Physiology of 1st, 2nd and 3rd Stages of Labour

Question 1

What is the latent phase of the 1st stage of labour?

Answer 1

Cervical dilation from 0 - 4 cm

Question 2

Why is it important to rest between contractions?

Answer 2

To allow perfusion of the placenta

Question 3

What is the normal range for fetal heart rate?

Answer 3

110 - 160 bpm

Question 4

What are the experiences of women in 1st stage of labour?

Answer 4

Experience it as a continuous process.
May or may not experience the latent phase which could be associated with discomfort and irregular/regular contractions.
Will mostly be able to hold normal conversation, eat, drink and sleep - carry on as normal.

During established labour, she would be having regular contractions, moving about and changing position frequently. Vocal changes, will find it more difficult to interact normally. Changes in state of consciousness, will often close eyes during contraction.

Question 5

What are the experiences of women in 2nd stage of labour?

Answer 5

Begins with transitional period.
Restlessness
Discomfort
Desire for pain relief
Demand to end whole process
Urge to push/expulsive contractions
Contractions become stronger and longer, but less frequent.
Sometimes SRM
Bloody show.

Question 6

How can the midwife support women during 1st and 2nd stage of labour?

Answer 6

By giving advice on;

Hydration
Diet, eating little and often
Pain management; immersion in warm water, relaxation
Rest

Using positive reassuring language
Facilitate a calm environment with low lighting
Encourage mobilisation and upright positions.
Provide support.
Be present, but not intervening in natural process of labour

Question 7

What are the experiences of women in 3rd stage of labour?

Answer 7

Significant elevation of oxytocin at this stage facilitates relationship development between mother and baby

New mother may feel shaky or cold after birth as a consequence of CA levels dropping steeply.

Question 8

How can the midwife support women during 3rd stage of labour?

Answer 8

A calm, warm and quiet environment
Encourage a comfortable semi upright position
Observe from a distance to facilitate parent-baby discovery
Facilitate breastfeeding
Facilitate skin to skin

Question 9

What is the fear-tension-pain cycle?

Answer 9

Dr Grantly Dick Read argued that women with a tense mind would have a tense cervix. Removing fear and its physiological consequence, the hormonal system and uterus can function as intended.

Question 10

What is retraction?

Answer 10

A unique property of the myometrium. During labour, the contraction does not pass entirely as muscle fibres retain some of the shortening of contraction instead of becoming completely relaxed.

Question 11

What is the retracting ring?

Answer 11

It develops between the 2 poles of the uterus during labour, between upper and lower uterine segments.

Question 12

What is the sequence of principle movements through pelvis during birth?

Answer 12

1. Engagement.
2. Descent
3. Flexion of Head
4. Internal Rotation
5. Crowning
6. Extension of the Head
7. Restitution
8. Lateral Flexion (external rotation)