Stages of Labor Nursing OB for Nursing Students | Stages of Labour NCLEX Explained Video Lecture

Summary

In this informative video, Sarah Thread Sterner provides an in-depth review of the stages of labor as part of a maternity nursing series. She outlines the four stages of labor, emphasizing the importance of understanding each stage for nursing exams. Stage one involves cervical dilation with three phases: latent, active, and transition. Stage two is the baby's delivery, stage three is the placenta's delivery, and stage four is the recovery period. Key points include monitoring cervical dilation, contractions, and nursing interventions. The video also covers signs of the baby's imminent delivery, the appearance of the placenta, and the nurse's role during each stage, concluding with a quiz for knowledge assessment.

Takeaways

• 📚 The video is part of an inkle review series focused on maternity nursing.
• 🤰 There are four stages of labor, each with specific events and nursing interventions.
• 🔑 The first stage is the longest and involves three phases: latent, active, and transition.
• 📏 During the first stage, the cervix dilates from 0 to 10 centimeters.
• 🚑 The latent phase is characterized by mild contractions and may not be recognized as labor.
• 💪 The transition phase is the most intense, with contractions becoming very close together.
• 👶 Stage two is when the baby is delivered, and it can last from 2 to 3 hours for first-time mothers.
• 🌀 In stage two, the mother will experience intense pressure and the urge to push.
• 🩸 Stage three involves the delivery of the placenta, which should happen within 5 to 15 minutes after the baby is born.
• 🔄 The Schultz and Duncan mechanisms are key methods for delivering the placenta.
• 🛌 Stage four is the recovery period, lasting one to four hours post-delivery, where the mother's vital signs and uterine health are closely monitored.

Q & A

What are the four stages of labor mentioned in the video?

The four stages of labor are: Stage one (cervix dilates from 0 to 10 centimeters), Stage two (baby is delivered), Stage three (placenta is delivered), and Stage four (recovery period one to four hours after the delivery of the placenta).

What are the three phases of the first stage of labor?

The three phases of the first stage of labor are the latent phase (also called early labor), the active phase, and the transition phase.

What happens during the latent phase of labor?

During the latent phase, the cervix dilates from one to four centimeters, contractions are every five to thirty minutes and 30 to 45 seconds in length, and they are mild compared to the active and transition phases.

How does the active phase differ from the latent phase?

In the active phase, the cervix dilates from four to seven centimeters, contractions are every three to five minutes and 45 to 60 seconds long, and they are stronger and longer than in the latent phase.

What is the main goal of the transition phase?

The main goal of the transition phase is to dilate the cervix from 8 to 10 centimeters, leading to full dilation for the baby to be delivered.

What are the signs that the baby is about to be delivered during stage two of labor?

Signs that the baby is about to be delivered include intense pressure, the baby descending through the birth canal, and changes in the perineum such as bulging or an increase in bloody show.

What are the two delivery mechanisms for the placenta mentioned in the video?

The two delivery mechanisms for the placenta are the Schultz mechanism, where the shiny side (baby side) is delivered first, and the Duncan mechanism, where the dull side (maternal side) is delivered first.

What is the significance of the color of the amniotic fluid during labor?

The color of the amniotic fluid is significant because meconium-stained fluid, which is yellow-brown or greenish, can indicate fetal distress and the risk of the baby aspirating it into its lungs, potentially causing infection or blocking airways.

Why is it important not to push before the cervix is fully dilated during the transition phase?

It is important not to push before the cervix is fully dilated because pushing before achieving a '10' on the dilation scale can cause the cervix to swell and prevent further dilation, which is necessary for the baby to be born.

What are some nursing interventions during the active phase of labor?

Nursing interventions during the active phase include providing comfort through nonpharmacological (e.g., warm showers, massage) or pharmacological (e.g., epidural) methods, monitoring vital signs, and ensuring the woman's bladder is empty to prevent interference with uterine contractions.

What is the primary focus of stage four of labor?

The primary focus of stage four of labor is the recovery period for the mother, which involves monitoring for complications like hemorrhage or infection, assessing the fundus of the uterus, and promoting bonding and breastfeeding with the baby.

