Stages of Labor

Summary

This educational video script delves into the stages of labor, guiding viewers through early to late term with a focus on identifying labor onset signs like bloody show or water breaking. It outlines the progression from uterine contractions to cervical changes, emphasizing the importance of continuous assessment. The script breaks down labor into four stages, detailing each phase's characteristics, from latent and active labor to delivery and postpartum care. It also addresses the significance of maternal and fetal monitoring, the role of oxytocin, and the necessity of placenta delivery to prevent complications, providing a comprehensive guide for expectant parents and healthcare professionals.

Takeaways

• 📌 The video discusses the stages of labor, focusing on the transition from early to late term for expectant mothers.
• 🔍 Signs of labor include the bloody show, rupture of membranes, and the onset of contractions, which can be distinguished from false labor by their frequency, duration, and pattern.
• 🤰 The beginning of labor is marked by uterine contractions and cervical changes, which are characterized by the frequency, duration, and regularity of contractions, as well as the thinning and dilation of the cervix.
• 👩‍⚕️ Nursing assessment during labor involves continuous monitoring of the patient, with early labor being the optimal time for education and orientation.
• 📋 The importance of reviewing the birth plan, monitoring maternal and fetal vital signs, and assessing the status of amniotic membranes is highlighted.
• 👶 The process of labor is initiated by the baby's pressure on the cervix, which triggers the release of oxytocin and prostaglandins, leading to uterine contractions.
• 📈 Stage one of labor has three phases: latent, active, and transition, each with distinct characteristics regarding contractions, effacement, and dilation.
• 🤔 The latent phase is marked by irregular contractions, while the active phase sees regular contractions every three to five minutes, and the transition phase involves strong, overlapping contractions.
• 🤱 Stage two of labor involves the delivery of the fetus, with complete cervical dilation, and the coaching of the patient to push during contractions.
• 🛑 Stage three is the delivery of the placenta, which is crucial for preventing postpartum hemorrhage and ensuring the uterus contracts back to its original size.
• 🔚 Stage four focuses on postpartum care, including monitoring for hemorrhage, assessing the uterus and lochia, and facilitating family bonding and maternal recovery.

Q & A

What are the main indicators that a mother is in labor?

The main indicators that a mother is in labor include the bloody show, which is the loss of the mucus plug, the rupture of membranes or water breaking, and the onset of contractions. These contractions can be distinguished from false labor by their frequency, duration, and regularity.

What is the role of the uterine contractions and cervical changes in the onset of labor?

Uterine contractions and cervical changes are crucial in the onset of labor. Contractions increase in frequency, duration, and become regular, while the cervix undergoes effacement (thinning) and dilation (opening) to facilitate the baby's passage.

How does the baby's position affect the onset of labor?

The baby's position pressing on the cervix can cause it to stretch or pull, leading to the release of oxytocin from the hypothalamus and posterior pituitary gland. This hormone causes the uterus to contract, pushing the baby further into the birth canal.

What are the three phases of stage one of labor?

The three phases of stage one of labor are the latent phase, the active phase, and the transition phase. Each phase is characterized by different levels of cervical dilation, effacement, and the mother's experience of contractions.

What is the significance of the latent phase in stage one of labor?

The latent phase is significant as it is the longest phase where contractions are irregular, and the mother can still engage in normal activities. It is also the optimal time for initial assessments, teaching, and preparing for the labor process.

What are the characteristics of contractions during the active phase of stage one labor?

During the active phase, contractions become regular, occurring every three to five minutes, lasting about one minute. This phase is when the mother starts to feel more moderate pain and may require comfort and coaching.

Why is it important not to push before reaching full cervical dilation?

Pushing before full cervical dilation (10 centimeters) can cause trauma to the cervix, leading to swelling that may prevent the baby from passing through easily, potentially complicating the delivery.

What is the primary goal of stage two of labor?

The primary goal of stage two of labor is to deliver the fetus. This stage begins with complete cervical dilation and involves coaching the mother to push during contractions and rest in between to facilitate the baby's birth.

