The 4 stages of Labor By: Pamela McDonald

The First Stage – Dilation and Effacement The first stage has 3 distinct phases: Latent Phase ACTIVE PHASE TRANSITION PHASE

Latent Phase During early labor (latent phase) the woman will dilate about 1- 4 centimeters. The contractions may last up to a minute and may come 15 to 30 minutes apart. The duration may last 4 to 6 hours, and amniotic membranes may be intact The contractions may be mild, comparable to strong menstrual cramps, and backache and mild diarrhea may be noticeable also. This phase of labor is the most unpredictable. Sometimes it can even stop and start over days before "real labor" begins. It may be better to be home during this part of labor, unless your pregnancy is unusually complicated and constant monitoring of you and the baby is needed. Some moms-to-be find it hard to relax during latent phase, other women may not even realize they have begun labor until active labor begins.

Mother’s Behavior during Latent Phase In phase 1 the mother is very talkative and excited to be in labor. The mother and father should be an active part of the care in this phase. Comfort is of the utmost importance, mother should seek assistance with changes in position and walking. Mother should also drink lots of fluids or ice chips. She is very cooperative for the most part

Active Phase In active labor the cervix will open up to near complete dilation about 4 -7 cm Effacement of cervix occurs Contractions will lengthen, lasting from 45 to 60 seconds and should come at two to three minute intervals. Contractions will also become stronger and more intense, and membranes may rupture if they have not already done so. Their will be a need to take action to manage pain control and discomfort with a epidural analgesia at this time. The mother will not be able to hide contractions, she will be anxious, less social, and her focus will be on breathing

Cervical Effacement and Dilation During the first stage of labor, the cervix opens (dilates) and thins out (effaces) to allow the baby to move into the birth canal. In figures A and B, the cervix is tightly closed. In figure C, the cervix is 60 percent effaced and 1 to 2 cm dilated. In figure D, the cervix is 90 percent effaced and 4 to 5 cm dilated. The cervix must be 100 percent effaced and 10 centimeters dilated before a vaginal delivery

Transition Phase The cervix opens from 7 to 10 centimeters. This picture shows the end of the transition phase of stage 1, and the beginning of stage 2 (birth of the baby) The cervix opens from 7 to 10 centimeters. For most women, this is the hardest or most painful part of labor. This is when your cervix opens to its fullest. Contractions last about 60 to 90 seconds and come every 2 to 3 minutes

Transition Phase cont’d During this phase there is very little time to rest and the mother may feel overwhelmed by the strength of the contractions. She may feel tired, frustrated, or irritated, and may not want to be touched. She may feel sweaty, sick to her stomach, shaky, hot, or cold. Although she may find slow, easy breathing to be most effective throughout labor, she may also find an uneven breathing pattern most helpful at this time.

Second Stage Expulsion of Fetus 30 Minutes to 2 Hours During stage 2 dilation of the cervix is complete. This stage is also know as the pushing phase. Contractions occur every 2 – 3 minutes with duration of 60 – 75 seconds and the intensity continues to be strong. The mother will feel and urge to bear down and the medical staff will assist the mother in her efforts to push. An increase in bloody show will occur. The vital signs of the mother are important to monitor at this point.

Second Stage cont’d The baby’s heart rate will be monitored before, during, and after a contraction. The normal heart rate of a baby is 120 – 160 beats a minute. Mother should be helped into positions of comfort and that assist in her efforts to push such as side- lying, squatting, kneeling, or lithotomy. The bulging of the mother’s perinea area or seeing the baby’s head are signs the birth is about to occur. http://www.mybirth.tv/video- play.cfm?id=193

3rd Stage of Labor Delivery of the Placenta The third stage is the delivery of the placenta and is the shortest stage. The time it takes to deliver the placenta can range from 5 to 30 minutes After the delivery of the baby, the doctor will be looking for small contractions to begin again. The contractions signal that the placenta is separating from the uterine wall and is ready to be delivered.

Delivery of Placenta Pressure may be applied by massage the uterus and the umbilical cord may be gently pulled. The result will be the delivery of the placenta also referred to as the afterbirth. Shaking and shivering may occur after the placenta is delivered. This is a common symptom and not a cause for concern http://www.medicalvideos.us/pla y.php?vid=235

4th Stage of Labor During the 4th stage of labor the uterus remains midline, contracted or below umbilicus level Cramping may occur and lochia rubra is seen on the perineal pad. Woman may also experience chills that may be a response to thermoregulation This time is them most critical stage of labor. It's critical because it is the time any post-labor complications, such as bleeding, will be detected and addressed

The baby is born, the placenta has delivered, and their will be feelings of joy, relief, and fatigue. Most babies are ready to nurse within a short period after birth, Others wait a little longer. If the mother is planning to breastfeed, it is strongly encouraged for her to try to nurse as soon as possible after the baby is born. Nursing right after birth will help your uterus to contract and will decrease the amount of bleeding.

Here is something that might help us to remember the 4 stages of labor Here is something that might help us to remember the 4 stages of labor Enjoy! http://www.youtube.com/watch?v=U1Z80-QNf84

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