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Stages of labor antenatal workshop
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Dr Nupur Gupta High Risk Obstetrician
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Antenatal workshop to make understand expecting mothers about stages of labour
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Stages of labor antenatal workshop
1.
1Copyright © 2014
Paras Hospitals. All rights reserved. STAGES OF LABOR Dr Nupur Gupta, Unit Head Department of Obstetrics & Gynecology Paras Hospital, Gurgaon
2.
2Copyright © 2014
Paras Hospitals. All rights reserved. Pain and the brain… What will labour feel like and can I cope with it?
3.
3Copyright © 2014
Paras Hospitals. All rights reserved. WHAT IS LABOR? Series of events to deliver viable fetus from uterus into outside world Term labor- 32-40wks Preterm labor- < 37 wks Post term labor- > or = 42wks
4.
4Copyright © 2014
Paras Hospitals. All rights reserved. ONSET OF LABOR Initiation of labor - hormones of mother & fetus - placental hormones Hormones - estrogen, progesterone, oxytocin & prostaglandin
5.
5Copyright © 2014
Paras Hospitals. All rights reserved. True Vs False Labor TRUE LABOR Regular contractions Increase in frequency and intensity Cervix dilates No relief with sedation Abdomen and back pain FALSE LABOR Irregular Remain the same Unchanged Relieved Lower abdomen pain
6.
6Copyright © 2014
Paras Hospitals. All rights reserved. 6 WOW! I AM IN LABOR? Waiting for this precious arrival! Mild pain radiating from back to abdomen Feeling frequency of urination
7.
7Copyright © 2014
Paras Hospitals. All rights reserved. STAGES OF LABOUR Conventionally labour divided into 3 stages (some 4th stage) First stage Second stage Third stage Fourth stage
8.
8Copyright © 2014
Paras Hospitals. All rights reserved. FIRST STAGE (Dilatation stage) From onset of true labour pains - full dilatation of cervix CERVICAL stage Duration - 12 hrs in primi & 6-7 hrs in multiparae
9.
9Copyright © 2014
Paras Hospitals. All rights reserved. SECOND STAGE (Expulsive stage) From full dilatation of cervix- expulsion of fetus Average duration 2hrs in primi & 30 mins in multipara
10.
10Copyright © 2014
Paras Hospitals. All rights reserved. THIRD STAGE (Placental stage) From expulsion of fetus to expulsion of placenta with membranes Average duration 10-15 mins
11.
11Copyright © 2014
Paras Hospitals. All rights reserved. FOURTH STAGE (Observation stage) Stage of observation At least 1 hr ( Golden Hour) observation after expulsion of afterbirths
12.
12Copyright © 2014
Paras Hospitals. All rights reserved. First stage Beginning of contractions -progressing changes in cervix & ends -cervix fully dilated 3 phases of labor - Early Labor Phase - Active Labor Phase - Transition phase
13.
13Copyright © 2014
Paras Hospitals. All rights reserved. Phases of First Stage Latent (EARLY) : Dilation 0-3 cms. Contractions mild/irregular. Active: 4-7 cms. Contractions 5-8 min. apart. Lasts 45-60 sec; moderate - strong intensity. Transition: Dilatation 8-10 cms. Contractions 1-2 min. apart; 60 – 90 sec.; strong intensity. Baby’s heart beats monitored
14.
14Copyright © 2014
Paras Hospitals. All rights reserved. First Stage of labour: Early Labour - How do you know? Mild, regular contractions, 30-45 sec / 5-30 min Cervical dilatation starts Contractions - lower back, menstrual cramps, & pressure on pelvis area Pink or brownish-red blood tinged vaginal discharge- “bloody show” Possibility of breaking of water bag Early labor ends -cervix about 4cm dilated
15.
15Copyright © 2014
Paras Hospitals. All rights reserved. First stage of labour: Active Labor (4 to 8 hrs) Contractions frequent, longer, and stronger 1-2 mins duration/ 2-3 mins Cervix dilates from 4 to 10 cm Baby begins to descend or drop The last part of active labor, cervix dilates upto 10 cm
16.
16Copyright © 2014
Paras Hospitals. All rights reserved. WHAT TO DO: Natural Pain Coping techniques? Take a walk Be relaxed Can take a warm bath Listen to favorite music or watch videos Take help from husband or close relatives
17.
17Copyright © 2014
Paras Hospitals. All rights reserved. Best to take rest Tired, try to doze off between contractions Be sure to drink plenty of fluids to stay well hydrated & energetic Pass urine frequently WHAT TO DO: Natural Pain Coping techniques?
18.
18Copyright © 2014
Paras Hospitals. All rights reserved. Try some breathing exercises Can watch a movie or read a book Opt for which relaxes you Different comfortable positions Pain medication WHAT TO DO: Natural Pain Coping techniques?
19.
19Copyright © 2014
Paras Hospitals. All rights reserved. Take a massage A cool cloth on forehead or a cold pack on back or warm compression for comfort Transition stage most painful- try to distract – music or conversation or loving touch from partner WHAT TO DO: Natural Pain Coping techniques?
20.
20Copyright © 2014
Paras Hospitals. All rights reserved. 20 Fathers do make a difference to birth……………
21.
21Copyright © 2014
Paras Hospitals. All rights reserved. Second stage Cervix fully dilated, and it is time to push Contractions will last 45-90sec with a 3-5 minute rest period Baby is very low in pelvis - feel pressure on rectum Each contraction forces baby down
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22Copyright © 2014
Paras Hospitals. All rights reserved. Second Stage Delivery of infant up to 1 hr. or approx 20 contractions – primigravida 20 min. or approx 10 contractions in multipara Most difficult & uncomfortable part of labor Strong urge to push & bear down
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23Copyright © 2014
Paras Hospitals. All rights reserved. Pushing stage Try to follow doctor’s instructions Use deep breathing techniques to stay controlled Concentrate on self power Positions: Sitting, Side Lying, Standing, Squatting, All Fours, Kneeling WHAT TO DO: Natural Pain Coping techniques?
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24Copyright © 2014
Paras Hospitals. All rights reserved. Third stage After birth of baby, uterus contracts First contractions separate the placenta from uterine wall
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25Copyright © 2014
Paras Hospitals. All rights reserved. Afterwards! Be patient Feeling of achievement All that pain subsides with touch of baby Try to put baby on breast Helps to create immediate bonding
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26Copyright © 2014
Paras Hospitals. All rights reserved. 26
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