Labour
Table of contents
Normal labour can be defined as spontaneous onset between 37 and 42 weeks gestation with labour progressing within acceptable limits.
Stages of labour
- 1st Stage from the start of labour until the cervix is fully dilated (several to many hours).
- 2nd Stage full dilation of the cervix until the birth of the baby (few minutes to several hours).
- 3rd Stage after birth of the baby until the placenta and membranes have delivered (few minutes to an hour).
- 4th Stage the first few hours after birth
Signs of imminent birth
- Loss of operculum plug (bloody show) occurs when the cervix dilates and the mucous plug dislodges
- Increasing frequency and severity of contractions (3-5 contractions in a 10-minute period)
- Urge to push or open bowels
- Bulging perineum/anal pouting
- Crowning/presentation of part of the baby
- Spontaneous rupture of membranes (SROM) can occur during the 1st or 2nd stage of labour
Care of the newborn
- Record time of birth (this is really important)
- Assess infants tone
- If tone good, dry baby with warm towel, place on mother and continue observing tone, respirations and HR
- If baby pinking up, breathing well (RR 40-60bpm), HR > 100bpm, leave skin-to-skin on mum and replace towel with warm wrap (keeping baby warm is very important)
- Record 1, 5 and 10 minute APGAR scores
- Clamp and cut umbilical cord, leave long - at least 10cm - in case neonate resuscitation required
- Keep baby warm and encourage/invite mum to breast feed
- Transfer to hospital