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.