First Stage of Labor

First Stage of Labor

Definition of the First stage of labor:

The first stage of labor is the Stage of cervical effacement and dilatation.

The first stage of labor refers to the period from the onset of true uterine contraction to the fully dilated cervix when the diameter of the cervical as measures to cm.
OR It Starts from the onset of true labor pain & ends with full dilation of the cervix.

Duration of the first stage of labor:

The 1st Stage of Labor is the longest stage. for primigravida ( 8-12 ) hours and multigravida ( 6-8 ) hours

Sign of First Stage of Labor:

  • Nesting 
  • Lightening
  • Contractions that range from mild ( during early labor) to strong ( during active labor)
  • Effacement
  • Dilation – widening the opening of the cervix
  • Loss of the mucus plug
  • Water breaking
  • Log cramping
  • Back pain on pressure
  • Nausea 



  • Evidence of true labor pain
  • Intermittent uterine contraction
  • FHR 120 – 160 bpm
  • Cervix become dilated
  • Gradual effacement of cervix


Symptoms of First labor

  • True labor pain
  • Show present
  • Pain full uterine contraction
  • A sudden gush of liquor amnii
  • Rupture of membrane
  • Strong contraction



  • Urine for protein, sugar, ketones
  • Blood for Hb%, CBC, RBS, Grouping
  • Cross-match for high-risk patients


Management of 1st Stage:

A. History:

1. Complete obstetric history

2. History of present pregnancy

  • Duration of pregnancy
  • Medical disorders during this pregnancy
  • Complications during this pregnancy as antepartum hemorrhage

3. History of present labor

  • Labor pains onset, frequency, and duration
  • Passage of “show” fluid or blood per vagina
  • Sensation of fetal movement


B. General:

  • Emotional support
  • Maternal position
  • Administration of fluids
  • Uterine activity
  • Maternal vital signs: pulse, temperature, and blood pressure
  • Vaginal Examination
  • Bladder empty
  • Diet fruit juice, soup, salt, lemon
  • Amnidtomy
  • Fetal Heart rate check


Complications of 1st Stage of Labor:

  • Early rupture of membranes with or without cord prolapsed
  • Fetal distress
  • Mal position
  • Cervix dystocia
  • Acute renal failure
  • Sepsis
  • Embolism
  • Anemia
  • Failure of lactation
  • Cord prolapse
  • Meconium Aspiration