Normal Labour Flashcards
Normal birth is _____ in onset, low-risk at the start of labour and remaining so throughout labour and delivery. Infant born in ____ position between __ and 42 weeks of pregnancy. After, mother and infant in good condition.
spontaneous
vertex
37
What happens during latent phase?
Contractions (irregular)
Mucoid plug (“show”)
Cervix beginning to efface and dilate
Can last up to 3 days
What happens in the first stage of labout?
Stronger uterine contractions
Cervix is continuing to efface and dilate up to 10 cm.
In the first stage of labour, the cervix dilates up to…
10cm
What does the second stage of labour involve?
From full dilatation to the birth of the foetus (pushing)
Having contractions every - minutes indicates first stage of labour
2-3
What does the third stage of labour involve?
From the birth of the foetus to the expulsion of the placenta
What happens during a physiological third stage
Women wait for placenta delivery (normally 1 hours)
Separation bleed as placenta becomes ready to be delivered
Active third stage
Give oxytocin and ergometrine as IM injection into leg or arm to help contract to help deliver placenta in 5-10 mins after baby. Reduces risk of heavy bleeding.
Rate of dilatation of cervix in women who’s never given birth before
1/2 cm an hour
What does surge in oxytocin do?
At onset of labour will contract the uterus.
Can have membrane sweep to encourage oxytocin
Prostaglandins role in labour
Aid cervical ripening
Oestrogen at onset of labour
Inhibits progesterone to prepare the smooth muscles for labour
Prolactin
Begin process of milk production in the mammary glands
What causes pelvic girdle pain
Weight of baby on pelvis. Ligaments are relaxed due to hormones in pregnancy
Antenatal colostrum harvesting
34 weeks, massage breast to see if milk can be collected and stored in fridge. Surge in hormones
What is colostrum?
First form of breastmilk. Nutrient dense and high in antibodies and antioxidants.
After 2-4 days production changes to breast milk
94% babies will be in ____ position at end of pregnancy
Cephalic
3% of babies will be in _____ position
breech
1% babies will be in _____ position
transverse
Contractions start in the ____
fundus (top of uterus)
Hormones cause retraction and shortening of muscle fibres.
(Like tennis ball at entrance of balloon, sides of balloon getting pulled up until ball can drop out.)
What is cervical effacement? (aka ripening)
Thinning of cervix
How is dilation measured?
Done by vaginal examination
Measured in cm
What is the most common shape of woman’s pelvis?
Gynecoid
Wide sacrum
Straight side walls with blunt ischial spine
Foetal skull is made up of _ bones that are not fully formed
3
Mechanisms of Labour
1) ______
Descent
Can occur from 37 weeks.
Encouraged by increased abdo muscle tone
Mechanisms of labour
2) ____
Flexion
Contraction exerts pressure down foetal spine towards occiput, forcing occiput to meet pelvic floor. Foetal neck fxlees allowing circumference of babies head to reduce.
Mechanisms of labour
3)
Internal rotation
Each contraction, head pushed to pelvic floor, then rotates head 90 degrees so comes out facing out direction of mothers back.
Mechanisms of labour:
4)
Extension
Foetal occiput will slip beneath suprapubic arch allowing head to extend.
Mechanisms of labour
5)
Restitution/external rotation
Foetus may naturally align its head with the shoulders. This is visible.
(if it doesn’t do this, suggests shoulder dystocia)
Mechanisms of labour:
6)
Delivery of body
Gentle axial traction my be conducted by midwife
What does SROM stand for?
Spontaneous rupture of membranes
What does ARM stand for?
Artificial Rupture of Membranes
True or false: foetus can swallow the amniotic fluid
True
Helps to create urine and meconium. Rich in stem cells.
Rarely, foetus can be born within the amniotic sac known as…
en caul
What is delayed cord clamping?
Umbilical cord is not immediately clamped and cut at the point of birth, Wait at least1 minute to transfuse blood to the baby. Could receive up to 214g of blood. Increase in red blood cells, iron and stem cells.
How many arteries and veins does the umbilical cord hold?
2 arteries and 1 vein
True of false: Vein supplies oxygen and 2 arteries bring deoxygenated blood away from baby/
True
Alcohol and ____ can be passed to foetus via the placenta, along with maternal antibodies to protect against infection.
nicotine
What are the 2 membranes of the placenta?
Amnion which is around the baby
Chorion
Pros of pool birth
Analgesic aspects
Promotes calmness
Hands off approach
Upright birth
Holistic pain management options
Water immersion
Aromatherapy
Massage
Hypnobirthing
TENS machine
Pain management
Entonox (gas and air)
Paracetamol
Codeine
Opioids (diamorphine, pethidine, remifentanyl)
Epidural
Pros of entonox
Fast acting (20-30 seconds)
Can be used alongside other analgesia
Epidural Pros
Total pain relief in 90%
Effect will last until baby is born
Epidural cons
Reduced mobility
Can take an hour to take effect
Will need a urinary catheter
Can slow own labour