How does the placenta's separation from the uterus indicate the onset of stage three labor?

The separation of the placenta from the uterus is indicated by the lengthening of the umbilical cord, a gush of blood, and increased uterine contractions. These signs precede the delivery of the placenta, which is stage three of labor.

What are the key assessments and care practices during stage four of labor?

Stage four of labor involves monitoring the mother for two hours postpartum, focusing on preventing hemorrhage, assessing vital signs, lochia (bleeding), and the condition of the uterus (fundus). It also includes aftercare such as perineal cleansing, ice pack application, and encouraging rest and nutrition.

Outlines

00:00

🤰 Introduction to Labor Stages

The video script begins by introducing the topic of labor stages, specifically focusing on the transition from early to late term for expectant mothers. The speaker outlines the signs of labor, such as the bloody show, rupture of membranes, and the onset of contractions. The video aims to educate viewers on the process of labor, from the start signaled by uterine contractions and cervical changes, to the delivery of the fetus and placenta. The importance of assessing the frequency, duration, and regularity of contractions, as well as the cervical thinning and dilation, is emphasized. The speaker also highlights the significance of early labor for patient assessment and education, setting the stage for a comprehensive understanding of labor management.

05:00

📈 Stage One of Labor: Latent, Active, and Transition Phases

The second paragraph delves into the first stage of labor, which is further divided into three phases: latent, active, and transition. The latent phase is characterized by irregular contractions, minimal cervical effacement and dilation, and is the period where the mother feels relatively comfortable, allowing for conversation and movement. This phase is crucial for initial assessments, such as Leopold maneuvers and blood work. As labor progresses to the active phase, contractions become more regular and intense, necessitating comfort measures and coaching for the mother. The transition phase is marked by strong contractions, pelvic pressure, and the urge to push, indicating the mother is nearing full cervical dilation. The paragraph emphasizes the importance of patient support and the assessment of contraction patterns throughout these phases.

10:01

👶 Stage Two of Labor: Delivery of the Fetus

The third paragraph discusses stage two of labor, which involves the actual delivery of the fetus. With complete cervical dilation, the focus shifts to coaching the mother to push during contractions and rest in between, especially if an epidural has been administered. The importance of comfort measures, such as cold and warm compresses, and the potential need for an episiotomy to facilitate delivery without causing trauma, are highlighted. The paragraph also touches on the significance of the mother's position during delivery and the involvement of the birth partner to enhance the bonding experience. The ultimate goal of this stage is the safe delivery of the baby, after which the focus shifts to the next stage of labor.

15:01

🩸 Stage Three of Labor: Placenta Delivery and Postpartum Care

The fourth paragraph addresses stage three of labor, which is the delivery of the placenta. After the baby is born, the placenta must also be delivered to prevent complications such as hemorrhage. The speaker describes the signs of placental separation, including the lengthening of the umbilical cord, a gush of blood, and increased uterine contractions. Once the placenta is delivered, attention turns to postpartum care, including the assessment of the umbilical cord, perineal area cleansing, and the potential need for pitocin to aid uterine contraction. The importance of monitoring the mother's vital signs, lochia, and fundal height to prevent postpartum hemorrhage is emphasized, concluding with the final stage of labor.

🛌 Stage Four of Labor: Postpartum Observation and Care

The final paragraph discusses stage four of labor, which is the postpartum period where the mother is closely observed for two hours after delivery. The focus is on preventing postpartum hemorrhage by monitoring vital signs, assessing lochia to ensure bleeding is decreasing, and ensuring the uterus is firm and contracted. The speaker also mentions the importance of urinary output, family bonding, and the mother's recovery, including eating, sleeping, and urination. The paragraph concludes by summarizing the four stages of labor and encourages viewers to engage with the content through likes and comments, signaling the end of the video script.

Keywords

💡Stages of Labor

The 'Stages of Labor' refers to the distinct phases a woman goes through during childbirth. In the video, the speaker discusses these stages in detail, emphasizing the progression from early to late term, highlighting the importance of understanding each stage for proper care and support during labor. The stages include early labor, active labor, transition, and delivery, each with specific physical and emotional changes for the mother.

