Stages of Labor

There are three stages of labor. The first stage occurs from the time true labor begins until the cervix

is completelydilated and effaced. During the second stage the baby is delivered. The third stage

follows the birth of the baby through the birth of the placenta.

First Stage

Second Stage

Third Stage

Labor and Delivery Checklist

First Stage

The first stage of labor is the longest. There are three phases within the first stage;

Early or latent phase

Active phase

Transition phase

At the end of the first stage, the cervix is dilated to 10 centimeters. In mothers having their first child,

this stage usually lasts 12 to 16 hours. For women having second or subsequent children, the first

stage lasts around 6-7 hours. 

Early Labor

During the early or latent phase, the cervix dilates to 4 centimeters. The duration of the first phase is

the longest, averaging around 8 hours. Your contractions may be irregular, progressing to rhythmic

and methodical. The pain felt at this early stage may be similar to menstrual pain: aching, fullness,

cramping and backache. You will still be able to walk. Walking is usually more comfortable than sitting.

Most women spend these hours at home, or they may be checked at the hospital and sent home until

labor becomes more active. You may feel eager, excited and social. It is important that you conserve

your energy for the work of labor. 

Active Labor

Active labor is marked by regular contractions that become longer, stronger and closer together over

time. Most providers recommend that you go to the hospital when your contractions are five minutes

apart, lasting more then 60 seconds for at least an hour. Measure your contractions from the start of

one contraction to the beginning of the next. 

Your physician will want to know:

How far apart are the contractions? 

How long they are lasting, and how intense?

Are you using breathing techniques to manage the pain? 

Has your "bag of water" broken? Your provider will want to know the time this

occurred, and any color or odor. 

Has there been any discharge, such as a bloody show?

If you have had previous deliveries, the active phase of labor can proceed more quickly. Your physician

may want to be contacted sooner. 

When you are in active labor, you will be concentrating on the task at hand, and will not feel like doing

anything else. Your labor partner's support is important at this phase. Contractions are growing

stronger, longer and closer together. Contractions will be about 3-4 minutes apart, lasting 40 to 60

seconds. You may have a tightening feeling in your pubic area and increasing pressure in your back. If

you have learned breathing techniques, begin using them now, if you haven't already. Pain medication

is often given at this stage. If you have chosen to have an epidural anesthetic, it is usually given at this

stage. Please see pain management for more information.

Transition

Transition is the most difficult phase of labor, and fortunately, the shortest, lasting from 30 minutes to

two hours. The cervix is opening the last few centimeters, from 7 to 10 centimeters. The pain may be

intense, as the cervix stretches and the baby descends into the birth canal. All of your energy is

concentrated on doing the work of labor. Try to remain calm and focused as your uterus works. At the

end of transition, you may feel a strong urge to push the baby out. The baby is ready to be born. 

Back to top

Second Stage

During the second stage the baby is born. This stage of labor lasts anywhere from one contraction to

up to two hours. The baby's head stretches your vagina and perineum (the skin between the vagina

and rectum). This may cause a burning sensation. Some women may feel as if they are having a bowel

movement, and feel the urge to push, or bear down. The labor nurse or physician will tell you when it

is time to push. It is important that you not push until instructed. Pushing too early will cause the

cervix to become edematous, or swollen. "Crowning" occurs as the widest part of the head appears at

the vaginal opening. In the next few pushes, the baby is born. Mucous and amniotic fluid will be

removed from the baby's mouth and nose with a bulb syringe. The baby will take its first breath, and

may begin to cry. Immediately after birth, the baby is still connected to the placenta by the umbilical

cord. The cord is clamped and cut. 

Back to top

Third Stage

The third stage begins with the birth of the baby and ends with the delivery of the placenta. It is the

shortest stage, lasting from 5 to 15 minutes. Your contractions may stop for awhile, then resume to

deliver the placenta. You will be observed closely for the next few hours to make certain that your

uterus is contracting and bleeding is not excessive. The nurse will massage your uterus, or your lower

abdomen to check that the uterus is contracting. Take this time to rest and get acquainted with your

new baby. 

