Parturition, Stages of Labour and Partogram

Parturition, Stages of Labour and Partogram: The journey from life inside the womb to the first breath outside the womb. Parturition means childbirth. Childbirth is the culmination of pregnancy , during which a baby grows inside a woman’s uterus. Childbirth is also called labor. Pregnant humans go into labor roughly nine months after conception.

Labor pain is nothing but uterine muscle contractions from pressure on the cervix, pressure of the baby on your bladders and bowels and from the stretching of your birth canal and vagina to which can cause pain.

The most common childbirth method worldwide is vaginal delivery. It involves four stages of labor : the shortening and opening of the cervix during the first stage, descent and birth of the baby during the second, the delivery of the placenta during the third, and the recovery of the mother and infant during the fourth stage, which is referred to as the postpartum .

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Stages of Parturition/ Childbirth

Stage 1/ Dilation

The first stage of parturition starts with the onset of labor . It continues until the cervix is fully dilated. This dilation is divided into two phases:

• Latent phase. The cervix is 0 to 4 centimeters (cm) dilated.
• Active phase. The cervix is 4 to 10 cm dilated.

Stage 2/ Expulsion

The second stage of parturition starts at full dilation and continues until birth. This stage also has two phases:

• Passive phase. The baby’s head moves down through the vagina .
• Active phase. The mother feels a need to push, or contract the abdominal muscles in time with uterine contractions .

Stage 2 ends with the birth of the baby. At this point, the umbilical cord is clamped, and breastfeeding is often encouraged to help with stage 3.

Stage 3/ Placental Delivery

The third stage of parturition starts after birth and ends with the delivery of the afterbirth ( placenta and membranes).

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Partogram and what’s its significance

The partograph or partogram has been established as the “gold standard” labor monitoring tool universally. It has been recommended by the World Health Organization (WHO) for use in active labor . The function of the partograph is to monitor the progress of labor and identify and intervene in cases of abnormal labor.

The development of partograph provided health workers a pictorial overview of labor which can identify pathological labor to allow early intervention. A partogram is used to record all observations made when the woman is in labor. It records the following points.

1. The progress of labor is monitored by cervical dilatation, descent of head and uterine contractions
2. The fetal condition is monitored by fetal heart rate, color of amniotic fluid and molding of the fetal skull.
3. Maternal condition is assessed by pulse, BP, temperature, urine output and urine for protein and acetone.
4. A separate space is given to enter drugs, IV fluids and oxytocin.

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P artogram has been heralded as one of the most important advances in modern obstetric care. WHO advocates its use as a necessary tool in the management of labor and recommends its universal use during labor. In under-resourced settings, prolonged labor and delay in decision-making are important causes of adverse obstetric outcomes. Owing to resource constraints in such settings, it is usually not possible to monitor each woman continuously throughout the duration of labor. In such settings, the partogram serves a simple and inexpensive tool to monitor labor in a cost-effective way.