💡Bloody Show

The 'Bloody Show' is a term used to describe the discharge of blood-tinged mucus from the cervix, signaling the beginning of labor. It is mentioned in the script as one of the indications that a mother is in labor, along with the rupture of membranes. The bloody show signifies the body's preparation for childbirth by releasing the mucus plug that has sealed the cervix during pregnancy.

💡Rupture of Membranes

This term refers to the breaking of the amniotic sac, colloquially known as 'water breaking'. In the video, it is described as another sign that labor has begun. The rupture of membranes is a significant event as it allows the baby to move down into the birth canal and can lead to the progression of labor.

💡Contractions

Contractions are the tightening and relaxation of the uterine muscles that occur during labor. The video script explains the importance of distinguishing between true labor contractions and false labor contractions (Braxton Hicks contractions). True labor contractions are characterized by their increasing frequency, duration, and regularity, which are critical for the dilation and effacement of the cervix.

💡Effacement

Effacement is the thinning out of the cervix as it prepares to dilate during labor. The script mentions that during the stages of labor, the cervix goes from being thick to thin, allowing for the baby to pass through the birth canal. The process of effacement is a key part of the cervical changes that occur during labor.

💡Dilation

Dilation refers to the opening of the cervix to allow the baby to pass through during childbirth. The video script discusses how the cervix dilates from about one centimeter to ten centimeters, which is considered full dilation and is necessary for the baby to be delivered. Dilation is a critical aspect of the first stage of labor.

💡Latent Phase

The 'Latent Phase' is the early part of the first stage of labor, characterized by irregular contractions and slow cervical dilation. The video script describes this phase as the longest, where the mother may still be able to engage in normal activities. It is a period where the body is preparing for the more intense stages of labor.

💡Active Phase

The 'Active Phase' of labor is when the contractions become more regular, frequent, and intense, leading to more rapid cervical dilation. The video script explains that this is the phase where the mother starts to feel significant discomfort and may require comfort measures and coaching. It is a critical period leading up to the transition phase.

💡Transition Phase

The 'Transition Phase' is the final part of the first stage of labor, just before the mother is ready to push. The video script describes this phase as being marked by strong contractions, a feeling of pelvic pressure, and the urge to push. It is a challenging period for the mother, often accompanied by restlessness and emotional intensity.

💡Cervical OS

The 'Cervical OS' refers to the opening of the cervix, measured in centimeters. The video script uses this term to illustrate the process of cervical dilation during labor. As the cervix dilates, the 'Cervical OS' increases, moving from a closed state to 10 centimeters, which is full dilation and indicates the mother is ready to push.

Highlights

Introduction to the stages of labor, focusing on the transition from early to late term.

Discussion on the signs indicating the onset of labor, such as the bloody show or rupture of membranes.

Explanation of the difference between true labor contractions and false labor contractions.

Description of the physiological process that starts labor, including uterine contractions and cervical changes.

Importance of continuous assessment during labor and the significance of early labor for patient education.

Details on the nursing assessment process upon the patient's arrival in the facility.

The role of oxytocin and prostaglandins in the progression of labor.

Explanation of the three phases within stage one of labor: latent, active, and transition.

Characteristics of the latent phase, including irregular contractions and minimal cervical changes.

The active phase's focus on increased comfort and coaching for the patient as contractions become more regular.

Description of the transition phase, marked by strong contractions and the urge to push.

Stage two of labor, focusing on the delivery of the fetus and the importance of coaching during pushing.

The significance of stage three, which involves the delivery of the placenta and the prevention of postpartum hemorrhage.

Highlighting the importance of postpartum care in stage four, including monitoring for hemorrhage and assessing the uterus.

Advice on facilitating family bonding and the importance of rest and nutrition for the mother post-delivery.

Conclusion and call to action for viewers to like, comment, and subscribe for more informative content.

