Normal Labour and Birth

Question 1

Normal labour is spontaneous and occurs during which weeks ?

Answer 1

37-42 weeks

Question 2

What are the key physiological changes which must occur to allow for expulsion of the foetus ?

Answer 2

Cervix softens
Myometrial tone changes to allow for coordinated contractions.
Progesterone decreases whilst oxytocin and prostaglandins increase to allow for labour to initiate.

Question 3

What occurs during stage 1 of labour ?

Answer 3

Complete when cervix is fully dilated.

Anticipated progress 0.5-1cm per hour.

Question 4

What occurs during stage 2 of labour ?

Answer 4

From full cervical dilation to the birth of the baby.

Question 5

How long would a Primigravida birth take within active 2nd stage ?

Answer 5

2 hours

Question 6

How long would a Multigravida birth take within active 2nd stage ?

Answer 6

An hour

Question 7

What occurs during the 3rd stage of labour ?

Answer 7

The time from the birth of the baby to the expulsion of the placenta and the membranes.

Question 8

What is the normal mechanism of labour ?

Answer 8

1. Descent
2. Flexion
3. Internal rotation of the head
4. Crowning and extension of the head
5. Restitution
6. Internal rotation of the shoulders
7. External rotation of the head
8. Lateral flexion

Question 9

What kind of analgesia is used in labour ?

Answer 9

Breathing, massage, TENS, paracetamol and dihydrocodeine.

Entonox (inhalation nitrous oxide and oxygen)

Opioids (Morphine, diamorphine and pethidine)

Remifentanil PCA

Epidural

Consider maternal position and mobility as a means of reducing pain and facilitating progress in labour