The Fourth Stage of Labour
The guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.
This stage is defined as the first hour after delivery of the placenta. The woman is at risk for postpartum haemorrhage & must be observed closely.
- Check if the uterus is well contracted
- Observe continuously for excessive vaginal bleeding
- Check & record the woman’s heart rate, BP & temperature
During this time, the baby can be given to the mother. Record the heart rate, BP & vaginal bleeding again after one hour. At the end of the fourth stage, the mother can be given something to eat & be sent to the postnatal ward.