Operational Obstetrics & Gynecology

Labor and Delivery

Watch a Video Showing a Normal Delivery or Cesarean Section

Labor	Contractions	Electronic Fetal Monitors
Latent Phase Labor	Fetal Heart Rate	Pain Relief
Active Phase Labor	Urine	Second Stage Labor
Progress of Labor	Estimated Fetal Weight	Preparing for Delivery
Delivery of the Baby	Dilatation and Effacement	Managing the Delivery
Delivery of the Placenta	Fetal Orientation	Episiotomy
Managing Labor and Delivery	Leopold's Maneuvers	Anesthesia
Initial Evaluation	Fetal Membranes	Clamp the Cord
History	Blood Count	The Placenta
Risk Factors	Early Labor	Uterine Massage
Vital Signs	Monitor the Fetal Heart	Post Partum Care

Delivery of the Baby

Delivery is also known as the second stage of labor. It begins with complete dilatation and ends when the baby is completely out of the mother. The exact time of delivery is normally taken at the moment the baby's anterior shoulder (the shoulder delivering closest to the mother's pubic bone) is out.

As the fetal head passes through the birth canal, it normally demonstrates, in sequence, the "cardinal movements of labor." These include:

Engagement (fetal head reaches 0 station.)
Descent (fetal head descends past 0 station.)
Flexion (head is flexed with the chin to its' chest.)
Internal Rotation (head rotates from occiput transverse to occiput anterior.)
Extension (head extends with crowning, passing through the vulva.)
External Rotation (head returns to its' occiput transverse orientation)
Expulsion (shoulders and torso of the baby are delivered.)

As the fetal head descends below 0 station, the mother will perceive a sensation of pressure in the rectal area, similar to the sensation of an imminent bowel movement. At this time she will feel the urge to bear down, holding her breath and performing a Valsalva, to try to expel the baby. This is called "pushing." The maternal pushing efforts assist in speeding the delivery.

For women having their first baby, the second stage will typically take an hour or two.

Home ╖ Introduction ╖ Medical Support of Women in Field Environments ╖ The Prisoner of War Experience ╖ Routine Care ╖ Pap Smears ╖ Human Papilloma Virus ╖ Contraception ╖ Birth Control Pills ╖ Vulvar Disease ╖ Vaginal Discharge ╖ Abnormal Bleeding ╖ Menstrual Problems ╖ Abdominal Pain ╖ Urination Problems ╖ Menopause ╖ Breast Problems ╖ Sexual Assault ╖ Normal Pregnancy ╖ Abnormal Pregnancy ╖ Normal Labor and Delivery ╖ Problems During Labor and Delivery ╖ Care of the Newborn

Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300

Operational Obstetrics & Gynecology - 2nd Edition
The Health Care of Women in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMEDPUB 6300-2C
January 1, 2000

This web version of Operational Obstetrics & Gynecology is provided by The Brookside Associates Medical Education Division. It contains original contents from the official US Navy NAVMEDPUB 6300-2C, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense. All material in this version is unclassified.

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