chapter 6: process of normal labor

• 1. passageway: pelvis, its sixe and shape
• 2. passenger: fetus size and position
• 3.power: effectiveness of contractions
• 4.psyche: preparation and previous experience

hemorrhage

to confirm whether the amniotic membranes have ruptured. will turn deep blue if fluid is present.

blue

• -begins with regular contractions
• -stage completed when cervix is dilated
• -referred to as stage of effacement and dilation
• -2 CHANGES!! : (1) complete efaacement 100% (2) complete dilation of cervix 10cm

1. Latent: contractions occur q 10-15 min last 15-20 seconds (good time to ask woman questions and explain things) ** phase last until cervix is dilated to 4cm

2. Active: cervical diation from 4cm to 7cm  fetal decent begins. contractions are moderate- strong

3.Transition: cervical diation of 8-10. contractions are more frequent

-cervix dilation to delivery of the baby.

• -mother should ot hold breath for more than 5 seconds. b/c it may trigger Valsalva's Maneuver
• - valsalva's maneuver= closing of glottis which increases intrathoracic pressure and CV pressure cutting off o2 across placenta.

-contractions occur q 2-3 min and last 60-90 seconds

• Effaccement- thinning and shortening of cervix
• Dilation- opening of the cervix

doula

cord compression

• placental separation stage. begins with the birth of he baby and ends with the expulsion of the placenta.
• -process can last up to 30 min

-umbilical cord is clamped in two places and is cut in between the clamps.

-mouth and nose of new born are suctioned to clear mucus and prevent aspiration.

-oxytocin (Pitocin) is given to mother to keep uterus firm and prevent blood loss.

• -last from first 1-4 hrs or until mothers VS are stable
• -blood loss ranges from 250-500ml
• -uterine muscles must stay contracted and firm to compress open vessels at placental site to prevent blood loss (hemorrhage)

• SHOW: ususally present increases as cervix changes
• CONTRACTIONS: regular, w/ increases in intensity and duration
• DISCOMFORT: begins in lumbar region and then abd
• ACTIVITY: contractions intensifies with activity (walking)
• CERVICAL CHANGES: effacement and progressive dilation of cervix

• SHOW: none present
• CONTRACTIONS: irregular no change in frequency and intensity
• DISCOMFORT: often located in abd
• ACTIVITY: contractions lessened by walking
• CERVICAL CHANGES: no cervical changes

• -series of movement that reflect changes in the fetus's posture as it adapts to the birth canal
• postures are dictated by the 4 P's

• Descent-
• Engagement-
• Flexion-
• Internal rotation-
• Extension-
• External rotation-
• Expulsion-

• lengthening of cord
• change in shape of uterus
• trickle or gush of blood from the vagina