-4 stages of labor-know defs and durations
-2nd stage of labor (decent) know what happens during this stage
-diff phases of labor, latent, transitional , etc
-Know which emotion lightly occurs in stage 1 during transition phase- grrr
-finding of a patient who is crowning
-know therapeutic communication with patient in transitional phase of labor/what should nurse tell partner
-understand second stage of labor, know what nurse encourages patient to do during this stage
Phases of Labor
During the latent phase, there is more progress in effacement of the cervix and little increase in descent. *
During the active phase & transition phase, there is more rapid dilation of the cervix and increased rate of descent of the presenting part. Maternal pre-pregnancy overweight and obesity can cause the active phase of labor to be longer than for women of normal weight; specifically arrest of dilation can occur.
Considered to last from the onset of regular uterine contractions to full effacement and dilation of the cervix. Commonly the onset of labor is difficult to establish because women may be admitted to the labor unit just before birth, and the beginning of labor may only be an estimate. The first stage is longer than the second and third stages combined. Great variability is the rule. Parity has a strong effect on the duration of first stage labor. Full dilation may occur in less than 1 hour in some multiparous pregnancies. In first-time pregnancy, complete dilation of the cervix can take 20 hours or more. Variations may reflect differences in the client population (e.g., risk, status, age) or in clinical management of the labor and birth.
Lasts from the time the cervix is fully effaced and dilated to the birth of the fetus. It takes an average of 20 minutes for a multiparous woman and 50 minutes for a nulliparous woman. Labor of up to 2 hours (up to 3 hours with use of regional anesthesia) has been considered within the normal range of the second stage; a wider range of normal was associated with no effect on mother or infant. Ethnicity may play a role in the length of second stage labor. *
Composed of 2 phases: latent phase and active pushing (descent phase). *
During the latent phase the fetus continues to descend passively through the birth canal and rotate to an anterior position as a result of ongoing uterine contractions. The urge to bear down during this phase is not strong and some women do not experience it at all. *
During the active pushing phase, the woman has strong urges to bear down as the presenting part of the fetus descends and presses on the stretch receptors of the pelvis floor.
Lasts from the birth of the fetus until the placenta is delivered. The placenta normally separates with the third or fourth strong uterine contraction after the infant has been born. After it has separated the placenta can be delivered with the nest uterine contraction. The placenta is usually expelled within 10 to 15 minutes after the birth of the baby. The third stage of labor is normally completed within 30 minutes, The risk of hemorrhage increases as the length of the thirs stage increases.
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