Stages/Phases of Labor

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dsherman
ID:
119829
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Stages/Phases of Labor
Updated:
2011-12-05 05:15:28
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Stages Phases Labor
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Stages/Phases of Labor
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  1. First stage of labor
    Begins with onset of labor

    lasts about 12 1/2 hours

    Ends with complete dilation

    Maternal characteristics:

    • Cervical dialation
    • 1 cm/hr for primigravida patient
    • 1.5 cm/hr for multigravida

    last on average 12 1/2 hours
  2. Latent phase (First stage of labor)
    • Duration:
    • *primigravida-approx 6 hrs
    • *multigravida-approx 4 hrs

    • Begins with:
    • *irregular, mild to moderate contractions
    • *frequency 5 to 30 min
    • *duration 30 to 45 sec

    • Ends with:
    • *cervix 3 cm

    • Maternal characteristics:
    • *some dilation and effacement
    • *talkative and eager
  3. Active phase (First stage of labor)
    • Duration:
    • *primigravida-approx 3 hrs
    • *multigravida-approx 2 hrs

    • Begins with:
    • *cervix 4 cm
    • *more regular, moderate to strong contractions
    • *frequency 3 to 5 min
    • *duration 40 to 70 seconds

    • Ends with:
    • *cervix 7 cm dilated

    • Maternal characteristics:
    • *Rapid dilation and effacement
    • *some fetal descent
    • *feelings of helplessness
    • *anxiety and restlessness increase as contractions become stronger
  4. Transition phase (First stage of labor)
    • Duration:
    • approximately 20 to 40 min

    • Begins with:
    • *cervix 8 cm
    • *strong to very strong contractions
    • *frequency 2 to 3 min
    • *duration 45-90 seconds

    • Ends with:
    • *complete dilation at 10 cm

    • Maternal characteristics:
    • *tired, restless, and irritable
    • *feeling out of control, patients often states "cannot continue"
    • *may have nausea and vomiting
    • *urge to push
    • *increased rectal pressure and feelings of needing to have a bowel movement
    • *increased bloody show
    • *most difficult part of labor
  5. Second Stage of labor
    • Duration:
    • *primigravida-30 min to 2 hr
    • *multigravida-5 to 30 min

    • Begins with:
    • *full dilation
    • *intense contractions every 1 to 2 min

    • Ends with:
    • *Birth

    • Maternal characteristics:
    • *pushing results in birth of fetus
  6. Third stage of labor
    • Duration:
    • *5 to 30 min

    • Ends with:
    • delivery of placenta

    • Maternal characteristics:
    • *placental separation and expulsion
    • *schultze presentation: shiny fetal surface of placenta emerges first
    • *duncan presentation: dull maternal surface of placenta emerges first
  7. Fourth stage of labor
    • Duration:
    • *1 to 4 hrs

    *maternal stabilization of vital signs

    • Maternal characteristics:
    • *achievement of vital sign homeostasis
    • *lochia scant to moderate rubra
  8. Nursing interventions during the fourth stage of labor
    • *assess maternal vital signs every 15 min for the first hour
    • *assess fundus and lochia every 15 min for th first hour
    • *massage the uterine fundus and/or administer oxytocics as prescribed to maintian uterine tone to prevent hemorrhage
    • *assess the patient's perineum and provide comfort measures as indicated
    • *encourage voiding to prevent bladder distention
    • *promote an opportunity for maternal.newborn bonding

    • Patient education:
    • *instruct the patient to notify the nurse of increased vaginal bleedign or passage of blood clots.
    • *Offer asssistance with breastfeeding and provide reassurance

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