Mayo Clinic Talks Obstetric and Gynecologic Health Series: Labor and Delivery
Oct 23, 2025
In this enlightening discussion, guest Rebecca Smith, Ph.D., APRN, CNM, a certified nurse-midwife with extensive obstetric expertise, dives into the intricacies of labor and delivery. She explains the stages of labor, from monitoring fetal heart rates to managing complications like shoulder dystocia and umbilical cord prolapse. Smith also covers essential postpartum care, including uterine assessments and addressing postpartum hemorrhage. Listeners gain invaluable insights into the art and science of guiding mothers through one of life's most critical moments.
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Labor Duration Differs By Parity
- Typical labor duration varies widely by parity: nulliparous 6–18 hours, multiparous 2–10 hours.
- Most cervical progress from 4 to 10 cm takes longer in first births than subsequent births.
Support Pushing And Protect The Perineum
- Encourage maternal pushing with contractions during second stage and provide perineal support to reduce laceration risk.
- Assess for nuchal cord and continue fetal monitoring; score newborns with APGAR immediately after birth.
Actively Manage The Third Stage
- Use active management in the third stage: gentle cord traction plus IV oxytocin and maternal pushing to expedite placental delivery.
- Inspect the placenta and cord for completeness and three vessels to reduce risk of retained tissue.