Stage of Labor

Childbirth is typically occur by vaginal delivery. It occur in three stages, first stage is cervical dilation and opening of cervix, second is descent of baby & delivery & third is placental expulsion. Fourth stage is of postpartum period, it is also called as involution period.

Labor is also called as childbirth, delivery and parturition.  It occur in three stages. Normal labor last for 12 to 24 houres to birth. Labor is a process through which  baby comes out from uterine area either by vaginal delivery or cesarean section.

First Stage of labor

First stage labor starts with mild abdominal contraction continue for 12 to 18 hour. Intensity and frequency of contraction increases with time. 

First stage follow complete dilation of the cervical area. It is also called as cervical ripening.

It begin with dilatation of cervix. It end with fully dilated cervix up to 10 centimeter.

• Early labor

Early labor mean initiation of labor. In this labor contraction occur for 50 to 60 seconds for 15 to 20 minutes.

Abdminal contraction causes cervical muscle stretching which lead to increase cervical area for dilation. Baby head get more close to cervix and fit into cervical opening called effacement.

In first stage, female has vaginal discharge and bleeding. It start very slow and lengthen upto more than 24 hour.

• Active phase

Active phase involve dilation of cervix from 6 to 8 centimeter. In this phase, active contraction stimulates high cervical dilation.

• Transition stage

Transition stage characterized by severe abdominal contraction ending with complete cervical dilatation. 

The second stage of labor

Second stage starts with full dilated cervix. In this stage delivery of baby occur.

It completes in one hour. baby and mothers efforts of expelling the baby out is so high, that baby head come out from vaginal introitus. The amniotic fluid breaks down and baby comes out. After head comes out, delivery of the baby take place.

In second stage baby head is descent into pelvis area which get attached to vaginal introitus. Mother try to expel baby out due to high abdominal pain. It is refer as maternal bearing down effort. Baby head is further appear at vaginal orifice called as crowning. 

Delivery of baby occur by following five steps, in cephalic presentation (head first presentation)

• Engagement 

Engagement is refer as attachment of fetal head in the pelvis area of dilated cervix. It is occur in 2nd stage.

• Descent and flexion of fetal head 

Baby moves continuously down due to abdominal contraction and maternal bearing down effect. 

• Internal rotation

Baby takes internal rotation & baby face towards rectum. After that baby head come out with blowed. 

• Restitution 

Restituition starts with external rotation through baby head turn to 45 degree to restore allignment with internal organs. 

• Delivery of baby 

After external rotation baby gets deliver followed by posterior shoulder expulsion.

Third stage of labor

Third stage of labor is star after delivery of baby and continues until placenta comes out.

Placenta come out naturally by the pressure exerted by cord clamp and small abdominal contraction. If not, then manual removal of placenta is performed.

Placental expulsion begins as a physiological separation from the wall of the uterus. The time for complete expulsion of placenta takes 10 to 12 minutes.

Placental expulsion is take place by active management and expectant management. If plaenta removal get longer than 30 minutes is term as retained placenta.

Fourth stage of labor

Fourth period start from placental expulsion and active for six weeks. In fourth stage, Kangaroo mother care and breastfeeding is given to baby.

During fourth stage involution of uterus take place. It involve restorstion of normal physiology of uterus and cervix.

Risk of postpartum period are infection, hemorrhage, psychological disturbance etc.

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