First Stage of Labour

Question 1

What is the order of the mechanism of labour?

Answer 1

• Descent
• Flexion
• Internal Rotation
• Extension
• Restitution
• External rotation
• Expulsion

Question 2

What shoulder is delivered first?

Answer 2

-Anterior shoulder then posterior shoulder

Question 3

What is the typical length of the first stage for a primigravida?

Answer 3

8-12hours

Question 4

What is the typical length of the first stage for a multigravida?

Answer 4

5-12hours

Question 5

What are some self-coping mechanisms for women in the latent phase?

Answer 5

• Mobilise
• Nutrition hydration
• Bath
• Paracetamol 2x500mg tablets. Max 8 tablets so 4gm in 24 hours

Question 6

For low risk nulliparous women presenting for care what should you do?

Answer 6

Consider an assessment at home or in a midwifery-led unit for one hour.

Question 7

What will the assessment include?

Answer 7

• Take full history
• Baseline observations
• Abdominal examination
• Auscultation of the FH
• Discussion of the birth plan
• Conduct vaginal examination if necessary

Question 8

What is the expected cervical dilatation according to NICE guidelines?

Answer 8

-2cm every 4 hours.

Question 9

What is a partogram?

Answer 9

-If progress does not occur as expected and cervical dilatation crosses the action line then augmentation of labour often takes place.

Question 10

Why is it important that a women’s bladder is empty?

Answer 10

-To allow descent of the presenting part

Question 11

What are the pharmacological options for pain relief in labour?

Answer 11

• Entonox
• Diamorphone
• Pethidine
• Remifentanil
• Epidural