Birth 2

Question 1

What part of second stage does this statement describe; baby is visible, expulsive contractions and active maternal effort?

Answer 1

Active second stage

Question 2

What three ways does the passenger facilitate descent during the second stage?

Answer 2

attitude= flexion of the head to reduce diameter
position= ideally occiput anterior
moulding= the fetal skull will mould as ti descends

Question 3

How often should we document contractions during the second stage?

Answer 3

half hourly

Question 4

During the first stage, we offer vaginal examinations 4 hourly, does this change in the second stage?

Answer 4

Yes, offer a VE hourly

Question 5

How often should we auscultate the fetal heart during the second stage?

Answer 5

Immediately after every contraction, for at least 1 min, or every 5 mins.

Question 6

Describe the mechanism of labour;

Answer 6

Descent- gravity and pressure of contractions force baby down into the pelvis
Flexion- baby flex’s head as it reaches the birth canal
Internal rotation of head- occiput reaches pelvic floor, which forces it to rotate
Crowning- head crowns under pubic arch, widest part of babies head is born
Extension- forehead, face and chin pass over the perineum
Restitution- head will turn left or right to align with shoulders
Internal rotation of shoulders- rotate to lie in anterior or posterior position
Lateral flexion- birth of shoulder to folllow the curve of carus

Question 7

What three things can a midwife do to prevent perineal tears?

Answer 7

position, coaching, and speed.