The intrapartum period represents a phase in childbirth, encompassing labor and delivery. This time involves significant physiological changes for the birthing person and baby.
The Intrapartum Period Defined
The intrapartum period is defined as the time from the onset of true labor until after the delivery of the placenta. It includes contractions leading to cervical changes and the expulsion of the baby and placenta. This phase follows the antenatal (before birth) period and precedes the postpartum (after birth) period.
This period begins with regular uterine contractions that cause progressive cervical dilation and effacement. It concludes when all products of conception, including the baby and the placenta, have been delivered.
Key Stages of Labor
Labor unfolds in three distinct stages. The first stage involves the opening and thinning of the cervix, preparing the birth canal. This stage is typically the longest and concludes with full cervical dilation.
The first stage is often divided into latent and active phases. During the latent phase, contractions are usually mild and irregular, gradually causing the cervix to dilate to about 4 to 6 centimeters and thin out. The active phase begins as contractions become more frequent, longer, and stronger, leading to more rapid cervical dilation from 6 to 10 centimeters. The final part of the active phase, known as transition, is often the most intense, with strong contractions occurring every two to three minutes as the cervix reaches full dilation.
The second stage of labor commences when the cervix is fully dilated to 10 centimeters and ends with the birth of the baby. During this stage, contractions continue to be powerful, aiding the baby’s descent through the birth canal. The birthing person often experiences a strong, involuntary urge to push.
The third stage of labor begins immediately after the baby is born and concludes with the delivery of the placenta. This stage is generally the shortest, often lasting five to thirty minutes. Mild contractions continue, helping the placenta separate from the uterine wall and then be expelled.
Care and Monitoring During Labor
Throughout the intrapartum period, continuous care and monitoring are provided to ensure the well-being of both the birthing person and the baby. Healthcare providers routinely check the birthing person’s vital signs, such as blood pressure, pulse, and temperature.
Fetal heart rate monitoring is a common practice, allowing healthcare professionals to assess how the baby is tolerating the contractions and the overall labor process. This can be done externally using devices placed on the abdomen or internally with an electrode attached to the baby’s scalp once membranes have ruptured. The pattern of the baby’s heart rate in relation to contractions provides important information about their oxygen levels and general status.
Care during labor involves supportive measures, including pain assessment and offering various pain relief options. Providers also encourage mobility and position changes during labor, which can aid comfort and progression.
Common Events and Interventions
During the intrapartum period, several medical events or interventions may occur. One such intervention is an amniotomy, also known as artificial rupture of membranes (AROM). This procedure involves deliberately breaking the amniotic sac using a specialized tool, which can be done to induce or expedite labor by strengthening contractions or to facilitate internal monitoring of the baby.
Epidural administration is a widely used method for pain management during labor. It involves injecting anesthetic medication into the epidural space in the lower back, creating a band of numbness that significantly reduces labor pain while allowing the birthing person to remain awake. The medication is delivered continuously through a small catheter.
An episiotomy is a surgical incision made in the perineum, the area between the vaginal opening and the anus, during the second stage of labor. This procedure is performed to enlarge the vaginal opening, potentially to prevent more extensive or severe natural tearing or to expedite delivery if the baby needs to be born quickly. While once routinely performed, current practice recommends episiotomies only in specific circumstances.