Transcripts

foreign

engineers in this video we're going to

be talking about the stages of labor if

you like this video make sure to give it

a thumbs up comment down below and don't

forget to subscribe check out nature.org

where we have all of our illustration

notes and drawings for you guys to check

out as well so let's get into it with

the stages of labor we're going to

specifically be talking about when Mom

is in her early term to late term so we

are talking about a client here who is

in the full-on stages of labor and how

do they start what's going to indicate

to us that our patient is in labor

so typically there is either the bloody

show where we lose our mucus plug or we

have our water breaking which is our

rupture of membranes or mom has the

indication of her contraction starting

and whether or not those are true labor

contractions or false labor contractions

we will talk about that in a minute

but I wanted to go over really quickly

what really starts the delivery of our

stages of labor how do we go from our

delivery of the fetus to the placenta to

being out of Labor so the beginning or

our start of Labor is our uterine

contractions and our cervical changes

and do you remember what those

indications are of the uterine

contractions which is our true labor

it's usually those three things the

increase in our frequency

so they're occurring more often increase

in

duration

which they are lasting longer and

they're becoming regular so our

contractions are going to increase in

their frequency happening more often

increase in the duration lasting a

longer time and they're going to be

happening more often in a regular

pattern and then what are our cervical

changes do you remember what we talked

about in our previous videos about the

changes that happen to the cervix that

indicate that we are in deed in true

labor

there is a basement

which is our thinning of our cervix so

our cervix eventually becomes

thinner it starts to thin out here

and then we also have our dilation

which is then the opening right so now

our cervical OS is maybe going from one

centimeter

all the way to 10 or right there's maybe

about three centimeters but you get the

point that it's increasing in dilation

so throughout this entire process of the

stages of labor with our client and with

our patient we're going to want to

continuously assess them and this is

what we're going to be doing kind of the

whole time so with our nursing

assessment when our patient comes in

they're in hopefully the earliest stage

of Labor that you're going to be seeing

them in and then from there advancing

through those stages so this time is

usually the easiest time to orient our

client and talk to them about what's

going on tell them what the unit looks

like what the process is going to be

like through here and do our teaching

and our talking here because this is the

most coherent or most at education that

our patient's going to be they're going

to be more likely to understand what

you're talking about and teaching them

in this process

when we do get them into our facility we

want to maybe review the birth plan for

them so you want to talk to them about

what their plans are for their birth are

they going to want an epidural do they

not want an epidural who do they want in

the room who they don't want in the room

and then also what kind of care they've

had through their anti-partum

we also want to start getting them on

the monitor monitoring maternal and

Fetal Vital Signs and then also try to

lay down what their contraction pattern

is at that time and the status of their

amniotic membranes did they have a

rupture of membranes if they did we're

going to document and talk about that

with them or if they didn't and then

we're going to continually assess them

through this entire labor

and you're probably wondering well how

does like how labor starts just all of a

sudden but what is that process and

there's a little process here that I

drew out for you guys to kind of

understand in a nutshell what is going

on so baby is going to be pressing on

the cervix and causing the cervix to

either stretch or pull or a face and

dilate because of that head being

engaged or maybe it's a foot maybe it's

a shoulder maybe it's a butt but they're

all pushing on these cervix

when that cervix stretches it sends a

signal to the hypothalamus and the

posterior pituitary gland saying hey

there's some stretching in the cervix

because of that process it releases

oxytocin oxytocin is then released it

causes the uterus to contract and when

we have that Contracting we're making

baby push down down into our further

down to our stations and because of that

baby's head is then continually

Contracting on this cervix and we have

this positive feedback right here

also when all this is occurring placenta

is also releasing some prostaglandins

and those prostaglandins are also

telling the uterus to contract as well

which is again pushing I'm telling baby

to go down and this baby pushes down

into the cervix cervix stretches and we

keep having this release of oxytocin

so this is the starting portion if we

are in true labor to start our stages of

labor so let's go in and talk about the

first stage stage one of labor now our

