DURATION OF 

LABOR
GROUP1

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 MEMBERS
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ADVINCULA, Sandra ALCANTARA, Perriel BALLORAN, Abegail

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BASILIO, Aina BARRIDO, Kenneth BELEN, Lei Camille

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BORJA, Gabrielle CABARLE, Roselle CALANTOG, Rigil

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CASTOR, Mike
 CASE SCENARIO
Edith is a 25 year old G1P0 39 3/7 weeks AOG who is admitted to the
labor room for labor monitoring. IE revealed cervical OS: 4 cms, cervical
effacement 80%, station +3, membranes intact. Uterine contractions
moderate every 4 minutes, FHR: 120-130 BPM with good variability. 

Edith said “I want to deliver my first child without assistance from

analgesia, I like a normal delivery. I will be upset if I will undergo
cesarean section” 
 01
COME UP WITH HELPFUL
ACTIVITIES THAT EDITH
CAN DO TO HELP ACHIEVE
HER GOAL 
Childbirth is an important milestone in a mother’s life. The mother must be calm and free of stress,
for effortless labor and normal delivery of the baby. Birthing the baby without drugs isn’t easy, but it
is usually possible. “Natural birth” is an outdated term, it refers to an unmedicated vaginal delivery
with minimal interventions. This type of childbirth isn’t for everyone, but ditching the drugs might
have some advantages for pregnant people. 
MOVE AROUND DURING LABOR
Walking is a great exercise for a woman in the later
stages of pregnant to help her have an easy delivery.
Walking helps in pushing the baby towards the cervix
and can help improve the process of childbirth.
Walking may shorten the length of the first stage of
labor and the mother will have a lower risk of having
unplanned cesarean sections. Walking is the easiest
and gentlest way to get your half an hour daily quota of
exercise done. Walking tones the right muscles and
also promotes a good positioning of the baby for
normal delivery. Regular brisk walks are something
that can do until birth, as long as there are no
pregnancy complications.
 SQUAT WITH A HOLD 

Squatting is beneficial because it tilts the uterus and pelvis forward,

placing the baby in proper alignment for delivery. Squats is the most
beneficial exercise for every woman preparing for a vaginal delivery close
to her due date. Due to its role in facilitating smoother deliveries, squats
are considered to be the best exercise for easy labor. Squatting also
encourages and strengthens the intensity of contractions, and can also
relieve pressure in the back. It is recommended to do 15 squats for
expecting mothers to have a great delivery experience.
HIP ROLLS ON A BIRTHING BALL

Pelvic movements on a birthing or stability ball can

help support the physical prep for the baby’s arrival
and the body’s readiness for birth. This exercise can be
done on any exercise ball or by kneeling with your butt
lifted up off your feet.
 PELVIC ROCKING 
Performing pelvic rocking exercises during
pregnancy can relieve back pain and improve
flexibility. Using this technique while laboring
and during delivery can distract from painful
contractions, help the baby move down the
birth canal, and relieve minor back pain.

PRACTICE BREATHING TECHNIQUES

Breathing helps the woman in labor to tolerate the

pain and also helps in relaxing her. Breathing
ensures that the body has enough oxygen and the
mother does not pass out due to the tremendous
labor pain and cramps that she is experiencing due
to her contractions.
 LEARN TO FACE CONTRACTIONS
One of the secrets to an unmedicated birth is being able to relax in
response to pain. When the mother is afraid in the throes of agonizing
contractions, her body's reaction is to stiffen, which tends to exacerbate
discomfort. Fear increases the tension. When a mother is tense, some
muscles are tightening and trying to hold the baby in, while the muscles in
the uterus are tightening to try to push the baby out. The muscles are
fighting with each other, which makes it hurt more. If the mother can stay
relaxed in the face of strong contractions, she'll have less resistance to
opening up for the baby to come out. 

