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Labor and Delivery (Exam 1)Processes of BirthObjectives:1.Describe the woman’s physiologic and psychologic response to labor2.Describe the fetal responses to labor3.Explain how each component of birth process affects the course of labor and birth4.Explain the early signs of labor5.Differentiate between true and false labor6.Compare each stage of labor and the phases within the first stage of laborEED (Estimated Date of Delivery): When was the first day of your last menstrual period? (LMP) Example: January 20th. Count back 3 months and add 7 days. October 27thPhysiological Effects of the Labor Process: MaternalLabor: The process of expelling an infant from the mother’s womb (uterus) or the birth canal -Labor usually begins between 38-42 weeks’ gestation-Several theories about what stimulates labor and birth-Labor has begun when the uterus begins to contract consistently and effectively to dilate (to open up) and thin (efface) the cervixThe 4 P’sPowers:-Uterine contractions-Maternal Pushing EffortsPassage:-Maternal Pelvis and soft TissuePassenger:-Fetus, membranes, and placentaPsyche:-Maternal psychological response to labor and birthPowers – Contractions: Normal labor contractions are coordinated, involuntary, and intermittent. Coordinated labor contractions begin in the uterine fundus and spread downward toward the cervix to propel the fetus through the pelvis. The primary force of labor in the first stage of labor-Involuntary: cannot will them to start or stop The mother cannot cause labor to start and stop by conscious effort. However, walking and other activities may stimulate existing labor contractions. Anxiety and excessive stress can diminish contractions because of elevated adrenaline levels that may cause uterine relaxation. 3 Phases: 1)Increment: the building up of the contraction (the longest phase)2)Acme the peakof the contraction (the most intense period)
3)Decrement: the decreasing intensity as the uterus begins to relax (the “letting up” of the contraction)Description of Contractions: Frequency:-How often the contractions are happening-Measures in seconds or minutes-Measures from the beginning of one contraction to the beginning of the next contractionDuration-How long the contractions are lasting-Measures in seconds-Measured from the beginning of one contraction to the end of the same contractionIntensity-Refers to the strength of the contraction-Palpation: oMild – Uterus indents easilyoModerate – falls between mild and strongoStrong – Uterus cannot indent-Intrauterine catheter most accurate way to measure contractionsInterval (rest period)-The Period between the end of one contraction and the beginning of the next-Uterus soft during this time-Fetus receiving oxygen, nutrients, and getting rid of waste products through the placentaContraction Cycle: Cervical Changes: Contractions cause the upper uterine segment to shortencausing the cervix to both dilate and efface-Effacement: thinning of the cervix and shortening-