Care in 1st Stage Labour

Question 1

What are some of the characteristics of the latent stag of 1st stage of labour?

Answer 1

Contractions or irregular
the spacing of contractions can vary an dwell as the strength
Contractions are not as painful
May stop and start
You can often sleep through

Question 2

What is positive practice?

Answer 2

Tailored care to individual women

Question 3

What are some practices that could have a negative impact?

Answer 3

Repetitive vaginal examinations
Continuous fetal monitoring 
Use of opiates rather than more natural approaches
Language used by the midwife
Focusing on objective measurement

Question 4

What are some non pharmaceutical pain releif?

Answer 4

Breathing techniques
Muscle relaxation
Visualisation
Immersion in warm water
Hypnosis
massage
TENS machines
Rhythmic movements

Question 5

What happens as labour progresses into the active stage?

Answer 5

Contractions are met regular and intense, 3:10 lasting 50-60 seconds

Breathing patterns become more vocal

Observation of behaviour pain

Question 6

What is the midwifes role during labour?

Answer 6

To support and reassure
Monitor maternal wellbeing
Monitor fetal wellbeing
Monitor progress of labour

Question 7

How often should blood pressure be monitors in 1st stage labour?

Answer 7

4 hourly

Question 8

How often should temperature be monitored in 1st stage labour?

Answer 8

hourly if in the pool but 4 hourly on land

Question 9

How often should should pulse rate be monitored in 1st stage labour?

Answer 9

hourly

Question 10

How often should should an abdominal examination be carried out in 1st stage labour?

Answer 10

4 hourly

Question 11

How often should fetal heart rate be monitored in 1st stage labour?

Answer 11

every 15 minutes and simultaneous to maternal pulse try hour

Question 12

What else do you have to monitor in labour?

Answer 12

Fetal movements
bladder care
documentation

Question 13

What is the purple line?

Answer 13

Purple line between the buttocks, moving up from the anal margin to the tip of the natal cleft in the lower back. It is said to appear and progress as the cervix dilates therefore allowing the midwives to judge cervical dilation.

Question 14

What is the Rhombus of Michaelis?

Answer 14

Kite shaped area in the lower back that includes the lower lumber vertebrae and the sacrum. the area of bone moves backwards,, allowing more space in the pelvis. When the woman is in a leaving forward position a lump appears at the start of the second stage.

Question 15

What are some other signs that labour is progressing?

Answer 15

As the cervix dilates the mucous show increases

Question 16

What is the transition stage?

Answer 16

Contractions are string, regular and long lasting. May feel rectal pressure. May start to vocalise her distress or become quiet. Do not disturb normal physiology. Facilitate changes in position.

Question 17

What cab vaginal examination determine?

Answer 17

Dilation
Effacement
Station (descent of presenting part)
Presentation
Position
Membranes stae: ruptured ot intact
Presence of any moulding, caput, limbs or placental tissue

Question 18

What must you do when performing a Vaginal examination?

Answer 18

Justification is required
Informed consent is required
Fetal heart must be auscultated prior and following VE.
VE just be preformed following an abdominal examination unless clinically indicated otherwise
Justification and finding of the examination must be documented accurately
A plan of care should be made in partnership with the women and her birth partners.