patient is in stage one and we're going

to be talking about all the stages of

labor stage one two three and four but

you're going to notice that right behind

me there are multiple phases to stage

one so stage one if you didn't know has

three phases there's latent active in

transition and if you're like me and

you're like oh great there's not only

stages but there's phases and now I have

to remember more stuff I always remember

that latent just starts with lat which

gives me the orientation of these three

latent active in transition

so the goal of stage one is to complete

the dilation and phasement of the cervix

what we're trying to do is open up that

cervix and thin it out so that we have a

nice big opening for baby to come on out

So within the latent phase which is the

first phase of stage one

we're going to be focusing on what's

going on with Mom and how mom is feeling

so we have the longest phase and this is

usually the phase where we can still

talk and breathe normally carry

conversations walk around these are the

ones the contractions and the dilation

facement that is going to be simplest or

the most mild so what we're looking at

here is Mom's probably coming into the

hospital we're going to do some Leopold

Maneuvers so we can get our external

fetal monitor on so we're going to check

where baby's back is feel where baby's

head is we're going to place our IV if

Mom is okay with that and get some blood

work drawn we want to be checking you

know hematocrine hemoglobins check those

Baseline levels see what their typing

screen is of their blood case we have to

administer some blood later we also want

to get some baseline Labs or anything

else that we might need for them we want

to get our paperwork out of the way so

this is the phase where if we're going

to be doing any type of teaching any

type of paperwork that needs to get done

for any type of procedures we might have

we want to fill those out now

do our complete head to toe and then get

our status on our membranes did we have

rupture membranes if we did we're going

to check with our paper if Mom's not

sure we'll check with our nitrozine

paper if not or we're not sure then we

can also validate with the nitrogene

paper and if it did and Mom did notice

it we're going to ask what was the color

what was was there an odor what was the

amount just so we can get an idea and

document all of that

but the biggest indicator of our latent

phase is where we are with our

contractions and our effacement and

dilation

within our contractions and this is the

big NCLEX thing right here is the latent

phase has The Irregular contractions

this is the beginning of labor so Mom

really might not notice that she's in

labor she might think oh I don't that

was just you know a random contraction

that I'm having it wasn't really true

labor so they're going to be a regular

of these contractions they're going to

last any or they're going to be in

anywhere from five to thirty minutes so

they might be as often as five minutes

or there might be a span of 30 minutes

in between each contraction and they're

going to last around 30 seconds

the effacement is going to be from zero

to thirty percent so we're thinning at

that zero to thirty percent and our

dilation is going to be from zero to

Thirty so remember our cervix is trying

to thin so you can see here as we

progress from latent all the way down

through active into transition we're

going to be trying to thin and dilate so

you can see the difference here now

we're going to move into active phase

and this is where our patient is going

to need some more comfort and coaching

this is where we're going to realize oh

I think I'm actually having contractions

now I can feel them they're a lot more

moderate in pain we can feel them so the

comfort and coaching of how we're going

to be breathing through these

contractions how we're going to maybe

reposition dim the lights play some

calming music and encourage our patient

to avoid every two hours in order to

keep that bladder nice and empty we want

to make sure that we are also talking to

our patient if they're feeling a lot of

pain that if they would like an epidural

this is kind of the phase or the area

that we would put that epidural in

because we're still still able to

control our contraction contraction

control our body and our breathing

because once we get past active into

transition they're a lot stronger and

it's kind of hard to sit still for an

epidural to go in so our contractions in

the active phase are going to be regular

they're going to be roughly

occurring every three to five minutes

now and they're going to have a duration

of about one minute and this is where

our Faceman is going to be 30 to 80

percent and our dilation is four to

seven so we're getting ready to have

baby but we're not quite there and as we

transition into transition phase

this is where we're going to start

feeling that pelvic and rectum pressure

this is where we're going to feel the

urge to push or Bear Down sometimes this

is where we may think we have to take a

bowel movement we got to go to the

bathroom but that may or may not happen

but we also may be pushing for a baby

and we don't want to push until we're at