Back to top

Labor and Delivery Checklist

1. Prior to labor, discuss the following issues with your physician or nurse practitioner: 

What do I do if I think I am in labor?

What pain management options are available?

When is an episiotomynecessary?

What are some reasons you might perform a cesarean delivery?

2. If you have not done so, take a hospital tour so you are familiar with the place where

you will give birth. 

3. Arrange for help to care for you and the baby after birth, if you can.

4. Shop and prepare food for the first weeks when you are home with the baby, and

collect take-out menus. 

5. Review Preparing for Baby checklist.

6. Make sure you always have gas in the car. 

7. Pack your bags. See what to pack for the labor room.

Stages of Labor and Delivery 

Delivery Stages 

You made it! If you are reading this undoubtedly you are approaching or soon will be approaching the final stages of pregnancy. You may be wondering what exactly to expect during labor and delivery. There are two distinct phases of labor - early or latent labor and active labor. Active Labor is subdivided into three stages, which will be described in more detail below. There is no criteria for exactly predicting the moment when labor will start. Some women can have all the signs of impending delivery but hold out for several weeks, whereas others will have no signs and go into active labor in a matter of hours.

Early or Latent Labor During early labor, you will probably be relatively comfortable. It is generally the longest part of the birthing process and may last anywhere from one to three days. During this time you may experience contractions that are mild or moderate, generally lasting anywhere from 30 to 45 seconds. These contractions may also be irregular in nature, and may stop and re-start again. 

During the early phase of labor most women will dilate to 3 cm.  During this phase of labor taking a warm shower may help you relax. Try to sleep if possible to prepare for the active stage of labor. 

If you are interested in speeding up the labor process, consider going for long walks which might help move the baby further into your pelvis. 

Most women will be able to talk and function relatively normal during this phase. You can typically enjoy this part of labor in the comfort of your home. Traditionally early labor is longer for first time mothers than it is for moms who have given birth previously. 

Active LaborActive labor is characterized by three distinct phases:

Stage One - The cervix dilates and effaces

Stage Two - The baby is born Stage Three - The placenta is delivered

First StageDuring the first stage the cervix will dilate and efface or thin out, preparing for birth. This stage typically commences when a woman is 3 to 4 cm dilated. Women will dilate until 10 cm. 

Uterine contractions during this phase of labor are generally more intense than they are during early labor. They are also more frequent, occurring 2-3 minutes apart and may last from 50-70 seconds. 

During active labor the bag of water often breaks. 

Most women will report significantly more discomfort or pain during the active stage of labor. Your physician might offer you some form of pain relief, including use of an epidural to help ease the pain you are feeling from uterine contractions. 

The first stage of active labor ends with the transition phase, where contractions become increasingly intense as the baby moves into the birthing canal. During this time you will be absorbed by contractions. You may feel anxious and exhausted. 

This is the time where you might start feeling the urge to push. You will be dilated a full 10 cm at this point in time. 

Second StageThe second stage of active labor is the actual birth of your baby, or the process of pushing the baby out. This is usually preceded by a powerful urge to push the baby out of the vagina. You may feel a great deal of pressure in the pelvic region, in your vagina or in the back. 

The pushing phase may be short or long. Most first time moms push for 2 to 3 hours, however some women may push for minutes before the baby passes through the vagina. 

Third StageThe third stage of labor is the time during which the placenta detaches and passes out of the body. Generally this occurs within 30 minutes after the second stage of labor. Though not as exciting as the actual birth of your baby, the passage of the placenta is a vital part of labor and delivery. 

This process may require that you push a small amount to deliver the placenta. However, many women are so involved with their baby and the process of birth that they hardly even notice the delivery of the placenta.

The more prepared for labor you are the more comfortable you will be with the birthing process. Childbirth education classes can help you prepare for the actual process of labor.

DILATATION AND CURETTAGE

Instruments Used in Dilatation & Curettage

1.Curettes are the primary instruments of D&Cs.

