90
KENTUCKY STATE UNIVERSITY
School of Nursing
CHARACTERISTICS OF LABOR
STAGE CHARACTERISTICS
1st Stage The first stage is usually heralded,
by one or more of the following:
A. Latent A. rhythmic contractions
B. rupture of membranes (“water
breaks”)
C. a blood tinged mucus
discharge from vagina
(“bloody show”)
The cervix dilates 1-4 cm over a
period of several hours.
B. Active Uterine contractions become
stronger, last longer (40-45
seconds), and are more frequent
(about every 4 minutes). Cervix
dilates to 4-8 cm and is getting
thinner (effacing).
Transition Phase Uterine contractions are strongest at
this time and last 50-60 seconds.
They may be accompanied by:
- hiccoughing
- leg cramps and shaking of legs
- restlessness
- nausea
- increased show
- backache
- stretching sensation in pelvis
- increased irritability
- membranes may rupture
spontaneously
- amnesia between contractions
HOW THE
MOTHER MAY
FEEL
Excited. She may also feel:
- a sense of anticipation
- a sense of relief
- happy
- some apprehension
Apprehensive, a growing
seriousness, ill-
defined fears.
Desire for constant
companionship.
Uncertain that you can
cope with
contractions.
Although this is the shortest
phase of labor, it often
seems to the laboring
mother that it will never
end. She may also feel:
- bewildered by intensity
of contractions
- frustrated and fatigued
- eager to be “given
something”
WHAT CAN BE DONE
Time duration and frequency of
contractions
Ask doctor when to go to hospital
Carry on with normal activities
Try pelvic rocking if back aches
Try abdominal breathing as
contraction become
uncomfortable
Assume most comfortable
position. Try abdominal
breathing with contractions
and breathe normally
between contractions.
Have back rubbed.
Ask for medication if unable to
relax effectively.
Need to be reminded to relax.
May receive epidural.
Try to relax as much as possible
although she may think this is
impossible. Abdominal breathing
usually becomes impossible so
choose:
- slow, deep chest breathing or
- very rapid, shallow chest
breathing at the peak of the
contraction.
Have pressure applied to small of
back if this helps.
Accept medication to help you
relax which will speed
labor.
Sleep in between contractions.
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CHARACTERISTICS OF LABOR (con’t)

STAGE CHARACTERISTICS HOW YOU MAY WHAT CAN BE DONE

FEEL
Cervix dilates completely - 10 cm or Relief because second stage Respond to the urge to push by:
5 finger breadths has begun and birth is - taking a deep breath
imminent - bend knees
- with mouth closed, bear down
2nd Stage This period begins with the Desire to bear down and with abdominal muscles
complete dilatation of the cervix push. Continue to push as long as each
and ends with the birth of the baby. Exhausted after each contraction lasts.
Increased “show” “pushing” Rest completely between
Feeling of fullness and pressure in contraction. contractions.
lower abdomen and perineal area Anxious because of Pant when asked to do so or
Strong desire to “push” when the stretching sensation when told not to push.
baby’s head comes in contact with during contraction.
the pelvic floor. Completely concerned
Increased amnesia between about yourself.
contractions.
Gradual appearance of the infant’s
presenting part of the vaginal
opening

After the anesthetic is given, he/she
may do an episiotomy to facilitate
delivery.
3rd Stage This stage begins with the birth of
the baby and ends after
delivery of the placenta and
membranes.
Contractions begin again; they are
usually very mild.
The uterus assumes a globular
shape.
There is a trickle of blood as the
placenta separates
4th Stage Uterus clamps down into a firm ball Tired but too excited to
the size of a small grapefruit.
Hungry and thirsty.
Want the companionship
With the birth of the head: Relax and enjoy this moment.
- alert and wakeful if
minimal medication
has been given or if
medication has not
been given prior to
this point of labor.
- weariness seems to
vanish for the time
being.
Exhausted but elated. Relieve tension by expressing
Eager to hear and see baby. emotions.
A sense of relief. Ask to touch baby’s hands.
Quite emotional. Ask for reassurance about baby’s
condition
Fathers are shown baby as he
goes to the nursery.
Nurse will massage “fundus” (top
sleep. of uterus) to insure its
contractibility. Nurse will take
blood pressure and check for any
of husband. excessive bleeding.
Husbands may stay with the
mother in the recovery room. Ask
for ice chips. Ask for medication
if unable to relax or if stitches
become uncomfortable.
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KENTUCKY STATE UNIVERSITY
School of Nursing

BREATHING PATTERNS
DURING LABOR

THIRD STAGE SECOND THIRD STAGE

STAGE
First Phase Second Stage Transition
1-4 cm 5-8 cm 8-10 cm PUSHING BIRTH
deep slow chest abdominal bulge deep slow chest semi-sitting position pant for head to turn push to
breathing breathing with with chin or chest slowly push baby expel
or blowing out back rounded legs out with contraction placenta
or pulled up
A-B-C-B-A
slow abdominal RELAX WITH at peak of RELAX WITH
breathing or CONTRACTIONS contraction take CONTRACTIONS
deep breath, hold it
or slow deep chest back pressure p.r.n. and push with
breathing abdominal muscles
A-B-A
RELAX WITH
RELAX WITH RELAX WITH CONTRACTIONS
CONTRACTIONS CONTRACTIONS

back pressure by
nurse or husband
p.r.n.

Revised: 5/07