pregnancy and childbirth Flashcards
duration of labour for primigravida and multigravida
- primigravida- 10-14 hours
- multigravida- 6-8 hours
what are premonitory signs of labour
- stress
- anxiety
- restlessness
- complex mood swings
- regular contractions
- they get closer together
- contractions last 30-70 seconds
- no change in contractions with movement/ position change
- contractions increase intensity
- they usually start in the back and move to the front
when does rupture of the membrane occur and potential hazards to mother and baby
Layers of tissue called the amniotic sac hold the fluid that surround a baby in the womb. In most cases, these membranes rupture during labor or within 24 hours before starting labor. Premature rupture of the membranes (PROM) is said to occur when the membranes break before the 37th week of pregnancy. After the membranes rupture, labor often soon follows. If labor does not begin within 6 to 12 hours, the risk of infections in the woman and fetus increases.
Complications in the baby may include premature birth, cord compression, and infection. Complications in the mother may include placental abruption and postpartum endometritis.
first stage of labour
Cervical effacement and dilation. During the first stage of labor, the cervix opens (dilates) and thins out (effaces) to allow the baby to move into the birth canal. The cervix dilates from 3-10cm
mother;
-BP, urinalysis, T, HR, leopolds meneuver, vaginal exam
- check for bleeding or leaking amniotic fluid
- length, intensity and frequency of contractions
baby;
CTG to monitoy foetal heart and contractions- initial 20 minute tracing to determine response to the stress of labour
- regular foetal heart rate monitoring
second stage of labour
The second stage of labour is when the pushing happens and your baby is born. This stage begins when the neck of the womb (cervix) is fully open and lasts until the birth of your baby. It can take 1–2 hours to push out your first baby.
the baby can come out
1. cephalic position
2. breech position
care of newborn;
- dry baby
-APGAR
- keep warm, skin to skin
- baby to breast
care of mother;
- position on knees
- examine for presenting part
- monitor for blood loss
- skin to skin and baby to breast to support delivery of placenta
- do not pull cord
third stage of labour
The third stage of labour is when the whenua/afterbirth (placenta) comes out. Umbilical cord is clamped and cut. Use of medication to cause contractions
what is transition
Transition is the final phase of the first stage of labour, following early and active labour. At this point, a woman progresses from seven to 10 centimetres, often in less than an hour. The word transition means that her body is making the shift from opening the cervix to the beginning of the baby’s descent.
emotional and social support for women and her support people
Try to reassure them all and advise them to remain calm and supportive to the woman to help her through the labour and birth. It is especially important to maintain communication with the woman and her companion if there is a problem with the baby.
Ensure she has someone there if she wants someone
comfort and pain management for a women during childbirth that are non pharmaceutical
Relaxation techniques such as music, yoga or meditationcan help reduce pain intensity. This is an option during the first stage of labour. A warm bath can relax you and help you cope with the contractions. Having a shower can help with any back pain you might be experiencing.
- massage
- hydrotherapy
- acupuncture
- support person
- maternal positions
- TENS
cultural/ spiritual needs for women during child birth
women from some cultures do not eat certain foods. During labour, women from some cultures avoid moving too much; some stay lying down, some prefer to sit or squat. In some cultures, the father does not attend the birth, but the mother or mother-in-law does.
assessments the nurse might make to baby after
- APGAR score at 1 and 5 minutes= appearance, pulse, grimace, activity, respiration
- note sex
- welcome, bonding with parents, cuddling, breast feeding
- identification
- birth check, weight and measure
- dry, keep warm and take axilla temperature
- observe umbilical clamp is secure- no oozing
- observe when/ if urine or meconium is passed
- vitamin K may be given
fourth stage of labour
- risk of postpartrum hemorrhage
- exhaustion
- urinary retention
- continue to monitor vital signs, bleeding, laceration
- assessment of vaginal tear
- perinatal depression
what is APGAR test done on babies
= appearance, pulse, grimace, activity, respiration
score out of 10. each of the 5 categories are score out of 2. 2 is the best. Taken at 1 minute after baby born and 5 minutes
1. skin colour
2. HR
3. reflexes and responsiveness
4. muscle tone
5. respiration
7+ is normal. if under 6 at 1 min and over 7 at 5 mins this is also normal. if score is low= medical team will keep an eye on and investigate
potential risks of a c-section
recovery from c section takes longer than recovery from a vaginal birth. Like other types of major surgery. C-sections also carry a higher risk of complications. Risks to mother include:
- inflammation and infection of the endometrium causing fever, foul-smelling vaginal discharge and uterine pain
- blood loss is more likely with a c-section than with a vaginal birth
- adverse reactions to any type of anaesthesia are possible
- blood clot risk is greater than after a vaginal delivery
- infection at the incision site is possible
- surgical injuries to nearby organs can occur during a c-section
- higher risk of potentially serious complications in subsequent pregnancies
what causes low birth weight in babies
maternal factors;
- maternal age less than 20
- medical illness
- take iron folate less than 60
- mothers less than 150cm tall
mothers who gain less than 12kg during pregnancy
placental factors;
- low placental weight
- low placental thickness
- gestational age
foetal factors;
- pre term birth
- fetal growth restriction
