normal birth and labour Flashcards
normal labour is process of
foetus, placenta and membranes being expelled via birth canal
normal labour is
spontaneous
37-42wks gestation
fetus presenting by vertex - head down
results in spontaneous vaginal birth
what is normal labour triggered by
paracrine and autocrine signals generated by materal, foetal and placental factors which interplay
what key physiological changes must occur to allow for expulsion of foetus
cervix softens
myometrial tone changes to allow for coordinated contractions
progesterone decreases whilst oxytocin and prostaglandins increase to allow for labour to initiate
stages of labour
1st stage: early/latent phase, active phase and transition
second stage: passive and active elements
third: active or physiological in labout
latent phase of labour
can be longest part of labour - up to days
irregular contractions - short lasting and mild
cervical changes (shortening and thinning out) and dilatation up to 4cm
active phase labour
8-12hrs
painful regular contractions, 3-4 in 10min period all lasting ~1min
cervix 4-10cm
transition phase labour
cervix 8-10cm
may experience physical changes such as shaking, vomiting, need to empty bowels
may express they can’t cope, need more pain relief etc.
second stage of labour
can have a passive and active element
full dilatation to birth
passive second stage of labour
assessed women is fully dilated but no involuntary expulsive contractions
active second stage of labour
presenting part visible, expulsive contractions or maternal effort we’ve encouraged
length second stage labour
vary 2-3hrs, depends if woman is nulliparous or multiparous
third stage labour
from birth of baby to expulsion of placenta and membranes
physiological management third stage labour
no uterotonics, do not cord clamp until pulsation stopped and placenta delivered by maternal effort
up to 60mins
active management third stage labour
uterotonic drugs, optimal cord clamping
30 mins
