Signs for the midwife to check in stage 1
Because a torn womb is inside the mother, you cannot see it. But these signs tell
you that the womb may be torn:
Wa r nin g s ig n s
• The mother has very bad pain between contractions, then a tearing feeling
in her belly, then less pain.
• The mother’s contractions stop.
• The mother may bleed from the vagina (although sometimes no blood
• The mother has signs of shock (see page 239).
• The baby feels loose (and sometimes higher) in the belly and
has no heartbeat.
Pain in the womb can also be caused by infection. An infected womb happens when
harmful germs get inside the womb and make the mother sick. The signs of an
infected womb are similar to the signs of other infections
(see page 179). During labor, an infection of the
womb can cause pain in or above the womb
between contractions. An infected womb
can also cause shock. See page 179 for
what to do for an infection of the womb.
Watch for signs of progress
Labors are all different. Some are fast, some are slow. This is normal. But in a
healthy labor, there should be progress. Progress means that labor should be
getting stronger and the cervix should be opening.
As labor gets stronger, you should see more and more of these signs:
• Contractions get longer, stronger,
and closer together
• The womb feels harder when you
touch it during a contraction.
I’m having a
• Amount of show increases.
• Bag of waters breaks.
• The mother burps, sweats, and
vomits, or her legs shake.
• The mother wants to push. This
may mean that stage 2 is near or starting. Do not encourage the mother to
start pushing until you are certain stage 2 is beginning (see page 195).
Usually, if she cannot stop herself from pushing, she is already in stage 2.
A Book for Midwives (2010)