Normal labor

Normal labor management is observe w/o intervention

Change in the cervix per time dictates normalcy in labor (not contraction patterns)

There are three stages:

1. Onset to complete dilation (@10cm)
• Active: >4cm, more rapid dilation
• Arrest of active phase: cervix does not dilate for 2 hours
• >=1.2cm/hr for nullipara, >=1.5cm/hr for ultipara
• Latent: <4cm
• Prolonged latent phase (> 18-20 hr for nullipara/ >14 hr for multipara)
2. Complete dilation to delivery of infant (<2-3 for nullipara, <1-2 for multipara)
3. Delivery of infant to deliver of placenta (less than 30 minutes)

When a labor abnormality occurs, assess powers, passenger and pelvis 

Adequate contraction = every 2-3 minutes, firm on palpation, lasting for 40-60 seconds

Passenger - cephalopelvic disproportion, consider C-section

Power - give IV pitocin