2-4.
THREE STAGES OF LABOR
The period of labor can be divided into three stages. The first stage is dilation,
the second stage is expulsion, and the third stage is placental stage.
a. First Stage: Dilation. During this stage, the cervix dilates at a rate of one to
two centimeters per hour until dilation is complete at 10 centimeters (four inches).
Effacement (shortening of the cervix) takes place in this stage. The uterus contracts
regularly and the amniotic sac ruptures. If the sac does not rupture by itself, it is
ruptured artificially.
NOTE:
Bearing down during the first stage of labor is of no help and will tire the
mother. Also, bearing down at that stage may cause fetal distress.
b. Second Stage: Expulsion.
(1) This stage is the period of time from complete dilation of the cervix
through the delivery of the baby. During this stage, contractions take place every two to
three minutes. The contractions last about 60 seconds and are more intense than in the
first stage. The mother bears down involuntarily. She may bear down when she has
the urge. There is increased pressure on the mother's rectum which causes her to feel
as though she has to have a bowel movement.
(2) If you find a woman in the second stage of labor, observe her condition
and ask her these questions:
(a)
Is this her first baby?
(b) How long has she been in labor?
(c)
What are her contractions like? (Frequency? Duration?
Intensity?)
(d) Is the bearing down involuntary?
(e) Does she feel as if she has to have a bowel movement?
(f)
Can you observe the baby's head crowning?
If you observe the baby's head crowning, DO NOT touch the vagina.
CAUTION:
Touching the vagina could cause infection.
MD0584
2-6
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