NOTE 5

Labor Onset

The process by which labor begins, influenced by factors from the mother and fetus, including uterine muscle stretching, pressure on the cervix, oxytocin stimulation, and changes in hormone levels.

Signs of Labor

Observable indicators that labor has begun, including lightening, increased activity level, Braxton Hicks contractions, ripening of the cervix, uterine contractions, show (pinkish vaginal discharge), and rupture of the membranes.

Components of Labor

The three main components of labor, including passage (the route the fetus must travel through the pelvis), passenger (the fetus and its alignment with the pelvis), and fetal presentation and position (the attitude, engagement, lie, and position of the fetus).

Passage

The route the fetus must travel from the uterus through the cervix and vagina to the external perineum, which includes the pelvic inlet and outlet and the adequacy of the pelvic size.

Passenger

Refers to the fetus, specifically the fetal skull and its structures (bones, fontanelles, and suture lines), as well as the degree of flexion and molding of the fetal head.

Fetal Presentation and Position

Describes the attitude, engagement, lie, and position of the fetus, including cephalic presentation (head first), breech presentation (buttocks or feet first), and the different types of breech presentations (complete, frank, footling).

Shoulder Presentation

In a transverse lie, the fetus is lying horizontally in the pelvis so that its long axis is perpendicular to that of the mother. Presenting parts become one of the shoulders, an iliac crest, a hand, or an elbow.

Determining Fetal Presentation and Position

Four methods are used to determine fetal position, presentation, and lie:combined abdominal inspection and palpation, vaginal examination, auscultation of fetal heart tones, and sonography.

Cardinal Movements of Labor

The passage of the fetus through the birth canal involves a series of position changes known as the cardinal movements of labor.

Descent

the downward movement of the biparietal diameter of the fetal head to within the pelvic inlet. Full descent occurs when the fetal head extrudes beyond the dilated cervix and touches the posterior vaginal floor.

Flexion

occurs when the fetal head bends forward onto the chest due to pressure from the pelvic floor during descent.

Internal Rotation

During descent, the fetal head enters the pelvis in a diagonal transverse position and rotates until the occiput is superior or just below the symphysis pubis, bringing the head into the best diameter for the outlet of the pelvis.

Extension

As the occiput is born, the back of the neck acts as a pivot for the rest of the head to extend and deliver the face and chin.

External Rotation

Immediately after the head is born, it rotates back to a diagonal or transverse position, bringing the aftercoming shoulders into an anteroposterior position for entering the outlet.

Expulsion

Once the shoulders are delivered, the rest of the baby is delivered easily and smoothly, marking the end of the pelvic division of labor.

Powers of Labor

The powers of labor are implemented by uterine contractions, which cause cervical dilation and expulsion of the fetus from the uterus.

Uterine Contraction

Labor contractions begin at pacemaker points located in the myometrium and sweep down over the uterus as a wave. Contractions consist of three phases:increment, acme, and decrement.

Cervical Changes

Effacement refers to the shortening and thinning of the cervical canal, while dilation refers to the enlargement of the cervical canal to permit passage of the fetus.

Psyche

The psychological state and feelings that a woman brings into labor with her, including apprehension, fright, excitement, and awe.

Station

refers to the relationship of the presenting part to an imaginary line drawn between the ischial spines of the maternal pelvis. It marks the narrowest diameter through which the fetus must pass.

Differentiation between True & False Labor

False labor pains remain irregular, are generally confined to the abdomen, do not increase in duration, frequency, and intensity, often disappear with ambulation, and are not accompanied by cervical changes. True labor pains become regular and predictable, are first felt in the lower back and sweep around to the abdomen, increase in duration, frequency, and intensity, continue regardless of activity level, and are accompanied by cervical effacement and dilatation.

Stages of Labor

The first stage of labor begins with true labor pains and ends with complete dilatation of the cervix. It is divided into three phases:latent, active/accelerated, and transition.

General Physical Examination

VS (esp. BP):This flashcard focuses on the importance of taking vital signs, especially blood pressure, during a general physical examination.

FHR Monitoring

This flashcard highlights the need to monitor fetal heart rate (FHR) during labor, with specific intervals depending on the stage of labor.

Coping Mechanisms in Early Active Phase

This flashcard emphasizes the increased anxiety and coping mechanisms used by women in the early active phase of labor.

Support Person's Role

This flashcard highlights the positive impact of having a support person, particularly the baby's father, during the birth process.

Anxiety in Transition Phase

This flashcard focuses on the significant anxiety experienced by women in the transition phase of labor.

Signs of Transition Phase

This flashcard lists the signs indicating that a woman has entered the transition phase of labor.

Signs of Fetal Distress

This flashcard outlines the signs of fetal distress, including bradycardia, tachycardia, meconium-stained amniotic fluid, and hyperactivity of the fetus.

Enema Administration

This flashcard provides guidelines for administering an enema during labor, including contraindications and the need to check FHR after administration.

Perineal Prep

This flashcard highlights the importance of perineal preparation before delivery.

Episiotomy

This flashcard explains the purpose of an episiotomy, including preventing laceration and reducing the duration of the second stage of labor.

Types of Episiotomy

This flashcard describes the two types of episiotomy:median and medio-lateral.

Nursing Care during Episiotomy

This flashcard outlines the nursing care measures during an episiotomy, including supporting the perineum and checking for a nuchal cord.

Placental Separation

This flashcard explains the process of placental separation and the signs indicating that the placenta is ready to be delivered.

Types of Placental Separation

This flashcard describes the two mechanisms of placental separation:Schultz and Duncan.

Nursing Care during Placental Separation

This flashcard highlights the nursing care measures during placental separation, including monitoring the uterus, noting the time of delivery, and checking for completeness of cotyledons.

Placental Expulsion

This flashcard explains the process of placental expulsion and the methods used to deliver the placenta.

Fourth Stage of Labor

This flashcard emphasizes the critical nature of the first 1-2 hours after delivery and the need for close monitoring of vital signs.

Unang Yakap

This flashcard explains the concept of Unang Yakap, which involves keeping the mother and baby together in the hospital to promote bonding.

Positioning for Birth

This flashcard discusses the different positions for birth, including lithotomy, lateral or Sim's position, dorsal recumbent, semisitting, and squatting.

Perineal Cleaning

This flashcard highlights the importance of perineal cleaning before birth and the proper technique to prevent contamination.

Postpartum Care

This flashcard covers various aspects of postpartum care, including pain relief, sexual activity, menstruation, postpartum check-up, urinary changes, gastrointestinal changes, vital signs, and weight loss.

Phases of Puerperium

This flashcard explains the taking-in phase of puerperium, which is characterized by the mother's focus on her own needs and dependence on others.

Talking-in phase

A time of reflection for a woman during postpartum where she is largely passive and dependent on others for care.

Taking-hold phase

The phase in postpartum where a woman begins to take action and make decisions, may experience postpartum blues.

Postpartum blues

Overwhelming feelings of sadness that cannot be accounted for, often experienced during the taking-hold phase of postpartum.

Letting-go phase

The phase in postpartum where a woman redefines her new role as a mother and accepts the reality of her child, letting go of previous expectations.