Question

A client is admitted to the labor and delivery unit. The nurse performs a vaginal exam and determines that the client's cervix is \(5 \mathrm{~cm}\) dilated with \(75 \%\) effacement. Based on the nurse's assessment, the client is in which phase of labor? A. Active B. Latent C. Transition D. Early

Short answer

Answer: A. Active

Step-by-step solution

Phase 1: Latent Phase

In the latent phase, cervical dilation ranges from 0 to 3 cm, and effacement ranges from 0% to 40%. In this case, the client has a dilation of 5 cm and effacement of 75%, which does not match the criteria for the latent phase.

Phase 2: Active Phase

In the active phase, cervical dilation ranges from 4 to 7 cm, and effacement ranges from 40% to 100%. In this case, the client has a dilation of 5 cm and effacement of 75%, which matches the criteria for the active phase. So the answer is A. Active.

Phase 3: Transition Phase

In the transition phase, cervical dilation ranges from 8 to 10 cm, and effacement is typically 100%. In this case, the client's cervical dilation and effacement do not match the criteria for the transition phase.

Phase 4: Early labor (not an option)

Early labor is not recognized as a separate phase, but rather as a part of the latent phase. Therefore, it cannot be taken into account as a possible answer. Based on our analysis, the client is in the Active phase of labor. The correct answer is A. Active.

Key concepts

Cervical Dilation

Cervical dilation is a pivotal part of labor and refers to the opening of the cervix. This crucial process is measured in centimeters, ranging from 0 cm, which indicates a closed cervix, to 10 cm, signifying full dilation ready for childbirth. Understanding cervical dilation involves grasping these key points:

• The cervix dilates gradually over three main phases of labor: latent, active, and transition.
• In the latent phase, dilation is typically between 0 to 3 cm. This initial stage can last several hours to days, especially for first-time mothers.
• Active labor sees dilation ranging from 4 to 7 cm, marking a faster pace towards delivery. This phase is shorter compared to latent labor.
• The transition phase is the final stage, where dilation progresses from 8 cm to 10 cm, preparing for the baby’s passage through the birth canal.

Recognizing the dilation level helps healthcare providers manage labor effectively, ensuring both the mother and baby are safe.

Effacement

Effacement is another essential concept in labor, referring to the thinning and shortening of the cervix. It is expressed as a percentage, from 0% (not effaced) to 100% (completely effaced), reflecting the cervix preparing for childbirth. Here's what need to know about effacement:

• It usually happens before dilation in first-time pregnancies, whereas it might occur simultaneously with dilation in subsequent pregnancies.
• At around 75% effacement, the cervix has thinned significantly, indicating that labor is progressing well.
• As labor advances, effacement progresses from a thick state to paper-thin, making way for the baby’s descent.
• Effacement can be affected by contractions and the baby’s position in the uterus.

Understanding effacement alongside dilation gives a clearer picture of how close the mother is to active labor, which is important for planning interventions or giving support.

Active Phase of Labor

The active phase of labor is a significant stage, characterized by increased cervical dilation and consistent contractions. It typically follows the latent phase and precedes the transition phase, playing a vital role in the birthing process. During the active phase:

• Cervical dilation ranges from 4 to 7 cm, progressing more swiftly compared to the latent phase.
• Contractions grow stronger, more regular, and closer together, typically occurring every 3 to 5 minutes, lasting about 60 seconds each.
• The intensity of the contractions aids in more effective dilation and effacement.
• This phase lasts between 4 to 8 hours for first-time mothers but can be shorter for those who have given birth before.
• Support from healthcare professionals and loved ones is crucial to manage discomfort and stress levels.

The active phase signifies that labor is moving forward efficiently, and it sets the stage for the transition phase, which leads to delivery. Recognizing this phase helps caregivers provide the necessary care and interventions to support both mother and baby.