frequency of contractions are the all-important hallmarks of true, progressing labor, it is a good idea for you to (1) know how to time correctly and (2) keep a written record. Then, when you call the mother's caregiver, you will have accurate and concrete information to provide.
Time contractions in this way:
1. Use a watch or clock with a second hand.
2. Use a written form similar to the sample "Early Labor Record."
3. You do not need to time every contraction. Instead, time and record four or five contractions in a row and then stop for a while (a few minutes to a few hours). Time and record another four or five contractions later when the mother thinks they have changed or if she has had some of the other signs of labor.
4. Always note the time each contraction begins (Specify A.M. or P.M.). Record this time in the column headed "Time Contraction Starts."
5. Time the length of each contraction (in seconds), and record this time in the column headed "Duration." Knowing when a contraction begins and ends is tricky. There are two ways: (a) the mother signals when she feels the contraction begin and end, or (b) you place your fingertips high on her uterus and begin timing when you feel the uterus become harder and rise slightly (it feels like your biceps muscle when you contract it); time the contraction until you cannot feel the hardness anymore.
Sometimes the birth partner cannot feel the contractions well or can only barely feel them. The mother can usually feel them for longer, from the "inside," than can the birth partner or even a nurse, who from the "outside" probably feels only the peak. Compare the mother's assessments with yours; tell her caregiver if they differ significantly (for example, you might say "She feels them lasting for ninety seconds, but I can feel them for only thirty."). When there is a large discrepancy, the other information on the "Early Labor Record" and the caregiver's knowledge of the mother's condition become more important in determining how labor is progressing.
6. Figure out how frequently the contractions are coming by subtracting the time at the start of one contraction from the time at the start of the next. Record the number of minutes between contractions in the "Frequency" column. (For example, if one contraction begins at 7:32 and the next one begins at 7:45, they are thirteen minutes apart.) Do the same for each subsequent contraction.
7. In the "Comments" column, record any other significant events; how strong the contractions seem now compared with earlier; the mother's appetite and what she has eaten; if she is using patterned breathing; if she has back pain or blood-tinged discharge if fluid is leaking or gushing; how she is coping.
8. When you call her caregiver, be prepared to report the items on the "Early Labor Record." Have it near the phone.