FIRST STAGE OF LABOR EXPLAINED

 What is first stage of labor?

Is the period between the onset of labor until full dilation. It is divided into two phases, Latent phase and Active phase of labor. 

Differentiation between the phases of first stage

Latent phase

Is characterized by moderate, irregular or adequate contractions and cervical dilation from 1cm to 4cm. In primigravida it can last up to 8 hours and multigravida is shorter than 4-6 hours (Not initially evident) It differs from women to women.

Active phase

Is characterized by adequate a strong uterine contractions and cervical dilation from 5-10cm. Duration in primi and multi takes 3-6 hours, or it doesn’t go beyond 10 hours.

Management of first stage of labor

  • Provide emotional support and reassure the patient 
  • Nurse the patient on the left lateral position 
  • Monitor vital signs (BP, HR, Urine, temperature, FHR)
  • Insert Intravenous line
  • Assess for contractions in 10 mins, the frequency, duration and strength 
  • Print CTG to monitor fetal well being 
  • Ensue hydration 
  • Offer pain relief options, non pharmacological and pharmacological 
  • If membranes ruptured, monitor color and cord prolapse should be excluded, avoid repeated vaginal examinations because it may introduce infection 
  • Support mobility, encourage walking and squats 
  • Prepare for delivery
NB: Monitor Labor Care Guide when cervical dilation is 5cm and above
Psychological management during first stage

  • Provide emotional support
  • Build a trusting relationship 
  • Communicate effectively and explain every procedure to reduce anxiety 
  • Encourage companionship 
  • Promote relaxation techniques such as breathing exercises 
  • Respect privacy and dignity 
What to look out for during first stage of labor

  •  Abnormal fetal heart rate ( tachycardia above 160/ bradycardia below 110)

  • Meconium-stained liquor (green/yellow)

  • Foul-smelling liquor

  • Blood-stained liquor

  • Heavy vaginal bleeding

  • Maternal fever

  • High blood pressure (>140/90)

  • Headache, visual disturbances

  • Epigastric pain

  • Dehydration signs

  • Slow cervical dilation

  • Very strong/long contraction

  • Maternal exhaustion

  • Maternal distress or panic

  • Signs of obstructed labor

    In the first stage of labor, the midwife’s role is to ensure safe progress by closely monitoring the mother and baby, identifying early warning signs, and providing continuous support. Early detection of abnormalities allows timely intervention, promoting a positive and safe birth outcome for both mother and newborn

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