Module 5: birth Flashcards
What is prodromal labor?
False labor
What are the characteristics of false labor?
Contractions do not increase in frequency, duration, or intensity/strength
Cervix does not dilate or efface
Contraction pattern decreases with change of position
What are the characteristics of true labor?
Contractions become rhythmic and regular (Q4-10 min)
Increase in frequency, duration and intensity/strength
Contraction pattern does not change with activity or position change
Associated with increase in vaginal discharge or show
Cervix begins to dilate and/or efface
What is the nurses role in labor and delivery?
- Assess onset and pattern of contraction
- Assess contraction frequency, duration, strength/intensity
- Provide information related to maternal self-care (nutrition and fluid intake)
- Provide reassurance
What are you determining during palpation of the abdomen
Lie
Position
Level of engagement
Presenting part
Presence of contractions (frequency, strength/intensity, duration)
Foetal well-being- heart rate, movement
What are the 3 levels described in “station” of birth?
Floating: -5
Engaged: 0
Crowning: +5
Fetal head becomes engaged deep into the boney pelvis and the height of the fundus decreases
True or False: There are known mechanism/triggers of why labor begins
False
Exact mechanism/trigger unknown- but there are many theories..
What are the hormonal theories regarding labor onset?
Oestrogen theory
Progesterone withdrawal
Prostaglandin theory
Oxytocin theory
Foetal cortisol theory
What are the mechanical theories regarding labor onset?
Uterine distension theory
Stretch of lower uterine segment by presenting part
What are the 4 P’s of the components of labor?
The Passage
The Passenger
The Power
The Psyche
What are the components of “The Passage” in labor?
DIMENSIONS:
Pelvis
Resistance provided by soft tissue
Cervix
Perineum
What are the components of “The Passenger” in labor?
POSITIONS, SIZE, & LIE:
Foetal head is largest diameter of the foetus
Head can pass through the pelvic ring
Foetal head molds, changes shape, and adapts as moves through maternal pelvis because of fontanelles
Molds in response to pelvic floor muscles and boney pelvis
What is “LIE” referring to?
Relationship of fetal spine to spine of mother
Longitudinal, transverse, or oblique
What is “presentation” referring to?
Part of passenger’s body presenting at the cervix
Usually….
Longitudinal lie
Occiput (bone)
Posterior fontanel
What are the components of “The Power” in labor?
STRENGTH, DURATION & FREQUENCY
What are the primary “powers” of labor?
Contractions begin in myometrium of uterus
Contractions move from the fundus downward in waves, separated by short periods of muscle relaxation
Contractions become progressively stronger, regular, and intense
Pressure of fetal head against cervix, causes thinning (effacement) and dilation of cervix
What are the primary “secondary” of labor?
As presenting part reaches pelvic floor, contractions change in character – become more expulsive
Woman may experience involuntary pushing urge
Begin bearing down to aid the work of the uterus to expel the baby
Bearing down- increases intra-abdominal pressure, compresses uterus on all sides, adds to expulsive power
What are the components of “The Psyche” in labor?
The psyche and the goal of health care providers:
Psychological outlook is preserved
Knowledge
Fear
Support
Trust
Self
Care provider
Support persons
Beliefs, values, culture