2. STAGES OF LABOR There are three stages of labor.

The first stage occurs from the time true labor begins until the cervix is completely dilated 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

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. Patientscontractions 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. Patient 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. Patient may feel eager, excited and social. It is important that patient 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 patientgo to the hospital when patient contractions are five minutes apart, lasting more then 60 seconds for at least an hour. Measure patients contractions from the start of one contraction to the beginning of the next. If patient have had previous deliveries, the active phase of labor can proceed more quickly. The physician may want to be contacted sooner. when patient are in active labor, the patient will be concentrating on the task at hand, and will not feel like doing anything else. Patent 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. Patient may have a tightening feeling in their pubic area and increasing pressure in your back. If patient have learned breathing techniques, they has to begin using them now, if they haven't already. pain medication is often given at this stage. If patient have chosen to have an epidural anesthetic, it is usually given at this stage. 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 patients energy is concentrated on doing the work of labor. Try to remain calm and focused as patients uterus works.

at the end of transition, patient may feel a strong urge to push the baby out. The baby is ready to be born. SECOND STAGE explain involutions of uterus:

The reproductive organs respond to the end of the process of pregnancy and childbirth by an initial period of rest and then a gradual revert back to their normal pre-pregnancy state.
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Uterus: Immediately after delivery, the uterus becomes a hard, immobile structure located just above the pubic bone. It is about 20 cm in length and, in a woman of average height, will reach up to the umbilicus. It is slightly tender when palpated. Inside the uterus, the site of attachment of the placenta becomes a small, raised, reddish region of only around 7 - 8 cms in diameter.