Second Stage

The second stage of labor is the stage of fetal expulsion. It begins when the cervix is fully dilated and ends with the delivery of the fetus.

Average Pattern of Fetal Descent

Duration of labor is typically shorter in the multiparous woman than in nulliparous women.

There are three stages of labor, and two phases of stage 1.

Remember the three "Ps" that affect the duration of the Active Phase:

■ Power (strength and frequency of contractions)

■ Pelvis (size and shape of mother's pelvis)

If progress during the active phase is slower than these figures, evaluation for adequacy of uterine contractions, fetal malposition, or cephalopelvic disproportion should be done.

6 8 10 Hours of labor

14 16 Delivery

FIGURE 6-1. Schematic illustration of progress of rotation of occipitoanterior presentation in the successive stages of labor.

(Reproduced, with permission, from DeCherney AH, Pernoll ML. Current Obstetric & Gynecologic Diagnosis & Treatment. Nor-walk, CT: Appleton & Lange, 1994:211.)

6 8 10 Hours of labor

14 16 Delivery

FIGURE 6-1. Schematic illustration of progress of rotation of occipitoanterior presentation in the successive stages of labor.

(Reproduced, with permission, from DeCherney AH, Pernoll ML. Current Obstetric & Gynecologic Diagnosis & Treatment. Nor-walk, CT: Appleton & Lange, 1994:211.)

Abnormalities of the second stage may be either protraction or arrest of descent (the fetal head descends < 1 cm/hr in a nullip and < 2 cm/hr in a multip).

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