LABOR and

DELIVERY
Cristina Cleofe, RM
BSN - III

SIGNS OF LABOR

Increased Braxton-Hicks Contraction

Irregular painless contraction of
pregnancy become stronger, longer
and more frequent when labor is near
at hand.

Lightening
The baby dropped
Settling of the presenting part to the
pelvic brim or inlet. It occurs about two
weeks before labor in primiparas and
just before or during labor in multis.
Results of Lightening:
Relief of dypnea
Increased frequency of urination
Leg pains
Decrease fundal height

Ripening of the Cervix

The cervix become soft when labor is
near at hand.

Increased Level of Activity

Show
It is considered as the surest sign that labor
may occur.

Rupture of Membrane
Rupture of bow is signified by a gush
or steady trickle of clear fluid from the
vagina. ROM is caused by the pressure
of contractions and dilatation of the
cervix.

True Labor VS False

Labor

True Labor
Uterine contractions increase in

intensity, frequency and duration.

Ambulation increases contractions
Discomfort radiates to the lower back or
lumbosacral area
Progressive cervical dilatation
Presence of show

False Labor
No increase in intensity, duration and

frequency of uterine contraction.

Contraction disappear with ambulation
Discomfort remains in the abdomen
Absence of dilatation
Absence of show

Stages of Labor

1st Stage: Cervical Stage

Onset of true labor to full cervical dilatation

2nd Stage : Expulsive Stage

Cervical dilatation to birth of the baby

3rd Stage : Placental Stage

Birth of the baby to delivery of the placenta

4th Stage : Immediate Post partum

Delivery of placenta until the condition of
woman is stabled
First 2-4 hours after delivery of the placenta

Duration of Labor
Stage of Labor

PRIMI

MULTI

1st

10 12 hrs

6 8 hrs

2nd

30 mins 2 hrs
(ave. 50 mins)

20 90 mins
(ave. 20 mins)

3rd

5 -20 mins

5 -20 mins

4th

2 4 hrs

2 4 hrs

Essential Factors of Labor

Passageway
Hard bony pelvis
Soft lower uterine segment, cervix,

vagina, perineum

Power
Primary Force : Uterine contractions
most important force during 1st stage of
labor.

 Secondary Force : Voluntary use of the

thoracic, diaphragm, and abdominal

muscles when the mothers bear down.

Passenger

Baby
Position, presentation are important factors

that affect labor outcome.

Person
Attitude of the mother during labor greatly

affects labor process and outcome.

Important Factors:
-Perception and meaning of childbirth
-Readiness and preparation for childbirth
-Past experiences
-Coping skills
-Cultural and social background
-Presence of significant others

Mechanisms of Labor

Danger Signs of Labor

Sign of fetal distress : tachycardia

Red stained amniotic fluid
Cord prolapsed
Pallor, cold clammy skin
Fever, foul smelling vaginal discharge
Vaginal bleeding

Signs of Imminent Delivery

Increased bloody show
Urge to push or move her

bowel
Bulging of perineum
Pain becomes more intense

Delivery Position

Lithotomy
Dorsal recumbent
Side lying
Squatting