This stage comes with the effacement and dilation of the cervix which up until now was closed off during the entire pregnancy. The cervix fully dilates up to 10 cm with the help of contractions. This is the longest phase in labour (it could take somewhere between 8 to 10 hours)
The 1st Stage is categorised as the early phase and active phase.
Early Phase: This is the longest phase of both labour and the first stage particularly for women giving birth for the first time. The contractions are infrequent and weak in this period. This could go on for a few hours or days. If there is no other symptom it is not necessary to go to the hospital.
Active Phase: The expectant mother becomes aware of the transition to this phase by the increase in frequency of the contractions and the intensity of the pain. It is recommended to go to the hospital when the contractions start coming in less than 5-minute intervals. However, hospital care must be sought immediately if the water breaks or bleeding starts in this period.
At the end of the first stage, in other words when the cervix is dilated to 8-9 cm, the expectant mother feels the need to push with the contractions. If the attending doctor permits, the mother can start pushing.
This stage covers the period from the full dilation of the cervix until the birth of the baby. This could take half an hour to 1.5 hours. Forceful pushes by the mother could shorten the duration of this period. A push is only effective if done according to a technique.
Pushes applied prematurely could cause oedema in the tissues and tire the mother too.
Pushing Technique: When the feeling to push peaks with strong contractions, the mother must take a deep breath and without releasing it, must place her chin on her breast and start pushing forcefully. When straining the hips and the waist curves in to form a “C” and the mother pushes the baby out with all her might bearing on her anus. The pushing action must continue all through the contraction and the mother should relax and stop pushing when the contraction eases. When the baby’s head is crowning, the mother is told not to push in spite of the continued need to push. To prevent straining, strong and short breaths are inhaled and exhaled through the mouth.
This is the period after the birth of the baby until the placenta is expelled. It is usually half an hour, at most an hour. After the placenta is expelled, it is examined to determine whether it has fully come away from the uterus. If a piece of the placenta is left inside the uterus, it will cause bleeding and infection. If an incision was applied to the perinium, this is sewn up. Generally, mothers feel very relaxed, happy and tired at this stage. Later, the mother is cleaned up, her bleeding is checked and she is moved back to her room. During the first few hours, her bleeding, blood pressure, pulse and other vital signs are regularly checked.
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