Labor and Birth Flashcards
1
Q
What is labor?
A
Sequence of events that cause cervix to efface and dilate leading to birth
2
Q
Prodromal Labor
A
- “Pre” labor
- Contractions may occur as “cramp-like” sensations low in abdomen
- Contractions may increase in intensity, frequency, and duration initially, then fail to consistently and persistently change
- These contractions may occur hours, days, or weeks before onset of labor
- Changes in cervix are usually minimal
3
Q
Prodromal Labor - Treatment
A
- Mother must maintain her food intake and excellent fluid intake
- Alternate activity - resting with mild activity if during day, and rest at night is essential
- Take warm bath
- Chamomile tea or Sleepy Time tea can increase rest and relaxation
- Benadryl or Tylenol PM may be suggested by some care providers
- Mother may engage in activities for distraction during day
- Use open knee position, pelvic tilt, or abdominal lift to increase comfort
4
Q
Conditions Affecting Labor - Posterior Cervix Treatment
A
- Abdominal lift
- Do not use pelvic tilt in hands and knees position if cervix is posterior as it hinders correcting posterior cervix
- Evening primrose oil taken orally is often recommended by midwives to soften scars on cervix. It should not be used before 37 weeks
- Squatting and use of birth ball may aid in correcting abnormal positions of cervix
5
Q
Conditions Affecting Labor - Posterior or Asynclitic
A
- TENS unit early in labor can be very helpful for back pain allowing mother to move about freely to aid in repositioning baby
- Stair climbing, lunge, double hip squeeze, and knee press are all helpful in repositioning baby
- Open knee-chest position can aid in freeing baby’s position so it can realign in pelvis
- Rock the baby position can also aid in repositioning baby
6
Q
Conditions Affecting Labor - Emotional stress
A
- Previous birth trauma
- Fears, anxiety
- Lack of support
7
Q
Onset of labor - primarily determined by baby
A
- Multiple hormonal changes occur starting with baby’s pituitary gland releasing hormone CRH, ACTH and cortisol all begin final stages of lung maturity in baby
- These hormones alone with other cause changes in estrogen, progesterone, and prostaglandin levels in mother’s body
- These changes lead to a significant increase in oxytocin receptors in uterine muscle making it responsive to increasing levels of oxytocin that mother’s body secretes during labor
- Additional changes occur with levels of relaxin, prostaglandin, and endorphins which contribute to progression of labor and birth
8
Q
CRH
A
- Corticotrophin releasing hormone
9
Q
ACTH
A
- Adrenal corticotrophin hormone
10
Q
Progression of labor
A
- Contractions generally begin sporadic, they are usually mild, and of short duration
- As levels of oxytocin rise, contractions become stronger, last longer, and become more frequent
- Mother often needs to use relaxation/pain relieving techniques
- Remaining in comfortable environment such as home can be very helpful in progress in labor
11
Q
Labor and Birth Transition
A
- Often referred to as most difficult or intense part of labor
- Contractions are usually very intense occurring every 2-3 minutes
12
Q
Laboring Down
A
- Process of allowing natural descent of baby when urge to push in not yet present regardless of whether mother is medicated or un-medicated
13
Q
Laboring Down - Advantages
A
- Less maternal fatigue
- Fewer fetal heart rate decelerations
- Less perineal trauma
- Less potential nerve damage for mother form improper potential of her knees and hips, especially with use of epidural
- Less use of instrument delivery - forceps or vacuum
14
Q
Laboring Down - Disadvantages
A
- Lack of control by medical staff
- Potential increased time from complete dilation to birth
15
Q
Laboring Down - Techniques
A
- Allow mother to assume position of comfort
- Allow baby to stimulate Ferguson’s reflex, ejection reflex
- Encourage mom to push only when urge is present
- Mom should hold her breath for 5-8 seconds with pushing and encourage mom to change positions every 30-40 min
- Squatting position is most effective for increasing intrauterine pressure and opens pelvis to maximum dimensions
