Contractions: Every 3-5 minutes (lasting 30-60 seconds)
Transition Phase:
Cervix dilates 8-10 cm
Intensity: Strong
Contractions: Every 2-3 minutes (lasting 60-90 seconds)
Interventions:
Promote comfort with warm showers, massage, or epidural
Offer fluids and ice chips
Provide a quiet environment
Encourage voiding every 1-2 hours
Encourage participation in care
Instruct partner in light abdominal stroking
Encourage effective breathing patterns and rest
Stage 2: Delivery of the Baby
Purpose: Begin when cervix is fully dilated and ends with the delivery of the baby
Interventions:
Provide ice chips and ointment for dry lips
Offer praise and encouragement to the mother
Monitor uterine contractions and mother’s vital signs
Maintain privacy and encourage rest between contractions
Encourage effective breathing patterns
Monitor for signs of birth (e.g., perineal bulging, visualization of fetal head)
Stage 3: Delivery of the Placenta
Timeline: Placenta is expelled 5-30 minutes after birth
Interventions:
Assess mother’s vital signs
Perform fundal rubs every 15 minutes
Provide warmth to the mother
Promote parent-neonate attachment
Examine placenta for intactness (2 arteries, 1 vein)
Signs of placenta delivery include:
Lengthening umbilical cord
Gush of blood
Uterus changes from oval to globular shape
Delivery Techniques: "Shiny Schultz" (baby side first), "Dirty Duncan" (mother side first)
Stage 4: Recovery
Timeline: First 1-4 hours after delivery of the placenta
Interventions:
Assess the fundus
Monitor vital signs and temperature for infection
Administer IV fluids
Monitor lochia discharge (moderate and red)
Monitor for respiratory depression, vomiting, and aspiration if general anesthesia was used
Watch for complications such as postpartum hemorrhage
Characteristics of the fundus:
Soft, Boggy, Displaced, FIRM, Midline
Mnemonic
Memory Trick: To remember the sequence and main points related to each stage of labor, use mnemonic devices or simple visual cues (e.g., smiley face for retained placenta).