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Stages and Phases of Labor

Did you know that there are FOUR different stages of labor...

AND one of the stages is so long it is broken down into phases!

It is important to know and understand all of these stages and phases and also recognize what the nursing responsibilities are for each of the stages and phases!

Stage 1 - when all of the cervical changes happen. The start of labor all the way to 10cm of dilation!

Stage 1 of Labor

The first stage of labor is the longest and involves three phases which are:

1. Early (or latent) labor

2.Active labor

3.Transition into delivery.

The first phase of stage one is normally the longest and least intense phase of labor. Early labor is also called the latent phase of labor. This period includes the thinning of the cervix and dilation of the cervix to 3cm.

It can occur over several days, weeks, or just a few short hours.

Contractions vary during this phase and can range from mild to strong, occurring at regular or irregular intervals.

Other symptoms during this phase can include backache, cramps, and a bloody mucus discharge.

Most women will be ready to go to the hospital at the end of early labor. However, many women will arrive at the hospital or birthing center when they are still in early labor.

EARY (LATENT) PHASE

The EARLY phase of labor involves :

Dilation of the cervix from closed through 3 cm.
Contractions become more persistent, more regular and closer together.
Can last hours or days.

How do we teach our patients how to calculate how far apart contractions are (the frequency of contractions)?

Quiz

How do we calculate how far apart contractions are?

From the beginning of one contraction to the end of the same contraction.
From the beginning of one contraction to the beginning of the next contraction.
From the end of a contraction to the beginning of the next contraction.

ACTIVE PHASE

The ACTIVE phase of labor involves:

Dilation of the cervix from 4 - 7 cm
Contractions are become stronger and closer together
The nurse providing comfort measures
The patient may be breathing through contractions and may be asking for pain relief in the form of medication or epidural.
Other symptoms may include backache and blood.
Usually only lasts hours.

Scan this QR code to review the active phase of labor in our textbook. If you do not have the electronic version, the material can be found on page 243.

Active Labor - Nursing Actions

In the Comment Box, name some nursing interventions during the active stage of labor:

TRANSITION PHASE

The TRANSITION phase of labor involves:

Dilation of the cervix from 8 - 10 cm
Last part of the first stage of labor.
The woman may become anxious, irritable, restless.
Contractions are become stronger and closer together and much more intense.
The woman may fear being alone.
Will likely experience intense perineal/rectal pressure.
May have nausea & vomiting.
May have difficulty following instructions.
May last only 15 minutes.

In the Comment Box, list 3 characteristics of the transition phase you may observe or assess as a nurse:

Stage 2 - pushing and the birth of baby!

Stage 2 of Labor

The second stage of labor is not broken down into phases because it does not last nearly as long as the first stage! The second stage of labor may only last minutes up to a few hours for a first time mom.

During the second stage of labor:

Some women may feel the unbearable urge to push and others may not. This may dependent on the station of the fetus or maybe their epidural.
As the fetal head continues to descend, the perineum will begin to bulge and bloody show will increase.
Crowning is when the top of the fetal head is visible and encircled by the vaginal opening -birth is imminent at this point.
Some women may feel relief with pushing, while others may be afraid due to the pain and exhaustion.
It is a very important nursing intervention to coach the woman and help her with her pushing.

There are may things we can do to encourage fetal descent and birth of the baby. Women can labor in many different positions, but they can also push in different positions.

Forum

In the Comment Box, list some interventions you saw nursing doing to help their patients through the labor and pushing process:

Stage 3 - From the birth of baby through the delivery of the placenta.

Stage 3 of Labor

The third stage of labor is from the birth of the baby until the placenta is delivered.

During this stage:

The uterus will contract tightly, which will shrink the surface area of the placental attachment - Because of this decrease in surface area, the placenta will start to detach.
This will likely occur as soon as 5 minutes after the baby's birth, but can take up to 30 minutes. If it takes longer than 30 minutes this would be considered abnormal and referred to as a retained placenta.

Caricamento...