Normal Labour Flashcards
What is labour
When and how does it happen
The process during which foetus, placenta and membranes are expelled through the birth canal
it is spontaneous and occurs around 37-42weeks gestation
How should a foetus present during labour
What initiates labour
vertex (head first or cephalic)
no one knows
What physiological changes have to occur during labour
Various paracrine and autocrine signals are generated by various maternal fetal and placental factors
essentially the opposite of gestation happens during labour: cervix relaxes, myometrial tone decreases, progesterone lowers, oxytocin rises.
How do you keep oxytocin levels high during labour?
Keep the mother relaxed and feeling safe. This scan be done by having a baby at home or alternatively using methods such as birthing pools
How many stages of labour are there
What occurs during them?
Stage 1- Cervical dilation 0-10cm
Stage 2- Full dilation until babies delivery
Stage 3- Babies delivery until placenta and membranes are expelled
How long does the first stage of labour take?
It various, can take up to 20 hours. The cervix typically dilates at a rate of around 0.5cm-1.0cm per hour
How is the second stage of labour further broken down?
Passive- contractions are felt but mother is not required to push
Active- mother is required to push
How long into the second stage does delivery take place?
Mothers who have delivered before- within 1 hour of active stage
First time deliveries- within two hours of active stage
When is the third stage deemed to be prologned
Within 30 minutes of active management or 60 minutes of physiological management
Provide examples of the monitoring that takes place in labour (5)?
Maternal observations Abdominal palpation vaginal examination Monitoring of amniotic fluid Auscultation of the fetal heart Palpation of uterine muscle contractions CTG monitoring- means of recording the fetal heartbeat and uterine contractions
What are the three lies of the baby
What may happen if labour is induced and the baby is in the wrong position
Lognitudinal
Obliquely
Transverse (horizontally)
Cord Prolapse- may lead to hypoxia within the baby
What are the first two stages of the babies descent
- baby engages
2. Uterus flexes and baby descends
What are the middle three stages of the babies descent
- Head rotates internally
- Head crowns through birthing canal
- Head extends through birthing canal
What are the last three stages of the babies descent
6.- Restitution- baby re-alligns itself so the rest of the body can fit out
7- The shoulders rotate internally and the head externally to allow the anterior shoulder to be delivered
- The body flexes laterally and the rest of the body comes out
What can be done to manage pain during childbirth? (5)
Breathing exercises, massages Paracetamol and Dihydrocodeine Water Entonox (NO2 and O2) Opiods Epidural- Spinal local anaesthetic Changing maternal position to educe pain
