Chapter 17: Nursing Care During Labour & Birth

Nursing Care During Labour & Birth overview explores the essential nursing roles and responsibilities during the intrapartum period, covering the four distinct stages of labor and birth. The first stage focuses on the progression from latent to active labor, where the nurse evaluates cervical effacement and dilation while providing continuous physical and emotional support. Key assessments during this phase include monitoring uterine activity, observing fetal heart rate patterns, and identifying the rupture of amniotic membranes through specialized testing like the Nitrazine or ferning tests. A major emphasis is placed on trauma-informed care for survivors of sexual abuse and the provision of culturally safe environments for diverse populations, including Indigenous families and gender-nonconforming individuals. As labor transitions into the second stage, nursing interventions support the expulsive phase through spontaneous open-glottis pushing and the promotion of upright or lateral positions, such as squatting or side-lying, to facilitate fetal descent and reduce the risk of perineal trauma. The presence of a support person, such as a doula or partner, is highlighted as a critical factor in improving birth outcomes and patient satisfaction. Following the delivery of the infant, the third stage involves the safe expulsion of the placenta, often managed through active techniques like the administration of oxytocin to minimize the risk of postpartum hemorrhage. Immediate newborn care priorities are established, emphasizing the benefits of immediate skin-to-skin contact and delayed cord clamping to support the infant's physiological transition to extrauterine life. The final fourth stage marks the initial recovery period where the nurse performs frequent assessments of the fundal tone, lochial flow, and bladder function to ensure physical safety and support early family bonding and breastfeeding. By merging clinical expertise with empathic communication, this summary provides a roadmap for delivering evidence-informed, family-centered maternity care.