A dilation and curettage, also known as a D&C, is a surgical procedure done on the uterus. It is a relatively common procedure, according to Healthcentral's website. Women sometimes require this procedure to remove uterine problems such as polyps and cysts, but it also is used to clean the uterus of potentially harmful matter after miscarriages or abortions. Regardless of why a doctor performs a D&C, medical professionals use the same instruments in the procedure. These instruments either control the cervix/uterus or remove tissue.

Speculums, Retractors, Dilators and Tenaculums2. Doctors use at least four related instruments to begin a D&C. Speculums and vaginal

retractors move the walls of the vagina and cervix out of the way so that the doctor performing the D&C has a better view during the procedure. Usually these instruments are dual sided, and the doctor expands the two sides once the instruments are in the vagina. Although the stretching of the cervix and vagina may be a bit uncomfortable, these instruments usually don't cause pain, as the cervix and vagina naturally have some elasticity. If the speculum and retractors don't open the cervix and vagina enough, then the doctor also uses dilators to stretch the opening further. Lastly, a doctor may use a tenaculum to physically grasp the cervix and pull it out of the way.

Forceps (Vulsellas)3. Ovum and vaginal forceps are instruments that look somewhat like scissors or tongs. The

doctor uses these instruments for grasping problematic or suspicious matter from the uterus. This is especially useful if the doctor needs to remove specific tissues for lab tests. Forceps use usually precedes the use of the curet and eliminates the need for excessive scraping.

Hystetometer4. The hystetometer, also known as a uterometer or uterine sound, is a probe. The doctor uses

this instrument to get an idea of how the uterus is placed directionally. Doctors also use the sound in conjunction with physical exams and palpitations to determine where the abnormalities in the uterus are, according to the University of Bonn and The Global Library of Women's Medicine.

Curet5. The curet is the main instrument of a D&C. A curet is a scraping instrument that gently

removes layers of the uterine lining. The removal of tissue through this scraping and minor cutting is what qualifies a D&C as a surgical procedure. Curettes may be "dull" or "sharp," just as any other knife--controlling the sharpness of the curet makes it less likely that the doctor will perforate the uterine lining in a way that causes excessive bleeding, according to The Global Library of Women's Medicine. Doctors thus usually use multiple curettes during a D&C

Read more: Instruments Used in Dilatation & Curettage |

eHow.com http://www.ehow.com/list_6589008_instruments-used-dilatation-curettage.html#ixzz0re9qUyTY

General Information

DEFINITION--Opening the cervix and scraping the inner wall of the uterus to remove tissue.

BODY PARTS INVOLVED--Uterus; cervix; vagina (as route for surgery).

REASONS FOR SURGERY

Diagnosis of abnormal bleeding or possible cancer inside the uterus.

Incomplete spontaneous miscarriage.

Treatment of minor diseases of the uterus.

Elective abortion during early pregnancy.

SURGICAL RISK INCREASES WITH

Obesity.

Smoking.

Excess alcohol consumption.

Recent or chronic illness, including anemia, diabetes mellitus, and heart or lung disease.

Use of drugs, such as: antihypertensives; cortisone; diuretics; or insulin.

Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Obstetrician-gynecologist, general surgeon or family doctor.

WHERE PERFORMED--Outpatient surgical facility or hospital.

DIAGNOSTIC TESTS

Before surgery: Pap smear (See Glossary); pregnancy test; blood and hormonal studies.

After surgery: Blood studies; Pap smear in 2 months.

ANESTHESIA--Local anesthesia by injection, or general anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

The vagina is cleansed with an antiseptic solution.

The cervix is carefully opened with a dilator, and a curette is inserted into the uterus.

The curette is used to scrape away a small part of the uterine lining for laboratory analysis.

The instruments are removed.

Some surgeons now collect tissue by suction curettage (see Abortion in Surgery section) rather than by the procedure described here.

POSSIBLE COMPLICATIONS

Surgical-wound infection.

Excessive bleeding.

Inadvertent injury to the uterus.

AVERAGE HOSPITAL STAY--0 to 1 day.

PROBABLE OUTCOME--Tissue obtained successfully without complications in virtually all cases. Allow about 4 to 6 weeks for recovery from surgery.

Postoperative Care

† Wear cotton panties or pantyhose with a cotton crotch. Avoid panties made from nylon, polyester, silk or other non--

ventilating materials.

