6.1c Third Stage of Labor

Question 1

Third Stage of Labor

Answer 1

• Lasts from birth until placenta is expelled

Question 2

Care Management

Answer 2

• Goal is for prompt expulsion in the safest way

- Placenta separates due to contractions, decrease in uterine size, and placental shrinking

Question 3

Placental Seperation

Answer 3

• Signs are lengthening of umbilical cord and rush of blood.

Question 4

Passive Management

Answer 4

• Expelled within 15 minutes after birth

- Fundus is massaged after expulsion and medication (oxytocin) is administered

Question 5

Active Management

Answer 5

• Administer oxytocin immediately after birth before placenta is expelled
• Immediately after placenta is expelled, fundal massage is given.
• Benefits are shorter third-stage of labor, less risk of hemorrhage, and decreased anemia.

Question 6

After Placenta Emerges

Answer 6

• Examine that all of the placenta has been expelled

- Obtain blood sample from umbilical cord for baby blood type and rH

Question 7

Nursing Care

Question 8

Signs and Symptoms of 3rd Stage of Labor

Answer 8

• Firmly contracting fundus
• Change in shape of uterus from discoid to globular ovoid
• Gush of dark blood from introitus
• Lengthening of umbilical cord
• Vaginal fullness during inspection (from placenta)

Question 9

Physical Assessment

Answer 9

• BP, Pulse, RR every 15 minutes
• Assess signs of placental separation and bleeding
• APGAR score at 1 and 5 minutes
• Assess patient/partner response to birth

Question 10

Interventions

Answer 10

• Assist patient in bearing down for expulsion of placenta
• Administer oxytocin as ordered to prevent hemorrhage
• Provide pain relief
• Explain purpose of medications
• Encourage immediate skin to skin contact (if conditions permit)
• Delay eye prophylaxis to introduce patient to baby
• Encourage breast feeding if desired