Stages of Labour Learning objectives By the end

Stages of Labour

Learning objectives By the end of the session the learners will be able to: • Define various stages of labour • List the differences between true and false labour pains • Relate stages of labour with check points of SCC 2

Recognizing True Labour True labour pains False labour pains Regular and predictable Irregular Felt first in lower back and sweeps towards lower abdomen Remains confined to lower abdomen Not relieved by rest Often relieved by rest Increase in duration, intensity and frequency with time Does not increase in duration, intensity or frequency “Show” blood stained mucus discharge present “Show” absent Accompanied by cervical changes Not accompanied by cervical changes 3

Stages of Labour First stage: From onset of labour pains till full dilatation of cervix. Has two parts: § Latent Phase (maximum 8 hours) o Cervix dilatation < 4 cms o 2 or less contractions per ten minutes § Active phase o Cervix dilatation > or = 4 cms o Contractions 3 or more per 10 min lasting >40 sec o Rate of cervical dilatation 1 cm / hour or more 4

Stages of Labour Second stage: From full dilatation of cervix till delivery of baby Signs of imminent delivery: § Bulging thinned out perineum § Gaping anus and vagina § Head visible at the perineum Third stage: From delivery of baby to delivery of placenta Fourth stage: For 2 hrs. after delivery of the placenta 5

Key Actions associated with Stages of Labour Stage 1 – Monitoring of labour with partograph Stage 2 – Preparation for birth of baby Stage 3 – Performing AMTSL Stage 4 – Review of condition of mother and newborn 6

Key Messages • There are 4 stages of labour ü 1 st stage starts from initiation of true labour pains till full dilatation of cervix ü 2 nd stage is from full dilatation of cervix till delivery of baby ü 3 rd stage is from delivery of baby till delivery of placenta ü 4 th stage is up to 2 hours after delivery of placenta • True labour pains are associated with changes in cervical condition 7