Stage III of Labor (Nursing)

00:01 Onto stage 3.

00:03 In stage 3, the baby is out.

00:05 We've done that and everybody is 'oohing and ahhing' about the baby and that's wonderful.

00:11 But there's still work to do.

00:12 So delivery of the placenta is what makes up stage 3.

00:17 This can last up to about 30 minutes.

00:20 And we want to think about the fact that the placenta has to come out, because if it doesn't, then we're going to have bleeding.

00:26 So it's a wonderful thing, it's a beautiful thing, it has to happen and there are things that we must monitor to make sure that it goes well.

00:34 How are we going to know the placenta cut is coming out? There are a few signs, one is lengthening of the cord.

00:40 The placenta is actually going to drop away from the uterine wall.

00:44 And so the the umbilical cord, that's sort of hanging on the outside is actually going to get longer.

00:49 We're going to see it because the placenta is going to move.

00:52 And then we're going to see a gush of blood from behind the placenta as it detaches from the uterine wall.

00:58 And then all of this happens because the uterus is contracting, right? And so as it contracts, it actually lifts up, and the provider can feel it.

01:08 So if you're palpating someone's abdomen, you can feel the uterus sort of make a tennis ball sort of feel to it.

01:14 And that lets you know, when those three things happen, that the placenta is ready to be delivered.

01:20 And we can apply gentle traction and actually evacuate the placenta from the uterus.

01:26 Right? Pretty cool, all right.

01:29 What is the nurse doing during third stage? They're monitoring transition of the newborn.

01:34 So while everybody is oohing and ahhing about the baby, we want to make sure the baby is transitioning okay.

01:39 We also want to be aware of any potential complication, So is third stage taking too long? Is there bleeding? Is the uterus not contracting? What's going on, is the mom doing okay? Vital signs, are they stable? Is the baby stable, because if anything is happening that we need to intervene, the nurse has to really be aware in order to make sure things happen the way they should.

02:03 All right, that's a lot.

02:05 So let's review, I have some questions.

02:09 I'm going to ask and then take a pause and let's see if you can come up with the answer.

02:13 We have a nurse who is caring for a patient who has recently delivered, which of the following indicates that the third stage of labor is ending? There is a gush of blood from the vagina, alright, very good! This lets us know that the placenta is ready to deliver because that is what happens in third stage.