labour

see also:

• Obstetrics
• ED Mx of 1st stage of labour
  • Mx of cord prolapse
• ED Mx of 2nd stage of labour - emergency delivery
  • Mx of shoulder dystocia in labour
  • ED Mx of emergency breech delivery
• ED Mx of 3rd stage of labour - delivery of placenta
• fetal macrosomia
• preterm labour / premature labour
• WH policy - Observations of Labouring Women (docx) - intranet only

• typically lasts 10hr in nulliparous & 8hrs in multiparous
• time of onset till complete Cx dilatation (10cm)
• latent phase:
  • 4-20hrs
• accelerated Cx dilatation phase:
  • av. rate of Cx dilatation is 3cm/hr in nulliparous & 5-6cm/hr in multiparous

• from full dilatation to delivery
• typically lasts 35min in nulliparous & 10min in multiparous
• fetal head descends 3-6cm/h but abnormal if < 1cm/h in nulliparous & < 2cm/h in multiparous
• only 21% of primigravid women in Australia will have a medically uncomplicated birth¹⁾
• only 8% of primigravid who aim to have a NVD in Australia will manage to avoid having sutures to repair episiotomy wound or tears
• home births in Australia even for “low risk women” appear to be associated with a 20x increase in perinatal mortality compared with all risk hospital births²⁾

• time of delivery to delivery of placenta
• av. time is 5min but not considered abnormally long unless > 30min