Outlines

00:00

📝 Introduction to Stages of Labor and Nursing Interventions

In this introductory paragraph, the presenter, Sarah, sets the stage for the video by discussing the stages of labor as part of a review series on maternity nursing. She explains that the video will cover key aspects essential for nursing students, especially for those preparing for the NCLEX exam. The focus is on understanding the four stages of labor, particularly the first stage, which includes three phases. She emphasizes the importance of knowing cervical dilation, contraction patterns, and nursing interventions at each stage.

05:02

📊 Overview of the Four Stages of Labor

This paragraph gives a brief overview of the four stages of labor. Stage 1 involves cervical dilation from 0 to 10 cm and is subdivided into three phases: latent, active, and transition. Stage 2 focuses on the delivery of the baby, Stage 3 involves the delivery of the placenta, and Stage 4 is the recovery phase following placental delivery. Each stage has specific nursing roles and signs to monitor, such as cervical dilation, contractions, and fetal monitoring.

10:04

👶 Stage 1: Latent Phase

In the latent (early) phase of Stage 1, the cervix dilates from 1 to 4 cm with mild contractions occurring every 5 to 30 minutes, lasting 30 to 45 seconds. This phase can be long, especially for first-time mothers, and may go unnoticed as contractions are mild. If the mother is at home, she should stay there until active labor begins or her water breaks. During this phase, mothers are usually excited and nervous. Nursing interventions include comfort measures and keeping the mother active and comfortable.

15:04

🚶‍♀️ Stage 1: Active Phase

During the active phase, the cervix dilates from 4 to 7 cm, with stronger contractions occurring every 3 to 5 minutes, lasting 45 to 60 seconds. This phase lasts 4 to 8 hours, and mothers should head to the hospital if still at home. Nurses must monitor for signs of meconium-stained fluid (which can indicate fetal distress) and provide comfort through pharmacological or non-pharmacological methods, such as breathing techniques or epidurals. Nurses also monitor vital signs and bladder function, as a full bladder can slow labor.

⏳ Stage 1: Transition Phase

The transition phase is the most intense and shortest, with the cervix dilating from 8 to 10 cm. Contractions are very strong and close together, occurring every 2 to 3 minutes and lasting 60 to 90 seconds. The mother feels intense pressure, especially in the rectum, but must refrain from pushing until fully dilated to avoid complications. Nurses provide encouragement, monitor fetal heart rates, and assess cervical dilation and fetal position. Support is crucial as this phase leads into Stage 2, where the baby will be delivered.

💪 Stage 2: Delivery of the Baby

Stage 2 begins once the cervix is fully dilated and ends with the baby’s delivery. Mothers feel intense pressure as the baby descends through the birth canal. For first-time mothers, this stage can last up to 2 to 3 hours, while for others, it’s typically around 20 minutes. Contractions remain intense, and the nurse’s role includes teaching the mother how to push properly, monitoring vital signs, and offering encouragement. The exact time of birth is recorded, and the perineum is observed for bulging or visible baby parts.

🩺 Stage 3: Delivery of the Placenta

Stage 3 involves the delivery of the placenta, which usually occurs within 5 to 15 minutes after the baby is born. It is crucial for the placenta to be delivered quickly to avoid hemorrhage or complications from retained placenta parts. Nurses monitor for signs of placental delivery, such as lengthening of the umbilical cord and a change in the uterus’ shape. Two mechanisms of placental delivery are highlighted: Schultz (baby side, shiny and new) and Duncan (maternal side, dull and rough).

🔍 Stage 4: Recovery and Postpartum Monitoring

Stage 4 covers the first 1 to 4 hours after placental delivery, focusing on monitoring the mother for signs of hemorrhage, infection, and uterine atony. Nurses frequently check vital signs and assess lochia (post-birth discharge) to ensure no excessive bleeding. The fundus of the uterus is checked to ensure it is firm and positioned correctly. If the fundus is soft or displaced, nurses perform fundal massage and ensure the bladder is empty. Comfort measures and bonding with the baby, including breastfeeding, are promoted.

Keywords

💡Labour Stages

Labour stages refer to the different phases a woman goes through during childbirth. In the video, Sarah Thread Sterner discusses the four stages of labour, emphasizing the importance of understanding what happens during each stage for maternity nursing. The video aims to educate viewers on the progression from the onset of labour to the delivery of the baby and placenta.

