when the cervix is fully dilated and ends when the fetus is fully expelled from the birth canal and an urge to push
1 of 10
whats it influenced by
position, stress and environment
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how long
3hrs in primigravida, 2hrs in multigravida
3 of 10
Sign
contractions are longer and stronger but less frequent, fetal axis pressure, membrane rupture, pressure on pelvic floor, blood loss, visible presenting part, fully dilated, purple line, rhombas of michaelis, bladder pushed into abdominal cavity
4 of 10
Flexion
brings the chin into contact with the fetal thorax in the vertex presentation due to fundal pressure on fetal buttocks and cervix resistance
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Engagement
the head descends into the pelvis and engages
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descent
fetal movement through the birth cannal
7 of 10
internal rotation
rotation of shoulders, occiput turns to same side of maternal pelvis as it was at the beginning of labour
8 of 10
Restitution and external rotation
realignment of the head with teh shoulders
9 of 10
fergusons reflex
oxcytocin released from posterior pituitary due to tactile stimulation of cervix and vagina
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