Labor and Delivery Exam 1.docx - Labor and Delivery(Exam 1...

Labor and Delivery (Exam 1)
Processes of Birth
Objectives:
1. Describe the woman’s physiologic and psychologic response to labor
2. Describe the fetal responses to labor
3. Explain how each component of birth process affects the course of labor and birth
4. Explain the early signs of labor
5. Differentiate between true and false labor
6. Compare each stage of labor and the phases within the first stage of labor
EED (Estimated Date of Delivery): When was the first day of your last menstrual period? (LMP)
Example: January 20 th . Count back 3 months and add 7 days.  October 27 th
Physiological Effects of the Labor Process: Maternal
 Labor: 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 cervix
The 4 P’s
 Powers:
- Uterine contractions
- Maternal Pushing Efforts
 Passage:
- Maternal Pelvis and soft Tissue
 Passenger:
- Fetus, membranes, and placenta
 Psyche:
- Maternal psychological response to labor and birth
Powers – 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 peak of 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 contraction
 Duration
- How long the contractions are lasting
- Measures in seconds
- Measured from the beginning of one contraction to the end of the same contraction
 Intensity
- Refers to the strength of the contraction
- Palpation:
o Mild – Uterus indents easily
o Moderate – falls between mild and strong
o Strong – Uterus cannot indent
- Intrauterine catheter most accurate way to measure contractions
 Interval (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 placenta
Contraction Cycle:
Cervical Changes:
Contractions cause the upper uterine segment to shorten
causing the cervix to both dilate and efface
- Effacement: thinning of the cervix and shortening
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