Labour

Question 1

What characteristics of the pelvis’s ability to ‘open up’ are inhibited by a woman’s reclined position on a bed for labour and birth:

Answer 1

• The pelvic ligaments cannot easily allow movement

* The pelvic inlet and outlet diameters are reduced potentially inhibiting movement of the baby

Question 2

The sub-occiput bregmatic presentation in labour is favourable due to what?

Answer 2

It is the smallest diameter for navigating the maternal pelvis

Question 3

What are the mechanisms of labour in sequence?

Answer 3

Descent

Question 4

How often should you check a woman’s temperature and blood pressure in labour?

Answer 4

Every 4 hours

Question 5

How often should you check the fetal heart rate in the first stage of labour?

Answer 5

• After every contraction or at least every 15 minutes for at least one minute

Question 6

How often should you do a vaginal examination in labour?

Answer 6

Every 4 hours or as indicated

Question 7

Common signs of labour?

Answer 7

• Increasingly painful contractions in the uterus
• Increasingly regular, longer and more frequent contractions
• Vaginal show (blood-stained mucus) – may occur before contractions
• Vaginal discharge of clear fluid (SRM)
• Nausea and frequent bowel movements

Question 8

How often should you listen to the metal heart rate in the second stage of labour?

Answer 8

• After every contraction or every 5 minutes - whichever comes first - for at least one minute with palpation of the maternal pulse every 15 minutes

Question 9

What are the defining characteristics of the first active phase of labour?

Answer 9

• Regular contractions (longer and stronger) 3 -4 contractions in 10 minutes lasting at least 60 - 90 seconds

Question 10

What is the expected amount of dilation an hour for a primipara mother (first baby)

Answer 10

0.5cm - 1cm an hour

Question 11

When should you consult regarding VE and dilation?

Answer 11

If she has not progressed at least 2cm since the last VE (every 4 hours)

Question 12

When is the transition stage of labour?

Answer 12

Between the first and second phase

Question 13

What is stage 2 of labour?

Answer 13

From full dilation (10cm) to the birth of the baby

Question 14

What is stage 3 of labour?

Answer 14

The birth of the placenta

Question 15

What can help reduce the likelihood of third and degrees tears in labour?

Answer 15

Warm compress to the perineum
Women directed pushing
Hands poised approach

Question 16

What are the signs of full dilation?

Answer 16

• A pouting anus
• Bloody show
• Urge to push

Question 17

What is directed pushing and why is it not considered best practice?

Answer 17

Telling a women when to push once they are 10cm dilated. It is often used for woman who have had epidurals. The woman may not have the urge to push, increase likelihood of tearing and cause hypoxia

Question 18

What is directed pushing?

Answer 18

Telling a woman to push at 10cm dilated that doesn’t have the urge to