Stages of Labor

• Stage 1: Cervical Stage


  Cervical dilatation from 0 to 10 cm
• Stage 1: Cervical Stage

  Phases: Mnemonic - LAT
• Stage 1: Cervical Stage

  Latent Phase

  • Dilatation - 0 to 3 cm
  • Effacement - 0 to 30 %
  • Frequency of Contraction - every 15 to 30 minutes
  • Duration of Contraction - 10 to 30 seconds
  • Mother - talkative or eager
• Stage 1: Cervical Stage

  Active Phase

  • Dilatation - 4 to 7 cm
  • Frequency of Contraction - every 3 to 5 minutes
  • Duration of Contraction - 30 to 60 seconds
  • Feeling of helplessness
• Stage 1: Cervical Stage

  Transition Phase

  • Dilatation - 8 to 10 cm
  • Frequency of Contraction - every 2 to 3 minutes
  • Duration of Contraction - 60 to 90 seconds
  • Mother is tired, restless, irritable, feels out of control
• Stage 2: Expulsive 


  From full dilatation and cervical effacement to infant birth
• Stage 2: Expulsive 


  From full dilatation and cervical effacement to infant birth
• Stage 2: Expulsive

  Denoted by a significant increase in contractions, Ferguson reflex, and strong urge to bear down.

  • Ferguson reflex spontaneous urge to push during labor when the presenting part reaches the pelvic floor.
• Stage 3: Placental Stage

  2 phases:

  • Placental Separation
  • Placental Expulsion
• Stage 3: Placental Stage

  Placental Separation

  3 signs:

  • lengthening of cord
  • sudden gush of blood
  • Calkin's sign (uterus becomes firm and glubular)
• Stage 3: Placental Stage

  Placental Expulsion

  • Crede maneuver - gentle pressure on the contracted uterine fundus
  • Brandt Andrew Maneuver - control cord traction with counter traction
• Stage 3: Placental Stage

  Types of Placenta

  • Duncan - mother's side; dirty
  • Schultze - fetal's side; shiny
• Stage 4: Recovery

  • first 1 to 4 hours after delivery
  • most critical stage due to rapid deterioration
• Stage 4: Recovery

  Fundus - firm and globular, 1 to 2 fingerbreadths below the umbilicus
• Stage 4: Recovery

  Stages of Lochia

  • Rubra - bright red flow; 0 to 3 days; small clots are expected
  • Serosa - pink brown; 4 to 9 days
  • Alba - white yellow; 10 days to 6 weeks
• Stage 4: Recovery

  Stages of Lochia

  • Report lochia with foul odor - infection
  • Report lochia with large clots, pooled lochia under the client, 1 pad every 15 minutes - hemorrhage