Birth Flashcards
The three stages of labour are :
- The neck of the uterus opens
2.The baby passes through the birth canal
- The baby becomes a separate person
Signs that labour has started in stage 1: The neck of the uterus opens
Breaking of the waters - the amniotic sac of fluid surrounding the baby I t he uterus may break before labour starts, can be a slow trickle from the vagina of a gush of water that can’t be controlled by mother.
A show - The plug of the mucus which has sealed the cervix during pregnancy has come away. It’s a sticky pink mucus and will come in before an early labour. There should only be a little blood at this stage.
- Regular and strong contractions occur - During a contraction the uterus becomes tight and then relaxes. They may have occured towards the end of pregnancy and these are called Braxton hicks contractions. However when the contractions become more regular, stronger, more painful and lasting more than 30 secs labour will have started. These will become more stronger and frequent as labour progresses.
The first stage is the longest stage and ends when the cervix has opened up wide enough for the baby’s head to pass through.
Stage 2: The baby passes through the birth canal
The uterus, cervix and vagina have now become one continuous birth canal. Contractions are very strong and they push the baby’s head first through the canal. When the baby’s head emerges from the vagina it is called crowning.
- Midwife clears the mucus from the baby’s head.
- The shoulders are the eased through the birth canal and the baby slides out.
- Baby will start to cry, before the rest of the body comes out
- The doctor of midwife will ease the shoulder through the birth canal and the baby slide out.
- Occasionally the midwife or doctor will have to make a small cut (episiotomy) in the vagina to open ot up a little more and speed up birth. When baby is born it will be stitched up again
Stage 3: The baby becomes a separate person
Once the baby is breathing the umbilical cord is clamped in 2 places and a cut is made between them
- The contractions continue until the placenta becomes separate from the wall of the uterus and has been pushed through to the vagina.
- when the baby first appears, the skin is a bluish colour. As soon as it starts breathing it turns pink.
- Labour is now completed
Hospital birth advantages
- Trained staff present at all times
- special monitoring equipment is available to check the baby’s health and safety throughout labour
- other equipment is immediately available in the event of an emergency
- the mother is free from domestic responsibilities and worries
- mother is protected from too many visitors
- there are other mothers to talk to and share experiences with
Hospital birth disadvantages
- She may be leaving the rest of the family behind at home
- She has to adhere to hospital routines and rules
- She might not have very much privacy as she is in a ward and it can be noisy and she may not get much sleep
Home birth advantages
- The mother will be attended by a midwife, usually one she knows
- She is in familiar surroundings among family and friends
- any other children in the family can be a part of this exciting event
- she will have more privacy than in a hospital with other women
- she will be able to chose the conditions in which she gives birth
- she will not have to keep to the hospital routine etc meals
- she will be able to look after her baby in her own way
- for most women it is a safe place to give birth at home
Home birth disadvantages
- She may not have as much privacy as her family are present
- she may not wish her children to see her giving birth
- Hygiene may be better in hospital
- She may not get as much of a chance to rest at home as she would in hospital
- If anything goes wrong with her or the baby, there are no facilities to deal with emergencies
- She may get a lot of visitors which can be tiring
- only method of pain relief is gas and air
Types of pain relief during birth (6)
- Relaxation and Breathing exercises
- Complementary forms of pain relief like:
- Acupuncture
- Aromatherapy
- Reflexology
- Self Hypnosis
- Hydrotherapy/Waterbirth
- Massage - Gas and air (Entonox)
- Pethidine
- Epidural anaesthetic
- TENS ( Transcutaneous electrical nerve stimulation)
What is relaxation and Breathing exercises
This is often taught in antenatal classes and helps to make labour easier for women, especially during the first stage. Helps the partner to be more involved in the birthing process by counting the breathing and putting into action advice from the antenatal classes. It also helps to relax the mother and distract her from the pain but not effective in later stages of labour when pain intensifies.
What is acupuncture pain relief
Acupuncture involves stimulating sensory nerves under the skin and in the muscles. This results in body producing natural substances, such as pain relieving endorphins. It’s likely acupuncture may relax the mother and it doesn’t affect the baby. It’s not effective as pain gets worse
What is aromatherapy
A holistic healing treatment that uses natural plant extracts ( usually in the form of oils) to promote health and well being. This may relax the mother, help her breathing to cope with contractions but may be expensive. It may not be effective as pain gets worse
What is reflexology
This is where a specific area on the mothers feet is massaged by a reflexologist.
This may reduce pain, distract from contractions and reduce the stress of labour but may be expensive.
It may not be effective as pain progresses
What is reflexology
This is where a specific area on the mothers feet is massaged by a reflexologist.
This may reduce pain, distract from contractions and reduce the stress of labour but may be expensive.
It may not be effective as pain progresses
What is self hypnosis
This can put the mother in a relaxed state, making it easier to cope with the stress of labour. It may not be effective as pain gets worse .
What is hydrotherapy/ water birth
The water encourages the release of endorphins, and does not affect the baby.
It can relax the mother, but not all hospitals offer it and a woman may not be able to use the pool if another woman is using it. It may not be effective as pain gets worse
What is massage pain relief
It can relieve stress and produce endorphins but it may not be effective as pain gets worse
What is gas and air (entonox)
- It is often offered to the mother near the end of the first stage of labour, when contractions are very strong.
- It helps to calm the mother but doesn’t stop the pain fully. - It is a gas called nitrous oxide (laughing gas) mixed with oxygen.
- The mother inhales the mixture through a mouthpiece attached to the gas supply.
- The gas takes Bout 15-20 seconds to work, so the mother will breathe it just as a contraction begins.
- It works best with slow, deep breaths and enables the mother to control her pain relief and take it as necessary.
- This can be organised by the midwife
What is Pethidine
- An injection of this painkiller may be given if contractions become extremely uncomfortable.
- This is injected by a doctor or midwife into the thigh or butttock to make the mother relax.
- Sometimes less commonly a drug called diamorphine is used. It helps with the pain and makes contractions easier.
- It takes about 20 minutes to work after the injection.
The effect last between 2 and 4 hours, so wouldn’t be recommended if the mother is getting close to the pushing stage .
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What is epidural anaesthetic
- It is injected into the space near the spinal nerves and works almost immediately.
- It stops the pain by blocking the nerves that carry painful sensations from the abdomen to the brain ( all pain is felt in the brain) so the mother will feel nothing below her waist.
- For most women epidural gives complete pain relief but top ups can be given.
- Helpful for women who are having a long or particularly painful labour.
- An anaesthetist is the only person who can give an epidural, so it won’t be available at home.
