LABOR

Labor Physiology

Passagewaypelvis, cervix, perineum

Passengerlie, presentation, station, engage-

ment, cardinal movements

Powerscontractions and pushing

Psychological componentfear, anxiety, tension,

pain
Fetal Skull
Cephalic Presentation
Stages of Labor

First- true labor to complete (10 cm)

Second stage- full dilation and effacement

to delivery
Third- delivery of placenta

Fourth- 1-4 hours after delivery (recovery)

Station
Fetal Presentations
First Stage of Labor
Three phases in first stage

Latent- closed to 3 cm

Active- 4cm to 7cm

Transition- 8cm- 10cm (Complete

dilation)
Signs of True Labor
Contractions are regular

Contractions intensify with walking

Increase in frequency, duration and intensity

Dilation and effacement are progressive

 Latent Phase
Frequency- irregular- duration 15-20 secs.

Length- nulli para 8 hrs 20 hrs

Multipara- 5.3 hrs

Little descent

Psychological response- happy, excited, small amount of

discomfort
Active Phase

Uterine contractions closer together

Duration -30 to 60 secs.

Nullipara- 4.6 hrs- Multi- 2.4 hrs

Descent noted

Psychological- Increase in pain, loss of control

Second Stage- Pushing
Complete dilation- complete effacement

1-3 hours

Pushing and crowning

Contractions less frequent

Pushing can be a relief

Evaluate for effectiveness and effort

Third Stage- Placental Separation
Up to 30 minutes for placental separation

Mechanism of separation

Signs of placental separation

1.Globular shaped uterus 2. Rise of fundus

3. Gush of blood 4. Lengthening of cord
Placental Delivery
Fourth Stage of Labor
1- 4 hrs after delivery

Time of recovery

After pains

Hunger and thirst

At risk for atony and hemorrhage

Promote bonding and attachment

Cardinal Movements
Descent

Flexion

Internal Rotation

Extension

Restitution

External Rotation

Expulsion