Stages of labour and birth ☺️ Flashcards
What is a normal birth
- epidemiology of normal birth
- benefits of normal birth
37-42wks, spontaneous labour and delivery
Proportion of natural births decrease with age
- avoid surgical risks
- colonisation of baby
- increase success breastfeeding
- increased bonding
Changes leading up to labour
Uterine contractions increase in frequency for several nights prior
+ve feedback loop
increased OXY => increased PG synth
Fetal CRH => ACTH causes
1. DHEA, DHEAS =(aromatase)=> increased O
2. Cortisol => lung maturation, surfactant prod, increased placental PG
Fetal movement => maternal OXY increase
Placenta => CRH, OXY prod
1st stage of labour
- latent
- active
Latent (can last for days, on and off)
- painful contractions
- some cervical effacement, dilation
Active - 4cm onwards
-regular painful contractions
Transitional stage of labour
10cm dilated
More frequent contractions
Mood changes, sweating
Greater urge to push
2nd stage of labour
- latent
- active
Passive
- frequency falls but v strong contractions
- no urges
Active
- expulsive contractions
- delivery of head, ant, post shoulder, lower body
3rd stage of labour
-describe active and physiological management
Placental separation => expulsion of membrane, uterine contraction
Active management
- OXY given
- cord clamped and cut 5mins after birth
- cord pulled out after placental separation
Physiological management
- no routine drugs
- clamped when pulsation stops
- maternal delivery
Benefits of immediate skin to skin contact
- mother
- child
Maternal
- successful breastfeeding
- latching
- feed longer and exclusively
Fetal
- maintain temp, HR, RR, BP, glucose
- less likely to cry
Pain relief that can be used
- not drugs
- drugs
Non drug
- breathe, relax
- massage
- water
Drugs
- entonox (gas and air)
- opioids (diamorph)
- epidural
