INTRAPARTUM Flashcards
Period extends from the beginning of contractions that cause cervical dilatation to the first 1 to 4 hours after delivery of the newborn and placenta.
INTRAPARTUM
FACTORS INFLUENCING A WOMAN’S RESPONSE TO PREGNANCY:
✓ Memories of her own childhood
✓ Cultural background
✓ Existing support systems
✓ Socio-economic conditions
✓ Perceptions of maternal role
✓ Coping mechanisms
✓ Knowledge of pregnancy changes
Initial ambivalence about pregnancy; pregnant woman places main focus upon self.
FIRST TRIMESTER
Acceptance of reality of pregnancy; increased awareness and interesting fetus; introversion and feeling of well-being.
SECOND TRIMESTER:
Anticipation of labor and delivery and assuming mothering role, viewing infant as reality vs. fantasy; fears, fantasies and dreams about labor are common, “nesting” behaviors like preparing layette.
THIRD TRIMESTER:
✓ Acceptance of pregnancy as a realityand incorporation of the fetus into body image.
✓ Preparation for physical separationfrom the fetus.
✓ Attainment of maternal role.
III. PSYCHOLOGICAL TASKS OF
PREGNANCY
✓ Accept the biological fact of pregnancy . . . . “I am pregnant”
✓ Accept the growing fetus as distinct from self and as a person to care for . . . . . “I am going to have a baby”.
✓ Prepare realistically for the birth and parenting of the child. . . . . . .
“I am going to be a mother”.
DEVELOPMENTAL TASKS OF PREGNANCY
Ambivalence and anxiety about role change; concern or identification with mother’s discomforts (couvade).
FIRST TRIMESTER:
Increased confidence and
interest in mother’s care; difficulty relating to fetus: “jealousy”
SECOND TRIMESTER
Changing self-concept; concern about body changes; active involvement common fears about delivery, mutilation or death of partner or fetus.
THIRD TRIMESTER:
✓ Normal rivalry depends on thedevelopmental stage.
✓ May need increased affection andattention.
✓ Regression in behavior (may appearin bedwetting and thumb sucking); rejection.
SIBLING REACTIONS TO
PREGNANCY
Subtle signs that can signal the onset of labor.
PRELIMINARY SIGNS
descent of the fetal presenting part into the pelvis.
LIGHTENING
approximately 10 to 14 days before labor begins due to tight abdominal muscles.
Primiparas
✓ usually on the day of labor or even after labor has begun.
✓ Changes the abdominal contour as the uterus become lower & more anterior.
✓ Gives relief from the diaphragmatic pressure & shortness of breath.
Multiparas
LIGHTENING RESULT IN:
- Gives relief from the diaphragmatic pressure & shortness of breath.
- relief of respiratory discomfort because of the release of pressure on maternal diaphragm
- increased frequency of urination because fetal head presses against the bladder
- leg pains caused by compression of the sciatic nerve
- muscles spasms
- increased vaginal discharge
- decreased fundal height because of descent of fetal head to pelvic brim.
Irregular painless contractions of pregnancy become stronger, longer, more frequent, enough to cause discomfort and alarm the mother.
INCREASED BRAXTON HICKS CONTRACTIONS
Consistency of cervix becomes butter soft when is near at hand.
RIPENING OF THE CERVIX
✓ Due to high level of adrenalin, woman become highly energetic and active.
✓ Advice mother not to use this energy for doing household chores but to save it for labor & delivery.
INCREASE LEVEL OF ACTIVITY
due to the decline in progesterone level.
WEIGHT LOSS
When the cervix dilates, this blood tinged mucus is released together with the operculum (mucus plug).
SHOW
Signified by a gush or steady trickle of clear fluid from the vagina.
RUPTURE OF MEMBRANES (bag of water)
The cervix feels softer than the normal, like the consistency of an earlobe during pregnancy, but at term, the cervix becomes “butter soft” & tips forward.
GOODELL’S SIGN
Uterine contractions
POWER
Begins at the onset of regularly perceived uterine contractions & ends when rapid cervical dilation begins.
LATENT PHASE OR
PREPARATORY PHASE
usually complete effacement in primigravida
CERVIX 1-4 cm dilatation;
