Hi everyone my name is ILO and I'm a registered Midwife I practice Midwifery in a large Urban setting in Canada and I have two lovely children at home so this is all familiar to me as a parent in addition to my clinical practice I love educating families in the prenatal period during birth and postpartum today we're going to talk about active labor so let's get started what is active labor active labor is when your cervix has completely thinned out softened shortened and is now dilating somewhere between 3 and 6 cm all the way to 10 cm or fully open those contractions are very frequent very intense and L in quite long most contractions will be coming in a clock like pattern so we tell folks to think about the 411 rule or the 511 Rule and what that means is the contractions are every four or five minutes apart lasting at least a full minute from the start of one to the end of one and that entire pattern's been going on for about an hour in active labor the contractions will not change despite changes in activity so if you have a bath if you lie down if you hydrate or have something to eat they will be very intense very frequent very close together so this is a great time when you're at home if you're planning on staying at home to page your midwife if you are planning to have your baby in the hospital this would be the time to move into a hospital once you arrive we go through a series of checks and assessments so you'll be admitted to the unit we'll ask some health questions um address background your overall pregnancy history and then your Midwife or a nurse will assess your well-being by doing Vital Signs blood pressure temperature pulse we will have a listen to Baby and make sure baby is well um by listening to the baby's heart rate on your tummy and we'll also assess the strength and frequency of the contractions by putting a hand on the top of your tummy we will do a cervical exam to see how far along you are by measuring how open and dilated that cervixes if it still happens to be a bit on the early side and you're not quite in active labor we will give you some instructions about what to look for when to come back and we'll send you home to rest and wait for stronger labor to set in if you're in good strong active labor then we will admit you to the birthing Suites and that's where you'll stay until baby is born at this stage the contractions are very frequent very intense strong and long and where people might feel a little chatty excited talkative in early labor generally in active labor they're quite focused and working through one contraction at a time if you're finding it hard to be present and to cope with those contractions thinking of them just one at a time can be helpful they generally have an increase in intensity like a wave that builds up gets really really strong at the top and then eases off and relaxes afterwards this is a time to practice that deep breathing to calm the nervous system to relax the body and some people really like companionship at the this stage they love to have their support people with them other folks want the exact opposite and that's okay too whatever works for you moment to moment you may feel intensity down the legs in the belly in the lower back and notice an increase in the bloody show at this stage changing positions having a warm bath shower or even handson pressure can help manage the discomfort of active labor in the active stage of Labor it's really important to manage your rest and to stay hydrated snack on light foods and keep your bladder empty in this stage we're going to be monitoring baby about every 15 minutes with a small handheld device called a Doppler it's very similar to the one that you would see in your prenatal visits when we listen to baby's heart rate in the clinic for most people the uh intermittent oscilation or listening every 15 minutes is absolutely fine but there are cases where we will need to listen continuously for continuous monitoring we put elastics on your tummy you'll have one to monitor the contractions and one to monitor baby's heart rate in a continuous strip that can be on a computer and sometimes on paper as well for people that have pre-term babies meconium in the water any risk factors in the pregnancy diabetes high blood pressure that sort of thing or if you have an augmentation or an induction with oxytocin or an epidural you will be on continuous monitoring this gives us a chance to listen to the baby continuously and to pick up on any times where the baby is not tolerating labor well in active labor we want to change positions as much as we can to give baby an opportunity to navigate the dimensions of the pelvis in general that means UFO that's our next acronym so so UFO stands for upright upright positions forward leaning and open so having those knees nice and wide and open that could be in a knee chest position it could be a supported squat it could be in a chair on a birthing ball yoga ball if you have an epidural that does limit positioning a little bit but we will try our best to get you into modified position positions that help increase the dimensions of the pelvis and make it easier for baby to descend and rotate through the pelvis that brings us to the end of this section I hope that you found this video useful and please be sure to check out the others in this series take care and we'll see you next time