Expect slight vaginal bleeding during recovery from surgery. Use a sanitary pad to protect clothing. Avoid tampons temporarily; they may lead to infection.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

Resume sexual relations when spotting ceases.

DIET---No special diet.

Call Your Doctor If

† Vaginal discharge increases or smells unpleasant.

You experience pain that simple pain medication does not relieve quickly.

Unusual vaginal swelling or bleeding develops.

You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.

Dual head stethoscope

inquiry

Products description:

Dual head stethoscope Components and material element:Colored chest piece or silver chest pieceBrass chrome

plated binaural;Plastic or soft eartips; All kinds of color available for the tube such

as :black,red ,green,yellow,blue,purple,pink,grey,white,etc;Standard tubing.Form of packing: One machine in a color

box,and every 100 color boxes in one export carton  Size of pa...

Click for detail  

Aneroid Sphygmomanometer with Separate Stethoscope

inquiry

Products description:

Sphygmomanometer Precision crafted 300mmHg manometer with division 2mmHgStop pin or Non stop pin

gaugeZinc Alloy caseCotton cuff or Nylon cuff with artery lable, D bar & gauge holderLatex or PVC inflation

systemVinyl or Nylon zippered carrying case...

Click for detail  

Digital thermometer

inquiry

Products description:

Digital thermometer PEN-LIKE, 3 digital•Display Range: 32.0℃-42.0ºC(89.6ºF-107.6ºF)•Accuracy:

±0.1ºC(±0.2ºF)•Min Scale: 0.1•Memory: last measuring reading •Taking times: 1.5minutes•Beeper function •Auto

Shut-off•Battery: 1.5V button Battery...

Click for detail  

Blood glucose test meter

inquiry

Products description:

Blood glucose test meter Features:.Economy--low price with good quality.Utility-one key operation, convenience and

utility.Rapitity-only one drop of blood, coming to an accurate result in 20 secondsPerformance

characteristics:Measuring Range: 2.2-27.8mmol/L (40-500mg/dl)Measuring Time: 20 secondsMemory capacitance:

the last resultBattery Life: >1000testsLife of test strips:...

Click for detail  

Nebulizer with mask

inquiry

Products description:

Nebulizer with mask •Made of non-toxic PVC•Easy to seal•100% atomized granules(≤5um)  •With 2m tube•Size:S, M,

L, XL...

Click for detail  

Endotracheal Tube

inquiry

Products description:

Endotracheal Tube Standard type. Sterile and single useWith cuff or W/O cuffSize: I.D 3.0mm-10.0mm...

Click for detail  

All Silicone Foley Catheter

inquiry

Products description:

All Silicone Foley Catheter two way or three waytwo way:Made from 100% Silicone.Colour-coded for visualisation of

size.Size: 8, 10, 12, 14, 16, 18, 20, 22, 24Fr/Ch.Three Way:Made from 100% Silicone.Colour-coded for visualisation

of size.Size: 16, 18, 20, 22, 24Fr/Ch....

Click for detail  

Nelaton catheter

inquiry

Products description:

Nelaton catheter Made of non-toxic PVC,medical grade Transparent,Mist surface is availiable Size: 6FR-24FR 

SterileBlister or polybag package...

Click for detail  

Disposable Syringe

inquiry

Products description:

Disposable Syringe Luer slip, 3 parts2ml,3ml,5ml,10ml,20ml...

Click for detail  

Disposable Infusion Set

inquiry

Products description:

Disposable Infusion Set Disposable Infusion Set ( IV Set) •Vented spike with cap, small chamber with filter•PE or

ABS adjustor •PVC tube length 150cm•Rubber luer lock or luer slip •With needle...

Click for detail  

Latex Exam Gloves

inquiry

Products description:

Latex Exam Gloves Powdered or Powder-free;Rough or Smooth SurfaceSize: XS; S; M; L; XL...