PRACTICE PATIENCE WHEN FOLLOWING NATURAL BIRTH 

Some labors start with days of on-and-off contractions that wear moms out long
before "real labor" begins. Even after contractions get organized into a regular pattern,
early labor takes an average of eight hours for a first-time mother and five or more for
experienced moms. Keep yourself entertained, relaxed, hydrated, and nourished and
plan on labor being a marathon, not a sprint. 
 02
PLEASE PROVIDE IMPORTANT
NURSING CONSIDERATION
FOR EDITH DURING THIS
STAGE OF HER LABOR 
 Active Phase starts from 4 cm cervical dilatation to 7 cm cervical dilatation. During this phase,
contraction intensity is stronger, interval shortens, and duration lengthens. This is where true
discomfort is first felt by the patient so she is dependent and her focus is on herself.

NURSING CONSIDERATION FOR 1st STAGE OF LABOR

(ACTIVE PHASE)
Assist patient with pant-blow breathing. Monitor maternal vital signs and fetal heart rate every 30 minutes –1 hour,
or depending on the doctor's order. Contraction monitoring is also continued.
The priority consideration is on the status of the fetus. Because each contraction temporarily interrupts blood flow
to the placenta, there is a decrease in oxygen available
Encourage frequent urination to keep bladder empty (full bladder prevents uterus from contracting properly and
can slow down labor).
Anticipate patient needs by providing non-pharmacological management to provide comfort for the patient. Non-
pharmacological: changing positions, warm shower or bath, massages between contractions, breathing techniques, ice
or fluids for dry mouth.
Encourage women to be active participants in labor by keeping active and assuming whatever position is most
comfortable for them during this time, except flat on their back.
Discuss with the client the expected physiological changes and a possible timeline for a return to the
pre-pregnant state.
Refer the client to counseling if the body image concerns begin to have a negative impact on the pregnancy.
 03
CREATE 2 NCPs FOR EDITH 1
PRIORITY AND 1 RISK OR
WELLNESS DIAGNOSIS
 ACTUAL DIAGNOSIS 
NURSING 
ASSESSMENT PLANNING INTERVENTION RATIONALE EVALUATION
DIAGNOSIS
Subjective data:  Impaired comfort Short term: INDEPENDENT INDEPENDENT Short term:
"I want to deliver my related to tissue After 1 hour of • Assess degree of • Attitudes and After 1 hour of
first child without dilation/stretching nursing  discomfort through reactions to pain are nursing
assistance from as evidenced by intervention the verbal and nonverbal individual and based intervention the
analgesia, I like a uterine contraction patient will be able cues; note cultural on past experiences, patient already able
normal delivery. I will moderate every to: influences on pain understanding of to :
be upset if I will 4 minutes • Identify/use response physiological changes  • Identify/use
undergo cesarean techniques to techniques to
section" as verbalized control • Educate the client • Breathing technique control pain
by the patient pain/discomfort about breathing and makes the     /discomfort
• Report discomfort relaxation techniques contractions more • Report discomfo
Objective data: is minimize  appropriate to each productive and it rt is minimized 
• G1P0 • Appear phase of labor; teach increases oxygen and • Appear
• 39 3/7 weeks AOG relax/resting and  review pushing provides more relaxed/resting
• Cervical OS: 4 cms between      positions for stage II strength and energy in between
• Cervical contraction      and III. for both the mother contraction
    Effacement 80%, • Be free of and baby, especially • Be free of
• Station -3 untoward side during 2nd and 3rd untoward side
• Membranes: intact effects if analgesia stages of labor. effects if
• FHR: 120-130 BPM     /anesthetic agents analgesia/anesth
• Uterine contraction       are administer etic agents are
every 4 minutes administered
 Long term: • Encourage client to • Keeps bladder free of Long term:
After 12-19  hours of void 1-2hr. Palpate distension, which can After 12-19
nursing intervention above symphysis increase discomfort,  hours of nursing
the patient will be pubis to determine      result in possible Intervention, the
able to experience a distension,      trauma, interfere patient
complication-free especially after      with fetal descent, experienced
labor and childbirth. nerve block      and prolong labor. a complication-
• Monitor and record • Provides information/ free labor
uterine activity      legal documentation and childbirth.
with each      about continued -goal met
contraction.      progress; helps
     assessment and
     intervention, and to
     monitor the progression
     of labor of the patient.
• Support client’s  • Helps reduce feelings of
     decision about the  failure in the client/
     use or nonuse of      couple who may have
     medication in a      anticipated an
     nonjudgmental      unmedicated birth and
     manner. Continue      did not follow through
     encouragement      with the plan. Enhances
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     for efforts and use      sense of control and
     of relaxation      may prevent/decrease
     techniques      need for medication
• Asses nature and • Cervical dilation
amount of vaginal should be
show, cervical approximately 1.2
dilation, effacement, cm/hr in the
fetal station, and fetal nullipara vaginal
descent show increases with
fetal descent

