Pregnancy & Childbirth Workbook (Lt)

Question 1

Whats the processes of labour (4)

Answer 1

1. Regular and coordinated contractions of the uterus
2. Gradual effacement and dilation of the cervix
3. Expulsive contractions
4. Birth of the baby and the placenta

Question 2

What does primigravida mean

Answer 2

A woman who is pregnant for the first time

Question 3

What does multigravida mean

Answer 3

A woman who is pregnant for at least the second time.

Question 4

What is the average duration for a primigravida? (Person who is pregnant for the first time)

Answer 4

8-16 hours

Question 5

What is the average duration for a multigravida? (Person who is pregnant for for at least the second time)

Answer 5

3-10 hours

Question 6

What are premonitory (warning) signs of labour?

Answer 6

• Vagnial discharhge of blood stained mucus
• Increasingly intense contractions that become painful
• Increasingly regular and more frequent contractions
• Vagninal discharge of clear fluid membranes rupture spontaneously

Question 7

When does rupture of the membranes occur?

Answer 7

Spontaneous rupture of the membranes occur under the pressure of uterine contractions. Artificial rupture of the membranes is sometimes performed to increase the progress of labour.

Question 8

What is the physiology behind labour?

Answer 8

The Ferguson reflex is a positive feedback loop that that involves a cycling of uterine contractions during labour. Label each stage of the reflex below.

1. posterior pituitary gland releases oxytocin into blood stream
2. oxytocin increases uterine contractions
3. Increased pressure of baby’s head on cervix
4. Signs transmitted via spinal cord to brain
5. neurons in hypothalamus produce oxytocin

Question 9

What is stage one of labour?

Answer 9

Cervix shortens, thins, and dilates. This is the longest stage of labour

Question 10

What is stage two of labour?

Answer 10

Baby passes down the birth canal and is born

Question 11

What is stage three of labour?

Answer 11

Placenta is expelled and uterus contracts

Question 12

What happens during stage one of labour?

Answer 12

Regular contractions of the uterine muscles cause the cervix to become even thinner and shorter until there is no length in the canal. The cervix dilates until its fully open.

Question 13

What happens during stage two of labour?

Answer 13

Cervix is fully dilated, baby’s head can now pass through it and down the vagina (birth canal). Muscles of the uterus contract powerfully to expel the baby. These contractions are helped along the by a very strong desire to push.

Question 14

What happens during stage three of labour?

Answer 14

Placenta, umbilical cord, and remnants of the pregnancy sac expelled. This usually occurs 10-15 mins after birth.

Question 15

What marks the end of stage one?

Answer 15

Cervix dilation is across 10cm

Question 16

What marks the end of stage two?

Answer 16

Baby is born and takes its first breath

Question 17

What marks the end of stage three?

Answer 17

Uterus becomes hard and much smaller, cervix closes up, vaginal walls and perineum start to shrink back to normal size

Question 18

Define and describe the term transition

Answer 18

Contractions are at their strongest near the end of the first stage, as the cervix nears its “fully open” state. This is known as the transition between first and second stages.

Question 19

Define episiotomy

Answer 19

A cut made in the perineum immediately prior to birth to prevent tearing of the tissues as the baby is born.

Question 20

Define show

Answer 20

A vagainal dishcarge of bloodtsained mucus that may occur before contractions begin

Question 21

Define induction of labour

Answer 21

Intervention to stimulate uterine contractions before the onset of spontaneous labour

Question 22

Define contraction and retraction of uterus

Answer 22

Retraction is the process by which the uterine muscle fibres shorten after a contraction. This is unique uterine muscle.

Question 22

Define dilation

Answer 22

The opening of the cervix in labour

Question 23

Define effacement

Answer 23

Shortening of cervix in early labour, prior to dilation

Question 24

Define perineum

Answer 24

The area of the skin and between the vaginal opening and the anal opening.

Question 25

Define involution

Answer 25

When uterus reduces in size immediately following birth, and then continues to reduce in size.

Question 26

How can you provide emotional and social support to the woman and her support persons?

Answer 26

• Encourage the women to rest as much as possible
• See if a back run would help
• Help her contraction on her breathing
• Ensure that she goes to the toilet regularly
• Encourage her to move to different positions
• Ensure support people get a break aswell

Question 27

What kind of comfort, pain management, and pain relief (include non-pharmaceutical methods and herbal remedies) can you provide?

Answer 27

Epidural for pain relief, or aromatherapy

TENS machine, pethidine, fentanyl, entonox, epidural, acupuncture, bathing and the use of water,

Question 28

What assessments for babies 1-2 hours after birth?

Answer 28

• APGAR score at 1 min and 5 min
• Identification
• Note sex
• Welcome, bonding with parents, cuddling, breast feeding, skin to skin contact
• Birth weight and measure
• Dry, keep warm, and take axilla temp
• Observe umbilical clamp is secure- no oozing
• Observe when urine is passed
• Vit K may be given

Question 29

What assessments for mothers 1-2 hours after birth?

Answer 29

• Assess the amount of vaginal bleeding
• Assess the fundus and uterus for firmness, height, and centrality
• Assess perineum and vulva for oedema, graze or tear
• Postpartum recordings- BP, temp, pulse, rr, documentation
• Assists with initial of breast feeding if appropriate
• Assessment of placenta and membranes
• Encourage to pass urine
• family time- privacy, food, fluids, mobile telephone
• Shower or bed bath

Question 30

How to initiate breathing in an emergent setting

Answer 30

Provide tactile simulation to th baby by rubbing his or her back and torso briskly, as done while drying the baby by tapping the heels. Puffs of air blown on the babys face may help stimulate breathing. If baby is not breathing after one minute clear airway of mucus and commence CPR.

Question 31

After you have delivered the baby what must you do about the placenta and umbilical cord?

Answer 31

Not recommended for it to be cut in emergency situations unless medical help is hours away or the mother or baby require CPR. If the cord is cut, firmly tie with sterile string or clamp in two places (after the cord stops pulsing).

Question 32

Shortly afterwards the placenta is expelled. What checks should you make of the placenta?

Answer 32

If its intact
Condition of placenta and membranes
Number of vessles in cord
Insertion sites and knots

Question 33

How to Minimising heat loss Immediately after birth

Answer 33

At birth, a healthy term babies are placed against their mothers body skin-to-skin, dried and covered with a warm blanket to maintain their body temp. A mothers body conducts direct warmth to the baby, and the blanket traps a layer of warmth, insulating air around the baby

Question 34

What is a sign of uterine atony

Answer 34

Steady flow or sudden gush of blood
Uterine fundus feels soft and boggy

Question 35

When assessing a new born what do they generally assess?

Answer 35

Is the head larger in relation to the body?
Is the umbilicus at the centre of the body?
Does the body appear long and extremities short?
Is the infant adopting a flexed position?
Are the hands clenched?
Does the neck look short
Does the infant move symmetrically?
Has the baby rounded contours due to presence of subcutaneous fat?