Click for detail  

Plain catgut

inquiry

Products description:

Plain catgut Thread length: 75cm, 150cm etc.Thread diameter: 4/0, 3/0, 2/0, 1/0, 1, 2, 3 etc.Needle length: 18mm,

22mm, 30mm,35mm,40mm, etc.Needle curvature: Straight,1/2 circle,1/ 4 circle,3/ 8 circle,5/ 8 circle, loop roundCross

section: round bodied,cutting...

Click for detail  

Urine bag

inquiry

Products description:

Urine bag •2000ml •90cm PVC material tube•With non-return valve and bottom with pull-push valve ...

Click for detail  

Luxury urine bag

inquiry

Products description:

Luxury urine bag .2000ml.with anti-reflux tower (one part), with needles samples port.With bed sheet clamp, Tubing

clip is optional.With reinforced double hanger & rope hanger.With T valve. Latex-free. Packed sterile. Blister pack or

poly bag packing...

Click for detail  

Patient ID Bracelets

inquiry

Products description:

Patient ID Bracelets Color: Blue, pink, white etcSize: Child or Adult...

Click for detail  

Surgical blade

inquiry

Products description:

Surgical blade Carbon steel or  Stainless steel•Size: 10, 11, 12, 12B, 13, 14, 15, 15C, 16,             18, 19, 20, 21,

22,22A, 23, 24, 25, 36...

Click for detail  

Cotton crepe bandage

inquiry

Products description:

Cotton crepe bandage Crepe80gWidth: 5cm, 7.5cm,10cm, 15cm, 20cm etcLength:3m, 4m, 4.5m etc...

Click for detail  

Gauze swab

inquiry

Products description:

Gauze swab sterile and single package40’s with or without X-ray threadSterile, and single packageMesh: 20x12,

19x15,24x20, 30x20 etcSize : 2"x2", 3"x3", 4"x4", 4"x8" etcPly: 8ply, 12ply, 16ply etcColor: White, Green,

Blue1pc/pack, 100pack/box, 2pc/pack, 50packs/boxOr according to custom needs....

Click for detail  

Zinc Oxide Plaster

inquiry

Products description:

Zinc Oxide Plaster •Width :1.25cm, 2.5cm, 5cm, 7.5cm, 10cm etc.•Length:1m, 5m, 10m etc.•Color: white,

fleshPacking: plastic shell, tinplate or simple packing are available..Anti-water material also available...

Click for detail  

First-aid adhesive plaster

inquiry

Products description:

First-aid adhesive plaster PE, PVC, PU, POE, elastic cotton, cotton, nonwovenSize: 70mmx18mm, 72mmx19mm,

75mmx22mm, Ø22mm, cross type, butterfly type, H type etc...

Click for detail  

Rescue Sheet

inquiry

Products description:

Rescue Sheet Rescue Sheet (silver/gold sheet)Size:210X160cm,220x140cm etc...

Click for detail  

Surgeon Gown

inquiry

Products description:

Surgeon Gown SMS or Spunlace fabric (sterile or non sterile)Available in different size (M, L, XL, etc.), weight and

colors. Packed in paper pouch or blister pack, etc...

Click for detail  

Non woven face mask

inquiry

Products description:

Non woven face mask 3ply, with tieNon wovenHeat sealed side or sewing sideColor: White, Green, Blue, Pink,

Yellow etc...

Click for detail  

Multi-purpose Operating Table

inquiry

Products description:

Multi-purpose Operating Table RT50202 table is designed for surgical procedures of the head, neck, thorax and

abdomen, And extremities as well as tor gynecological, oto-rhino-laryngological and orthopedics operations, It can be

raised or lowered hydraulically by means of an oil pump. Various positions can be controlled on the head.

SpecificationsLength:2040mmWidth:480mmHeight...

Click for detail  

Shadowless operation lamp with 9 reflectors

inquiry

Products description:

Electronic Operating Table Main Technical DataLuminance:L739≥90000Lx             739≥54000Lx Color

Temperature:4000±500KMains Voltage:~220V±22V 50Hz±1HzRated Voltage of Bulb:24VRated Power of

Bulb:25W...

Click for detail  

New Product

Oxygen mask

Venturi mask

Latex Condom

Disposable Infusion Set

All Silicone Foley Catheter