💡Cervical Dilation

Cervical dilation is the process by which the cervix opens to allow the baby to pass through the birth canal. The video script mentions that stage one of labour involves the cervix dilating from 0 to 10 centimeters, which is critical for the baby's delivery. It's a key concept because it measures the progress of labour and is a focus for nursing interventions.

💡Contractions

Contractions are the tightening and relaxation of the uterus that occur during labour. In the script, Sarah explains that contractions start mild and become more intense, particularly during the transition phase of stage one. They are essential for progressing cervical dilation and are a significant focus for monitoring during labour.

💡Nursing Interventions

Nursing interventions are actions taken by nurses to assist women during labour. The video mentions interventions such as providing comfort measures, monitoring vital signs, and assisting with pushing during stage two. These interventions are crucial for the safety and comfort of the mother and the successful progression of labour.

💡Meconium

Meconium is the first stool of a newborn, which can sometimes be present in the amniotic fluid. The script warns about the importance of identifying meconium-stained fluid, as it can indicate fetal distress and the potential for the baby to aspirate it, leading to lung issues. It's a critical concept for nurses to recognize and manage during labour.

💡Fetal Heart Rate

Fetal heart rate monitoring is a standard procedure during labour to assess the baby's well-being. Sarah mentions the importance of monitoring the fetal heart rate, especially during contractions, to ensure the baby is not in distress. This is a key nursing responsibility and an essential aspect of labour management.

💡Perineum

The perineum is the area between the vagina and anus, which can show signs of impending birth. The script describes changes in the perineum, such as bulging and bloody show, as indicators that the baby is about to be born. Understanding perineal changes is vital for nurses to know when to prepare for the baby's delivery.

💡Placenta Delivery

Placenta delivery refers to the process of the placenta being expelled after the baby's birth, which is stage three of labour. The video script explains the signs that the placenta is about to be delivered and the importance of monitoring the mother's condition closely to prevent complications like hemorrhage.

💡Pitocin

Pitocin is a medication used to stimulate or augment labour. The script mentions that Pitocin may be ordered after the delivery of the placenta to help with its delivery and prevent hemorrhage. Understanding the role of Pitocin is important for nurses involved in labour management.

💡Lochia

Lochia refers to the vaginal discharge that a woman experiences after giving birth. The video script discusses monitoring the amount and characteristics of lochia as an indicator of the mother's postpartum health. Excessive bleeding or large clots could signal complications like hemorrhage.

💡Fundus of the Uterus

The fundus of the uterus is the top part of the uterus, and its condition is monitored post-birth to ensure it is firm and in the correct position. The script mentions checking the fundus to prevent complications like uterine atony, which can lead to hemorrhage. This is a critical post-labour nursing task.

Highlights

Sarah Thread Sterner introduces the four stages of labor and their importance in maternity nursing.

The first stage of labor involves cervical dilation from 0 to 10 centimeters and is divided into three phases: latent, active, and transition.

The latent phase is the early labor stage where the cervix dilates from 1 to 4 centimeters.

The active phase sees the cervix dilate from 4 to 7 centimeters with stronger and longer contractions.

The transition phase is the most intense and leads to full cervical dilation at 10 centimeters.

Stage two begins with full cervical dilation and ends after the baby is delivered.

In stage two, the woman experiences intense pressure as the baby descends through the birth canal.

Stage three is the delivery of the placenta, which should occur within 5 to 15 minutes after the baby is born.

The fourth stage of labor is the recovery period, lasting one to four hours after the placenta is delivered.

Nurses play a crucial role in monitoring and supporting the mother during each stage of labor.

The importance of recognizing signs of fetal distress, such as meconium-stained fluid, is highlighted.

Non-pharmacological and pharmacological interventions for pain management during labor are discussed.

The significance of monitoring the fetal heart rate and the mother's vital signs is emphasized.

The role of the nurse in teaching the mother how to push and breathe during stage two is explained.

The Schultz and Duncan mechanisms of placenta delivery are described, with tips for remembering which side is delivered first.

Post-delivery interventions include monitoring for hemorrhage, assessing the placenta, and promoting mother-baby bonding.

The nurse's role in the first few hours after delivery includes monitoring for complications and providing care to the mother.

The importance of assessing the mother's lochia and fundus after delivery is discussed.

The lecture concludes with a reminder to take a quiz to test knowledge on the stages of labor.

