The document outlines the stages of labor and the nurse's role in managing each stage. It discusses 4 stages: 1) dilation of the cervix, 2) expulsion of the fetus, 3) delivery of the placenta, and 4) postpartum observation. During the first stage the nurse provides comfort measures, monitors maternal and fetal health, and assesses labor progress. In the second stage the nurse assists the delivery and provides pain relief. For the third stage the nurse ensures delivery of the placenta and examines the membranes. In the fourth stage the nurse continues vital sign checks and fundal assessments for one hour.

1. Role of nurse on management in
labor

2. DEFINITION
Labor is a process by which the fetus, Placenta
and membranes are expelled through birth canal.
 Series of events that take place in the genital
organs in an effort to expel the viable products of
conception out of the womb through the vagina in to
outer world is called labour.

3. STAGE OF LABOUR
FIRST STAGE:- It starts from onset of true labor
pain and ends with full dilatation of cervix. It’s
average duration 12hrs in primigravida and 6hrs in
multipara.
SECOND STAGE:- It starts from the full dilatation of
cervix and ends with expulsion of fetus from the birth
canal.
THIRD STAGE:- It begins after expulsion of fetus
and ends with expulsion of the Placenta &
membrane.
FOURTH STAGE:- It is the stage of observation for
at least one hour after expulsion.

4.  MANAGEMENT OF FIRST STAGE LABOUR

Enema

Perineal shave

Food & Fluids by mouth

Intravenous infusion

Position & Ambulation

Medication

Monitoring Maternal physiological changes

Vital sign

Renal system

GI changes

Haematological changes

Monitoring Of Fetal Wellbeing

5. 
Evaluation Of Maternal Wellbeing

Vital sign

Bladder care

Urine test

Hydration

Bodily Care Of Progress Of Labour

Back rub

Abdominal rub

Effleurage

6. EVALUTION OF PROGRESS OF LABOUR:
Partogram –
Partogram is a graphic recording of the salient features
of labour status. In the management of women in labour
partogram serves to validate the normal progress of labour
and to facilitate early identification of deviations from
normal pattern.







Maternal vital signs
Uterine contractions
Fetal heart rate
Vaginal examination findings
Fluid balance
Urine analysis
Drugs administered

7. MANAGEMENT OF SECOND STAGE OF LABOUR:
Vital Sign
Bladder care
Hydration & General condition
Maternal pushing effort
Analgesia & Anaesthesia
Perineal integrity
Episiotomy
Evaluation of progress of labor
Contraction Pain
Length of Second Stage
Descend & Station
Progress through the mechanism labor

8. PREPARATION FOR THE DELIVERY:
Location of the delivery
Position for the delivery
General preparation
CONDUCTION OF DELIVERY:
Clamping and cutting the Umbilical
cord
Immediate care of the Newborn

9. MANAGEMENT OF THIRD STAGE OF LABOUR:
Delivery of the Placenta & Membrane.
Sign of placental separation
•Fresh blood loss
•Lengthening of the cord
•Fundus becomes rounder,smaller & more mobile in the abdomen
Expectant management
Assisted expulsion
•Controlled cord traction
•Expression by fundal pressure
Use of Oxytocic agent.
Examination of Placenta & Membrane.
Immediate care to mother & baby.

10. MANAGEMENT OF FOURTH STAGE LABOUR:
Evaluation & Inspection
•Evaluation of Uterus
•Inspection of Cervix
•Repair
•Perineal Cleansing & Positioning Of Leg

11. Continuing Case Monitoring:
Vital sign check
Palpation of the fundus of uterus for contractility
Massage of uterus and expression of clots
Measurement of fundus
Inspection of the perineum
Inspection of bladder
Inspection and change of perineal pad