Normal births Flashcards
By what percentage does blood volume increase in a pregnant woman?
30-40%
By how many bpm does a pregnant woman’s heart rate increase?
20bpm
Does cardiac out put increase or decrease in a pregnant woman?
Increase
In pregnant women, does blood pressure decrease or increase and why?
BP decreases as progesterone is a natural dilator of blood vessels
Why does the position of the heart shift up and left during pregnancy?
Due to uterus enlargement
What changes occur in the respiratory system during pregnancy?
Uterus presses on the diaphragm, reduced capacity to take deep breaths, progesterone relaxes the ligaments in the ribcage
What happens to the positioning of the spine during later pregnancy?
Lordosis
What is the fundus?
fundal height / fundus is…
What anatomy changes occur to the pelvis during pregnancy?
What anatomy changes occur to the pelvis during child birth?
What is the pelvic inlet vs pelvic outlet?
What normal shape that appears abnormal can you often see in a baby’s head?
coning
What happens in the first stage of labour?
Cervix opens fully over several hours, comprises latent phase, early labour, active labour and transition
What happens during the second stage of labour?
From full dilatation to birth of baby
What happens during the third stage of labour?
From birth of baby to delivery of placenta and membranes (afterbirth)
What happens to the mother and baby during pre labour?
- Cervix long and closed but will start to soften (‘ripen’)
- Head sitting in the pelvis
- Baby facing to the side
What happens to mother and baby during the latent phase of labour?
- Contractions irregular and short but often painful
- Cervix becoming effaced (shortening) and starting to open
- ‘Show’ (mucus plug)
- The woman is fine at home. Can last around 20hrs
- Cervix can dilate from 0-3cm
What happens to mother and baby during early labour?
- Contractions more regular, longer, more intense, but can still be variable in frequency and strength
- Cervix thinning, continues to open
- Baby starting to be pushed down through pelvis
- The woman is fine at home
What happens to mother and baby during active labour?
- Contractions strong, 3-5mins, intense and woman concentrating on labour
- Cervix opening toward full dilatation. 3-6cm
- Baby descending
- The woman is likely to want to be in the place where she is booked to give birth
What happens to mother and baby during the transition phase?
- Contractions every 3-5 mins and very intense
- Woman often feels she can’t cope (need lots of encouragement)
- Rectal pressure at peak of contractions
- Membranes bulging if not already broken
- If not the woman’s first baby, birth is imminent
What happens to mother and baby during full dilation?
- Contractions every 6090 seconds, intense and expulsive
- Strong urge to push with peak of contraction as pressure on rectum
- Membranes rupture if not already broken
- Blood-stained ‘show’
- She may open her bowels – reassure that this is normal
- (Head moulding and starting to rotate).
When taking a history of a woman in labour, what must you ask?
Parity, gestation, any complications, how long has she been contracting painfully?
What other assessments must you consider of a woman in labour?
- Count contraction rate
- Set of observations
- Any loss per vaginum?
Define parity
The number of times a woman has given birth
