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Chapter 5 Labor and Delivery
Frank J. Craparo, MD
❍ What is the definition of labor?
Labor is defined with the initiation of regular and rhythmic contractions that result in serial dilatation and
effacement of the cervix.
❍ How many stages of labor exist?
Labor is traditionally divided into three stages and some consider there to be a fourth stage.
❍ What is the definition of the first stage of labor?
The first stage of labor is defined as the onset of regular contractions that result in cervical change. This stage ends
when the cervix is fully dilated.
❍ What is the definition of the second stage of labor?
The second stage of labor is defined from the time of full dilatation of the cervix until delivery of the infant.
❍ What is the definition of the third stage of labor?
The third stage of labor begins with delivery of the infant and ends with the delivery of the placenta.
❍ Is there a fourth stage of labor?
Some consider the 1 to 2 hours time period after delivery of the placenta to be the fourth stage. This is not part of
the traditional description of labor.
❍ What is a common complication of this “fourth stage”?
This is a time when postpartum hemorrhage is most likely to occur.
❍ What is the latent phase of labor?
The latent phase of labor is the initiation of contractions with slow cervical change that continues until accelerated
cervical change occurs.