Stages of Labor Comparison

Characteristic
Cervix Dilation Effacement

Latent Phase
Cervix 0 cm 3 cm

1st Stage Active Phase

Cervix 4 cm 7 cm

2nd Stage Transition Phase

Cervix 8 to 10 cm

3rd Stage

4th Stage

Full Dilation 10 cm

Irregular

Contractions Frequency Duration Intensity

Intensity: Mild to Moderate Duration: 30-45 sec. Frequency: 5-30 min

More regular, moderate to strong contractions Frequency 3 to 5 min Duration 40 to 70 sec

Strong to very strong contractions Frequency 2 to 3 min Duration 45 to 90 sec

Intense contractions every 1 to 2 min Ends with Birth

Length Nullipara Multipara

Nullipara: 8-10 hours after reaching active phase Multipara: 2-10 hr after reaching active phase

Stages of Labor Comparison

Maternal Behavior
Some dilation and effacement Talkative and eager Rapid dilation and effacement Some fetal descent Feelings of helplessness Anxiety and restlessness increase as contractions become stronger Tired, restless, and irritable Feeling out of control, client often states, cannot continue May have nausea and vomiting Urge to push Increased rectal pressure and feelings of needing to have bowel movement Increased bloody show Most difficult part of labor Pushing results in birth of fetus Placental separation and expulsion Schultze presentation: Shiny fetal surface of placenta emerges first Duncan presentation: Dull maternal surface of placenta emerges first Achievement of vital sign homeostasis Lochia scant to moderate rubra

Maternal Behavior on the Stages of Labor Comparison chart: ACTIVE PHASE: more intent and inwardly focused, absorbed in the serious work of labor; limits interaction to those in the room. TRANSITION: restless movement, increased apprehension and irritability, inability to relax, feelings of loss of control and being overwhelmed. 2ND STAGE: mother feels more in control, less irritable and agitated, focused on the work of pushing. 4TH STAGE: sense of peace and excitement, wide awake, very talkative initially; usually hungry and thirsty, bladder hypo tonic, she has limited sensation to acknowledge a full bladder (may need to offer toileting to the new mother)