Transcripts

hey everyone it's sarah thread sterner

sorry and calm and in this video I want

to be going over the stages of labour

this video is part of an inkless review

series over maternity nursing so if

you're studying this section be sure to

check out the other videos in this

series and as always in the youtube

description below or at the end of this

video you can access the quiz that will

test your knowledge on the stages of

labour so let's get started

okay as we go through the stages of

labour there are some things that you

want to pay attention to for the ink Lex

exam or your maternity lecture exams

like for instance there's four stages

and what is happening during each of

those stages especially your first stage

because first stage has three phases and

you want to know what's happening with

cervical dilation with contractions and

nursing interventions and then

throughout the other stages like 2 3 & 4

you want to pay attention to what's

going on and why your role is as the

nurse like when the baby is delivered

what are some signs and symptoms the

baby's about to be delivered or in stage

3 when the placenta is delivered what

are you looking at after the placenta is

delivered

meaning and what's the placenta supposed

to look like and then in stage 4 what

are you going to be doing during

recovery so be sure you pay attention to

all that as I'm going through this

lecture so let's go over the four stages

of labor

what are they okay Stage one is where

the cervix dilates from 0 to 10

centimeters and this stage has three

phases known as the latent which is also

sometimes called early labor

active and transition then you have

stage to this stage is where the baby

will be delivered and then stage three

will be delivery of the placenta and

then stage four will be the first one to

four hours after the delivery of the

placenta let's look at stage 1 of labor

in debt okay the whole goal of stage one

is to get the cervix dilated from zero

to ten centimeters and a hundred percent

of face so dilation is opening up of the

cervix and effacement is thinning of the

cervix and all this is going to happen

due to the contractions the woman will

be having and they'll start out very

mild in the latent phase and then when

you get to transition phase they're

going to be really intense because that

cervix is trying to open all the way up

so that baby can be born that's the

whole goal of this stage now some facts

about stage one stage one is the longest

stage of all the stages of labor and it

tends to be longer for first-time

mothers compared to women who've already

had children and it starts when true

labor starts now as I said before stage

one has three phases so um I would

remember the name of each phase what

happens in them in regards to the

dilation of the cervix your

interventions and remember the order of

them because the transition which is the

third part of this stage the face will

lead into stage two where the baby will

be delivered so to help you remember the

order in the name of the stages remember

this mnemonic labor actively

transitioning because our labor is

transitioning to stage two which is

where the baby's going to be born the

whole goal is to have contractions open

up that cervix thin that cervix so the

baby can get out and be born okay so

let's look at the first phase this is

called the latent phase or sometimes

referred to as early labor

the cervix is going to dilate from one

to four centimeters in thin contractions

will be every five to thirty minutes and

30 to 45 seconds in length

now these contractions are going to be

very mild compared to what will be

happening in the active and transition

phase and um this phase is longest for

first-time mothers and sometimes women

may not even know that they're in um the

latent stage of labor

because the contractions may be mild

they not they may just have pain in

their back and so they really don't know

now during this phase if the woman's at

home she needs to stay at home until

she's actively in active labour or the

water breaks and the whole goal is to

keep comfortable try to keep busy as the

labor progresses

during this phase mother is going to be

excited and nervous and talking now

we're going to go into the active phase

and this is where things start to heat

up and start to get active okay in this

phase the cervix is going to dilate from

four to seven centimeters the woman will

probably be dilating anywhere between

about one centimeter per hour

contractions are going to be every three

to five minutes and forty-five to sixty

seconds long and the woman is going to

notice that these contractions are a lot

stronger and longer compared to what was

happening in the latent phase this phase

can last between four to eight hours now

if the mother is still at home it's time

for her to go to the hospital also

during this phase the water may break

and you'll want to check and if it

breaks in the hospital or if it broke at

home you'll want to ask for what color

was the fluid that was leaking and

because you're looking for what's called

meconium staying fluid and this fluid

will look like a yellow brown or

greenish fluid and what can happen is

that the baby can aspirate this into its

lungs cause infection block the Airways

and it can be an indication of fetal

distress so you want to ask that another

thing you may be doing is performing a

nitrazine paper test where you'll take

the fluid put it on a little strip of

