F] Second Stage of Labour

• Defined as from full dilation of the cervix to the birth of the baby.
• Anticipatory signs of second stage of labour include expulsive uterine contractions, rupture of membranes, pouting and gaping of the anus.
• However, second stage of labour is only confirmed by vagina examination when no cervix is felt.
• Women in the second stage of labour (completely dilated but not yet delivered) usually have their fetal heart rate evaluated every 5 minutes until delivery.

G] Birth of the Baby

1. Mechanisim of Normal Labour (Document)
Allow the women to adopt the position of her choice:

• Swab vulva using 6 swab technique.
• Do vaginal examination for:
• Cervical dilation – confirmation of second stage
• Note time, station, sutures and fontanelles
• Explain the findings to the mother.
• Review the pushing technique with the mother.
• Ensure bladder is empty.
• Place pad over the anus to absorb fluids and feces.
• Ask assistant to check fetal heart rate (continues to check after every contraction).
• Note the time when delivery started to see if there is reasonable progress being made with each contraction.
• With a contraction ask the mother to hold her ankles, take a deep breath and push.