STAGES OF LABOUR

 (1) 1ST STAGE (Dilation of the cervix):-

Start from the true labour pain & ends with the full dilation of the cervix.

Duration- 12-16 hrs. in primigravida

6-8 hrs. in multi gravid

Dilation of cervix in three phases:-

(1) Latent phase

(2) Active phase

(3) Transitional phase

(1) Latest phase:- Cervical dilation is 1-3 cm

(Primi – 8 hrs. multi – 4 hrs.)

Latent Mean hidden or no any evidence of remarkable

Uterine contraction occurs every 15-30 minutes & are 15-30 sec. in duration 

         -  Severity –mild intensity

-  Mother condition is talkative

(2) Active phase: - Cervical dilation is 4 to 7 cm

(Primi -4 hrs. multi – 3-4 hrs.)

Uterine contraction occurs every 3 to 5 minutes & is 30 to 60 sec. in duration

Moderate intensity

Mother become rest less & anxious

Contraction becomes stranger.

(3) Transitional phase:- (Cervical dilation is 8 to 10 cm)

(Primi – 3.5 hrs multi-various)

                        Waiting period b/w 2 stage

Uterine contraction occurs 2 to 3 minutes & are 45 to 90 sec in duration

Strong intensity

Mother become tired, irritable & feel out of control.

Cervical dilation is practically by finger examination.

1 finger equal to 2 cm (4 fingers considered as 8 cm)

Average dilation rate (1.2 cm/hrs in primi) (1.5 cm/hrs. in multi)

Curve during dilation b/w cm and hrs. is Friedman curve

Sigmoid shape

(2) IInd Stage (Expulsion of fetus):-

Full dilation of cervix to ends with expulsion of fetus

Duration- In primigravida – 2.3 hrs.

Multi gravida- 30-40 min

Uterine contraction occurs every 2 to 3 minutes lasting 60-70 sec.

Intensity is strong

Increase in bloody show occurs

Mother feel urge to bear down, assist mother in pushing efforts

(3) IIIrd Stage (Expulsion of placenta & Membrance):-

It start after the delivery of fetus & with expulsion of placenta & membrance

Duration- 15-20 minutes in both

Schultz Mechanism:- Center portion of the placenta separate first & its shying fetal surface emerge from vagina, 

Duncan Mechanism:- Margin of placenta separates & the dull, red, rough maternal surface emerge from the vagina first.

(4) IV stage (Observation):- The period of time from 1 to 4 hrs. after delivery

Observation –vital sign & any bleeding