Chapter 6 - Part 2 Flashcards

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1
Q

How does labour begin?

A

Labor may begin in a variety of ways

Small amount of “Bloody show” as cervix begins to efface (thin) and dilate

Amniotic sac may rupture
-May or may not bring on contractions right away

Mucous plug may be lost weeks before labour begins

  • May be accompanied by bloody show
  • mucous and blood
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2
Q

What is Parturition?

A
whole process of childbirth
Labour
-Effacement
-Dilation
-Transition

Birth

  • Dilation,
  • Pushing,
  • Delivery of the baby,
  • Delivery of the
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3
Q

What is effacement?

A

Thinning out of the cervix during labor

  • expressed as %
  • happens before dilation
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4
Q

What do we say when baby is -3, 0, +3?

A
  • -3 head is above spine of mom
  • 0 making way down birth canal
  • +3 crowning
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5
Q

What does the first stage of labour look like in terms of dilation?

A

dilation from 0-10 centimetres

Dilation/Dilatation
0-7 centimeter

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6
Q

What are the characteristics of the transition phase?

A

7 – 10 centimetres (the last phase of dilation)

10 centimeters is complete dilation

At the end of transition the woman can begin pushing with her contractions

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7
Q

What is the transition phase?

A

A time when a woman delivering needs a lot of support and encouragement

Birth partner and other team members may also feel tired and vulnerable

How to provide physical and emotional care

Questions about “how much longer”?

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8
Q

What are contractions like in the transition phase?

A

During transition
contractions are stronger, come closer together and last longer;

contractions every 2-3 minutes, lasting 90 seconds.


This is the most intense stage of labor, but it is also usually the shortest.

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9
Q

What is a doula ?

A

Not a clinical care giver

Informational support and planning during pregnancy
-Birth Plan

Emotional and physical support during labor

Post-partum support

  • Breast-feeding
  • Emotional support
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10
Q

What is a midwife?

A

Primary clinical care provider

Normal pregnancy

Provides care throughout the entire process

  • pregnancy
  • birth
  • post partum
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11
Q

What is the second stage of labour?

A

The pushing stage

Begins when cervix is fully dilated (10 centimetres)
-Bulging of the perineum

Urge to push or bear down
-May not occur if medicated (epidural)

Crowning
-top of the head is visible

Baby is born during stage 2

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12
Q

What is an episiotomy?

A

Episiotomy may be performed
- incision that is
sometimes made at the vaginal entrance during birth

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13
Q

How long can pushing take for the first child?

A

Up to 2 hours

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14
Q

What is the 3rd stage of labour?

A

Placenta detaches from walls of the uterus

Afterbirth (placenta) is expelled

Several contractions may
accompany placental expulsion
-Afterpains more intense with subsequent pregnancies

Episiotomy and tears are sewn up

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15
Q

How do we know there is no placenta left in the uterus?

A

Placenta is examined for completeness

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16
Q

What is Lamaze technique?

A

Use of breathing to relax and assist in natural childbirth

17
Q

What are pain relief options for hospital birth?

A

Hypnotherapy,
-Hydrotherapy, Manual Therapy, Props (birthing ball)

Demerol

Local anesthesia

Regional anesthesia

General Anesthesia

18
Q

What does local anesthesia do?

A

!-numbs a painful area

!-may be used after delivery if stitching of the perineum is necessary

19
Q

What is regional anesthesia?

A

Regional anesthesia (epidural/spinal anesthesia)

  • anesthesiologist administered
  • woman remains awake
  • reduces pain throughout the birthing process (variability)
  • spinal block used for c-section procedures
20
Q

What is general anesthesia?

A
  • complete/woman is asleep

- used in high risk and emergency procedures

21
Q

Why are women afraid of labour?

A

Family of origin

Media

Peers

Myths and Misinformation

Medicalization of childbirth

22
Q

What is the midwifery model of care?

A

Principles

  • Woman-centred care
  • Informed choice
  • Continuity of care provider-Choice of birthplace
23
Q

What is the scope of practice of a midwife?

A

Collaborate with health professionals

Certification in skills (delivery complications,
resuscitation, treatment of hemorrhages)

Prescribe, administer drugs

Order, interpret tests (blood/urine, ultrasound, neonatal metabolic screening)

Carry emergency equipment

24
Q

Where can women give birth?

A

Home birth
-Home births attended by midwives

Birthing centres
-Usually attended by midwives

Hospital birth
-Births attended by MDs, Obstetricians, Midwives

25
Q

What is a c section?

A

A method of delivering a baby surgically, by an incision in the abdomen

26
Q

What are the medical reasons for a c section?

A

Baby is too large, mother’s pelvis is too small
-Cephalo-pelvic disproportion

Cervix is not dilating after a trial of labour

Umbilical cord prolapses
-Obstetrical emergency

Excessive bleeding

Placenta previa

  • Vaginal delivery not possible
  • Danger of hemorrhage
27
Q

What % of babies in Canada are delivered with C section?

A

28%

Brazil is 90% (due to how its framed)

28
Q

What is the cultural associations with postpartum?

A

Postpartum period valued more historically

Cultural associations with the postpartum period where mother recuperates and bonds with/ nourishes child

Modern day associates the word postpartum with depression

29
Q

What are the physical changes in post partum period?

A

Hormone levels return to normal

Woman may feel exhausted

Discomfort from episiotomy or perineal tearing/ stitches

30
Q

What are the psychological changes in post partum period?

A

Postpartum “blues” or depressed state

31
Q

What is post Patum depression?

A

Prolonged depressed state that inhibits daily functioning or caring for self and/or baby

Mild form called “baby blues”
-Associated with hormonal changes after childbirth and with breast feedin

32
Q

What is the treatment for post partum depression?

A

Treatment may include counselling; nutrition/vitamin therapy; pharmaceutical anti- depressants

33
Q

What is Postpartum dysphoria?

A

Severe form of post partum

Strong self-doubt and loss of confidence in ability to be a mother

Woman envisions harming child and/ or self

Rare condition

Always requires intervention

34
Q

When should you have sex again after baby?

A

Couple should wait at least 2-6 weeks before resuming intercourse

35
Q

What must be completed before sex post baby?

A

Lochia, bleeding, vaginal discharges must be completed before intercourse to avoid potential infections

36
Q

Is there pain during sex post baby?

A

Pain after vaginal delivery

Pain after c section

37
Q

When can bonding with baby occur?

A

Bonding cna occur before and after the baby is born

-facilitated by breast-feeding process

38
Q

What is the critical period of bonding?

A

Occurs in minutes and hours immediately after birth

39
Q

What are the chemicals released during breastfeeding?

A

Prolactin: Stimulates breasts to produce milk

Oxytocin: stimulates breasts to eject milk