Lamaze Exam

What is a Bishop score?

A Bishop score is a pelvic exam that helps predict the likelihood of successful labor induction, vaginal delivery, and cervical ripening. It's a subjective measurement that's based on five factors of the cervix:

• Cervical dilation: How open the cervix is in centimeters

• Cervical effacement: How thin or short the cervix is

• Cervical consistency: How firm or soft the cervix is

• Cervical position: The position of the cervix in relation to the pelvis, with posterior being 0 points, middle being 1 point, and anterior being 2 points

• Fetal station: The position of the baby's head in relation to the pelvis

What is Augmentation of Labor?

Augmentation of labour is the process of stimulating the uterus to increase the frequency, duration and intensity of contractions after the onset of spontaneous labour. It has commonly been used to treat delayed labour when poor uterine contractions are assessed to be the underlying cause

What is the Supine position?

The supine position is when someone lies on their back with their face and torso facing up. It's also known as the dorsal decubitus position

How long can Prelabor last?

May last for a few hours or may last for days.

What is a characteristic of prelabor?

may have nonprogressing contractions (change very little in length, intensity, or frequency over time.

Cervix begins to ripen, efface, and move forward.

What time period does Early labor encompass?

Denotes the time from the onset of labor until your cervix is dilated to about 4-5cm. Contractions are progressing, usually mild at first then becoming longer, stronger, closer together. May have bloody show.

How long does it take on average for mom to dilate from 4 to 6cm?

2 hours on average but for a first-time mother, can take up to 9 hours.

What is Prodromal Labor?

Prodomal Labor

• The cervix begins to soften, thin and move forward, and it may begin to open. The baby settles into the pelvis.

• At this point of childbirth, contractions may be noticeable as an achy sensation or as pressure in the lower abdomen or back. Contractions in this phase are usually irregular—starting and stopping; sometimes strong, sometimes mild. This is your body’s natural way of gearing up.

• This phase can last from a few hours to a few days.

• Sometimes referred to as false labor. Prodromal labor is often called “false labor,” and is somewhere in between Braxton Hicks contractions and active labor contractions. Prodromal labor is a part of labor, occurring before active labor but it does not progress toward delivery.

What are symptoms that mom is in the Latent phase of labor?

• The cervix continues to thin out and open, dilating up to 6 centimeters.

• Labor is meant to be gradual, so this phase may take quite a while—usually about two-thirds of the total labor time. Over a period of several hours, contractions will become longer, stronger and more regular (about 5 minutes apart, each one lasting 25 to 45 seconds).

• A pinkish vaginal discharge (called “show”) usually increases as labor progresses.

What takes place during the active labor phase?

• Contractions continue to become longer and stronger, until they’re eventually about 3 minutes apart and last for about a minute or more.

• During this phase, which generally takes from 2 to 6 hours, the cervix effaces and dilates to about 8 centimeters.

• In active labor you usually get very focused as the hard work begins.

What phase of labor is transition a part of ?

First Stage of Labor

What happens during the transition stage of labor?

• The cervix finishes dilating and effacing.

• Contractions are now powerful and efficient, so this phase is usually quite short (less than an hour).

• You may feel nauseous, shaky, restless or irritable during this phase of childbirth

• Pain and intensity of labor probably at maximum.

What are phases make up the First Stage of Labor?

Early Labor, Active Labor and Transition

What phases make up the Second Stage of Labor

Resting Phase, Decent Phase, and Crowning and Birth

What is the Third Stage of Labor?

Recovery

• Your baby can be placed on your abdomen so you can be skin-to-skin immediately after birth. There should be a delay of at least one minute (preferably 1-3 minutes) before the umbilical cord is cut to allow the blood carrying iron-rich hemoglobin in your placenta to transfer to your baby.

• What a mix of feelings—excitement, joy, awe, accomplishment and relief!

• The placenta is delivered, usually within the first 10 minutes.

• Your health care provider will make sure you are comfortable. Cold compresses are often applied to the perineum to ease discomfort and reduce swelling.

• You may experience after-pains or “the shakes” after childbirth.

What is the difference in the midwifery model of of care vs obstetrics?

Midwifery training focus on understanding and protecting what is normal and natural in pregnancy and birth, while obstetric training focus on understanding and looking for complications.

What organization’s work are the Six Healthy Birth Practices adapted from?

World Health Organization(WHO)

What is Analgesia?

Any effect that reduces your perception of pain.

What is the difference between systemic, regional, and local medications?

Systemic- Affecting entire body

Regional- affecting a large area of the body

Local - affecting a specific relatively small part of your body

What are some of the risks of pain medications in labor?

Itching,

nausea,

prolonged labor,

fever in the mother and baby

variations in fetal heart rate

Medications mom receives do not impact baby? True or false?

