(3) Third phase--transition. Encouragement is especially important now
since the patient is most likely losing control at this point. She may be nauseated or
flushed and may vomit. Assist the patient to turn on her side or to sit up to prevent
aspiration. Wipe her face and mouth with a cool cloth. Be aware that the patient may
want to be left alone, but don't leave; stay and support her. Remind the patient that
this is the shortest stage and that the baby will be born soon. Encourage her to
concentrate on relaxation and breathing techniques. Use more intensive breathing
techniques (high chest, pant-blow). Make sure to give instructions in short, simple
phrases. Remind the patient that she still can't push even though she may have a
strong urge to do so.
o. Preparation of the Delivery Room. Preparation is usually done by the
paraprofessional on duty if the scrub technicians are not employed. Strict aseptic
technique is maintained. The room is prepared while the patient is in the first stage of
labor. The local SOP will determine how soon before anticipated delivery the room can
be set up. It is usually 2 to 12 hours if the tables are covered and rooms are closed.
Section III. SECOND STAGE OF LABOR (DELIVERY STAGE)
2-6.
SECOND STAGE OF LABOR
As previously mentioned, the second stage of labor begins when the cervix is
completely effaced and dilated and ends when the infant is born.
a. These signs of the second stage of labor are considered imminent or
impending signs.
(1)
Imminent signs.
(a) Increased bloody show.
(b) Desire to bear down or have bowel movement (result of the
descent of the presenting part).
(c)
Bulging of the perineum.
(d)
Dilatation of the anal orifice.
(2)
Impending signs.
(a) Nausea and retching.
(b) Irritability and uncooperativeness.
(c)
Complaints of severe discomfort.
(d)
Pleas for relief.
MD0922
2-15