Relaxation, Rhythm, Ritual

Using the 3 R’s is based on simply observing birthing persons and their individual coping strategies when under stress or experiencing pain. Some cope well; others are overwhelmed in labor. There are three things to look for in a birthing person who is coping well:

1. They are able to relax during and/or between contractions. In early labor relaxation during contractions is a realistic and desirable goal. Later in labor, however, many women cope much better if they don’t try to relax during contractions. They feel better if they move or vocalize during the contractions, or even tense parts of their bodies. It is vital, however, that they relax or be calm between contractions;

2. The use of rhythm characterizes their coping style;

3. They find and use rituals, that is, the repeated use of personally meaningful rhythmic activities with every contraction.

 While laboring persons draw heavily on the coping measures learned in childbirth class, those who cope well usually do more than that; they discover their personal organic rituals spontaneously in active labor.

If disturbed in their ritual or prevented from doing the things they have found to be helpful, laboring persons may become upset and stressed.

 Laboring persons  are most likely to find their own coping style when they feel safe and supported, and are able to move and make sounds freely and are undisturbed during their concentration (other people talking or attempted procedures during contractions.)

Early Labor
0-6 centimeters
The longest phase
3-24 hours or more

• Diarrhea or loose stools

• Contractions with our without backache that are now following a pattern of longer, stronger, closer together.

• Increasing bloody show

• Your water may or may not break

Active Labor
6-7 centimeters
2-6 hours

• 5-1-1: Contractions that are 5" apart or less AND lasting a minute or more for at least 1-2 hours

• Increased bloody show

• Your water may or may not break

• Nausea/vomiting

• Shaky

• Desires company but isn't talkative

• Rhythmic coping skills, breathing, movement

• May feel rectal pressure

Transition
8-10 centimeters
The shortest phase
10”-2hrs

• Back to back contractions

• Nausea/vomiting

• Shaking

• Staccato sounds

• Extremely focused

• Unable to ask for help

• Crying, panic

• Irritability

• Copious bloody show

• Intense rectal pressure