The big day has finally arrived! Everyone must be in a state of panic and happiness, but the pregnant woman, who is the center of everything, must stay focused so the entire labor process would go by smoothly and safely.
Assessment
The key to a successful individualized care plan is the precise assessment and accurate obtaining of data. The woman would be placed under observation during labor to monitor her progress and ensure a safe delivery for her and the child.
Assess for the signs of true labor. The signs of true labor are contractions that begin irregularly but progresses regularly and predictably, the pain is felt first at the lower back and circles towards the abdomen, continues to progress no matter what the woman's activity level is, increases in duration, frequency, and intensity and cervical dilation is already present.
Assess for the appearance of show, which is blood mixed with mucus and would be present once the operculum or mucus plug is expelled.
Assess for the rupture of membranes. This is the scanty or sudden gush of clear fluid from the vagina.
Assess for the engagement of the fetal head. Engagement refers to the settling of the presenting part into the pelvis at the level of the ischial spines.
Assess for the station. Station is the relationship of the presenting part to the level of the ischial spines.
Assess for the effacement and dilatation of the cervix. Effacement is the shortening and thinning of the cervical canal. In cervical dilatation, the enlargement or widening of the cervical canal is assessed.
Diagnosis
Main topic: Stages of Labor
During labor, a pregnant woman might encounter difficulties that could affect her progress. These conditions should be prevented to ensure a smooth labor period and eventually, a safedelivery.
First stage of labor
This stage of labor is divided into three phases.
The latent phase starts during the onset of true labor contractions until cervical dilatation.
The active phase occurs when cervical dilatation is at 4 to 7 cm and contractions last from 40 to 60 seconds with 3 to 5 minutes interval.
The transition phase occurs when contractions reach their peak with intervals of 2 to 3 minutes and dilatation of 8 to 10 cm.
Second stage of labor
This stage starts at full cervical dilatation until the birth of the infant.
The woman may experience an uncontrollable urge to push and bear down with every contraction.
Crowning or the appearance of the fetal head on the vaginal opening occurs.
Third stage of labor
The third stage begins with the birth of the infant until the delivery of the placenta.
The signs of placental expulsion are lengthening of the umbilical cord, sudden gush of vaginal blood, changes in the shape of the uterus and its firm contraction, and the appearance of the placenta at the vaginal opening.
Planning
With all the data gathered during assessment and through an accurate diagnosis, a care plan for the woman in labor would be made to aid her through her progress.
