By Amanda Phillips, CPM, MA-MCHS, ICCE, PD

This month’s Brilliant Activities for Birth Educators activity comes from childbirth educator Amanda Phillips. She introduces the fun use of emojis to talk about and reinforce information on the stages of labor. This activity is sure to be a hit with families who already pepper their communication with lots of these images! To read all the Brilliant Activities for Birth Educators posts in the series, click here. - Sharon Muza, Community Manager, Science & Sensibility

Introduction

I love to make people laugh in my class. It helps them remember what they need during labor and birth and reduces all the tension that might be in the air when talking about what to expect. Injecting humor my “stages of “Labor” section has always been more challenging. I want them to be able to retain a lot of info that will spiral on through the entirety of the class. Using fun emojis is a memorable way to help class members recall the details of the stages of labor. A good understanding of the stages of labor helps families to know what to expect, tears down preconceived notions of unrealistic characterizations and empowers birthing people by learning more about how amazing the process is.

Materials

• White board
• Dry erase markers
• Large emoji faces (these are what I use)
• I couldn’t find a set with a baby emoji so I used an open source image and printed it on heavy card stock.
• Resources that the class can access on information on stages of labor such as childbirth education books.  People can also look up information on their phones.

When to conduct this activity

It’s good to start this activity fairly close to the beginning of class, after people have had some time to settle in, get to know other class members and you have already covered anatomy. I love doing the “Late Pregnancy Cast of Characters” from a previous “Brilliant Activities for Birth Educators” post first!

How to conduct this activity

You can divide class members into groups to tackle each phase/stage and use the teach-back method for them to share with the rest of the class. Having a representative from the group walk the class through the details of their assigned stage/phase, while you act as scribe and write down this info on the board. You are able to fill in any missing information. Another alternative is to let people look up the info on their own and provide the details as you walk them through the stages. This activity takes me about 15 minutes, including time for questions. Note: if people are working in small groups, it adds another 5-10 minutes.

1st Stage of Labor

Prelabor phase:

Ask people about the characteristics of this very important part of labor. We open up our workbooks, pointing out where information can be found, and start asking people, “What stands out for you in this phase? Have you noticed any of these symptoms of prelabor happening in your own body?” Then I elicit the differences in true labor verses this warm-up phase. I give tips for managing this often bothersome time that may seem to drag on. We have an opportunity to talk about the characteristics of the cervix and what all needs to happen in order for baby to come out. We also talk about how practice contractions can be like the uterus going to the gym to work out. I don’t cover any positions at this point but do tell families the importance of rest, hydration and nutrition as they move through the prelabor phase.

Latent Phase:

I ask people about characteristics of this generally longest phase of labor. We don’t dwell on how long it lasts, but rather talk about what they will be noticing. Again, I mention the importance of rest, hydration, nutrition, and moving through the day as if nothing is happening. If it is nighttime, we discuss the benefits of going back to sleep. Then I give them the big smiley face emoji and talk about how the birthing person will most likely be chatty, excited and a bit nervous.

Active Phase:

Again, all the characteristics of this part of labor are elicited from the class members through discussion. We talk about the general need to focus on the contractions and truly start participating in the process with positions and comfort/coping measures. I model positions that would be great for home, car and managing the time in triage while they wait to be assigned a bed. I give them a few emojis at this point that represent five, six and seven cm of dilation as birthing person’s mood changes and their ability to cope decreases. I use this time to talk about when they might  head to the hospital (3-1-1 around here, but your community may have different standards) and what to do if their water breaks (TACO).

Transition:

As a group, we discuss the characteristics of this hopefully shortest phase of labor. We talk about how a birthing person needs to turn inward and focus. We talk about comfort measures and possible positions that are most suitable for this phase. I share that the birthing person’s mood may be pretty disagreeable and the support people need not take anything personal. We talk about tears (from birther and partner) and how this really shows us that things are progressing. Then I show them the crying emoji.  

2nd Stage - Pushing

Together we brainstorm some characteristics of the pushing stage. I suggest positions and comfort measures for pushing.  We also talk about pushing with the urge to push and avoiding , purple pushing unless there is a need to get baby out very fast. We talk about good partner support during the pushing phase. Then I show the poop emoji and discuss that pushing is engaging the same muscles as having a bowel movement. I also let them know that their nurse will magically make any stool disappear before anyone notices.

Immediate skin-to-skin:

Baby is out!  I put up the baby emoji (I did not have this at the time I took the pictures) and we talk about what those first minutes look like after birth, with baby skin to skin, cord clamping and cutting, and the emotions of the birthing person, their support and the baby.

3rd Stage - Placenta

We talk about the delivery of the placenta, when that usually happens, how the health care provider will examine it to be sure it is all out, and how there may be some uncomfortable fundal massage. I don’t go into too much detail on this phase since most of the focus is on baby at this point. I use a heart eyes emoji for this stage.

I sprinkle in lots of stories about laboring people in funny situations during this activity. Support people often come up and take a picture afterwards to help them during labor as a quick reference. I model positions through the activity but this is just an introduction for the class into positions. I provide another time later in class to practice the positions that they have already seen and add a few more. It is possible to add in practice, however, you should allow more time as this activity will then run longer.

What families say about this activity

I always ask families what the biggest takeaways are from this activity. I hear many people state that they had no idea about the stages of labor or the range of emotions that they will transition through. Media has taught today’s birthing people that labor looks like transition from beginning to end! That this is not true is a big eye-opener for most of the families that I teach.

How you could modify this

The basic idea behind this activity is the emoji signs. These simple tools could be incorporated into many pre-existing methods of teaching stages of labor. Instructors could break families into groups and have them choose the appropriate emoji for their assigned stage after they investigate the stage. The emojis can also be used to talk about comfort measures and the postpartum period.

Conclusion

I find that it is pretty important to engage folks of all ages, backgrounds and learning styles. Stages of labor is a very crucial part of the learning that I want both birthing people and their support to take home. This activity draws on many teaching styles: teach backs, lecture, images, brainstorming, and storytelling. It works well for millennials who love the application of a familiar text icon that we work into labor talks. It is also fun for me as the instructor and allows for flexibility to add in info as you see fit! Have fun, always!

About Amanda Phillips

Amanda Phillips has been a birth nerd since 2007 when she trained as a midwife. In the beginning, she lived in India where she developed culturally appropriate teaching materials and trained village health workers in safe birth practices. These days Amanda lives a much less exotic life. She wears many hats including Midwife, Executive Director of ECTA International, Director of Distance Academics for Mercy In Action, Childbirth Educator at EvergreenHealth and Postpartum Doula. For her most recent feat, she graduated from Bastyr University with a Master’s in Maternal Child Health Systems. Amanda is a mother of four little people, wife of one and lives in the Seattle area.

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