Stages of Labor

By VeriScorePrep Team · 6 min

Labor progresses through four stages, each with distinct assessments and nursing priorities.

First stage: dilation

From onset of regular contractions to full cervical dilation (10 cm). Three phases:

• Latent (0–4 cm): long, mild contractions. Encourage rest, hydration, positioning.
• Active (4–7 cm in multiparas; 6–10 cm more current standard): stronger, more frequent contractions. Monitor fetal heart rate and contraction pattern closely.
• Transition (8–10 cm): intense, frequent contractions. Patient may feel overwhelmed, irritable, or nauseated.

Second stage: expulsion

From full dilation to delivery of the baby. Coach pushing, monitor fetal heart rate after each push, prepare for delivery.

Third stage: placental

From birth of the baby to delivery of the placenta (usually within 30 minutes). Watch for signs of separation (lengthening cord, gush of blood, firm fundus). Inspect the placenta for intactness — retained fragments cause postpartum hemorrhage.

Fourth stage: recovery

First 1–2 hours postdelivery. Fundal checks every 15 minutes initially — fundus should be firm, midline, and at the umbilicus. Massage a boggy fundus. Watch lochia and perineum. This is the highest-risk period for postpartum hemorrhage.