Before Your First: Vaginal Delivery

Cardinal movements of labor: engagement, descent, flexion, internal rotation, extension, external rotation and expulsion
Complete dilation, now station: Labor down vs push
2nd Stage of labor: Pushing
Offer to help with maternal positioning—holding ankle/leg
Delivery—downward traction on head, thumbs to nose, anterior shoulder, posterior shoulder, body. Skin to skin. Delayed cord clamping.
3rd stage placenta: Active management, Pitocin, gentle cord traction. 3 signs of placental detachment
Bleeding: Atony, meds
Lacerations: degree, repair
Postpartum: Fundal tenderness, lochia, voiding, BMC.

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