Examination and care of the mother and fetus

Question 1

What are the steps of labour? (in order)

Answer 1

Decent 
Flexion
Internal rotation
Crowning of the head
Extension
Restitution 
Internal rotation of the shoulders 
Delivery of the shoulders

Question 2

Summarise Decent

Answer 2

1. The fetal head moves into the pelvis

2. When the widest diameter of the fetal head enters the pelvis engagement occurs

Question 3

Summarise Flexion

Answer 3

1. Flexion increases when the vertex meets the resistance of the pelvic floor
2. The fetal axis pressure is transmitted through occiput
3. Forehead is pushed upwards by the resistance of the soft parts and complete flexion is obtained

Question 4

Summarise Internal rotation

Answer 4

1. When the occiput meets the resistance of the pelvic floor it rotates forward
2. The slope of the pelvic floor aids the rotation forward which leaves room for the head to emerge in the longest diameter of the pelvic outlet - anteroposterior diameter. if the head is well flexed the occiput will rotate to the front.
3. Rotation can be seen externally by changes in abdominal palpations showing decent, changes in position, and where the fetal heart is located

Question 5

Summarise Crowning of the head

Answer 5

1. The occiput escapes under the pubic arch and the head is crowned
2. No longer recedes between contractions
3. Biparietal diameter is born

Question 6

Summarise Extension

Answer 6

1. The bragma, the forehead, face, and chin pass over the perineum

Question 7

Summarise Restitution

Answer 7

1. The shoulders meet the pelvic floor and begin to turn

2. The head rights itself with the shoulders and therefore the babies neck is untwisted by restitution

Question 8

Summarise Internal rotation of the shoulders

Answer 8

1. Shoulders move into the anteroposterior diameter of the outlet
2. The head outside the birth canal also rotates

Question 9

Summarise the Delivery of the shoulders

Answer 9

1. The anterior shoulder is born under the pubic arch
2. The posterior shoulder passes over the perineum
3. The baby is lifted to the mother for skin to skin contact. (Bonding moment)

Question 10

What are the external signs that the process of labour is occurring?

Answer 10

• The movements of the woman
• Rocking hips
• Woman making different noises
• Water break