Ppt Normal Labor Unit 2.1

7/23/2019 Ppt Normal Labor Unit 2.1

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Labor:

Labor is defined as the onset of rhythmic contractions and the relaxation

of the uterine smooth muscles, which results in effacement or progressive

thinning of the cervix, and dilation or widening of the cervix. This

process culminates with the expulsion of the fetus and expulsion of the

other products of conception (placenta and membranes) from the uterus.

WH defines normal birth as! "spontaneous in onset, low#ris$ at the start

of labor and remaining so throughout labor and delivery. The infant is

born spontaneously in the vertex presentation between %& and '

completed wee$s of pregnancy. fter birth mother and infant are in good

condition"



Normal Labor:

*ormal labor or eutocia is a physiological process by which fetus,

placenta and membrane are expelled through the birth canal between %+

to ' wee$s. Labor is called normal if it fulfills the following criteria !#

• pontaneous in onset and at term

• With vertex presentation

• Without undue prolongation

• *atural termination with minimal aid.

• Without having any complications affecting the health of the mother

and -or the baby.



Abnormal Labor:

ny deviation from the definition of normal labor is called abnormal

labor . ystocia of labor is defined as difficult labor or abnormally slow progress of labor. ther terms that are often used interchangeably with

dystocia are dysfunctional labor, failure to progress (lac$ of progressive

cervical dilatation or lac$ of descent), and cephalopelvic disproportion

(/0). 1t is the conse2uence of four distinct abnormalities that may exist

singly or in combination.

• 3terine forces that is not sufficiently strong or appropriately coordinated

to efface and dilate the cervix.

• 4orces generated by voluntary muscles during the second stage of labor

that are inade2uate to overcome the normal resistance of the bony birth

canal and maternal soft parts.



• 4aulty presentation or abnormal development of the fetus of such

character that the fetus cannot be extruded through the birth canal.

• bnormalities of the birth canal that form an obstacle to the descent

of the fetus

Delivery:

elivery is the expulsion or extraction of viable fetus out of thewomb. 1t is not synonymous with labor. 1t can be ta$e place without

labor as in elective caesarean section. elivery may be vaginal, either

spontaneous or aided and or may be abdominal.

Premature labor:

0remature labor is defined as labor occurring before the %& th wee$ of

gestation.



Stage of labour

Labour has four distinct stages. The first starts with

regular contractions that open up your cervix and

lasts until the cervix is fully opened (dilated) to

about 56cm diameter. The second stage of your

labour begins when the cervix is fully dilated and

concludes with the birth of your baby. The third

stage is from the birth of your baby to the delivery of

the placenta and membranes.



First stage of labour

The first stage of labour is the period from the onset of labour (when

you begin to get regular painful uterine contractions) to complete

dilatation of the cervix. 1t is called cervical dilating stage. 1t is

concerned with the thinning of the cervix. This initial stage is usually

the longest but every birth is different and the timescale varies. 1t can

often ta$e 7#5 hours or sometimes more for a first baby and is

usually 2uic$er in subse2uent labours. uring the first stage of labour

you may experience a range of emotions. 8any women experience

nausea or actually vomit near the end of the first stage of labour.



Cont……….

dditionally, you may have a strong urge to push ($nown as bearing

down) with each contraction as your baby9s head is pushed against

the cervix.

This is when your breathing exercises come in useful as you will be

advised not to push until the cervix is fully dilated. t this stage you

may experience some loss of bladder or bowel controls due to the

pressure of the baby:s head so don:t feel embarrassed or concerned

because this is normal. nce the cervix is fully dilated your baby is

ready to be born and the second stage of labour begins. The first

stage can be divided functionally into three phases! the latent phase

and the active phase.



