After an endocrine signal from the baby, the maternal labor process is triggered.

This is what the wikipedia has to say: The stages of normal human birth Latent phase The latent phase of labor causes confusion with many. Latent phase may last many days and the contractions are an intensification of the Braxton-Hicks contractions that start around 26 weeks gestation. Cervical effacement occurs during the closing weeks of pregnancy and is usually complete or near complete, by the end of latent phase. Cervical effacement is the incorporation of the cervix to form the lower segment of the cervix. The muscular portion of the uterus is the upper segment, and is made of non-striated muscle. The lower segment of the uterus has no muscles and is comprised of the cervix itself, which becomes massively stretched and thinned out. This cervical effacement will usually be accomplished fully prior to the onset of labor. The degree of cervical effacement may be felt during a vaginal examination. A 'long' cervix implies that not much has been taken into the lower segment, and vice versa for a 'short' cervix. Latent phase ends with the onset of active first stage; when the cervix is about three cm. dilated. First stage: contractions The first stage of labor is an active stage and should not be confused with the latent phase of labor. The first stage of labour starts classically when the effaced cervix is 3 cm dilated. There is variation in this point as some patients may present a little before this point with active contraction, or later, without regular contractions. The onset of actual labor is defined when the cervix begins to progressively dilate. Rupture of the membranes, or a blood stained 'show' may or may not occur at around this stage. Uterine muscles form opposing spirals from the top of the upper segment of the uterus to its junction with

If these have been accomplished. Except for cervical dilatation and fetal decent. This is the narrowest part of the pelvis.the lower segment. This is assisted by the additional maternal efforts of "bearing… I. Maternal blood loss is limited by the compression of the spiral arteries of the uterus as they pass though the lattice-like uterine muscles of the upper segment. the widest diameter of the head has successfully passed through the pelvic brim. At this point the woman may feel a burning or stinging sensation." The fetal head is seen to 'crown' as the labia part. The second stage of labor will vary to some extent. Delivery of the fetal head signals the successful completion of the fourth mechanism of labor (delivery by extension). Normal labor Emanuel Friedman in his elegant treatise on labor (1978) stated correctly that "the clinical features of uterine contractions namely frequency. these muscles contract causing shortening of the upper segment and drawing upwards of the lower segment. and ends when the baby is finally delivered. Third stage: placenta In this stage. Physiology of Normal Labor and Delivery A. Source(s): http://en. depending on how successfully the preceding tasks have been accomplished. and is followed by the fifth and sixth mechanisms (restitution and external rotation). During a contraction. in a gradual expulsive motion. Full dilatation is reached when the cervix is the size of the baby's head. and duration cannot be relied upon as measures of progression in labor nor as indices of normality. the head is fully engaged in the pelvis. all that will remain is for the fetal head to pass below the pubic arch and out though the introitus. at around 10cm dilation for a term baby. but active phase averages some 8 hours for women giving birth to their first child ("primiparae") and 4 hours for women who have already given birth ("multiparae").wikipedia. Normal blood loss is less than 600 mL. During effacement. Ideally it has successfully also passed below the interspinous diameter. intensity. Second stage: delivery This stage begins when the cervix is fully dilated. At the beginning of the normal second stage. the uterus expels the placenta (afterbirth). This draws the cervix up over the baby's head. the cervix becomes incorporated into the lower segment. The placenta is usually delivered within 15 minutes of the baby being born. The duration of labour varies widely. none of the clinical features of the parturient patient appears to be useful in assessing labor .

" Friedman sought to select criteria that would limit normal labor and thus be able to identify significant abnormalities of labor. arrest of descent. protracted descent Interval Measurement Diagnosable disorders . failure of descent Contractions Cervix actively coordinated. secondary arrest of dilatation. B. is used extensively to evaluate laboring patients. appear to be logical and clinically useful. or a modification of it. polarized. It.progression. These limits. fetal descent. Labor has been divided functionally into a preparatory division (including latent and acceleration phases of the dilatation curve). Figure 2. The graphic representation of labor plotting descent and dilatation against time has become known as the Friedman curve. Functional classification of labor Principal Clinical Features on the Functional Divisions of Labor Characteristic Functions Preparatory Division Dilatational Division Pelvic Division Pelvis negotiated. Graphic portrayal of the relationship between cervical dilatation and elapsed time in labor (heavy line) and between fetal station and time (light line). a dilatational division comprising only the linear phase of maximum slope of dilatation. admittedly arbitrary. dilated oriented. and a pelvic division encompassing the linear phase of maximum descent. mechanisms of labor. delivery Deceleration phase and second stage Linear rate of descent Prolonged deceleration. cervix prepared Latent and acceleration phases Elapsed duration Prolonged latent phase Phase of maximum slope Linear rate of dilatation Protracted dilatation.

4. It is the consequence of four distinct abnormalities that may exist singly or in combination.2 cm/hr or less Nulliparas 1 cm/hr or less Multiparas 2 cm/hr or less Nulliparas 3 hr or more Multiparas 1 hr or more Secondary arrest of dilatation Arrest 2 hr or more . Forces generated by voluntary muscles during the second stage of labor that are inadequate to overcome the normal resistance of the bony birth canal and maternal soft parts. Abnormalities of the birth canal that form an obstacle to the descent of the fetus. 3.C. Labor Disorders Pattern Prolonged latent phase Protracted active phase dilatation Protracted descent Prolonged deceleration phase Diagnostic Criterion Nulliparas 20 hr or more Multiparas 14 hr or more Nulliparas 1. 2. Abnormal labor Dystocia (literally difficult labor) is characterized by abnormally slow progress in labor. Uterine forces that are not sufficiently strong or appropriately coordinated to efface and dilate the cervix. Faulty presentation or abnormal development of the fetus of such character that the fetus cannot be extruded through the birth canal. 1.

Secondary arrest of dilatation pattern with documented cessation of progression in the active phase Prolonged deceleration phase pattern with deceleration phase duration greater than normal limits Failure of descent in the deceleration phase and second stage B. Prolonged latent phase of labor (see Figure) Prolonged Latent Phase Pattern (solid line) Etiologic factors that appear to be responsible for the development of prolonged latent phase disorders in multiparas most often include excessive sedation administered during the course of the latent phase and poor prelabor soft-tissue preparation. Arrest disorder (see Figure 3) A. (see Figure) 2.Arrest of descent Failure of descent Arrest 1 hr or more No descent in deceleration phase of second stage 1. In addition. C. . false labor and myometrial dysfunction are found but can be diagnosed only retrospectively.

Etiology of arrest disorders are as follows. being readily differentiated from the normal dilatation and descent curves (broken lines). as necessary. whenever encountered. Showing line of axis traction perpendicular to the plane of the pelvis at which the head is stationed. Other factors very often occur in combination with each other and with disproportion as well.D. the operators fingers are insinuated between the symphysis pubis and the fetal head until the posterior surface is reached. These four abnormalities are similar in etiology. The head is carefully lifted anteriorly and. superiorly to bring it from beneath the symphysis . and prognosis. arrest patterns should signal the likelihood that a bony impediment exists. (see Figure 4) V. Arrest of descent characterized by halted advancement of fetal station in the second stage. Cesarean delivery (See Figure) Immediately after incising the uterus and fetal membranes. response to treatment. The striking association with cephalopelvic disproportion makes these disorders especially ominous. Forceps delivery Forceps Figure 5. VI.

Take Home Points The progress of labor is measured by evaluating dilatation of the cervix and descent of the presenting part as a function of time. http://library.forward through the uterine and abdominal incisions.utah. When an abnormality is . the cause is identified and the appropriate treatment