Labor Lena — Stages of Labor and the Normal Newborn Assessment
Four stages, one APGAR at 1 and 5 minutes, and one number that says push
The stopwatch and the swaddle tell the whole story: what stage she is in, and how the newborn is doing one minute and five minutes later.
Lena keeps labor in order. First stage runs from onset of true labor to full 10 cm dilation and contains the latent, active and transition phases. Second stage is full dilation to birth — the pushing stage. Third stage is birth of the baby to delivery of the placenta. Fourth stage is the first 1 to 4 hours after delivery, when hemorrhage is the danger and the fundus is checked firm and midline. The newborn gets an APGAR at 1 and 5 minutes scoring heart rate, respiratory effort, muscle tone, reflex irritability and color; 7 to 10 is reassuring. Normal newborn vitals: heart rate 110 to 160, respirations 30 to 60, axillary temperature 97.7 to 99.5 F.
Read Labor Lena's full story →The story arc
The setup
A laboring client is 5 cm dilated with contractions every 4 minutes.
The turn
She becomes irritable, shaky and says she cannot do this anymore.
The crisis
The newborn arrives blue in the hands and feet, crying vigorously, with a heart rate of 148.
The save
After the placenta delivers, Lena's hand goes straight to the fundus.
NCLEX study section — Stages of Labor and the Normal Newborn Assessment
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Maternal & Newborn
Take this chapter into practice questions on the same topic.