 Labour- is a dynamic process where

series of events take place to expel

the viable product of conception from
the uterus through vagina to outside
world.
 Normal labour: Labour is said to be normal
when it fulfills the following criteria-
1. Spontaneous onset.
2. Term pregnancy.
3. Vertex presentation.
4. Progressed naturally without undue
prolongation.
5. Ends naturally with or without minimal aids
like episiotomy.
6. With healthy mother with healthy baby.
 Stages of labour:
Three stages:
1. Stage I :
Duration : In case of primi-8-16 hrs.
Average 12 hours
In case of multi 4-8 hours.
Average 6 hours
1. Stage II
Duration :In case of prmi-1-2 hours.
In case of multi ½ -1 hour
1. Stage III.
Duration -15 minutes in both primi &
multi.
 Defination:
It starts from onset of true labour pain &
ends with full dilatation of the cervix. This is
the cervical stage of the labour
True labour pain.
 Pain associated with uterine contraction at
regular interval.
 Pain increasing in intensity, duration &
frequency.
 Pain starts from back, lower abdomen then
radiate to the groins & thigh.
 Pain is not relieved by analgesics or enema.
 Pain is associated with
-show.
-Progressive effacement & dilatation of the
cervix.
-Formation of bag of water during
contractions.
 False labour pain
Cause:
1. Urinary tract infection
2. Constipation
3. Dysentery.
4. Indigestion.
Characteristics of false labour pain:
1. Constant, dull lower abdominal pain
2. No radiation.
3. Not associated with uterine contraction
4. Relieved by antibiotics in case of UTI, spasmolytic
Enema etc.
5. Not associated with cervical dilatation, show,
formation of bag of water.
Effacement of the cervix or taken up means
the process by which the cervix becomes thin
due to pulling & merging of the cervix with the
lower segment.
Full dilatation of the cervix-it means when
there is no cervical lips & uterine wall vaginal
wall forms a single cavity.
Show-expulsion of cervical mucus plug, mixed
with blood is called show.
 General measures:
1. Assurance encouragement
2. Shaving or clipping of vulva & perineal hair
3. Cleaning of vulva& perineum with soap
water.
4. Bowel preparation by glycerine suppository
or by enema simplex.
5. Bladder preparation by frequent voiding & if
failed then catheterization.
6.Ambulation in early stage & comfortable
position in late stage specially left lateral
position.
7. Diet. Liquid
8.Releife of pain by-
Narcotic analgesics-inj. Pethidine 75-100mg
I/M from 4cm to 8cm dilatation of the cervix in
case of primi & 6cm in case of multi.
Epidural analgesia.
Inhaler analgesia.
 Observations are to be noted in partograph.
Progress of labour.
Fetal condition.
maternal condition.
Progress of labour :
1.By abdominal examination
 Changing of nature of pain with uterine
contractions in duration & frequency.
At first 1-2 contractions in 15-20 min. then
2-3 contractions in 10 min.
 Changing in pelvic grip- gradual
disappearances of occiput & sinciput.
 Shifting of fetal heart sound downwards &
medially.
2.By vaginal examination-
 Cervical dilatation-progressive.1cm/hour in
case of primi & 1.5 cm /hour in case of multi.
 Position of the head- changing from transverse
to anterior or from posterior to anterior
 Station of the head- above the ischial spine is
minus(_) to (o) to (+) 1cm/hr in case of primi &
2cm/hr in case of multi.
 Fetal condition
1. FHS
2. Colour of liqour
3. Degree of moulding
 Maternal condition
 Prolong first stage.
 Fetal distress.
 Cord prolapse.
 Fetal death-stillbirth.
 Maternal distress.
 Rupture uterus.
 Abruplacenta.
 Events of first stage of labour.
1. Effacement & dilatation of the cervix.
2. Full formation of lower segment.
3. Rupture of the membrane.
4. Some descent of the head.