2nd Stage of labor

How does the 2nd stage of labor begin?

Full dilation of cervix (10 cm)

How does the 2nd stage of labor end?

Birth of infant

When would the nurse suspect that the woman has entered the 2nd stage?

Woman has urge to push

Involuntary bearing-down efforts

Contractions during the 2nd stage

Similar to the transition phase

• Frequent and intense

Woman’s Physical Discomfort during the 2nd stage

• Urge to push

• When head is crowning may feel burning

• Feels like she needs to move her bowels

Maternal Behavior during the 2nd stage

may get “second wind” as they see they are making progress

Intense concentration with pushing efforts

May be nervous or fearful

Nursing action during the 2nd stage

• DON’T LEAVE ALONE

• Encourage rest between pushing

• Don’t let her use the bathroom if she feels like she needs to move her bowels

  • Perform cervix exam

Characteristics of occiput posterior fetal positon

Back pain and long labor

Why are vaginal births beneficial to the infants respiratory system?

Fetal stress (compression) helps to eliminate fluid in the lungs

What could a maternal fever indicate at this stage?

Septic shock or infection

What is the first sign of hemorrhage

Low BP and High HR

When can the woman be encouraged to push?

10 cm dilated and 100% effaced

Methods to reduce perineal trauma

• Perineal massage = most effective

• warm compress

• lube

• manual support

How long should you delay cord clamping?

at least 60 seconds, probably for 120 seconds, or until cord pulsation ceases

Risks of delayed cord clamping

Polycythemia and hyperbilirubinemia

Practice is usually not a standard in care

What should the cut cold look like?

two arteries and one vein