Editing Maternal and Newborn Nursing (section)

=== Stages of labor ===

* '''First stage''' - onset of true labor to full dilation (10 cm).
** '''Latent phase''' (0 to about 5 or 6 cm): contractions mild to moderate, patient talkative and sociable. Nursing focus is orientation, ambulation, hydration, and teaching.
** '''Active phase''' (about 6 cm to 10 cm): contractions every 2 to 5 minutes, strong, patient inwardly focused, may become irritable, nauseated, and shaky in transition. Nursing focus is comfort, coaching, and closer fetal and maternal monitoring.
* '''Second stage''' - full dilation to birth of the infant. Encourage pushing with the urge; support spontaneous rather than prolonged breath-holding pushing when possible.
* '''Third stage''' - birth of the infant to delivery of the placenta, usually within 5 to 30 minutes. Signs of placental separation are a gush of blood, lengthening of the cord, and a globular firming uterus. '''Do not pull on the cord'''; traction risks uterine inversion.
* '''Fourth stage''' - the first 1 to 4 hours after delivery of the placenta, the highest-risk window for postpartum hemorrhage. Assess fundus, lochia, vital signs, bladder, and perineum on a frequent schedule per facility protocol (a common pattern is every 15 minutes for the first hour).

'''Cardinal movements''': engagement, descent, flexion, internal rotation, extension, external rotation (restitution), and expulsion.