Signs for the midwife to check in stage 1
Baby lies sideways
A baby that lies sideways in her mother’s womb cannot be
born in this position.
The baby may turn easily (see page 369). But only try
to turn a baby if the mother has had babies before,
her contractions are more than 15 to 20 minutes apart,
her bag of waters has not broken, and you are skilled at
turning babies. If it is not safe to turn this baby, or if the
baby cannot be turned, get medical help immediately!
The baby must be born by a cesarean surgery.
A baby who lies sideways
will not fit through the
Safe ways to encourage labor
If labor is taking too long, or needs to be started, there are some safe ways to
encourage it. These methods will not hurt the mother or baby, and they may help
Try encouraging labor when:
• the bag of waters has broken, the head is engaged, and labor has not started or
the birth is not near.
• the mother has been in active labor for several hours, but the birth is not near.
• the mother has been in light labor for many hours. The labor is active enough
to keep her from resting but it is not strong enough to open the cervix.
Do not try to encourage labor if there are warning signs that mean you
should take the mother to a medical center. Especially do not encourage labor if
the baby is sideways in the womb, if there is unusual bleeding, or if the baby’s
heartbeat is less than 100 beats in a minute. Encouraging labor at these times can
endanger the baby and waste time. If there are warning signs — get medical help!
Try any of these methods to encourage labor, but if they do not seem to work
after an hour or 2, think about bringing the woman to a medical center. Waiting
too long for a birth can be dangerous. If you see no signs of progress after 8 to 12
hours of active labor, or if progress stops for several hours, take the mother to a
medical center quickly. This is especially important if the medical center is more
than 1 hour away.
(There are more ways to start or strengthen labor starting on page 341. Those
methods have more risk, so should only be used if there are no other options.)
WARNING! Never use medicines to start labor at home (such
as oxytocin or misoprostol) . These medicines can cause
contractions strong enough to kill the baby or the mother.
A Book for Midwives (2010)