DEPENDENT DEPENDENT
• Advise the patient to • Ambulation can
ambulate as much as decrease the
possible as per duration of labor,
doctor’s order. helps in cervical
dilation and less
need for analgesics
and reduce chances
of fetal heart
abnormalities.
COLLABORATION COLLABORATION
• Obstetrician • For further
Gynecologist  instruction, for
confirmation of
preferred
birth/delivery plan
and for further
assessment.
 POTENTIAL DIAGNOSIS 
NURSING 
ASSESSMENT PLANNING INTERVENTION RATIONALE EVALUATION
DIAGNOSIS
Subjective data:  Risk for anxiety Short term: INDEPENDENT INDEPENDENT Short term:
"I want to deliver my related to After 4 hrs of • Assess psychological • Any interruption of After 4 hrs of
first child without unanticipated nursing intervention, and emotional status. the normal nursing
assistance from deviation from the patient will be progression of labor intervention,  the
analgesia, I like a expectations able to use support can contribute to patient was able to
normal delivery. I will as evidenced by systems effectively feelings of anxiety use support systems
be upset if I will wanting normal and appear to be and failure. These effectively  and
undergo cesarean delivery without relaxed feelings can interfere appear to be relaxed
section" as verbalized analgesia as with client
by the patient verbalized by the cooperation and
Long term: Long term:
patient hamper the induction
After 10 hrs of After 10 hrs of
Objective data: nursing intervention, • Monitor maternal process. nursing
• G1P0 the patient  will be vital signs  • To identify physical intervention, the
• 39 3/7 weeks AOG able to have responses associated patient established
• Cervical OS: 4 cms successful labor and with both medical successful labor and
• Cervical delivery and emotional delivery
    Effacement 80%, • Provide accurate conditions.
• Station -3 information about • This may help the
• Membranes: intact the situation patient to identify the
• FHR: 120-130 BPM possible problem that
• Uterine contraction  may occur and
every 4 minutes change in decision.
 • Promote comfort • To minimize the
measures such as calm factor that may
environment and contribute to stress
breathing exercises.  level of the patient
during labor.
• Encourage  the client
to develop exercises • This may help reduce
and stay active the level of stress or
anxiety by relieving
the tension from labor
enables client to
participate actively.
• Provide opportunities
for client input into • Enhances client’s
decision-making sense of control even
process. though much of what
is happening may be
beyond her control.
• Use positive
terminology; avoid • Helps client/couple
use of terms that accept the situation
indicate abnormality without self-
001 of procedures or recrimination.
processes.
 • Emphasize and • This allows the client
discuss the benefits to make an informed
of analgesia during choice about the
labor means of pain
control ; this can allay
the patient’s fear and
anxieties about
medication use

DEPENDENT DEPENDENT
• Refer to the • This help the client
physician for facilitate decision for
reportable danger the use of medication
signs such as pelvic and provide
pressure, acute appropriate health
abdominal pain care
and bleeding

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 REFERENCES
https://www.parents.com/pregnancy/giving-birth/vaginal/dos-and-donts-of-natural-childbirth/
https://parenting.firstcry.com/articles/12-tips-for-easy-labor-and-delivery/ 

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 THANK YOU !

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