Labor and Birth Final Exam Flashcards
True or False: Fetal presentation refers to the direction towards which the back of the baby’s head (or other presenting part) lies within the mom’s body.
False
The back of the baby’s head is toward mom’s right back
ROP–Right occiput posterior
The back of the baby’s head is toward mom’s left front
LOA–Left occiput anterior
The back of the baby’s head is toward mom’s left back
LOP–Left occiput posterior
The back of the baby’s head is directly toward mom’s front
OA–occiput anterior
The back of the baby’s head is towards mom’s left side, or facing her right thigh
LOT–left occiput transverse
The back of the baby’s head is toward mom’s right front
ROA–right occiput anterior
The baby’s tailbone, or sacra is toward mom’s right front
RSA–right sacrum anterior
The back of the baby’s head is directly toward mom’s back
OP–occiput posterior
What position is halfway between a posterior and anterior position and can indicate positive movement towards an anterior position if the baby has previously been known to be posterior?
LOT–left occiput transverse
Which position would describe a breech position?
RSA–right sacrum anterior
True or false: During labor, the presentation of the baby rarely changes; however, the position of the baby usually does change.
True
Station refers to the location of the ? ? ? in ? , in relation to (which pelvic anatomy) ?
baby's Presenting part centimeters Ischial spines
If the baby’s head is assessed at a +2 station, it is where anatomically?
2 centimeters below the ischial spines
List in proper order the 4 cervical changes that take place before and/or during labor?
Moves forward
Softens (ripens)
Effaces (thins/shortens)
Dilates (opens)
List in proper order the 3 categories of the signs of labor
Possible
Preliminary
positive
List 3 signs experienced in each “signs of labor” category
Possible: 1. backache such as before menstruation 2. abdominal cramping 3. nesting urge Preliminary 1. Braxton Hicks contractions 2. Bloody Show 3. Leaking of amniotic fluid Positive 1. Cervical dilation 2. Rupture of membranes with a gush 3. Progressive contractions of the uterus
What are the phases of the first stage of labor?
Latent, early phase
Active labor
Transition
Give 3 points of advice for a first time mom calling you to say she is in early labor.
Keep your normal routine (sleep if night, stay busy if day)
Do something fun like a walk or movie
Eat easy to digest foods
What is the reason why mom should be encouraged not to arrive at the hospital too early in labor?
She may become exhausted if the unfamiliar environment of the hospitals slow her progress. She may also become subject to the time table hospitals expect for labor.
List 3 signs that might convince you a mom has entered active labor.
Contractions become more noticeable, stronger, and closer together.
Mom’s focus moves more inward as she copes with contractions.
Mom may begin weeping in active labor because she realizes she can’t turn back.
List 2 helpful tips you might suggest to mom or dad during active labor:
Try different positions that feel best to your body.
Use massage and other comforting touch to help cope with contractions
Explain 2 keys to coping with transition.
Recognition: When you recognize you are in this phase you can be encouraged by your progress and see the pain as challenging, because baby is coming rather than discouraging.
Understanding the signs as normal: can help parents cope with transition and not become afraid or worried by what is experienced.
What are the phases of the second stage of labor?
Latent
Descent
Crowning/birth
Explain 2 keys concepts that should help guide mom during second stage of labor.
Listen to your body: find positions that are most comfortable to you and push when you feel the urge.
Push with contractions: push when you feel the urge to push rather than rushing
Describe what it means for a mom to bear down spontaneously during second stage and what are the advantages of a mom using spontaneous pushing as opposed to the very popular directed pushing during a natural second stage.
When a mom bears down spontaneously she will likely push for 5-7 seconds and take deep breaths in between. She will probably have 3 sets of these per contraction. A mom who pushes in this way is more likely to push her baby out without tearing and more comfortably than when directed. She also will not waste her energy.
Why do they refer to directed or Valsalva pushing as “Purple pushing?”
The mother has to push so hard that her face turns purple. This pushing occurs without contractions and requires a lot of strength and energy from mom.
What are the six reasons why it is not beneficial for mom to have a prolonged maximal pushing stage?
- exhausting mom
- Tearing the perineum
- Failure of baby to rotate
- Arrest of descent
- Over stretching of pelvic ligaments and muscles
- Decreasing oxygen to the baby, causing HR to drop.
According to several large studies, evidence says that not clinging to Friedman’s Curve and allowing labor to continue for a longer period before ?? centimeters of cervical dilation may reduct what rate in the united states?
6
c-section
In 5 lines, write how you might explain the Rule of 10 to a group of expecting parents as well as why such information is important for them to know during their birth and what they can proactively do about it?