The Latent Phase Latent phase labor (also $nown as prodromal labor) precedes the

active phase of labor. 1t is period of effacement, which begins with

the onset of labour and ends with the cervix is %#'cm dilated. The

latent phase begins with mild, irregular uterine contractions that

soften and shorten the cervix. 1t is often long about +hours, in which

average dilatation of cervix is only 6.%;cm-hrs in primigravida. 1n

multipara, the latent phase is short about ' hrs and effacement and

dilatation occur simultaneously. 1n this phase contractions are short

and mild in strength. /ontractions usually occurs in every 5;#6

minutes,lasting 6#;sec.



hows the thin cervix now opening (or dilating) to about

% to ' cm.



The active hase

ctive phase labor is a time of rapid change in cervical dilatation,

effacement, and station. ctive phase labor lasts until the cervix is

completely dilated. 1n this phase acceleration of cervical dilation

proceeds at a rate of 5cm-hrs in primigravida and 5.;cm-hrs in

multipara.

!omen in active hase labor:

• re at least ' cm dilated<

• Have regular, fre2uent contractions that are usually moderately

painful<

• emonstrate progressive cervical dilatation of at least 5.#5.;

cm per hour.

• 3sually are not comfortable with tal$ing or laughing during

their contractions.



hows the cervix now open to about & to + cm



The transition hase Towards the end of the 5st stage # $nown as transition, the

contractions generally become very strong and close together(or for some women bac$ to bac$, with little to no rest in

between). 8any women experience vague urges to push, or

feelings of pressure in their bottom, as their baby9s head moves

lower down the birth canal. 1t is stage of labour when the

cervix is from around + centimeters dilated until it is fully

dilated with strong contractions #% minutes apart lasting ';#

76 seconds. Women often experience feelings of being 9out of

control9 or not wanting to 9do it anymore9 during transition.



hows the cervix almost fully open, with the bag of waters bulging down in front of the baby9s head



Sign an" symtoms of first stage of labor

• 0ainful and progressive uterine contraction with

progressive dilatation of cervix.

• =ulging of membranes during contractions.

• /omplete effacement and dilatation of cervix.

• There might-might not be rupture of membrane.

• 0resentation of show.



Secon" Stage of Labor

The second stage of labor begins when cervix is fully dilated

and is complete with the birth of the baby. This stage lasts on

average between 5 and hours for a first baby and is usually

shorter in a subse2uent pregnancy ( hrs in primi and %6 min. in

multi). s your baby9s head descends onto the perineum your

bac$ passage may bulge because the baby9s head is >ust behind it

and you may feel the need to defecate. /ontractions may

become less fre2uent but more intense. 1t has got two phases.



• The roulsive hase# starts from full dilatation up

to the descent of the presenting part to the pelvic

floor. 1n this phase descent and rotation of head occur.

The soft tissues of the vagina and pelvic floor

gradually stretched and thinned under the pressure of

the advancing fetal head.

• The e#ulsive hase# it is distinguished by maternal

bearing down efforts and ends with delivery of the

baby.



Sign an" symtoms of secon" stage of labor• 0rogressive and expulsive uterine contraction.

•

=ulging of perineum.

• nus gaping with escape of fecal matter.

• /omplete ta$ing up of the cervix.

• ?upture of membrane.

• 3rge to defecate with descent of the presenting part.

• Woman has the urge to push.

• 0resenting part visible at the perineum.

•

1t is complete with delivery of the baby.



Thir" Stage of Labor

The third stage of labor is referred to as the "placental"

stage. This is the period from birth of the baby until

delivery of the placenta. 1ts average duration is about ;#

%6 minutes in both primigravida and multiparae. The

duration is however, reduced to ; minutes in active

management.n 9active9 third stage usually speeds up

the delivery of the placenta and helps to reduce the

chance of a postpartum hemorrhage.



Fourth Stage of Labor.

The fourth stage of labor is referred to as the "recovery

or stabili@ation" stage. 1t is stage of observation for at

least one hour after expulsion of the placenta. The

forces involved are uterine contractions. uring this period general condition of the women and behaviour

of the uterus are to be carefully watched.

Ppt Normal Labor Unit 2.1

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