Labor and Birth Flashcards
How is the first stage of pregnancy characterized?
- Onset of labor until full dilation and effacement (10 cm/100%)
- Three phases: latent, active, transition
How is the second stage of pregnancy characterized?
- Full dilation and effacement until birth of fetus
- Stretch receptors in pelvic floor activated as fetus passes through pelvis
When is the third stage of pregnancy?
From birth of fetus until delivery of placenta
When is the fourth stage of pregnancy?
From delivery of placenta until 2 hours postpartum
What does true labor look like?
- progressive cervical change
- contractions felt in back and abdomen
- contractions increase in duration, intensity, and frequency
- bloody show
- ROM (rupture of membranes)
What does false labor look like?
- no cervical change
- contractions mostly felt in lower abdomen
- contractions have little to no pattern and do not get stronger
- contractions stop with hydration or activity
What are three questions asked during pregnancy triage?
- How is baby moving?
- Are you having any vaginal bleeding?
- Are you leaking any fluid?
What kind of data is collected during initial assessment of laboring patient?
- Three questions!
- What is their indication for labor (contractions, rupture of membranes)
- Fetal heart rate and contraction assessment (frequency, duration, intensity, rest)
- Cervical exam (dilation, effacement, station, and presenting part)
- Vital signs
- Thorough past medical and surgical history
- Any issues with current pregnancy (hypertension, diabetes)
- Current medication use
- Allergies
- Assessment (heart, lungs, edema, DTRs)
What are the 4 P’s that impact labor progression?
- Passenger (fetus)
- Passageway (birth canal)
- Powers (contractions)
- Psychologic response
What is Station in relation to Passenger?
Position of the baby (fetus) within the mother’s pelvis.
What is the ideal positioning of the fetal head during a vaginal birth?
- Baby is chin to chest
- Cephalic presentation is ideal (head down, chin tucked to chest, facing mom’s back)
- Vertex presentation is the preferred subtype
What does the Passageway of birth consist of?
- Bony pelvis
- Pelvic musculature
- Cervix
- Vagina
What are the Powers of birth characterized by?
frequency, duration, intensity
How do Powers affect the two stages of labor?
1st stage of labor:
- Goal: dilate and thin (efface) the cervix
2nd stage of labor:
- Goal: expel fetus
- Urge to push/bear down
Describe Psychological Responses of the birthing process.
- Overall emotional response to pregnancy
- Previous pregnancies/births/children
- Support system
- Prenatal education and coping abilities
- Cultural factors
- Emotions may fluctuate throughout labor
