Intrapartum Labor and Delivery
Nursing Care of a Family During Labor and Birth
Page 1: Introduction
Scriptural Reference: Romans 8:22 highlights the natural process of childbirth.
Page 2: Onset of Labor
Definition: Series of events leading to the expulsion of the fetus and placenta.
Nursing Care Plan:
Address physiological and psychological aspects.
Implement care and evaluate outcomes.
Page 3: Theories of Labor Onset
Uterine Myometrial Irritability
Low Progesterone Theory
Oxytocin Theory
Estrogenic, Fetal Hormone & Prostaglandin Theories
Theory of Aging Placenta
Page 4: Components of the Labor Process (5 P's)
Passenger: The fetus.
Passageway: Route through cervix and vagina.
Powers: Uterine contractions.
Position: Maternal positioning.
Psyche: Maternal psychological state.
Page 5: Passageway
Soft Structures: Cervix, vagina, perineum.
Bony Structures: Pelvis.
Page 6: Pelvic Types Comparison
Gynecoid: 50% of women, ideal for vaginal birth.
Android: 23% of women, may require cesarean.
Anthropoid: 24% of women, favorable for vaginal birth.
Platypelloid: 3% of women, less favorable.
Page 7: Pelvic Measurements
Inlet: Narrowest diameter ~11 cm.
Midpelvis: Contains planes of greatest and least diameter.
Outlet: Anatomical outlet.
Page 8: Plane Diameter Measurements
Inlet: Diagonal conjugate ~12.5-13 cm.
Midplane: 10.5 cm.
Outlet: 8 cm.
Page 9: Fetal Head Dimensions
Widest Diameter: Fetal head.
Page 10: Fetal Skull Structure
Fontanelles: Open spaces between skull bones.
Sutures: Fibrous tissues connecting bones.
Page 11: Fetal Attitude and Presentation
Fetal Attitude: Degree of flexion.
Fetal Lie: Relationship of fetal body to mother.
Fetal Presentation: Body part contacting cervix.
Page 12: Types of Cephalic Presentations
Vertex: Good attitude.
Brow: Moderate flexion.
Face: Poor flexion.
Page 13: Engagement and Station
Engagement: Fetal head enters birth canal.
Station: Position of baby's head relative to ischial spines.
Page 14: Cardinal Movements of Labor
Position Changes: Fetal adjustments to fit through pelvis.
Page 15: Maternal Positioning
1st Stage: Left lateral recumbent.
2nd Stage: Lithotomy position.
Page 16: Powers of Labor
Primary Power: Uterine contractions.
Secondary Power: Maternal efforts.
Page 17: Effacement and Dilatation
Effacement: Thinning of the cervical canal.
Dilatation: Widening of the cervical canal.
Page 18: Psychological Aspects of Labor
Maternal Feelings: Apprehension, excitement, or awe.
Support: Encourage questions and discussions.
Page 19: Stages of Labor
First Stage: True labor to full dilation.
Second Stage: Full dilation to birth.
Third Stage: Birth to delivery of placenta.
Fourth Stage: First 1-4 hours post-delivery.
Page 20: Labor Intensity and Duration
First Stage: Latent, Active, Transition phases.
Second Stage: Full dilation to birth.
Third Stage: Placental separation and expulsion.
Page 21: Initial Assessment
History: Current and past pregnancy history.
Physical Assessment: Abdominal, fetal position, and vital signs.
Page 22: Partogram
Labor Record: Vital signs, FHR, cervical dilation, and medications.
Page 23: Conditions Not Requiring Partograph
Examples: Antepartum hemorrhage, severe pre-eclampsia, fetal distress.
Page 24: Monitoring During Labor
Status of Membranes: Intact or ruptured.
Labor Record: SOPIES format for monitoring.
Page 25: Fetal Heart Rate Monitoring
Normal Range: 110-160 BPM.
Variability: Indicator of fetal well-being.
Page 26: Documentation of FHR
Categories: Absent, minimal, moderate, marked variability.
Page 27: Decelerations
Early Deceleration: Fetal head compression.
Late Deceleration: Uteroplacental insufficiency.
Variable Deceleration: Umbilical cord compression.
Page 28: Recommended Practices During Labor
Admission: When in active phase.
Continuous Support: One patient, one watcher.
Upright Position: Encouraged during labor.
Page 29: Delivery Practices
Upright Position: Recommended during delivery.
Selective Episiotomy: Non-routine.
Prophylactic Oxytocin: For third stage management.
Page 30: Postpartum Care
Inspection: Birth canal for lacerations.
Uterine Massage: Ensure contraction.
Page 31: Summary of Unang Yakap
Antenatal Visits: At least four.
Birth Plan: Preparation and monitoring during labor.
Page 32: Essential Newborn Care
Immediate Drying: Skin-to-skin contact.
Cord Clamping: After pulsations stop.
This note summarizes the key points from the transcript on intrapartum care, focusing on the nursing care of families during labor and birth, including physiological, psychological, and procedural