Care in Normal Birth (WHO, 1996, 60 p.): 4. CARE DURING THE SECOND STAGE OF LABOUR: 4.1 Physiological Background

Care in Normal Birth (WHO, 1996, 60 p.)

4. CARE DURING THE SECOND STAGE OF LABOUR

		4.1 Physiological Background
		4.2 The Onset of the Second Stage
		4.3 The Onset of Pushing during the Second Stage
		4.4 The Procedure of Pushing during the Second Stage
		4.5 Duration of the Second Stage
		4.6 Maternal Position during the Second Stage
		4.7 Care of the Perineum

4.1 Physiological Background

During the second stage of labour the oxygenation of the fetus is gradually reduced because the fetus is being expelled from the uterine cavity, with resulting retraction of the uterus and decrease in placental circulation. Moreover, strong contractions and strenuous pushing may further reduce the uteroplacental circulation. The decrease in oxygenation is accompanied by acidosis. There are however large individual differences in the rate and seriousness of this process, and therefore the caregiver should carefully monitor the condition of the fetus.