PHASES OF SECOND STAGE LABOR: Four Descriptive Case Studies

Authors

  • Kathleen J. Aderhold CNM, MS,

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    • Kathleen J. Aderhold, CNM, MS, received her B.S. in nursing at the University of Northern Colorado, and her M.S. at the University of Colorado Health Sciences Center. She is currently practicing midwifery as the coordinator of the Adolescent Pregnancy Program at Presbyterian/St. Luke's Medical Center, Denver, Colorado. Ms. Aderhold is a member of ACNM, NAACOG, and Sigma Theta Tau.

  • Joyce E. Roberts CNM, PhD, FAAN

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    • Joyce E. Roberts, CNM, PhD, FAAN, completed her B.S. in nursing at the University of Wyoming, her M.S. in maternal-newborn nursing and nurse-midwifery from the University of Utah, and her PhD. in nursing science from the University of Illinois at Chicago. She is currently head of the Department of Maternal-Child Nursing at the College of Nursing, University of Illinois at Chicago. She was principal investigator of the NIH/NCR-funded study on management of bearing-down efforts during the second stage of labor at the University of Colorado Health Sciences Center, of which this project was a part. Dr. Roberts is a member of ACNM, NAACOG. ANA, Sigma Theta Tau, and the American Academy of Nursing.


Address correspondence to Kathleen J. Aderhold, CNM, MS, Presbyterian/St. Luke's Hospital, Adolescent Pregnancy Program, 601 East 19th Avenue, Denver, CO 80203.

ABSTRACT

In recent years, the second stage of labor has become an area of interest to a number of observers who have described divisions or phases with behavioral characteristics. Using a descriptive case study design, four normal nulliparous women in spontaneous second stage labor were videotaped from the occurrence of involuntary bearing-down efforts or the recognition of complete cervical dilation until birth. Analysis of these videotapes, the accompanying narrative transcripts, and uterine monitor tracings provided evidence that some behaviors changed over the progression of the second stage. These changes could be divided into three behavioral phases that the nurse/midwife can Identify in order to recognize the typical pattern of progression and possible deviations from normal.

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