Stages of Labor

STAGES OF LABOR
1stStage –Stage of Dilatation

LATENT PHASE–
 Duration: 6 hours (nullipara); 4.5 hours
(multipara)
 Duration of contractions: 20-40 sec
 Interval of contractions: 5-10 minutes
 Cervical dilatation: 0-3cm
 Psyche: excited, still can communicate
ACTIVE PHASE
 Duration: 3 hours (nullipara); 2 hours
(multipara)
 Duration of contractions: 40-60 sec
 Interval of contractions: 3-5 minutes
 Cervical dilatation: 4-6cm
 Psyche: frightened, anxious, irritable, but
still can comprehend
TRANSITION PHASE
 Duration:
 Duration of contractions: 60-90 sec
 Interval of contractions: 2-3 minutes
 Cervical dilatation: 8-10cm
 Psyche: loss of control
 NURSING CARE
1ST STAGE OF LABOR
 LATENT AND ACTIVE PHASE
➢ Assessments and monitoring
Physical exam Vital signs
Internal exam FHR
Uterine contractions
➢ Health Teachings
Bath Emptying the bladder
Ambulation Sim’s Position
NPO Discourage pushing
Breathing
 LATENT AND ACTIVE PHASE
–Preparation for birth
 Perineal Prep
 Perineal Shave
 Administer analgesics as ordered
 Assist in the administration of anesthesia
 Assist in the transport to Delivery Room
TRANSITION PHASE
 Comfort Measures
 Proper bearing down techniques
 NURSING CARE
2ndStage –Stage of Expulsion

 Put legs at the same time when positioning in

lithotomy
 As soon as the head crowns, instruct not to push
but to pant
 Assist in episiotomy
 Apply the Modified Ritgen’s Maneuver
 NURSING CARE
3rdStage –Placental Stage
➢ Do not hurry the expulsion of the placenta
-Note for the signs of placental separation
-Follow the Brandt-Andrews Maneuver
➢ Take note of the time of placental delivery
➢ Inspect for the completeness of cotyledons
➢ Palpate the uterus to determine the degree of
Contraction
➢ Inject oxytocin / Methergine after placental
delivery
 NURSING CARE
3rdStage –Placental Stage

 Inspect perineum for lacerations

 Perineal care
 Provide additional blankets
 Allow to sleep to regain lost energy
 NURSING CARE
4thStage –Recovery Stage

Assessments:
 Fundus
 Vital Signs
 Lochia
 Perineum
Health Interventions and Teachings
 Rooming-in concept
 Early ambulation
 Dangling of legs
Thank you!