The rule of 10 is a popular way of talking about when many caregivers consider the mom ready to begin pushing–10cm dilation of the cervix becomes the goal, then you can push. However, recent studies are showing that when a woman has the urge to push before 10cm, doing so can help to rotate the baby and fully dilate the cervix. In contrast, most mothers who try to resist this urge experience considerable discomfort and slowing of progress. You should feel the freedom to listen to your body, and respond in the way that is most comfortable. If that means you want to push before 10, be encouraged that you will not push so hard that you will rupture your cervix, as an unmedicated woman will stop in response to that kind of pain.
List 2 ways mom can best protect her perineum during birth:
- Panting or blowing through the burning sensation of crowning.
- Choose a caregiver who prefers to avoid episiotomy.
More than ?? in 10 women who had Cesareans for failure to progress had not even reached 5cm dilation before they were taken to surgery.
4
Explain what it means for a mom to “hold back” during second stage of labor and list 2 reasons why she might be holding back?
Holding back occurs when a mom resists the urge to push and does not follow the urges of her body. She may be afraid of the pain or have a psychological reason, such as issues with her partner, that keep her from wanting to surrender and let the baby come.
What is something you might tell a mom in labor who you know is holding back?
It is time to get your baby out. You need to let go so that your body can do this and you can meet your baby! You are almost done.
What kind of position should mom be encouraged to assume if her baby seems to be descending too quickly?
side-lying position
According to midwife and author Lydi Owen, the phase of maximum slope is defined as dilation occurring most rapidly from ?? to ?? centimeters.
6 to 8
Why are squats the new kegel?
The goal of your pelvic floor in labor is to stretch and open as the baby moves down and out. Kegels, though popularly recommended to prevent pelvic floor trauma during and after labor, actually serve to tighten and shorten the pelvic floor. Squats, on the other hand, help lengthen and strengthen your pelvic floor, making it more flexible and able to stretch as the baby comes out, an return to normal after delivery. Doing squats rather than keels, especially during pregnancy, is a much more effective way of preparing your pelvic floor to withstand and bounce back from labor and birth. Kegels can be done to tone while not pregnant, but should be avoid during pregnancy and replaced with squats.
The gate control theory states that the balance of ?? and ?? stimuli reaching your consciousness determines the ?? of pain and its severity.
painful
nonpainful
perception
What three coping mechanisms are a description of the essential, universal, and instinctual behaviors of women who sole well in labor?
relaxation
ritual
rhythm
What are three benefits to relaxation in labor?
Helps to relieve the stress of labor
Helps women cope with the pain of labor
Conserves energy throughout the labor process.
Why is it important for an expecting mom to practice and learn what muscle tension feels like?
This enables her to identify where she holds tension and prepare herself to be able to relax well during labor. Practicing this technique will equip her to do it more easily in the stress of labor.
Draw the charge that explains the power of the mind body connection in birth and then provide a word example next to the chart
idea/word/thought about birth feeling belief behavior positive or negative experience
favorite moment happy,excited birth will be fun relaxed, accepting, happy positive experience
The release of hormones necessary for the birth process is accompanied by a reduction of what part of her brain ?? This part of the brain enables women to do what two things?
neocortex
think scientifically and rationally
communicate through language
According to Odent, a main component of protecting the mother and birth process is assuring what does NOT happen to a woman in labor?
She should not be asked any questions or spoken to rationally.
Complete the Labor tools acrostic
Encouragement Massage Position open mind Walking Empty bladder Refreshments
Breathing Imagery Relaxation Trust Honor the process Surroundings
?? coupled with pressure for more than two minutes will anesthetize a body surface area?
Vibration
List the 4 different touch relaxation techniques that may help mom cope in labor?
Still touch
firm touch
stroking
massage
Describe 5 different comfort measures that can assist a woman to cope better with labor.
- utilizing water, such as a bath or shower, to help her relax and folate the pain.
- Touch–massage and other methods of touch are important comfort measures.
- Music that relaxes and distracts the mother
- Utilizing hot and cold such as heating pads or cold rags.
- Visualization of the process internally or through use of an external focal point
Describe 3 benefits provided to mom when using a birth ball during labor?
It can relieve pressure on her arms when in the hands and knees position.
It can support her perineum and encourage descent of the baby.
It is helpful to use in situations for addressing the diagnosis of failure to progress.
Why should a mom be encouraged to empty her bladder every ?? minutes during labor?
45
A full bladder can slow progress and increase the pain of labor.
Why should mom be encouraged to alternate positions every ?? minutes during labor
30
This can change the shape of her pelvis, encouraging good position of the baby. It can also utilize gravity, encouraging descent. An added benefit is distraction provided to mom.
Why are breathing techniques important for mom to practice and master before birth?
Breathing is a very effective way to relax during labor. Mastering this before will help a woman know what technique works best for her and enable her to utilize it more efficiently during labor because she is familiar with it.
If hyperventilation does occur in labor, you can help a mom correct it by suggesting she:
Rebreathe her own air through cupped hands, paper bag, or surgical mask. Hold her breath in between contractions. Take a long deep breath. Also implementing relaxation methods such as touch or a warm shower can help calm her down.
