Care in the First Stage of Labour

Question 1

What are some of the characteristics of the latent phase?

Answer 1

Contractions/spacing of contractions can vary
Strength of contractions are not as painful
May stop and start
You can often sleep through

Question 2

What are some practices that could have a negative impact?

Answer 2

Repetitive vaginal examinations
Continuous fetal monitoring
Use of opiates rather than more natural approaches
Language used by the midwife

Question 3

What are some non pharmaceutical pain releif?

Answer 3

Breathing techniques
Muscle relaxation
Visualisation
Immersion in warm water
Hypnosis
massage
TENS machines
Rhythmic movements

Question 4

What happens as labour progresses into the active stage?

Answer 4

Contractions are met regular and intense, 3:10 lasting 50-60 seconds

Breathing patterns become more vocal

Observation of behaviour

Question 5

What is the midwifes role during labour?

Answer 5

To support and reassure
Monitor maternal wellbeing
Monitor fetal wellbeing
Monitor progress of labour

Question 6

How often should blood pressure be monitors in 1st stage labour?

Answer 6

4 Hourly

Question 7

How often should temperature be monitored in 1st stage labour?

Answer 7

Hourly if in the pool but 4 hourly on land

Question 8

How often should should pulse rate be monitored in 1st stage labour?

Answer 8

Hourly

Question 9

How often should should an abdominal examination be carried out in 1st stage labour?

Answer 9

4 Hourly

Question 10

How often should fetal heart rate be monitored in 1st stage labour?

Answer 10

Every 15 minutes

Question 11

What else do you have to monitor in labour?

Answer 11

Fetal movements
Bladder care
Documentation

Question 12

What is the purple line between the buttocks?

Question 13

What is the Rhombus of Michaelis?

Answer 13

Kite shaped area in the lower back that includes the lower lumber vertebrae and the sacrum. the area of bone moves backwards,, allowing more space in the pelvis. When the woman is in a leaving forward position a lump appears at the start of the second stage.

Question 14

What is the transition stage?

Answer 14

Contractions are string, regular and long lasting. May feel rectal pressure. May start to vocalise her distress or become quiet. Do not disturb normal physiology. Facilitate changes in position.

Question 15

What can vaginal examination determine?

Answer 15

Dilation
Effacement
Station (descent of presenting part)
Presentation
Position
Membranes stae: ruptured ot intact
Presence of any moulding, caput, limbs or placental tissue

Question 16

What must you do when performing a Vaginal examination?

Answer 16

• Justification is required
• Informed consent is required
• Fetal heart must be auscultated prior and following VE.
• VE just be preformed following an abdominal examination unless clinically indicated otherwise
  Justification and finding of the examination must be documented accurately
• Sterile gloves must be worn
• A plan of care should be made in partnership with the women and her birth partners