MANAGEMENT OF 3rd AND 4th STAGE
MANAGEMENT OF 3rd AND 4th STAGE
MANAGEMENT OF 3rd AND 4th STAGE
OBJECTIVE TEACHER
ACTIVITY AND
AV AIDS
2 min INTRODUCTION: Student teacher
The stages of labor are often thought to be a mystery. In all honesty, it is a introduces topic to
mystery in many ways. Each woman will have a different labor experience, the group by
and yet many parts are the same. Below you will find a crash course in the assessing the
stages of labor, what each does, the parameters, and some average events previous
of each stage. Remember, however, that very few women will follow this knowledge of
to the letter; there will be some variation. students.
Stages of labor:
First stage: The first stage is the longest part of labor and can last up to
20 hours. It begins when your cervix starts to open (dilate) and ends
when it is completely open (fully dilated) at 10 centimetres.
Second stage: The second stage of labor begins when cervix is fully
dilated at 10 centimetres. This stage continues until baby passes
through the birth canal, vagina, and is born. This stage may last two
hours or longer.
Third stage: The third stage of labor begins after the baby is born and
ends when the placenta separates from the wall of the uterus and is
passed through the vagina.
Fourth stage: the fourth stage begins with the birth of placenta and
ends one hour later.
2 min Explains about THIRD STAGE OF LABOR: Student teacher Describe about
the third stage The third stage of labor begins upon completion of the birth of the birth of explains about the the third stage
of labor. the baby and ends with the birth of placenta. It is known as the placental third stage of labor of labor
stage of labor. The third stage of labor averages between five to fifteen with the help of
minutes but any period up to one hour may be considered within normal ppt.
TIME SPECIFIC CONTENT STUDENT EVALUATION
OBJECTIVE TEACHER
ACTIVITY AND
AV AIDS
limits.
Physiological processes of placental separation and expulsion:
Placental separation
Descend of the placenta
Expulsion of the placenta
Hemostasis
10 Elucidates MANAGEMENT OF THE THIRD STAGE: Student teacher Describe the
min about the Third stage is the separation, descent and expulsion of the placenta with elucidates about management of
management its membranes. It is the most important stage as many life threatening the management the third stage.
of the third complications can occur during this stage. The management of the third of the third stage
stage. stage of labour in given below in flow chart. One should never try to of labour.
deliver the placenta before its separation to avoid uterine inversion.
The fundus is pushed upwards and backwards when uterus becomes firm.
Controlled cord traction by right hand is given to the clamp in downward
and backward directions in a steady and slow manner until complete
expulsion of the placenta occurs. Uterine elevation and not cord traction
assists in the expulsion. If the placenta is undelivered after 30 minutes, it is
TIME SPECIFIC CONTENT STUDENT EVALUATION
OBJECTIVE TEACHER
ACTIVITY AND
AV AIDS
called retained placenta necessitating manual removal of placenta.
Records:
The midwife is responsible for documentation of all the events of labor
and observations. Her recording should include the following details:
TIME SPECIFIC CONTENT STUDENT EVALUATION
OBJECTIVE TEACHER
ACTIVITY AND
AV AIDS
- All the drugs administered
- Examination of the placenta, membrane and cord
- Amount of blood loss.
- After the specified period of observation the mother and the baby
are transferred to the post-natal ward.
Assessment
Analysis/Nursing Diagnosis
1. Anxiety related to knowledge deficit
2. Risk for infection
3. Pain
4. Fatigue
5. Impaired skin integrity
6. Anxiety
7. Ineffective individual coping
8. Powerlessness
9. Impaired adjustment
10. Self care deficit: Bathing/hygiene.
Planning
1. Complete initial assessment of the newborn.
2. Monitor maternal and newborn status.
3. Provide support in parental newborn interactions.
4. Provide support and comfort measures during the third stage.
TIME SPECIFIC CONTENT STUDENT EVALUATION
OBJECTIVE TEACHER
ACTIVITY AND
AV AIDS
Implementation
1. Observe and record birth of placenta
2. Monitor maternal blood pressure
3. Dry the baby completely
4. Complete initial newborn assessments
5. Provide initial newborn care
a) Provide warmth
b) Prevent infection
c) Promote mother-baby attachment
6. Administer oxytocic drugs as per physician's order.
Evaluation
1. See that the newborn establishes and maintains adequate
respiratory pattern.
2. Be sure that mother and newborn maintain normal physical
parameters.
3. Monitor mother-baby attachment/bonding.
4. Make sure that mother feels comfortable and supported during the
third stage.
15 Explain the MANAGEMENT OF THE FOURTH STAGE: Student teacher Describe the
min management The fourth stage of labor begins with the birth of the placenta and ends explains the management of
of the fourth one hour later. This stage marks the completion of the tasks associated management of the fourth stage.
stage. with the first- three stages of labour. The mother may have expressions of the fourth stage
relief and accomplishment, intermingled with excitement. with the help of
ppt.
TIME SPECIFIC CONTENT STUDENT EVALUATION
OBJECTIVE TEACHER
ACTIVITY AND
AV AIDS
EVALUATION AND INSPECTION:
The first postpartal hour is a critical time of initial recovery from the stress
of labor and delivery and requires close observations of the mother. A
portion of this hour will be spent in activities directly related to the
intrapartal period. These activities may include the
following
1. Evaluation of the uterus.
2. Inspection and evaluation of the perineum, vagina and cervix.
3. Inspection and evaluation of the placenta, membranes and
umbilical cord.
4. Repair of episiotomy and laceration, if any.
2. Psychological assessment
a) Assess the mother’s emotional state. May vary from exhaustion to
euphoria.
b) Some mothers may want to interact with their baby, and others
may wish to rest at this time.
Nursing Diagnosis
Planning
Evaluation
Ensure that the mother:
1. Has physical parameters monitored at frequent intervals.
2. Had uneventful recovery period and does not develop
complications.
3. Has opportunity to interact with newborn as desired.
4. Can demonstrate fundal massage and practice comfort measures.
TIME SPECIFIC CONTENT STUDENT EVALUATION
OBJECTIVE TEACHER
ACTIVITY AND
AV AIDS
2 min Summarization Summarization of
of the topic the topic :
Today we have
studied about the
management of
third and fourth
stage of labor. In
third stage we
learned that there
are two methods of
separation one is
Schultz method
and other one is
Mathews Duncan’s
method and there
are various
measures of
management
which are as
Crede’s method
and modified
Brandt- Andrew’s
technique. And
then we studied
about fourth stage
of the labour
TIME SPECIFIC CONTENT STUDENT EVALUATION
OBJECTIVE TEACHER
ACTIVITY AND
AV AIDS
where we studied
that it is a stage of
observation and
which extends for
about 1-2 hours
where we observe
the mother and the
newborn.
2 min Conclusion of Conclusion of the
the topic topic:
The process of
labor is a natural
process though and
does not require
much interventions
but any normal
labor can turn into
abnormal at an
stage of labour
therefore it is
needed to learn
about the various
measure that are
required to
maintain a safe
labor practice.