---

Navigating the Study Packet Table of Contents | Overview | Framework | Lesson 1 | Lesson 2 | Lesson 3 | Lesson 4 | Lesson 5 | Lesson 6 | Lesson 7 | Lesson 8 | Lesson 9 | Lesson 10 | Authors/Acknowledgements | Appendix A | Appendix B | Appendix C | Appendix D | Appendix E | Appendix F | Download PDF Version The Table of Contents has longer descriptions of these links.

---

Lesson 9: The Stages of Labor

Labor and Delivery

Labor is the process of birth. The uterine contractions cause the lower part of the uterus to stretch and thin, the cervix to dilate. This forms the birth canal through which the baby descends. We will look at the stages of labor in this lesson.

Objectives: At the end of this lesson, the interpreter will be able to:

• State the three stages of labor.
• Describe what happens at each stage of labor.

Step 1: The First Stage of Labor

The first stage of labor is from the start of contractions to the full dilation of the cervix.

You may have heard someone talk about a mucus plug or the “bloody show.” As labor progresses, the muscles of the upper segment of the uterus contract to stretch and thin the lower segment muscles. At this point the cervix consists mainly of fibrous connective tissue. The internal os is the internal portion of the cervix, and likewise, the external os is the lower, outside portion of the cervix. The effacement and dilatation of the cervix loosens the membranes from the region of the internal os with slight bleeding and sets free the mucus plug (operculum). This is what people often refer to as the “bloody show.” At this point, the amniotic sac is pushing against the cervix.

You have probably also heard the phrase, “My water broke.” This refers to the amniotic sac breaking and the flow of amniotic fluid out the vagina. This may happen prior to labor, during labor, or the doctor or midwife may break the sac to encourage or speed up labor.

Activity: Watch All in Due Time Disc 2, Russell and Melody Stein.

View Video.

Start by watching their introductions of themselves to familiarize yourself with their signing styles. Then watch as they talk about their labor with their first baby.

• How long was Melody in labor?
• Compare that with All in Due Time Disc 1, Heidi and Jeff Branch. How long was their labor?

As you watch the other people’s stories, take note of the length of their labor. Ask two women who have given birth how long their labor was. There’s a lot of variation!

Activity: Watch All in Due Time Disc 1, Brandi and Tim Rarus.

View Video

Brandi delivered three babies (not all at the same time!) – which of her labors were induced?

Step 2: The Second Stage of Labor

The second stage of labor goes from the full dilation of the cervix to the birth of the baby.

When the woman is fully dilated (10 centimeters), she is encouraged to push with her contractions to help the baby out through the birth canal. “Pushing” time can vary from a matter of minutes to a matter of hours.

Activity: Watch Texts Focused on Second Stage of Labor

For this activity, you will view two videos focused on the second stage of labor. The first is from All in Due Time Disc 2, with Jimmy and Egina Beldon as they talk about the delivery of their Second Baby.

• Were forceps used for this delivery? Why or why not?

Then, we return to All in Due Time Disc 1, with Heidi and Jeff Branch.

There is discussion about whether to have an episiotomy, not have an episiotomy, have a C-section, or not have a C-section…what finally happened? From what they said about the interpreter they had for the delivery, what role do you think she played in all of this back and forth action?

View Video

Step 3: The Third Stage of Labor

The third stage of labor is from after the birth of the baby to delivery of the placenta (afterbirth).

The placenta, which has sustained the baby for nine months, must be delivered. It sometimes is expelled spontaneously, and sometimes requires some gentle pushing on the mother’s stomach to help it along. Occasionally, a health professional needs to reach inside the uterus to free it from the uterus. Whichever way it is delivered, it is then inspected to be sure that the entire placenta has been expelled. An incomplete placenta would require immediate exploration of the uterus.

Step 4: Baby’s here!

If there are no special concerns about the baby or the mother, the baby is generally put on the mother’s chest. If the woman had an episiotomy, the doctor or midwife will suture it at this point. This is often a time when an interpreter is not needed. It’s a good time to step back and take some deep breaths – let mom and partner enjoy a private moment with their new child.

Nurses will be busy evaluating the baby in order to give him or her an Apgar score. This is done at one minute after delivery and again at five minutes. Here’s how babies are scored:

Sign	0 points	1 point	2 points
Skin color	cyanosis/pallor	peripheral cyanosis	pink
Muscle tone	flaccid	moves limbs	good
Resp. effort	none	gasps	good
Heart rate	none	less than 100	greater than 100
Response to stimulus	none	slight	good

 

---