STAGES OF LABOR – Stage I

First Stage

The first stage consists of three phases: latent, active, and transition. This stage begins with the first true contraction and ends with complete effacement and dilation to 10 cm.

Latent Phase (Early Labor):

• Duration: 10-12 hours in primipara and 8-10 hours in multipara
• Cervical dilation is 1 to 4 cm
• Uterine contractions occur every 15-30 minutes and are 15-30 seconds in duration and mild intensity
• Mother is talk active
• Encourage mother and partner to participate in care
• Change position and ambulation to comfort mother
• Offer fluids an ice chips
• Inform the progress to mother and partner
• Encourage voiding every 1-2 hours

Active Phase:

• Duration: 2-4 hours in primipara and 2-4 in multipara
• Cervical dilation is 4-7 cm
• Uterine contractions occur every 3-5 minutes and are 30-60 seconds in duration and of moderate intensity
• Mother becomes restless and anxious as contractions become stronger
• Mother may experience feeling of helplessness
• Encourage mother in maintenance of effective breathing
• Provide a quiet environment
• Inform the progress to mother and partner
• Backrubs, sacral pressure, pillow support and position changes to promote comfort
• Offer fluids and ice chips
• Instruct partner in effleurage
• Encourage voiding every 1-2 hours

Transition Phase:

• Duration: 2-4 hours in primipara and 1-2 in multipara
• Cervical dilation is 8-10 cm
• Uterine contractions occur every 2-3 minutes and are 45-90 seconds in duration and strong intensity
• Mother may becomes tired, restless, irritable, and feels out of control
• Encourage rest between contraction
• Inform the progress to mother and partner
• Provide privacy
• Offer fluids and ice chips
• Encourage voiding every 1-2 hours

Special Nursing Interventions First Stage:

• Monitor vital signs
• Monitor fetal heart rate via ultrasound Doppler, fetoscope or electronic fetal monitor
• Assess fetal heart rate before, during and after a contraction (normal FHR is 120-160 beats per minute)
• Monitor uterine contractions by palpating, determining frequency, duration, and intensity of contraction
• Assess status of cervical dilation and effacement
• Assess fetal station presentation and position by Leopold’s maneuver
• Assess the color of the amniotic fluid if the membranes have ruptured because meconium-stained fluid can indicate fetal distress