gynecology and obstetrics
Management of Normal Labor
Preparation for delivery
Women are admitted to the labor suite for frequent observation until delivery. If labor is active, they should receive little or nothing by mouth to prevent possible vomiting and aspiration during delivery or in case emergency delivery with general anesthesia is necessary. Shaving or clipping of vulvar and pubic hair is not indicated, and it increases the risk of wound infections. An IV infusion of Ringer's lactate may be started, preferably using a large-bore indwelling catheter inserted into a vein in the hand or forearm. During a normal labor of 6 to 10 hours, women should be given 500 to 1000 mL of this solution. The infusion prevents dehydration during labor and subsequent hemoconcentration and maintains an adequate circulating blood volume. The catheter also provides immediate access for drugs or blood if needed. Fluid preloading is valuable if epidural or spinal anesthesia is planned. If instrumental or cesarean delivery seems unlikely, women may drink clear liquids. 