Introduction for the pregnant and birthing family Flashcards
Which hormones are involved in the menstrual cycle?
FSH - follicle stimulating hormone
Estrogen
LH - leutenising hormone
progesterone
What causes the bleeding?
When the egg is not fertilised and there in a drop in progesterone
What hormone helps to identify pregnancy?
HCG
What are subjective signs of pregnancy?
nausea vomiting fatigue breast changes ahmenhorea frequency to urinate quickening (kicks as early as 16 weeks)
What are objective signs of pregnancy?
HCG in urine and blood
goodals sign - softening of the cervix
chadricks sign - blue vagina
baxton hicks contractions - irregular painless contracting of the uterus
What are the diagnostic tests for pregnancy confirmation?
HCG urine test
Blood test
Ultrasound
How do you work out what the estimated due date is?
Using the woman dates
- Naegeles rule - LMP (last menstrual period) + 9 months + 7 days
(You need to take into account the woman cycle and adjust appropriately)
Ultrasound
What is antenatal care?
To monitor the process of pregnancy in order to support maternal health and normal foetal development
What are the types of antenatal care?
Midwifery led care
Shared care
Obstetric care
What is midwifery led care?
Birth centre type model
Main carer is the midwife
Only if low risk
What is shared care
Shared with midwife and obstetrician
But only really see GP
Low risk
Prefer to see GP
What is obstetric care?
Obstetric led care
Moderate or high risk
What is the booking in visit and when is it done?
complete history of both mother and father and family physical assessment mental health assessment birth preferences feeding preferences health promotion blood tests urine tests
often completed at 12 weeks
What are the stages of labour?
early/latent phase
first
second
third
3 stages
What happens in early/latent phase of labour?
can last hours days or even weeks prep for labour may pass mucus plug cervix • moved from posterior to anterior • ripens and softens • effaces • dilates
What happens in the first stage of labour?
onset of regular, painful uterine contractions
woman cannot speak during contraction
cervix is 3-4 cm dialated
feel urge to push
What are the 5 P’s
Passage Passenger Pain Psyche Powers
What can be done for comfort for the woman during labour?
massage heat pack movement and positioning breathing techniques shower music
What happens in the second stage of labour?
full dilation to the birth
expulsive contractions
pushing the baby out
What happens during the third stage of labour?
birth of the placenta and membranes
What happens after labour is over?
the first hours following birth regular vital signs uterus contracts down track vaginal loss possible sutchering assistance with breast feeding skin to skin contact
What happens with the neonate after birth?
Airway clamping and cutting the cord drying First cry warm skin to skin contact
What is the APGAR score? explain what should be expected in each part
Appearance - blue or pale all over - blue extremities, but torso pink - pink all over Pulse - none - 100 Grimace - no response - weak grimace when stimulated - cries of pulls away when stimulated Activity - None - some flexion of arm - arms flexed, legs resist extension Respirations - None - Weak, irregular or gasping - Strong cry
0-3 low, 4-6- fairly low, 7-10 generally normal
taken at 1 min then 5 mins
What does Postnatal mean?
after childbirth
What does Postpartum mean?
After labour
What does puerperium mean?
the time from the completion of the thirds stage of labour to 42 days postpartum
What postnatal care should be done for the mother?
physical assessment - breast - abdomen - genito-urinary and pelvic - lower limbs consider any complicating medical conditions consider the type of birth
When doing a breast assessment what questions would the midwife ask?
do they know how to self express
is the baby feeding well
Has the milk come in?
What do you need to check in an abdominal assessment of the mother?
Is the uterus involuting?
What needs to be discussed with the mother about the Genito-urinary system?
haemorrhoids? micturition? have they passed stools pelvic floor exercises checking on blood loss
What assessment on the mother needs to be done for Lower limbs?
DVT
oedema
When can intercourse be resumed?
When stitches are healed
When the mother feels ready
What are the 3 major components of breastfeeding?
LPA
latch
positioning
attachment
What are the 10 steps to successful breastfeeding?
policy training inform help initiate show and maintain breast milk only room in encourage no pacifiers support groups
What are the three types of psychological conditions after labour?
Baby blues
Postnatal depression
Postnatal psychosis
Explain baby blues
Very common
linked to changes in hormones
brief period of emotional vulnerability
usually subsides within a few days
What are some causes or risk factors of postnatal depression?
refugee status parenting and caring responsibilities poor housing domestic abuse poverty or poor socioeconomic status lack of social support language barrier
What happens in postpartum psychosis?
Hyperactivity irritation mood swings suspiciousness/paranoia strange beliefs of delusions difficulty communicating inability to sleep seeing or hearing things
How long is the postnatal period?
6 weeks
What is done at the daily newborn care or check?
feeding cord care skin weight output - urine/meconium
How long does the umbilical cord stay on?
4-10 days
How does breast feeding work?
Works by supply and demand
- baby feeds and a message is sent to brain pituitary gland
- prolactin and oxytocin are released
- this increases milk production and let down reflex
What are the advantages of breastfeeding?
cost effective
environmentally friendly
less risk of illness and chronic disease
less ear infections
What needs to be considered about artificial feeding?
Equipment
sterilisation
formula
different teat sizes
Why do babies develop jaundice?
a physiological response
usually on head and torso
they can be lethargic irritable or not feeding
as a rapid amount of RBCs are broken down bilirubin is release but the baby can’t expel enough to keep up with it and that come out on skin
How is baby jaundice treated
UV lights
What immunisations are given to newborns
Vitamin K - for bleeds
Hep B
What safety issues need to be discussed with the mother
Car seats
sleeping on back
no toys in cot
What is a healthy hearing screening
screening test to see if babies can hear at birth
What neonatal screening tests are done?
Cystic fibrosis
Galactosaemia
Phenulketonuria - PKU
Hypothyroidism
