T (para 2-5f(5))
See chart. (para 2-2a)
Do not produce progressive
Produce progressive dilation and
dilatation and effacement. Are
effacement of the cervix. Occur
irregular and do not increase in
regularly and increase in
Not present. May have brownish
discharge which may be from
vaginal exam if within the last 48
Becomes effaced and dilates
Usually uneffaced and closed.
No significant change, even
May intensify for a short period or
though fetus continues to move.
it may remain the same.
Active or accelerated phase. (para 2-4b)
Transient or transitional phase. (para 2-4c)
Prevent fecal contamination of the perineum during delivery. Cleanse the bowel,
providing more room for fetal passage. Stimulate uterine contractions. (para
Over the fundal area of the patient's uterus. (para 2-5d(3))
To detect presence of fetal life at time of admission and to detect development of
fetal distress during labor. (para 2-5f)
Second phase. (para 2-6a(2))
Never leave a patient alone nor turn your back on the perineum. Encourage the
patient to rest between contractions and to push with contractions.
Position patient's legs in stirrups.
Prep the patient's perineum.
Monitor the patient's blood pressure and the fetal heart tones every 5 minutes
and after each contraction. (para 2-8)