Learning outcome 3 Labour and Delivery

Question 1

Powers - Primary Powers. Purpose of contractions

Answer 1

Effacement and dilation of cervix
Facilitation of descent and rotation of fetus
Seperation and expulsion of the placenta
maintenance of homeostasis

Question 2

Parturition

Labor

Delivery

Answer 2

Childbirth which involves both labour and delivery

Function by which a new individual is expelled into the outside world

Expulsion or extraction of a child at birth

Question 3

Contractions

Contraction Duration

Contraction Frequency

Contraction Intensity

Answer 3

Temporary and involuntary shortening and thickening of the uterine muscles

Length of the contraction itself

Time between start of contraction to start of the next one

Strength of the contraction (mild, moderate and strong)

Question 4

The FOUR P’s of Variable Labour

Answer 4

Powers - Effectiveness
Passage (Pelvis) - size and shape
Passenger - fetus size and position
Psyche - Prep / Previous experience

Question 5

Three phases of contraction

Answer 5

1. Increment
2. Acme (peak of the contraction)
3. Decrement

Question 6

Intervals between contractions

Answer 6

Allow uterus to rest

Uninterrupted blood circulation

Question 7

Retractions

Answer 7

Shortening of uterine muscles that persists after a contraction
Aids in reducing the size of the uterine
Aids in a thickening of the muscle in the fundus

Question 8

Effacement of the cervix

Answer 8

Shortening thinning and shortening of cervical canal.
Measured in %
Primipara - effacement usually precedes dilation
Multiparas - occurs with dilation and the cervix may be effaced 50% before the labour begins.

Question 9

Cervical Dilation

Answer 9

Opening and enlargement of external cervical os
caused by the retraction of the cervix
full dilation is 10cm

Question 10

Powers - Secondary Powers

Answer 10

“Bearing down” - pushing
Augment of the primary power
Involved the abdominal muscles and diaphragm
Increase in pressure to expels fetus
voluntary initially
involuntary - when pressures of the fetal head on the pelvic floor -> very strong. Sacral nerve stimulation

Question 11

Passages

Answer 11

Boney Pelvis 
Soft Passage (Uterus, Cervix, Vagina and Perineum)

Question 12

Boney Pelvis

Answer 12

Size and shape are adequate for delivery
Estimation of adequacy (bony muscles of the pelvic floor and perineum
Angle of birth canal (J shape, downward, forward and then upward)

Question 13

Will a physician preform and C-section if the there is an anticipated problem with the boney pelvis

Answer 13

Yes

Question 14

Soft Passages (four of them)

Answer 14

Uterus, Cervix, Vagina and Perineum

Question 15

Soft passages surrounding structures (two of them)

Answer 15

Pelvic muscles and bladder / urethra

Question 16

Passengers

Answer 16

Fetus, Amniotic fluid / sac, umbilical cord and placenta

Question 17

Fetus - Descent and three factors involved

Answer 17

Undergoes a series of maneuvers to accommodate its descent

Factors - fetal head, fetopelvic relationship and mechanisms of Labour

Question 18

Fetal Head

Answer 18

Presenting part, not compressible like the rest of the body and represents the largest part of the infant.
Ability to mold - overlapping of cranial bones (sutures and fontanelles; usually without damage to underlying tissue

Question 19

Fetopelvic Relationship (5 situations)

Answer 19

Presentation
Position
Atttitude 
Lie 
Station

Question 20

1. Presentation

Answer 20

Portion of the fetus coming first to the pelvic inlet.
Cephalic (95% - occiput, brow / face)
Breech (4%)
Shoulder (1%)

Question 21

2. Position

three elements to fetal position

Answer 21

Relationship of the identified landmark on the presenting part to the four quadrants of the mothers pelvis

**What part of the baby is presenting and where is it pointing **

Side of the maternal pelvis
Point of fetal presenting
Designated side of the maternal pelvis

Question 22

Side of the Maternal Pelvis

Answer 22

Right or Left

Question 23

Examples of Positions - ROA / LOA

Answer 23

Right Occiput Anterior

Left Occiput Anterior