The second stage of labor is regarded as the climax of the birth by
the delivering woman, her partner, and the care provider. International
health policy and programming have placed emphasis on the
first stage of labor, including appropriate use of the partogram and
identification of hypertension or sepsis, and have also focused on
the third stage of labor with active management (AMTSL). More recently,
a concerted effort to reduce perinatal losses has been made
through dissemination of skills in neonatal resuscitation. However,
the provision of skilled care and avoidance of complications during
the second stage of labor have been relatively neglected. These guidelines
are intended to strengthen policy and frameworks for care provision
to enable providers to attend to women in the second stage of
labor in line with current evidence-based recommendations for practice
to optimize outcomes for mother and baby. The document is
not intended as a formal systematic review of the literature, but
aims to identify important clinical, programmatic, and policy issues
that require attention.
The 3 stages of labor are conventionally defined as: