STAGES OF LABOUR

Before you actually get into it, you might want to know what labour is?
Well, labour is a series of events that bring about the opening up of the cervix (opening of the mouth of uterus) descent of the foetus and finally the delivery of the baby and the afterbirths.

It is divided in to four stages:

1^st STAGE

It is the beginning of labour. It commences with the onset of true pain and uterine contractions, which bring about gradual opening up of the cervix. The opening of cervix is assessed in terms of “centimeters”

 When the cervix is fully opened or dilated as it is medically referred to, it is approximately 10 cms in diameter.

 This is so because the diameter of the foetal head (biparietal diameter) is approximately 9.5 cms at full term.
The 1^st stage can be divided in to 2 parts:

• (a) Latent phase:
  This is the period from onset of true labour pain to the time when the cervix is approximately 3 cms dilated.
  During this period the intensity and frequency of contraction and labour pain is less and the progress is slow.
  This may last for varying lengths of time from 6 hours to as much as 24 hours (rarely for 72 days up to a week). 
  In primigravida (woman pregnant for the first time) it is longer than compared to a multigravida (woman with more deliveries in the past).
  The duration labour itself is usually shorter in women who have delivered previously.

• (b) Active Phase:
  This is the part of labour where cervix dilates from 3 cms to 10 cms (full dilatation).  During this phase there is progressive increase in the intensity, duration and frequency of uterine contraction and labour pains. This is to facilitate the descent of the baby in to your pelvis and also to force open the cervix completely so that delivery can take place. This stage in an average lasts for 4 – 8 hours. It is usually shorter in women who have experienced labour before and longer in first timers.
  Since pain is a relative / subjective feeling, it may be appreciated or felt differently by different women. Some may find it only mildly discomforting and others may find it very excruciating.
  But, labour is a physiological or normal phenomenon just like passing urine and stools. Hence if you train your mind properly, the fear component can be overcome and it may not be so uncomfortable or painful.

2^nd STAGE

Once the cervix is fully dilated (10cm. diameter) The baby can now pass out of the uterus, through the vagina and be delivered. This part of labour from full dilation of the cervix to delivery of the baby is called the 2^nd stage of labour.
 During this stage, the contractions are extremely strong and come every 2 – 3 minutes. You may feel that the second contraction starts before the cessation of the first one.

3^rd Stage

Once the baby is delivered, the uterus contracts and shrinks in size. Due to this the placenta separates from the inner surface of the uterus and is expelled out.  The period after delivery of the baby to delivery of the afterbirth is called 3^rd stage of labour.
This usually lasts for more than 30 minutes. If it lasts for more than 30 minutes, surgical intervention may be needed to remove the placenta. Surgical intervention may also be needed in case of excessive bleeding during this stage.

4th Stage

This is the period from the delivery of the afterbirth to the time when the woman is examined and then transferred to her room. This is usually done after 2 hours of delivery.

                                                    Next