10 centimeters because if we push before

10 centimeters we are going to maybe

cause some trauma to that area the

cervix is going to get angry because

we're going to be pushing really hard

and it might swell and when that

swelling occurs baby's not going to pass

through as easily as we would like to

because of this the client's going to be

restless sweating hiccuping nausea and

vomiting in a lot of pain so we want to

encourage them to stay calm support them

through the breathing through the

contractions because these contractions

are going to be strong they're going to

be super super strong they're going to

be super super painful because we are

moving now in through our labor they're

going to be occurring every 30 seconds

to two minutes and they're going to be

lasting around 60 to 90 seconds if

you're looking at this you're like wait

a minute how can they be occurring every

30 to 2 minutes but a lasting almost a

minute to a minute and a half or 60 to

90 seconds they will overlap as one

contraction is starting to fall off

another one might start right back up

and that's how we know we're getting

really close to baby

80 to 100 of our effacement and then

eight to ten centimeters on our dilation

and once we have reached our 100

effacement and our 10 centimeters

dilated we are now ready to push and to

get baby out so let's move into stage

two and now we're on to stage two so now

we are getting ready to have baby so we

have complete cervical dilation or if

you assess mom you may see crowning or

the baby's head right there and we are

ready to deliver the fetus so again this

is where it's really important to coach

the client and encourage them you want

to make sure that they are pushing when

they feel contractions and resting when

there isn't a contraction and if our

patient did have an epidural they may

not be able to feel the contraction so

this is when we want to really coach

them through okay a contraction is

coming I'm going to need you to push and

push and then time to rest we got to

breathe and get our rest in because

labor sometimes can take a long time and

we don't want mom getting tired so with

this we also want to try to get that

Comfort going for Mom so we want to

either use a cold compress for the head

or the back of the neck and warm

compresses down the perineum to allow

everything to relax down there we want

to assist in positioning so be able to

get them in whatever delivery position

they would prefer and then also get the

partner involved that is there because

we want to make sure that we are getting

Mom comfortable and also building that

bonding if we can and then we also are

going to have to ask Mom if there is an

option for an episiotomy or if you know

what this is this is when we maybe

aren't able to get baby out quite it's a

lot of stretching going on and in order

to prevent a tear we may do a small

incision in the perineum so we'll do an

incision

thank you

in the perineum

and that's going to allow just a little

bit a little small incision to allow

baby's head to pass through and be able

to have babies and then baby is

delivered baby is out and now we're

going to move into stage three now that

baby has been delivered we are going to

move into stage three babies out and

it's now time to deliver the placenta so

don't get confused that baby is out and

labor is over we still have to have the

placenta come out as well because

remember if we retain placental

fragments or the placenta what can

happen is we are never going to have our

uterus contract back down to its

original size so that will keep that

exposure of hemorrhage or bleeding out

so we need to deliver the placenta baby

is born and we want to perform our

apgars of one in five minutes and we

want to promote that skin to skin dry

baby off get baby comfortable get baby

warm put them on our mom and then be

able to move forward with focusing on

mom getting that placenta out so we are

going to be looking for certain signs

that are telling us that our placenta is

separating from from the uterus because

remember it is adhered onto the uterine

wall and it's going to have to separate

in order to come out

so some signs of separation from the

uterus are a couple things you want to

imagine right this uterus here and the

placenta are going to start to separate

right and as they separate it's a

tearing I kind of picture it as like a

scab when you pick a scab off you're

like breaking all those little vessels

in there so as you pull off the placenta

you're going to have some separation so

the first thing that's going to happen

is that umbilical cord also is going to

lengthen right it's going to separate

from the uterus it's going to lengthen

you're going to see it all of a sudden

lengthen from them because of that

separation and that pulling off we're

going to have a gush of blood so we have

that long eating of the umbilical cord a

gush of blood and then we're going to

have the fun to start Contracting you're

going to feel a little bit more

contractions as we're trying to push

that placenta out

when this all is happening we're going

to say yay the placenta is delivered but

there is something we need to do before

the placenta is delivered when baby is

out once baby is out

baby is out

