Week 5

Question 1

Between which weeks gestation is a baby considered full term?

Answer 1

38-42 weeks. (Txt book says 37).

Question 2

What are two physiological changes that must occur for birth to proceed smoothly?

Answer 2

1. Effacement and dilation of cervix.

2. Strong and regular contraction - myometrial tone change.

Question 3

Identify and explain the stages of labour:

Answer 3

1st stage: (passive - active - transitional)
0 - 10cm.

2nd stage: 10cm - birth.

3rd stage: delivery of placenta - control of bleeding.

4th stage: early post birth, 1-2 hours.

Question 4

Explain what you might expect of contractions and changes in the cervix in early labour:

Answer 4

Contractions: mild and irregular.
Cervix: starts to soften, efface, dilate, move from posterior to anterior.

Question 5

Define effacement:

Answer 5

Thinning of the cervix. Inner and outer OS thin into lower uterine segment.

Question 6

Describe what differences you might encounter in the effacement of the cervix in a primip compared to multip

Answer 6

Primip= effaces as dilates, may take longer.
Multip= effaces before dilates. 

lip of cervix

Question 7

Define forewaters:

Answer 7

Waters of baby’s head, puts even pressure on cervix and cushions baby’s head.

Question 8

Explain the significance of the purple line:

Answer 8

Indication of the progress of labour/ cervical dilation. Purple line which develops superiority from anus.

Question 9

Describe what might be expected of contractions or the contraction pattern in the second stage of labour:

Answer 9

Strong, regular (5/10), lasting 45 seconds - 1 minute.

Softening of uterus…

Question 10

How does “directed” pushing or coaching compare to spontaneous or physiological pushing in second stage of labour.

Answer 10

Directed = midwifery, health professional lead. 
Spontaneous = woman lead.

Question 11

Give an explanation as to how the placenta separates during a physiological 3rd stage and what are the signs of separation?

Answer 11

1. The uterus contracts to expel the placenta.

Signs:

1. Trickle of blood.
2. The umbilical cord appears white.
3. The umbilical cord stops pulsating.
4. The umbilical cord appears to lengthen.
5. The woman may experience an urge to push.
6. Fundus is firm and rises slightly.

Question 12

Describe the active management of the 3rd stage of labour:

Answer 12

1. Syntocinon injection in the mothers thing after the anterior shoulder of baby has presented.
2. Immediate cord cut and clamp.
3. Controlled cord traction to remove placenta.

Question 13

Describe physiological management of the third stage of labour:

Answer 13

1. Potential delayed cord clamping.

2. Allow for the signs of separation.