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Atilano, Patrick Raymond F.

BSN IV – F Mrs. Maridel B. Dagalea


Ciudad Medical Zamboanga – Delivery Room (Name and Signature of Clinical Instructor)

RESOURCE UNIT
PLACEMENT: Level 4
TOPIC: Stages and Mechanisms of Labor
GENERAL OBJECTIVE: To know about the different stages and mechanisms of Labor

Specific Contents Time Strategies Resources Evaluation


Objective/ Allotment
Instructional
Objective
1. States the > Stage 1 has 3 distinct phases. Don’t confuse stages with 15 mins. > Lecture >http://ww Pen and Paper Test
different and phases. with Visual w.babycente
descriptions of Aid r.com 1. How many stages of labor
Phase 1 (latent phase)
each stages of are there?
labor. - The cervix is at a dilation of around 1– 4 cm > Answers: here are three
- Contractions occur every 15 – 30 minutes with duration of 15 http://hubpa levels of labor
– 30 seconds and are of mild intensity ges.com
2. When does the first stage
- Mother is very chatty and excited to be in labor of labor begins?
- Comfort is of the utmost importance, mother should seek Answers: The first stage
assistance with changes in position and walking begins with the onset
of contractions that
- Mother should also drink lots of fluids
cause progressive
- Voiding every 1 – 2 hours is important at this point changes in your cervix
Phase 2 (Active Phase)
3. When does the second
- The cervix is dilated to 4 – 7 cm stage of labor begins?
- Contractions take place every 3 – 5 minutes with duration of Answer: The second stage of
30 – 60 seconds and are of moderate intensity labor begins once you're
fully dilated.
- Mother becomes restless and anxious and because of this may
have feelings of helplessness
4. When does the third stage
- Keep the mother’s breathing pattern effective, keep the room
of labor begins?
as quiet as possible
Answer: The third stage of
- Comfort measures used in this phase include back rubs, labor refers to the
sacral pressure, support with pillows, and changes in period following the
position completed delivery of
- Mother can use ointment for dry lips and continue to drink the newborn until the
fluids or ice chips and should void every 1 – 2 hours delivery of the
placenta.
Phase 3 (Transition Phase)
- The cervix is dilated to 8 – 10 cm 5. What is the longest stage
of labor
- Contractions are occurring every 2 – 3 minutes with duration Answer: The first stage when
of 45 – 90 seconds and are of strong intensity the cervix opens (dilates)
- The mother has become exhausted, is edgy and irritable, and and thins out (effaces) is
feels out of control the longest of the three
stages of labor.
- The mother should rest between contractions to conserve
energy
- Mother should be awakened at beginning of a contraction so
she can begin her breathing pattern
- Continuing fluid intake or ice chips and voiding every 1 – 2
hours is important
> Stage 2
- Dilation of the cervix is complete
- The progress of this stage of labor is measured by the
changes in fetal station, which means the descent of the
baby’s head through the birth canal
- Contractions occur every 2 – 3 minutes with duration of 60 –
75 seconds and the intensity continues to be strong
- The mother will feel and urge to bear down and the medical
staff will assist the mother in her efforts to push
- The vital signs of the mother are important to monitor at this
point
- The baby’s heart rate will be monitored before, during, and
after a contraction
- The bulging of the mother’s perinea area or seeing the baby’s
head are signs the birth is about to occur
> Stage 3
- The baby has already been born
- The delivery of the placenta
- Contractions will continue until the placenta is born
- The birth of the placenta takes place 5 – 30 minutes after the
birth of the baby
- There are two different mechanisms of birth of the placenta
that can happen; they are “Dirty Duncan” or “Shiny
Schulze’s”
- Duncan’s mechanism the margin of the placenta separates,
and the dull, red, and rough maternal surface emerges
from the vagina first
- For Schulze’s mechanism the center portion of the placenta
separates first, and its shiny fetal surface emerges from
the vagina
> Stage 4
- Extends 1 to 4 hours after delivery
- During this time the mother’s blood pressure will return to
pre-labor level, pulse is decrease than that of the labor
pulse. The fundus remains contracted; this is normal and
essential
- Checking the mother frequently after birth is important. She
is checked first every 15 minutes for 1 hour, then every
2. States the 15 mins. > Lecture >http://ww
30 minutes for an hour, and lastly every hour for 2 hours
different and with Visual w.brookside
descriptions of the - Teach the mother how to breast feed and ask open ended Aid press.org Pen and Paper Test
mechanisms of questions to promote conversation about breast feeding
labor. Descent: As the fetal head engages and descends, it assumes an >http://ww 1. Name the five mechanisms
occiput transverse position because that is the widest w.brookside of labor?
pelvic diameter available for the widest part of the fetal press.org/Pr Answers:
head. oducts/OBG
YN • Descent
Flexion: While descending through the pelvis, the fetal head • Flexion
flexes so that the fetal chin is touching the fetal chest. • Internal Rotation
This functionally creates a smaller structure to pass • Extension
through the maternal pelvis. When flexion occurs, the • External Rotation
occipital (posterior) fontanel slides into the center of the
birth canal and the anterior fontanel becomes more 2. What is the other name for
remote and difficult to feel. The fetal position remains External Rotation?
occiput transverse. Answers: Restitution
Internal Rotation: With further descent, the occiput rotates
anteriorly and the fetal head assumes an oblique 3. Explain each of the
orientation. In some cases, the head may rotate mechanisms of labor.
completely to the occiput anterior position.
Extension: The curve of the hollow of the sacrum favors
extension of the fetal head as further descent occurs. This
means that the fetal chin is no longer touching the fetal
chest.
External Rotation: The shoulders rotate into an oblique or
frankly anterior-posterior orientation with further
descent. This encourages the fetal head to return to its
transverse position. This is also known as restitution.

 Expulsion: The shoulders and torso of the baby are


delivered.

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