Stages/Phases 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

• 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

• 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

• 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

• 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

• 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

• Duration:
• *1 to 4 hrs

*maternal stabilization of vital signs

• Maternal characteristics:
• *achievement of vital sign homeostasis
• *lochia scant to moderate rubra

• *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