1. FIRST STAGE - onset of regular contraction to full dilatation.
- Duration is 4 hours for primigravida and 2 hours for multipara, Transition is 1 hour for primigravida and 10-15 minutes for multipara.
- Frequency of contraction is every 2-4 minutes lasting for 49-90 seconds.
- Nursing care: Monitor V/S and FHR every 15 mins, bed rest for ruptured membrane. Have her empty bladder, pain relief, breathing techniques, maintain safety.
2. SECOND STAGE OF LABOR - from full dilatation to delivery of infant.
- 30-60 mins for primigravida, 20 mins for multipara; frequency is 2-3 mins lasting 60-90 seconds; strong intensity.
- Nursing care: Transfer to delivery room for 8-9 cm dilation for multigravidas and full dilation for primigravidas; monitor FHR and V/S, prepare perineal area, encourage pushing with contractions , immediate newborn care.
3. THIRD STAGE - from delivery of infant to delivery of placenta.
- 5-30 mins duration.
- Nursing care: assess for placental separation, inspection of placenta, monitor V/S, initiate breastfeeding, administer oxytoxic and antilactation agents as ordered, sending cord blood to laboratory if the mother is O-positive or Rh-negative, and allow bonding.
4. FOURTH STAGE - time from delivery of placenta to homeostasis.
- Monitor V/S every 15 mins, including fundal height, position and consistency.
- Assess for lochia, check perineum, perform peri care from front to back.
- Post partum care.
