Here is a list I've compiled on what you can find out by simply observing. (I think a lot of this came from the gentlebirth archives as well the sections below specifically from Gloria Lemay)
External and Observed Signs of Dilation, Descent and Progress
From gentlebirth.com archives:
* Location of FHT with pinard or fetoscope; good for gauging descent. FHT early decel pattern will indicate resistance onto pelvic floor and therefore descent
* 6cm = cx pattern shifts, flushing over cheekbones
* 8cm = hot/cold/trembly/irritable/nauseous. Cx seem to not give her a break
* Near full = increased pressure, vomits, breathing more ragged, "catch" in breath, deeper, guttural moaning. FHT's midline and low. Sacrum seems flat and full. Her energy will be acutely aware during cx but she will retreat just as intensely between them. More show, spotting of fresh blood. Feels like pooing, ROM.
* Purple line that creeps up like a mercury thermometer from anus to top of bum crease. When it reaches the top, the woman is fully (increase in intrapelvic pressure affects veins in the sacrum).
* Vomiting and ROM at the same time = 7 cm stretch
* Look at bottom of foot with the toes pointing up. The spot above the heel and in the center will tighten and release as the uterus contracts IF she is at least 5 cm.
* Full = passing stool involuntarily, pouting of anus, instinctive bearing down begins at the beginning of the contraction and not at the height of it
* The contracting uterus swells upwards as it pulls in the dilating cervix. Before a woman begins to dilate and is about at term, you can get about 5 fingerbreadths of measurement between the fundus and the tip of the breastbone (xyphoid). As she dilates, this measurement decreases at about 2 cms per fingerbreadth. I.e., 1 1/2 fingerbreadths between these two points would be equal to 7-8 cms. dilation. It's an old trick I learned several years ago. This really works but, like vag exams, it takes practice. Unlike vag exams, it's not out of the scope of practice as a doula to do this type of exam because it's not done internally and not "really" considered a clinical test.
* Watch her rectum. The rectum will tell you a good deal about where the baby's forehead is located and how the dilation is going. If there is no rectal flaring or distention with the grunting, there is still more dilating to do. A dark red line extends straight up from the rectum between the bum cheeks when full dilation happens. To observe all this, of course, the mother must be in hands and knees or sidelying position.
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