we want to think about clamping

after one minute right we're going to

place two clamps on our umbilical cord

so baby is out we're clamping the

umbilical cord we're trying to get

placenta delivered placenta comes out

and now we are focusing more on the

Aftercare of Labor so we already have

our placenta out we are going to cleanse

the perineal area Place some ice packs

if there was an episiotomy uh performed

you want to make sure that we are

getting the suture or if there were some

tears we were getting that all sutured

up nice and clean we also maybe want to

think about starting pitocin so that we

can have our uterus contract back down

and then decrease our chances of

hemorrhage postpartum hemorrhage we also

want to assess our umbilical cord

remember when we are looking at the

opening of our umbilical cord where we

cut it we're looking to make sure

there's two umbilical arteries and one

umbilical vein making sure that we have

the appropriate vessels in there we also

want to make sure that we are assessing

our placenta our placenta has two sides

remember we have dirty Duncan which is

the underside that ripped away from the

uterus which is the maternal side and

then we have the shiny Schultz which is

the part that is where the umbilical

cord comes and it's on the baby because

the baby's new and happy and shiny so

once we do all this assessing and we're

documenting through all this we are now

going to move into stage four which is

the Care at the end of Labor we're not

quite done with labor we still got to

keep an eye on mom for the next two

hours so let's talk about stage four

baby is out placenta is out and now we

need to take care of stage four so stage

four is now once a placenta is out we

have about two hours after to keep an

eye on Mom and the biggest things that

we're going to be focusing on is that

postpartum Hemorrhage what's going on

with Mom so the maternal Vital Signs we

want to make sure that we are keeping an

eye on on our Vital Signs and

particularly blood loss so we're going

to be focusing on our blood pressure and

our pulse and we want to make sure

there's two things we're basically

looking for are they hypovolemic

or if they had any other

problems we might be thinking are they

having preeclampsia right if they had

some eclampsia prior preeclampsia prior

to labor they could still be in that

range for the preeclampsia so we're

keeping an eye on their blood pressure

and their pulse and we're also going to

be keeping an eye on their lochia which

is every 15 minutes we're going to be

assessing that bleeding and what we're

looking at is we're going to be looking

at that pad

and seeing if that pad is going from a

heavy to moderate all the way down to

hopefully a light okay as we progress

from labor from placenta being out and

on from labor so what we're looking at

here is it should be decreasing over

time our bleeding should be decreasing

over time our Vital Signs Should Be

steady and when we are assessing our

fundus it should feel nice and firm if

it feels boggy

we're going to think a couple things I

can do big end question here you assess

your postpartum patient and all of a

sudden you're feeling a boggy fund it's

what are you going to do you're going to

massage the fundus right we're going to

be using our hands to place here and

here on either side of our uterus and

we're going to try to massage the fundus

right try to make it shrink back down

because what we want to do is have this

contract all the way back down into its

small

pre-baby shape right if it's not or if

the fungus still feels a little boggy or

mushy to you you know maybe you want to

think about some medications like

oxytosis or oxytocin those medications

that are going to increase that uterine

contraction so help that uterus to

shrink back down we also want to be

looking at the urinary output of our

patient making sure that we are

preventing distension of the bladder we

don't want the bladder to be distended

because it may cause some other issues

within our abdomen we want to facilitate

the family bonding to the baby so we

want to make sure we're doing skin to

skin we'll make sure that we are

increasing with the feeding and getting

that bonding experience whether it's

breastfeeding or bottle feeding so that

we are building that bonding moment with

baby

if mom had an episiotomy or had some

tearing and there was a laceration you

want to make sure you're assessing that

area and making sure you're providing

care so there's no infection rate there

going on and then we also want to

encourage that we have our client eat

sleep and urinate the eating and

sleeping is a big part sleep when baby

sleeps and try to eat as well because

there might have been a really long

labor labor might have been over 20

hours in total so we want to make sure

that we're keeping an eye on our client

and making sure that they are getting

that rest and that energy back that they

had

and that is it that is the four stages

of labor I hope it made sense I hope you

got something from this video if you did

and you liked it make sure to hit that

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and as always until next time

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