paper and if it turns blue that means

that the woman is for surely leaking

amniotic fluid okay interventions during

this phase is comfort because she's want

to be having those intense contractions

so comfort either through nonfarm

illogical or Pharma logical techniques

and non pharmacological could be warm

shower

or baths or massage during contractions

or an epidural which is pharmacological

breathing techniques and keeping the

bladder empty I'm helping her if she has

an epidural she'll get a Foley but I'm

helping her go to the bathroom every

couple hours to void to empty that

bladder because a full bladder can

prevent the uterus from contracting

properly which can slow down labor and

you'll also want to be monitoring the

woman's vital signs and the heart rate

of the baby and I have a whole video on

fetal decelerations talking about early

and variable how to monitor those and a

card should be popping up so you can

access that and the mom she's going to

be a lot different in this phase

especially as it progresses she's going

to be serious in pain and anxious now

let's look at the transition phase this

phase is going to lead into stage 2

where the baby will be delivered the

cervix is going to dilate from 8 to 10

centimeters remember 10 is where we

wanted to get that perfect 10 so the

baby can be delivered now the thing with

this phase is it's um shortest of all

the phases but it's the most intense and

most painful for the mother it can last

anywhere from 30 minutes to 2 hours

contractions are going to be very

intense they're going to be long

sometimes back-to-back overlapping each

other they can occur every 2 to 3

minutes and lasts 60 to 90 seconds the

mom will be concentrating she's not

going to feel like talking be irritated

very much in pain and could be shivering

also she may start to feel an intense

pressure in the rectum as that baby is

pushing down and descending and you

don't want the mother to start pushing

even though she's going to want to push

until that cervix is fully dilated

because if the cervix is not dilated to

10 centimeters you can be pushing which

can cause and the cervix to become

swollen and then

we'll never dilate so you want to make

sure that she's all the way to ten

before she starts pushing so some

interventions a lot of support

encouragement and praise let her know

you've made it this far you can do this

we're almost there the breathing

techniques monitoring vital signs of

mother and especially baby the fetal

heart rate and especially during those

contractions after them and before how's

the baby responding making sure it's not

any distress and assessing cervical

dilation and effacement is she at the 10

yet and fetal positioning and what

station is that is the baby I and 0 is

where the baby is engaged it's a little

imaginary line you would draw on the

pelvis 0 would be at the ischial spine

which is the most narrow part of the

pelvis and as the baby advances it will

be entering into the positive numbers

because behind 0 above the ischial spine

our negative numbers like negative 1

negative 2 2 3 4 or 5 but as the baby's

starting to descend and will be coming

out and we get positive numbers so it'll

go from plus 1 to plus 5 and plus 5 is

crowning so you'll want to be watching

where baby is at okay now let's look at

stage 2

okay this stage starts when the cervix

has fully dilated in a face so it's all

the way open to that 10 centimeters and

it's a hundred percent sin and it ends

after the baby is delivered then we go

into stage 3 where our placenta will be

delivered so what's the big highlights

you need to know about stage 2 okay

stage 2 is where this woman is going to

be feeling some really intense pressure

at the end of the transition stage and

set phase in stage 1 she felt some

pressure as that baby was pushing down

but now the baby is going to start

descending through the birth canal so

it's going to start changing fetal

stations remember + 1 2 + 5 is where

we're going in 5 is crowning

and and for first-time mothers this

stage

and lasts approximately about one hour

anywhere it could last anywhere from two

to three hours so it lasts a little bit

longer for the first time others and for

my women who've already had children

last about twenty minutes and the main

thing was going to be making up this

phase is pushing the woman's going to be

pushing that baby out of the birth canal

to be born

okay so contractions will be similar to

what she experienced in the transition

phase they're going to be painful

they're going to hurt they're going to

be about 60 to 90 seconds in length and

occurring every two to three minutes now

interventions from the nurse you're

going to be teaching her how to push

propria when to push because if she has

an epidural she may not be able to feel

the contractions but you can see the

contractions on the monitor you're going

to help her breathe through them how to

do them positioning and high fowlers and

lithotomy or squatting or sideline

you're also going to be offering lots of

encouragement and praise talking to her

and telling her how far the baby is

along and you're going to be recording

that exact time that baby is fully

delivered because that's the birth time

and monitoring bottle sons and the fetal

heart rate of course making sure

everyone's doing good although you're

going to be looking at the perineum and

there will be specific changes in the

perineum before the baby is born so I

would remember these and you may see

