Normal Labor



Stage Definition Duration Comments
STAGE 1
Latent Phase
Begins: Onset of regular UC
Ends: Accel of cervical dilation to 3- 4 cm.
Prepare cx for dilation.
<20 hr in primi
<14 hr in multi
Prolongation in excessive sedation & hypertonic uterine contractions
STAGE 1
Active Phase
Begin: Accel. of cervical dilation (4cm)
Ends: 10 cm (complete)
Rapid cervical dilation
>1.2 cm/hr primip
>1.6 cm/hr multip.
Prolongation w/ Cephalopelvic disproportion
STAGE 2 Begins: 10 cm (complete)
Ends: Delivery of baby
Descent of the fetus
< 2hr in primipara
<1hr in multipara
Add 1 hr in epidural
Baby goes through all cardinal movements of labor.
STAGE 3 Begins: Delivery of baby
Ends: Delivery of placenta
Delivery of placenta
< 30 min Placenta separates & uterus contracts to establish hemostasis.


Failure to progress:

Stage Definition Treatment
STAGE 1
Latent Phase
 
Failure to have progressive cervical change:
- Prima: > 20 hrs
- Multi: > 14 hrs
Therapeutic rest via parenteral analgesia; Oxytocin; Amniotomy; Cervical ripening.
STAGE 1
Active Phase
 
Failure to have progressive cervical change after reaching 3-4 cm. Amniotomy; oxytocin; C-section if the previous interventions are ineffective.
STAGE 2 Arrest of fetal descent:
- Prima: > 3 hrs
- Multi: > 2 hrs
- Close observation
-↓ in epidural rate & continued Oxytocin.
- Assisted vaginal delivery (forceps or vacuum).
- C-section.