How to Assess the Progress of Labour in First and Second Stage

Labour Progress Assessment Method in First and Second Stage

Common Signs and Symptoms of Labor:

Although every pregnancy is different and there is no definite set of events, some common, early labor signs include:

  1. Lightening:
    Women can breathe again! This is an indication that the baby has dropped, settling deeper into the pelvis and relieving some of the pressure on diaphragm helping women to not be so short of breath.
  1. Bloody Show: Loss of mucus plug / bloody vaginal discharge.
  2. Rupture of Membranes/Water Breaking.
  3. Early strong and regular contractions.
  4. Nesting: Spurt of energy.
  5. Effacement: Thinning of the cervix. In the last month of pregnancy the cervix will begin to stretch and thin.
  6. Dilation: Opening of the cervix. Dilation is the process of the cervix opening in preparation for childbirth.
  7. Lower back pain and cramping.
  8. Nausea present.
  9. Abdomen looks lower and more protruding.
  10. Diarrhea or flu -like symptoms.
  11. Braxton-Hicks contractions (false contractions) during the last week of pregnancy.
  12. Frequent urinating.
Labour progress assessment method in first and second stage
Fig: Labour progress assessment method in first and second stage

Labour Progress Assessment Method in First and Second Stage:

Progressive of labour can be assessed by the following ways:

a. Uterine contraction:
It gradually increases in intensity, frequency and duration which are assessed by per abdominal palpation.

  • 3 times per 10 minutes,
  • Each contraction lasts for 40 – 60 second,
  • Strong enough.

b. Dilatation of cervix:

  • Dilation of cervix (in cm),
  • Effacement of cervix (in %),
  • Consistency and position of cervix,
  • Presence or absence of fore waters,
  • State of liquor if any,
  • Status of membranes.

c. Descent of foetal head/presenting part:

Per abdominal examination:

The descent of foetal head is assessed from level of the head in relation to the brim of pelvis and is measured in fifths. The width of the 5 fingers is a guide to the expression in fifths of the head above the brim-

  • 5/5 – Head floating above the brim,
  • 3/5- Not engaged,
  • 4/5– Fixing,
  • 2/5 – Just engaged,
  • 1/5– Engaged,
  • 0/5 – Deeply engaged.

Per-vaginal examination:

  • Descent is judged by zero station – rotation of the head with ischial spine. Zero is the level of the ischial spine, i.e. mid pelvis and estimation are in cm above zero.
  • Position of occiput can be felt.
  • Caput and moulding can also be felt.

Auscultation of foetal heart sound: Shifting of FHS downwards towards the pubic symphysis.

More questions related to this article:

  1. What are the most common sign and symptoms of labour?
  2. How will you recognize progress of labour?
  3. How will you assess the progress of labour in first and second stage?
  4. How can you diagnose that a labour progressing normally?
  5. What are the sign that shows your body is getting ready for labour?
  6. What are the first signs of labor approaching?

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