labor and birth process

NRS 400

What are the two learning goals listed in the Labor & Birth Process lecture?

Recognize whether labor is progressing normally and identify when maternal or fetal findings require further assessment or intervention.

What defines true labor according to the lecture?

Strong, regular contractions with cervical change.

What does cervical dilation mean?

The cervix is opening or getting bigger.

What does cervical effacement mean?

The cervix is thinning.

What does fetal station describe?

The location of the baby's presenting part/head in relation to the pelvis.

What are the signs of labor listed in the lecture?

Lightening, back pain, uterine contractions, slight weight loss, increased feelings of energy, increased vaginal discharge or bloody show, and leaking amniotic fluid ('water breaking').

What is lightening?

A sign of labor listed in the lecture; the slide does not provide a further definition.

What are the four stages of labor?

First stage: onset of regular contractions until full cervical dilation. Second stage: full cervical dilation until birth of the infant. Third stage: birth of the infant until delivery of the placenta. Fourth stage: delivery of the placenta until stable postpartum, approximately 1–2 hours.

When does the first stage of labor begin and end?

It begins with the onset of regular contractions and ends with full cervical dilation.

What phases of the first stage are mentioned in the lecture?

Early phase and active phase.

How does the lecture characterize the early phase of the first stage?

It lays the groundwork for the active phase to be effective.

How does the lecture characterize the active phase of the first stage?

Labor is progressing quickly.

When does the second stage of labor begin and end?

It begins with full cervical dilation and ends with the birth of the infant.

What phases of the second stage are mentioned?

Latent phase and active pushing phase.

What is expected during the latent phase of the second stage?

The woman does not need to push.

When does the third stage of labor occur?

From the birth of the infant until delivery of the placenta.

When does the fourth stage of labor occur?

From delivery of the placenta until the mother is stable postpartum, approximately 1–2 hours.

What are the 5 P's of labor?

Passenger, passageway, power, position, and psychologic response.

What does the passenger factor of labor include?

Fetal size, presentation, lie, attitude, position, station, and engagement.

What does the passageway factor of labor include?

The maternal pelvis and soft tissues.

What does the power factor of labor include?

Uterine contractions and maternal pushing.

What does the position factor of labor include?

Maternal positioning.

What does the psychologic response factor of labor include?

Anxiety, coping, and response to labor.

A fetal head has entered the pelvis but its position may make rotation and descent difficult. Which P of labor should the nurse consider?

Passenger.

A laboring patient has remained in one position for an extended period, and the nurse encourages a position change. Which P is being addressed?

Position.

What maternal cardiovascular changes during labor are listed in the lecture?

Maternal cardiac output increases by approximately 10–30%, blood pressure may increase slightly, and supine hypotension may occur.

What maternal respiratory changes during labor are listed?

Oxygen needs increase, and there is a risk for respiratory alkalosis.

What maternal gastrointestinal change during labor is listed?

Gastrointestinal motility slows.

What maternal renal change during labor is listed?

Spontaneous voiding may become difficult.

What maternal emotional change may occur as active pushing approaches?

The woman may become nervous and more serious.

What fetal heart rate range is listed in the lecture as normal?

110–160 beats per minute.

Which fetal heart rate changes does the lecture identify as reassuring?

Accelerations and moderate variability; the lecture also describes early decelerations as normal.

What does moderate fetal heart rate variability indicate according to the lecture?

It helps the fetus manage stress.

What happens to blood flow to the placenta during a uterine contraction according to the lecture?

Blood flow to the placenta is reduced during the contraction.

A patient has regular contractions, cervical thinning and dilation, and fetal descent. What does this indicate?

Normal progression of labor.

Which cervical changes indicate labor is progressing?

The cervix becomes thinner (effacement) and gradually opens (dilation).

What fetal change can accompany normal labor progression?

The presenting part moves downward through the pelvis.

What is the key distinction between true labor and contractions that are not producing labor in the lecture?

True labor includes strong, regular contractions with cervical change.

What is the relationship between cervical examination and labor assessment?

Cervical dilation, effacement, and fetal station help the nurse evaluate cervical change and the baby's descent.

What does the fetal-skull illustration on the 5 P's slide support the nurse in considering?

Fetal size and characteristics of the passenger, including presentation, lie, attitude, position, station, and engagement.

What does the maternal-position illustration on the 5 P's slide emphasize?

Maternal positioning as a factor that can be changed during labor.

What does the cervical dilation diagram illustrate?

Progressive opening of the cervix from 0 to 10 cm.

What does the effacement diagram illustrate?

Progressive thinning of the cervix from 0% to 100% effacement.

What does the station illustration help identify?

The position of the fetal presenting part/head in the pelvis.

What is the nurse's overall role when assessing labor progress, according to the lecture objectives?

Recognize normal progression and identify maternal or fetal findings that require further assessment or intervention.