Labour and Its Stages: Complete Guide for Medical Students and General Readers

Labour and Its Stages: A Complete Professional Guide

Written for medical students, healthcare professionals, and general readers

Introduction

Labour is a natural physiological process that marks the culmination of pregnancy and results in the delivery of a baby and placenta. Understanding its stages is essential not only for medical students and healthcare professionals but also for expectant mothers and their families.

This article provides a comprehensive discussion of labour, its definitions, stages, physiology, management, complications, and related FAQs. It is structured in a way that meets both academic standards for medical education and accessibility for general readers.

Definition of Labour

• Medical Definition: Labour is a sequence of uterine contractions, cervical changes, and fetal descent resulting in the expulsion of the fetus and placenta from the uterus after the age of viability (around 28 weeks in some countries, and 24 weeks in others).
• Layman’s Definition: Labour is the process through which a pregnant woman gives birth to her baby.

Physiology of Labour

Labour involves the interplay of maternal and fetal factors, hormonal changes, and mechanical forces. The uterus contracts rhythmically and progressively, leading to cervical effacement, dilation, and eventually the delivery of the baby. Key hormones involved include oxytocin, prostaglandins, and relaxin.

Table 1: Key Hormones in Labour

Hormone	Role in Labour
Oxytocin	Stimulates uterine contractions
Prostaglandins	Softens cervix, increases uterine sensitivity
Relaxin	Relaxes pelvic ligaments

Stages of Labour

Labour is divided into four major stages:

1. First Stage: Onset of regular uterine contractions until full cervical dilation (10 cm).
2. Second Stage: From full cervical dilation to delivery of the baby.
3. Third Stage: From delivery of the baby to expulsion of the placenta and membranes.
4. Fourth Stage: Immediate postpartum period (first 1–2 hours) for observation of complications.

First Stage of Labour

The first stage is the longest stage of labour, characterized by cervical effacement and dilation. It is further subdivided into:

• Latent Phase: Cervical dilation from 0 to 3–4 cm.
• Active Phase: Cervical dilation from 4 cm to 10 cm with more intense contractions.

Duration:

• Primigravida (first pregnancy): Average 12–18 hours
• Multigravida (subsequent pregnancies): Average 6–10 hours

Second Stage of Labour

This stage begins with full cervical dilation (10 cm) and ends with the delivery of the baby. It involves maternal bearing down efforts combined with uterine contractions. Proper fetal positioning is crucial for safe delivery.

Duration:

• Primigravida: 30 minutes to 2 hours
• Multigravida: 20 minutes to 1 hour

Third Stage of Labour

This stage extends from the delivery of the baby to the expulsion of the placenta and membranes. It typically lasts 5–30 minutes.

Management:

• Active management with oxytocin injection
• Controlled cord traction
• Uterine massage after expulsion of placenta

Fourth Stage of Labour

The fourth stage is the immediate postpartum period lasting up to 2 hours after delivery. Close observation is necessary for:

• Postpartum hemorrhage
• Uterine tone and involution
• Maternal vitals and stability

Complications During Labour

• Prolonged labour
• Obstructed labour
• Fetal distress
• Postpartum hemorrhage

Management of Labour

1. Monitoring uterine contractions and fetal heart rate
2. Assessing cervical dilation and progress
3. Providing pain relief options (epidural, analgesics)
4. Ensuring hydration and nutrition
5. Assisting with delivery techniques when required

Frequently Asked Questions (FAQs)

1. What is the average duration of labour?

For first-time mothers, labour can last 12–18 hours, while for women with previous deliveries, it may last 6–10 hours.

2. What is the most painful stage of labour?

The second stage of labour is usually the most painful due to active pushing and fetal descent.

3. Can labour be induced?

Yes, labour can be induced using medical interventions such as oxytocin infusion or prostaglandins.

4. What is active management of the third stage?

Active management includes oxytocin administration, controlled cord traction, and uterine massage to prevent hemorrhage.

Conclusion

Labour is a complex but natural physiological process. Understanding its stages, physiology, and management is essential for medical students, healthcare providers, and expectant families. With proper monitoring, timely interventions, and supportive care, labour can progress safely, ensuring the well-being of both mother and child.

Disclaimer: This article is for educational purposes only and should not replace medical consultation with qualified healthcare providers.