PHYSIOLOGY OF LABOR

Submitted by: RABOY, ELIZER MARIO P. 2E

1. In a tabular form, give a summary of the phases of labor. 

FOUR PHASES OF PARTURITION

PHASE 1 PHASE 2 PHASE 3 PHASE 4
UTERINE QUIESCENCE AND PREPARATION FOR LABOR LABOR THE PUERPERIUM
CERVICAL SOFTENING
 Prelude to parturition  Uterine preparedness  Processes of labor  Recovery
for labor
 contractile  Cervical ripening  Uterine contraction,  Uterine involution,
unresponsiveness, cervical dilation, fetal cervical repair, breast
cervical softening and placental expulsion feeding
o Uterine smooth muscle o Uterine awakening or o Active labor: Uterine o Immediately after
tranquility with activation contractions bring delivery & for 2 hours
maintenance of o Progression of change about progressive or so thereafter,
cervical structural in uterus during last 6- cervical dilatation & myometrium in state of
integrity 8 weeks of pregnancy delivery rigid & persistent
o Unresponsive to o Cervical change contraction &
natural stimuli, o Myometrial change retraction
contractile paralysis  Effect compression
o Myometrium: of large Uterine
quiescent state vessels
o Cervix: firm unyielding  Severe post-
o Successful anatomical partum
structural integrity: hemorrhage
essential for successful prevented
parturition o Involution of Uterus &
reinstitution of
ovulation
o Complete Uterine
involution: 4~6 wks.
o Infertility persist as
long as breast feeding
is continued (lactation,
anovulation &
amenorrhea)

2. Which phase of labor is the active labor and delivery included.

 PHASE 3

3. What are the different stages of labor

THREE STAGES OF LABOR

ST ND
1 STAGE OF LABOR 2 STAGE OF LABOR 3RD STAGE OF LABOR 4TH STAGE OF LABOR
 Begins when uterine  Begins when complete  Begins after delivery of  From birth of the
contraction of dilatation of Cervix fetus placenta to the first 4
sufficient frequency,  Ends with delivery of  Ends with delivery of hours postpartum
intensity & duration fetus placenta and fetal
 Ends when Cervix is  Stage of expulsion of membranes
 fully dilated (10cm) fetus  Stage of separation &
 Stage of cervical expulsion of placenta
effacement &
dilatation

4. Enumerate and explain also the cardinal movements of labor

CARDINAL MOVEMENTS IN LABOR
 1. Engagement
 When the greatest transverse diameter of the head in the vertex passes thru the pelvic inlet (usually station
0).
 Head usually enter the pelvis with the sagittal suture aligned in the transverse diameter.
 2. Descent
 Downward movement of the fetal head until it is within the pelvic inlet. Occurs intermittently with
contractions and is brought about the pressure of the amniotic fluid, pressure of fundus on head/butt,
contractions of abdominal muscles (2nd stage), extension of fetal body
o Occurs throughout labor, ending with birth
o Mom feels discomfort
 3. Flexion
 Occurs as the vertex meets resistance from the cervix, walls of the pelvis or pelvic floor.
 The chin is brought into contact with the fetal thorax and the presenting diameter is changed
 4. Internal rotation
 The head rotates about 45 degrees anteriorly to the mid-line under the symphysis.
 5. Extension
 Resistance from the pelvic floor causes the fetal head to extend so that the nuchal can pass under the pubic
arch.
 The head emerges thru extension under the symphysis pubis along with shoulders.
 The anterior fontanel, brow, nose and chin are born successively.
 6. External rotation (restitution)
 After head is born and is free of resistance it untwists, causing the occiput to move 45 degrees back to its
original left/right position.
 External rotation of the head allows the shoulders to rotate internally to fit the pelvis
 7. Expulsion
 Of the rest of the body occurs more smoothly after the head and shoulders