Signs of Placental Separation

 Calkin’s sign – 1st sign of placental separation. Uterus becomes firm and globular rising to the
level of the umbilicus.
 Sudden gush of blood from the vagina
 Lengthening of the cord as the placenta separates form the uterus
 Appearance of the placenta at the vaginal opening

Different Stages of Labor

1st stage of labor: Cervical dilatation and effacement

- Period from the onset of true labor contractions until full cervical dilatation and effacement is
achieved
- Effacement – shortening of the cervical canal; express in percentage
- Dilatation – enlargement or widening of the cervical canal; expressed in cm

2nd stage: Expulsive stage/ delivery of the baby

- Occurs from full cervical dilatation until the birth of the baby
- Birth of the baby

3rd stage: Placental stage/ expulsion of the placenta

- Delivery of the baby to the expulsion of the placenta

- Delivery of the placenta

4th stage: immediate postpartum period/ transition phase

- Period from the delivery of the placenta until the condition of the woman has stabilized

Types of Episiotomy

Schultze’s Mechanism – separation of the placenta starts from the center. Shiny smooth fetal side is
delivered first. 80%

Duncan Mechanism – separation begins from the edges of placenta. Maternal side is delivered first. 20%