bulging of the perineum and the anus or

rectum as the baby's head is coming

through that canal an increase in bloody

show or visible baby parts of course you

may see the baby's head depending on the

fetal position

you may see it presenting there so that

is telling you hey this baby is fixing

to come out okay now on to stage three

okay stage three starts with the full

delivery of the baby and ends with full

delivery of the placenta

okay this stage is pretty short pretty

easy for moments smooth sailing really

after this and then we go into stage

four which is a

period so this stage lasts about five to

15 minutes we want it to be quick

because the longer the stages the longer

it takes to deliver the placenta it

increases the risk of hemorrhage or

retain placenta parts which will cause

hemorrhage or infection now some signs

and symptoms that you want to remember

that the placenta is about to be

delivered and the umbilical cord starts

to lengthen there may be a trickle or a

gush of blood all of a sudden and the

uterus will change shape from an oval to

a globular shape so that are some signs

and symptoms that the placenta is fixing

to make its entrance okay some delivery

mechanisms I would remember this I

remembered questions from my maternity

lecture exams on this okay and this is

when the placenta is delivered which

side is delivered first and so remember

that and which side is the baby side and

which side is the maternal side that was

attached to the uterus okay so you have

two delivery mechanisms you have the

Schultz and you have the Duncan okay

Schultz is the side that is shiny that

um was delivered first so it was the

baby side and how liked remember this

was taught this shiny Schultz and

remember it's the baby side because the

baby is shiny and new so it's shiny a

new length of baby it's the shiny Shultz

and it was the saw that was facing the

baby it was delivered first then you

have the Duncan side the Duncan

mechanism and this is the side of the

mother the maternal side of the placenta

that was delivered first a lot of people

like to remember this dull dull dirty

Duncan the 3ds and because this side

looks dull red and rough and remember

momma just went through labor so she is

dirty from labor and she's in rough

condition so that's the maternal side so

remember those in some interventions for

this what you need to remember is you'll

be monitoring the MoMA's blood pressure

before and after delivery placenta

there's a risk of hemorrhage so you want

to monitor that and the doctor may order

what's called pitocin a master the

delivery of the placenta because this

prevents hemorrhage so remember you may

be giving pitocin after the delivery of

the placenta and you'll be assessing the

placenta making sure it's fully intact

and nothing is missing and still inside

the uterus and you'll be looking at that

cord which should have two arteries in

one vein and making mother comfortable

getting her cleaned up the sheets

changed peri care encouraging bonding

between the mother and the baby and

helping her with breastfeeding okay now

stage four this is our last stage and

this is the hours one to two one to four

hours after delivery of the placenta so

what you're going to be doing is you're

going to be monitoring the mom making

sure her health is doing good and she's

adjusting after she's just given birth

because she's at risk for a lot of

things like hemorrhage infection uterine

atony all that stuff so you want to make

sure you're monitoring those things so

you'll be monitoring bottle signs

especially her heart rate and blood

pressure because I'm hemorrhage if she's

hemorrhaging she'll have job and blood

pressure and she'll become tachycardic

as she's losing blood volume and her

temperature because I'm risk of

infection so your monitor that and the

lochia this is the discharge after birth

she'll be having a moderate to read

amounts of lochia there may be little

small clots but large clots is a huge

warning sign and you want to assess how

often she's having to change that parry

pad and she's changing it every 15

minutes because there's just so much

blood that is not normal that's abnormal

she's possibly hemorrhaging so you'll

want to assess that and another thing is

you'll be assessing the fundus of the

uterus this is the top portion of the

uterus and you want to make sure that it

is firm

midline and near or at the bellybutton

the umbilicus make sure it's there so

you will be filling that and depending

on Hospital protocol you'll be checking

it every 15 minutes for one hour and

then every 30 minutes for two hours now

a lot of questions like to ask you okay

you feel the fundus it's soft and boggy

and it's displaced what are you going to

do and videos are going to provide funds

and massage on that fundus of the uterus

and a sister to the bathroom because a

lot of times a full bladder can cause

the fundus to become displaced and soft

so those are the things you would do for

that if that question ever came up and

other things you're going to do is

you're going to administer pain relief

per doctor's orders provide peri care

like ice and witch hazel because she'll

have a lot of swelling and she may have

suffered from some tears or an

episiotomy and promote bonding and

breastfeeding with the woman and her

baby okay so that wraps up the lecture

on stages of labor thank you so much for

watching don't forget to take the free

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