©Pregnancy bliss 2008
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Duration of the second stage of labor
The pain reaches its pinnacle in the second stage. This is where the pushing has to be done. All the swearing is done during this stage. And then suddenly it is over! The baby is delivered. The transformation of the woman in this instant from one writhing in extreme pain to one wreathed in the most wonderful smile is one of the incredible wonders of childbirth. Usually, the second stage of labor lasts between thirty minutes and two hours, give or take.
Epidural analgesia, though very effective in pain control, could have the indirect effect of prolonging this stage of labor. This is thought to be a direct weakness of its effectiveness. As the woman feels no pain, so she gets no urges to push and is really not motivated. Nature is somehow cheated!
Duration of the third stage of labor
Once the baby is born, in most cases an injection of ergometrine or oxytocin (or a mixture of the two) will be administered to facilitate detachment of the afterbirth (Oxytocin is also known as Pitocin in North America).
The afterbirth is then eased out within about five minutes of the baby being delivered. There is no need to push in the third stage.
Some women prefer ‘natural’ childbirth and do not want any of these drugs administered for the third stage. Here, the delivery of the placenta may take a bit longer.
Either way, the third stage rarely lasts more than fifteen minutes and is usually not allowed to last beyond thirty minutes. If the placenta is not detached by then, steps are taken to have it removed manually, usually in the operating theatre under an effective anesthetic. It is usually a general anesthetic, but a spinal or even an epidural could suffice for this.
Labor progress
To ensure that labor in the first stage is progressing smoothly -
Different units operate different polices and the length of the intervals between examinations makes little difference, provided appropriate action is taken whenever necessary.
The intervals between examinations could be two, three or four hours. Sometimes, the intervals are tailored to suit the particular individual and examinations may be performed more frequently if this is deemed necessary. The examinations are never left for longer than standard, however.
Expected rate of labor progress
As mentioned, two of the main developments that are assessed during a vaginal examination are cervical dilatation and descent of the baby’s head. Regarding dilatation, which is the main yardstick of labor progress, the cervix is expected to dilate a minimum of 1 cm per hour.
If, for example, the initial examination shows the cervix to be 4 cm dilated, an examination three hours later should reveal a dilatation of at least 7 cm. Remember, full dilatation is 10 cm, so a woman at 7 cm cervical dilatation should expect to come to the end of the first stage in around three hours.