Obs/Gynae - Normal Birth

  1. When is labour deemed normal?
    It starts spontaneously after 37 weeks.  Baby's head is down in the cephalic position.
  2. Describe the first stage of labour:
    • Dilation 0-10 cm.
    • There may be a show.
    • Contractions become frequent, regular and stronger.  
    • Membranes may rupture.
    • At 8cm dilation, mum will become vocal!
  3. Describe second stage of labour:
    • Spontaneous membrane rupture.
    • Fully dilated cervix.
    • Contractions become explusive (3 in 10 mins = established labour)
    • Baby's head descends.
    • Baby's head crowns.
    • Completed with birth of baby's body.
  4. Describe the third stage of labour:
    • Expulsion of placenta.
    • Takes 15-20 mins.
    • Cord lengthens.
    • Contractions restart.
    • Gush of blood (no more than 200-300ml).
  5. What is considered a "delayed birth" of the placenta?
    More than 20 mins
  6. What should you assess for at the start of a normal birth?
    • ABCDE
    • History (gestation, maternity records).
    • A show.
    • Ruptured amniotic sac?
    • Contractions.
    • Bleeding?
    • Visual inspection of vaginal entrance.
    • Assess contractions.
    • Any urge to push?
    • Any crowning?
  7. What prep is required for a birth area?
    • Resus area with BVM and O2 and PALS kit.
    • Inco pads.
    • Maternity pack.
    • Towels.
    • Blankets.
    • Turn heat up.
    • Entonox.
    • Primary response bag. 
    • Call for backup!
  8. How do you encourage mum to give birth?
    • Make sure she is comfortable (whatever position is best for her)
    • Entonox.
    • Allow head to be born slowly.
    • Encourage mum to keep breathing / pant. 
    • Do NOT remove cord from baby's neck.
    • Hold baby as it's born.
    • Wipe away any mucous from baby's mouth.
  9. How do you assess a newborn?
    • Tone
    • Colour
    • Heart rate
    • Resp rate
    • Wrap in dry twoel.
    • Quick ABCDE - check airway with neutral head position.
  10. When/how do you cut the cord?
    • When placenta has been birthed.
    • 2 clamps - 1 x 15cm from baby, 2nd x 3cm from that. 
    • Ensure no parts of the baby are in the cord.
  11. What are the best techniques to birth the placenta?
    • Get mum to squat.
    • Encourage her to pass urine.
    • Do NOT pull the cord.
    • Allow placenta to be born into a bowel.
  12. How should you assess blood loss after the placenta delivery?
    • Should not exceed 200-300ml.
    • Perform a uterine massage. 
    • Get backup if bleeding is severe. 
    • Monitor and reassure mum. 
    • Administer O2 target 94-98%.
Card Set
Obs/Gynae - Normal Birth
Obstetrics and Gynaecology normal birth flash cards