Stages of Labor -begins with the birth of the infant

and ends with the delivery of the

First Stage
-beginning with true labor
contractions and ending when the
cervix is fully dilated.
• Latent of Preparatory phase
-contractions are mild and short,
lasting 20-40 sec. and cervix dilates
from 0-3 cm, lasts 6 hours in
nullipara and 4.5 hours in
multipara
-(15-30 mins interval)
•Active Phase
-rapid cervical dilatations from 4-7
cm, contractions are stronger,
lasting 40-60 sec every 3-5 min,
lasts 3 hours in nullipara and 2
hours in multipara
-(3-5 mins interval)
•Transition Phase
-maximum dilatation of 8-10 cm,
intensity of contractions at their
peak that last 60-90 sec every 2-3
min.
(2-3 mins interval)
Nursing Care:
•monitor V/S and FHR every 15 mins
•bed rest for ruptured membrane
•empty the bladder as ordered
•teach breathing techniques
•maintain safety
Second Stage
-from full dilatation and cervical
effacement to birth of the infant
Nursing Care
•transfer to delivery room for 8-9 cm
dilatation for multigravidas and full
dilatation for primiparas
•monitor V/S and FHR
•prepare perineal area
•encourage pushing with contractions
•initiate breastfeeding “unang yakap”
placenta.
1. Placental Separation
-occurs automatically as the
uterus resumes contractions
The ff. signs indicate that the placenta has
loosened and is ready to deliver:
-lengthening of the umbilical cord
-sudden gush of blood (normal blood loss
is 300-500ml)
-change in the shape of the uterus
Types of Placental Separation
 Shults- the presenting part is the
fetal side which is shiny
 Duncan- the presenting part is the
maternal side which is called
“dirty” because it is raw and red.
2. Placental Expulsion
-after separation, the
placenta is delivered either
by the natural bearing down
effort of the mother or by
gentle pressure on the
contracted uterine fundus
by the physician or nurse-
midwife (Crede’s
maneuver)
Nursing Care
•assess for uterine contraction
•monitor V/S
•administer 10 units oxytocin IM with BP
Precaution and infuse oxytocin as ordered
•send cord blood to laboratory if mother is
0- positive or Rh- negative

Third Stage (placental stage)