them (the preferred method of
sterilization), sterilize them by submersion in 70 percent isopropyl
alcohol solution for at least 20 minutes or up to 3 hours, if possible.
Sterile tapes for tying the umbilical cord will be needed. (Do not
remove them from their sterile wrappings until you are ready to use
them.) If no tapes are available, a clean shoestring or a strip of
sheeting (folded into a narrow tie) can be boiled and used wet as a
cord tie substitute.

STAGES OF LABOR

Labor is the term used to describe the process of childbirth. It
consists of the contractions of the wall of the womb (uterus) which
force the baby and, later, the afterbirth (placenta) into the outside
world. Labor is divided into three stages. Its duration varies greatly
in different persons and under different circumstances.

During the first and longest stage, the small opening at the lower end
of the womb gradually stretches until it is large enough to let the
baby pass through. The contractions (tightening) of the uterus, which
bring about this stretching and move the baby along into the birth
canal, cause pains known as labor pains.

These pains, usually beginning as an aching sensation in the small of
the back, turn in a short time into regularly recurring cramplike pains
in the lower abdomen. By placing your hand on the mother's abdomen just
above the navel, you can feel each tightening of the uterus as an
increasing firmness or hardness. It lasts for 30 to 60 seconds. The
pains disappear each time the uterus relaxes.

At first these pains occur from 10 to 20 minutes apart and are not very
severe. They may even stop completely for a while and then start up
again. The mother should rest when she is tired but need not be lying
down continuously. She may sleep between tightenings if she can. She
can take a little water or perhaps tea during the entire labor process.
She should urinate frequently during labor so the bladder will be as
empty as possible at the time of birth.

The skin in the vaginal area of the mother should be sponged
occasionally with soapy water. Special attention should be given to
cleaning the inner sides of the thighs and the rectal area with heavy
lather. Soap or water should not be allowed to enter the vagina.

A slight, watery, bloodstained discharge from the vagina normally
accompanies labor pains or occurs before the pains begin.

For first babies, this stage of labor may continue for as long as 18
hours