What cycle tends to happen when a laboring mom chooses to only breathe with her chest and why?
Tension–>fear–>chest breathing–>pain
Chest breathing increases tension, which leads to fear and pain. this shallow breathing doesn’t get as much oxygen into the body and can result in hyperventilation
List two benefits of abdominal breathing for a birthing mother?
- It is natural
2. It uses less energy
What are two things you will teach women about vocalization in birth?
- Vocalization in birth is empowering and can enable you to feel a sense of control during your birth.
- Choose a poem or chant and practice it while utilizing other relaxation techniques in order to prepare for labor.
True or false: A widely accepted notion is that all women should respond to labor pain calmly and quietly
true
Every mom should come to expect and accept that she will probably lose ?? at some point during labor.
control
How might you encourage a mom that feels like she is ‘losing control’ in labor?
You can encourage her to surrender and give into the process because by doing this her baby will come. This moment often comes at a time that signals the process will be over soon if she can embrace the moment.
What 3 variables make each woman’s perception of labor pain unique?
Frequency of contractions
Freedom to move around
Size and position of baby
What are 2 purpose for pain in birth?
The pain signals the process to continue by releasing more hormones (oxytocin, adrenalin, endorphins, prolactin)
The pain signals to those around you what is going on in the labor process
List 2 factors that can increase or decrease the degree of labor pain a woman feels
What she has been told about birth
Her past experiences with birth
List 3 functional sources of labor pain
- pressure of baby on nerves in cervix and vagina
- pressure o baby on bladder, rectum, and perineum.
- stretching and opening of the cervix (dilation)
The birth process is a ?? process
brain
What is the more accurate meaning of the word “sorrow” in the Genesis 3:16 context?
“work” or “labor”
In 5 sentences, explain what God’s intended purpose is for women to experience pain or hard work in childbirth.
God gave childbirth to women as a directive, not as a corrective. Women are able to participate with God in the labor, or hard work, that he also endured in creation. This process bonds women to their children as it bonds God to his. It teaches women their appropriate gender roles and disciplines us as we interact with our husbands. This process is what creates a healthy family, society, and ultimately world!
Write the 4 basics of the sphincter law.
Sphincters function best in situations of familiarity, intimacy, and privacy.
Sphincters do not open at will and do not respond well to commands such as “open” “relax” “stop it”
A sphincter in the process of opening may suddenly close if interrupted.
The degree of relaxation of the mouth and jaw is directly related to the ability of the cervix, vagina, and anus to open.
Liste and explain the Law of the 3Ps
Passenger
Passage
Power of contractions
Labor is often described in terms of the passenger, or baby, the passage, or mom’s pelvis, and the power of contractions to move the baby down and out.
What are 3 benefits for mother when she is able to change positions and move around during labor and birth?
It provides distraction
It changes the position of her pelvis so the baby can get in better position
It utilizes gravity to encourage descent.
Describe 2 ways the baby benefits when a mother is mobile and changing positions in labor and birth:
The baby is able to maneuver into a better position for birth.
The baby remains oxygenated well.
Leaning forward on a birth ball, partner, or bed
Relives pressure on back when there is a lot of back labor while also supporting mom so she doesn’t tire as easily.
Helpful to use this position if mom is feeling a lot of back pain at any time in labor
Sitting on the toilet
relaxes the perineum
This is a good position to utilize when labor has stalled and mom needs to relax.
Knee-chest
Encourages the baby’s head out of the pelvis and can relieve pressure on a swollen cervix
This is helpful to use when mother needs to lower the intensity of contractions or slow progress down.
Side-lying
Helpful to slow labor that is going too fast or a very large baby.
This is a good position to try when pushing, if pushing is going too fast.
Hands and Knees
Relieves pressure on mother’s back in case of an OP baby
Good to use anytime in labor that a mother is experiencing a lot of back pain.
Squatting
Helps push the baby down as it provides little room for the baby
This position is useful at any time in labor to encourage progression and descent.
What are 3 beneficial position for a woman to use during 2nd stage labor?
Side lying, in order to slow a fast 2nd stage, especially with a very large baby
Hands and knees, in order to relieve back pain and pressure of an OP baby
Squatting, in order to open the pelvis to its greatest diameter (1-2cm larger)
What does a woman learn when she births without drugs, anesthesia, or medical intervention?
She is strong and powerful. Self confidence trusting herself realizes her own strength and power Gives her a different attitude about pain and difficult situations
What is one of the issues that creates the need for childbirth education classes?
The breakdown of family, no longer any stories told about childbirth.
The cognitive matrix surrounding birth is that it is a chaotic bewildering and terrifying experience.
Who founded Lamaze and when?
Elizabeth Bing and Marjorie Karmel in 1965
