Labor is defined as the sequence of events by which the uterus expels the fetus into the vagina and thus the outside world. The goal of Obstetrical care is to manage this process so that a healthy mother safely delivers a healthy viable child.
Labor is divided into three stages:
FIRST STAGE begins with the onset of regular uterine contractions that result in progressive dilatation of the cervix. The exact moment that this begins is often unclear. The first stage ends with full dilation.
SECOND STAGE, begins with the full dilation of the cervix and ends with the completed delivery of the baby. The second stage of labor is the stage of delivery.
THIRD STAGE begins with the completed delivery of the baby and ends with delivery of the placenta.
The duration of each stage differs from pregnancy to pregnancy. Factors such as the number of pregnancies, size of the baby, size of the maternal pelvis, and of course problems with labor impact on the duration. There are graphs of the average time for each stage that physicians can use as a guide. If a stage of labor lasts longer than is expected, there may be a problem with the mother or baby.
Membranes
The membranes or 'bag of water' is the sac that surrounds the fetus throughout the pregnancy. The membranes may spontaneously rupture before labor begins, during labor or may be artificially ruptured by the physician to assist the labor. Rupture or leaking of the membranes may occur without the mother recognizing it. Damp areas while seated or upon awakening my be due to a rupture of the membranes. There are tests available to the health care provider in order to ascertain if the membranes have ruptured.
Fetal Monitoring
The baby’s heart rate should be monitored to look for signs of stress to the baby from labor. In some instances, the baby’s heart rate can be manually ausculated (listened to) or this can be done continuously and electronically. See the Electronic Fetal Monitoring Newsletter.
Medications
Various medications can be used during Labor and Delivery. Medications to induce or augment contractions, pain medication and anesthetic can be utilized during labor and delivery. Each has benefits and poses risks to mother/ child or both. Every health care provider has a responsibility to explain both the risks and benefits of the medication or treatment proposed. You as a patient have a right to be fully informed before you consent to treatment.
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