Question

1. Describe the first stage and phase(s) of the labor process including cervical dilation, expected duration or each and maternal behavior and nursing care during each stage. Select a nursing diagnosis for each stage.

Answer 1

The first stage of labor starts from the start of regular contraction to complete cervical dilatation:

phases of the first stage of labor:

1. Latent stage: starts from the onset of true labor pain to cervical dilatation
2. Active phase: Start when cervical dilatation is at 4 - 7 cm and contraction last for 40 - 60 sec with 3 - 5-minute interval
3. Transition phase - When contraction reaches it peak with an interval of 2 - 3 min. Now the cervix is dilated to 10 cm

Duration:

• Primigravida - 12 hr
• Multigravida - 6 hr

Nursing care in stage 1 labor:

1. labor should be allowed to start naturally
2. Pregnant woman's mobility should be encouraged.
3. Avoid intervention
4. Allow the patient to assume a non-supine position for delivery
5. Upon delivery of the child, the mother and child should be given enough opportunity to breastfeed

Nursing diagnosis -

• Ineffective coping regarding fear and anxiety ( pertaining to labor)
• Impaired gas exchange ( fetal distress)
• Reduced maternal perfusion due to excess blood loss during delivery.