child birth

Question 1

define childbirth

Answer 1

the process by which the baby and placenta are expelled from the uterus

Question 2

when does childbirth usually occur

Answer 2

37-42 weeks gestation = term

Question 3

what is the first step of obstetric examination

Answer 3

use your eyes

- look for scars e.g. previous caesarean

Question 4

what is the 2nd stage of obstetric examination

Answer 4

use your hands:

• fetal size/gestational age = measure fundal height
• fetal lie = the relation of the long axis of the baby to the uterus
• presentation = part of the fetus that occupies the lower segment of the uterus
• engagement = refers to how deep the presenting part is engaged in the bony pelvis

Question 5

what are the aspects of ‘presentation’

Answer 5

(what part is coming out first)

• cephalic (vertex)
• breech
• shoulder

Question 6

what is the 3rd stage of obstetric examination

Answer 6

use your ears:

• fetal heart rate
• handheld doppler

Question 7

what is the 4th stage of obstetric examination

Answer 7

use your mouth:

- ask for babies movements

Question 8

how can you tell when childbirth has started

Answer 8

when painful uterine contractions accompany effacement and dilation of the cervix

Question 9

describe the first stage of labour

Answer 9

cervix opens to full dilatation

longest stage

Question 10

describe the second stage of labour

Answer 10

from full dilatation to the delivery

Question 11

describe the third stage of labour

Answer 11

lasts from the delivery of the baby to the delivery of the placenta

Question 12

what determines the progress through the stages of labour

Answer 12

3 mechanical forces

• passenger
• passage
• power

Question 13

describe passenger and its aspects

Answer 13

diameter of babies head

• it is the largest part to negotiate the birth canal
• bones are not fused yet, therefore, can overlap when passing through cervix
• occiput is the reference point
• position = degree of rotation of the head
• attitude = degree of flexion of the head
• presenting part = lowest part of fetus palpable on vagina examination

Question 14

describe passage

Answer 14

the bony pelvis:

• inlet = wider transverse diameter
• mid cavity = round
• outlet = wider A-P diameter

Question 15

describe power

Answer 15

degree of force expelling baby

- contractions

Question 16

what are the stages of dilatation

Answer 16

latent phase = 1st 3cm dilatation

active phase = 3-10cm

Question 17

what are the stages within the second stage of labour

Answer 17

passive stage
= till head reaches pelvic floor and mother experiences desire to push

active stage
= irresistible desire to bear down

Question 18

what are the stages within the 3rd stage of labour

Answer 18

active management
- medication to induce

physiological management
- not clamping, no traction, no induction

Question 19

how can we change power

Answer 19

give oxytocin to make contractions more powerful

-synthetic

Question 20

what aspects of ‘passenger’ can cause abnormal labour

Answer 20

disorder of rotation
OC = occiput posterior
OT = occiput transverse

fetal size

Question 21

what is it referred to when the pelvis is not wide enough for the passage of the baby

Answer 21

cephalo-pelvic disproportion

Question 22

describe instrumental delivery techniques

Answer 22

forceps

• quicker
• more maternal injury
• more neonatal facial nerve palsies

ventouse

• rotation possible
• suction can cause bruising

caesarean delivery