Chapter 6 - Part 2 Flashcards
How does labour begin?
Labor may begin in a variety of ways
Small amount of “Bloody show” as cervix begins to efface (thin) and dilate
Amniotic sac may rupture
-May or may not bring on contractions right away
Mucous plug may be lost weeks before labour begins
- May be accompanied by bloody show
- mucous and blood
What is Parturition?
whole process of childbirth Labour -Effacement -Dilation -Transition
Birth
- Dilation,
- Pushing,
- Delivery of the baby,
- Delivery of the
What is effacement?
Thinning out of the cervix during labor
- expressed as %
- happens before dilation
What do we say when baby is -3, 0, +3?
- -3 head is above spine of mom
- 0 making way down birth canal
- +3 crowning
What does the first stage of labour look like in terms of dilation?
dilation from 0-10 centimetres
Dilation/Dilatation
0-7 centimeter
What are the characteristics of the transition phase?
7 – 10 centimetres (the last phase of dilation)
10 centimeters is complete dilation
At the end of transition the woman can begin pushing with her contractions
What is the transition phase?
A time when a woman delivering needs a lot of support and encouragement
Birth partner and other team members may also feel tired and vulnerable
How to provide physical and emotional care
Questions about “how much longer”?
What are contractions like in the transition phase?
During transition
contractions are stronger, come closer together and last longer;
contractions every 2-3 minutes, lasting 90 seconds.
This is the most intense stage of labor, but it is also usually the shortest.
What is a doula ?
Not a clinical care giver
Informational support and planning during pregnancy
-Birth Plan
Emotional and physical support during labor
Post-partum support
- Breast-feeding
- Emotional support
What is a midwife?
Primary clinical care provider
Normal pregnancy
Provides care throughout the entire process
- pregnancy
- birth
- post partum
What is the second stage of labour?
The pushing stage
Begins when cervix is fully dilated (10 centimetres)
-Bulging of the perineum
Urge to push or bear down
-May not occur if medicated (epidural)
Crowning
-top of the head is visible
Baby is born during stage 2
What is an episiotomy?
Episiotomy may be performed
- incision that is
sometimes made at the vaginal entrance during birth
How long can pushing take for the first child?
Up to 2 hours
What is the 3rd stage of labour?
Placenta detaches from walls of the uterus
Afterbirth (placenta) is expelled
Several contractions may
accompany placental expulsion
-Afterpains more intense with subsequent pregnancies
Episiotomy and tears are sewn up
How do we know there is no placenta left in the uterus?
Placenta is examined for completeness
What is Lamaze technique?
Use of breathing to relax and assist in natural childbirth
What are pain relief options for hospital birth?
Hypnotherapy,
-Hydrotherapy, Manual Therapy, Props (birthing ball)
Demerol
Local anesthesia
Regional anesthesia
General Anesthesia
What does local anesthesia do?
!-numbs a painful area
!-may be used after delivery if stitching of the perineum is necessary
What is regional anesthesia?
Regional anesthesia (epidural/spinal anesthesia)
- anesthesiologist administered
- woman remains awake
- reduces pain throughout the birthing process (variability)
- spinal block used for c-section procedures
What is general anesthesia?
- complete/woman is asleep
- used in high risk and emergency procedures
Why are women afraid of labour?
Family of origin
Media
Peers
Myths and Misinformation
Medicalization of childbirth
What is the midwifery model of care?
Principles
- Woman-centred care
- Informed choice
- Continuity of care provider-Choice of birthplace
What is the scope of practice of a midwife?
Collaborate with health professionals
Certification in skills (delivery complications,
resuscitation, treatment of hemorrhages)
Prescribe, administer drugs
Order, interpret tests (blood/urine, ultrasound, neonatal metabolic screening)
Carry emergency equipment
Where can women give birth?
Home birth
-Home births attended by midwives
Birthing centres
-Usually attended by midwives
Hospital birth
-Births attended by MDs, Obstetricians, Midwives
