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

The Placenta

Anywhere from a few minutes after delivery to an hour later, the placenta will separate and deliver.

While you are awaiting delivery of the placenta, don't pull on the cord or massage the uterus to try and make it deliver more quickly. Pulling to vigorously on the cord, in the right clinical setting, may lead uterine inversion (the uterus turns inside out), a very serious and dangerous complication.

Massaging the uterus often only causes dis-coordinated contractions which slow a clean shearing of the placenta.

As the placenta detaches and descends through the birth canal, the woman will again feel contractions and the urge to bear down. As she does this, the placenta will be expelled. Make sure all the fetal membranes come out with the placenta.

Inspect the placenta for completeness. If a portion is missing, she will need to have her uterus explored and the missing piece removed.

Also inspect the cord to make sure there are 3 blood vessels present (2 arteries and 1 vein). Two-vessel cords are associated with certain congenital anomalies.

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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