8: Second Stage

Question 1

Passive fetal descent

Answer 1

complete dilation –> urge to push

8cm, baby rotates

Question 2

Ferguson’s reflex

Answer 2

urge to push! feels like need to BM

Question 3

Premature pushing

Answer 3

if not dilate to 10cm, cervix can swell or tear
mom will fatigue
baby may be OP

Let her push if baby at +1, pos is OT/O, cervix is soft/8-9cm

Question 4

To avoid premature pushing if mom feels the urge

Answer 4

move to hands & knees, breathe through UCs with her!

Question 5

Pushing technique: valsalva

Answer 5

decreased maternal CO/venous return, decreased arterial BP, decreased oxygenation

GOOD for epidural, OP pres

Question 6

Pushing technique: go for it when fully dilated

Answer 6

can lead to maternal exhaustion, perineal trauma, dependence on others to guide pushing

Question 7

Pushing technique: Involuntary pushing

Answer 7

less FHT decels, less maternal fatigue

slightly longer pushing stage

Question 8

Positions in 2nd stage

Answer 8

upright–decrease episiotomies
mobile vs immobile
lateral–to slow things down, decrease tearing
birthing chairs–increase perineal edema, lacerations