Conference One - Module 5 (Exam 2) 1 Flashcards
The 5 “Ps”
- Powers
- Passage/Passageway
- Passenger
- Psyche
- Position/Partnership
Powers
- Primary Power
- Secondary Power
- Tertiary Power
Primary Power
Regular, Effective, Uterine Contractions
Secondary Power
Maternal Pushing Effots
“Bearing down”
Tertiary Power
Forceps (FAVD) or vacuum assisted delivery/birth (VAVD)
Coordinated Uterine Contractions
Begin in the uterine fundus and spread downward toward the cervix to proper the fetus through the pelvis.
*Upper 2/3 of the uterus contract, muscle thickens and shortens*
Involuntary Uterine Contractions
Uterine contractions are involuntary and not under conscious control. The mother cannot cause labor to start or stop by conscious effort. Walking and other activities stimulate labor contractions and anxiety and excessive stress can diminish contractions, relaxation can facilitate the natural processes
*Lower 1/3 of the uterus relaxes and the muscle thins*
Intermittent Uterine Contractions
“Off and on” instead of sustainedd, allowing relaxation of the uterine muscle and resumption of blood flow to and from the placenta
What does the uterus and cervix do during contractions?
- Upper two thirds of the uterus contracts, muscle thickens
- Lower one third of the uterus relaxes, muscle thins
- Uterus elongates and narrows - straightens and directs the fetus downward
- Cervix relaxes and contractions pull the cervix up and over the presenting part
Bearing down: Pushing with/through contractions to birth the baby
- Physiological pushing
- Open glottis (airway) that provides better oxygenation to fetus
- Directed Pushing
- Closed glottis
- Active “pushing” with effort
Bearing Down: Passive Descent/Laboring Down
Delayed addition of secondary power until maternal urge to push presents itself
*usually happens with an epidural*
Pelvis
- Gynecoid and thropoid pelves are most favorable for vaginal birth
Cervix
- Effacement (thinning) that is measured in percentage (0-100%)
- Dilation (opening) that is measured in centimeters (1-10)
Weight of Fetus
- 2500-4000 grams
Fetal Lie
Orientation of the fetal long axis to maternal long axis
“L for Lie, L for Long”
can be vertical, horizontal
Fetal Attitude
Attitude is the relationship of body parts to one another. Normal attitude is flexion.
Fetal Presentation
The fetal part entering the pelvis first
Cephalic Presentation
- Vertex
- Military
- Brow or Face
Vertex Presentation
Complete flexion of baby. Most common type of cephalic presentation in which the fetal head is fully flexed. It is the most favorable for normal progress of labor because the smallest suboccipitobrematic diameter is presenting.
Military Presentation
- The head is in a neutral position, neither flexed nor extended . The longer occipitofrontal diameter is presenting
Brow Presentation
The fetal head is partly extended. The brow presentation is unstable, usually converting to a vertex presentation if the baby flexes or toa face presentation if it extends. The longest supraoccipitomental diameter is presenting
Face Presentation
The head is extended, and the fetal occiput is near the fetal spine, The submentobregmatic diameter is presenting
Fetal Position
Location of the fetal occiput R/T pelvic quadrant
Can be:
- Left occiput anterior (LOA)
- Right occiput anterior (ROA)
- Left occiput posterior (LOP)
- Right occiput posterior (ROP)
Psyche
Depends on:
- Experience
- Preparation
- Cultural Norms
- Inherent Coping Skills
- Partner/Family Support
- Chronologic/Developmental Age
- Progression of Labor/Birthing Process
- Nursing Care
