Second Stage of Labor Overview

Second Stage of Labor

• The second stage of labor involves the expulsion of the fetus.
• It begins after the cervix is fully dilated and ends with the delivery of the infant.
• The woman is typically moved to the delivery room during this stage.

Criteria for the Second Stage of Labor:

• Uterine Contractions: Become stronger, longer, and more frequent, accompanied by full cervical dilation and effacement.
• Rupture of Membranes: The membranes should have ruptured by the end of the first stage; they are no longer necessary and can hinder labor.
• Involuntary Bearing Down: The woman begins to push involuntarily with uterine contractions.
  • This is triggered by the pressure of the fetal head on the pelvic floor muscles.
• Bulging Perineum: The fourchette thins, the perineum bulges outward, and the vagina dilates as the fetal head descends, potentially leading to vaginal mucosal lacerations.
• Pelvic Floor Displacement:
  • The woman feels pressure on the rectum and may experience the urge to defecate due to compression from the descending fetal head.
  • The anal orifice dilates.
  • The bladder is pulled upward into the abdomen, creating more space for fetal descent.
  • The rectum is pushed downward in front of the presenting part.
  • The pelvic floor muscles are displaced.
• Leg Cramps:
  • Pressure from the descended fetal head on the sacral nerves can cause leg cramps.

Signs and Symptoms of the Second Stage:

• Contractions: Strong, frequent, and intense.
• Ruptured Membranes: Membranes are typically already ruptured at this stage.
• Perineal Bulging: The perineum bulges outwardly, and the anal orifice may dilate.
• Involuntary Bearing Down: The woman experiences a strong urge to push.
• Emotional Changes: The woman may be apprehensive, irritable, and unwilling to be touched. She may cry if disturbed and demonstrate frustration and a need for assistance.

This quiz covers the second stage of labor, detailing the expulsion of the fetus after full cervical dilation. It highlights the key criteria for the second stage, including uterine contractions, rupture of membranes, involuntary bearing down, and perineum changes. Understanding these concepts is essential for those studying labor and delivery.