False. Any medication you receive affects your baby. Because his liver and kidneys are immature the effects of some drugs last longer for her than mom.

How do pain medications impact your labor progress?

Often slow contractions and increase need for medical interventions.

Alternatively, if labor progress is abnormally slow, drugs may speed up progress by letting you relax.

What class of drug reduce the transmission of pain messages to the pain receptors in your brain?

Narcotics, or narcotic-like drugs

What impact can narcotics have on your baby?

After Birth, the narcotics in your baby’s bloodstream may cause baby to breather slowly and have poor muscle tone

What are local or regional anesthetics?

Often called “blocks” they cause reduced feeling or numbness in a particular part of your body. Often end in “caine”.

What are neuraxial medications?

Epidurals and spinals are injected in your lower back near nerve roots in spinal column. The medications affects the region of your body to which these nerves and their branches go.

drugs that are injected or infused near the spinal cord to treat pain, provide anesthesia, or treat spasticity

What is the difference between spinal analgesia and an epidural catheter?

Spinal analgesia is an injection that takes effect quickly and lasts for an hour or two. An epidural catheter is a tube placed in the lower back through which medication is given for as long as it’s needed.

What other interventions accompany an epidural?

IV Fluids, a bladder catheter, continuous monitoring of blood pressure, contractions, and fetal heart rate.

The milk-ejection reflex is dependent upon the release of which of the following hormones?

Oxytocin

What is Occiput posterior position?

Occiput posterior (OP) position, also known as the posterior position or "sunny-side up" position, is when a baby is head down but facing the mother's abdomen instead of her back during delivery. This position occurs when the baby's occipital bone, or skull, is against the back of the mother's pelvis

What is macrosomia?

Macrosomia is a condition that describes a newborn who is larger than average for their gestational age, which is the length of time they have been in the uterus.

What hormone is released to soften the cervix?

Prostaglandins

If the back of your baby’s head is against your back, what position is the baby in?

Occiput Posterior Position

The surge of what hormone signals the brain to release endorphins in labor?

Oxytocin

What are some guidelines for pregnant women and exercising.

ACOG- void standing still or lying flat on your back as much as possible. When you lie on your back, your uterus presses on a large vein that returns blood to the heart. Standing motionless can cause blood to pool in your legs and feet. These positions may cause your blood pressure to decrease for a short time.

Avoid supine(on back) exercises after 16 weeks.

What are the origins of Lamaze?

The origins of Lamaze are rooted in the work of French obstetrician Dr. Fernand Lamaze, who developed a method of childbirth education and pain management in the 1950s that emphasizes breathing techniques, relaxation, and support during labor.

An American woman, Marjorie Karmel, gave birth in Paris with Dr. Lamaze. Upon returning to the United States where the Lamaze method was unknown, she wrote the book, Thank You, Dr. Lamaze, which helped to spark the natural childbirth movement in the United States. In 1960, both Lamaze International (known then as the American Society for Psychoprophylaxis in Obstetrics) and the International Childbirth Education Association (ICEA) formed. These organizations have continued to inform birthing women since that time.

What is psychoprophylaxis?

A method of childbirth preparation that combines education and psychological techniques to reduce pain and anxiety during labor.

What are the six steps to birth?

1. Your cervix moves forward.

2. Your cervix ripens

3. Your cervix effaces

4. Your cervix dilates

5. Your baby’s head rotates and tucks (chin to chest)

6. Your baby descends through your pelvis, and is born.

The first 3 steps happen at the same time and usually begin days or weeks before labor starts (prelabor).

What does presentation refer to?

It describes the part of your baby that’s lying over your cervix and will emerge from your body first. The most favorable presentation is vertex. Others are breech(buttocks or feet down-or both) and shoulder, face, brow, and compound (head and hand coming out together

What does the baby release to signal it’s lungs have matured and are ready to breathe air?

Surfactant is secreted into the amniotic fluid, which begins a chain of events guided by the baby’s and mother’s hormones.

What is the medical term used when a mother’s water’s break?

Rupture of membranes(ROM) with a gush of amniotic fluid.

What two things should a mother take note of when her water’s break?

The time, and color.

What is the Gate Control Theory of Pain?

Explains how distractions reduce pain. Some examples in labor are massage, music, aromatherapy, or a heating pad.

What position might you suggest to a laboring mom that also needs to lower their blood pressure.

Side-lying or side-lying lunge(semiprone). In the second stage of labor it can also allow the sacrum to shift to create a wider opening for baby’s descent.

What is the ideal position for baby to be born in?

The cephalic position is when a fetus is positioned head down, facing the mother's back, and with its chin tucked to its chest. It's the most common and safest position for a baby to be in for birth, and is considered ideal for labor and delivery