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POWERPOINTPRESENTATIONELIZABETH.pptx

Elizabeth Gonzalez Dr. Alain Llanes Rojas Advanced Primary Family  

Reproductive Health across

the lifespan

1

Labor and Birth Processes

A woman and the fetus during the late pregnancy prepares for labor process. During this period the fetus is ready for extra uterine life. There are several physiologic adaptations that a woman undergoes which prepares her for birth and motherhood. The end of pregnancy is represented by the labor and birth process which ushers in a extra uterine life for the newborn and a change for the family.

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Birth Process

Giving Birth In United States

Model of birth

Medical model

Midwifery

Site of birth

Home

Birth center

Hospital

Stages of Labor

First stage: latent, active, transition

Dilatation

Second stage

Pushing and birth

Third stage

Delivery of placenta

First Stage DILATATION

The first stage of labor is divided into three phases: latent, active, and transition.

The first, the latent phase, is the longest and least intense. During this phase, contractions become more frequent, helping your cervix to dilate so your baby can pass through the birth canal

Active phase

You may feel intense pain or pressure in your back or abdomen during each contraction.

Transition phase

During transition, the cervix fully dilates to 10 centimeters. Contractions are very strong, painful, and frequent, coming every three to four minutes and lasting from 60 to 90 seconds.

Second stage: PUSHING AND BIRTH

Begins when the cervix is completely opened. At this point, your doctor will give you the OK to push. Your pushing, along with the force of your contractions, will propel your baby through the birth canal. The fontanels (soft spots) on your baby's head allow it to fit through the narrow canal.

Your baby's head crowns when the widest part of it reaches the vaginal opening. As soon as your baby's head comes out, your doctor will suction amniotic fluid, blood, and mucus from his or her nose and mouth

Third stage: DELIVERY OF THE PLACENTA

After your baby is delivered, you enter the final stage of labor. In this stage, you deliver the placenta, the organ that nourished your baby inside the womb.

Each woman and each labor is different. The amount of time spent in each stage of delivery will vary. If this is your first pregnancy, labor and delivery usually lasts about 12 to 14 hours. The process is usually shorter for subsequent pregnancies.

Stages of Labor

Labor Process

True Vs False Labor

True labor

Discomfort in the abdomen and the back

The cervix dilates

Sedation cannot stop the discomfort

Contractions at regular intervals

Gradually intensity increase

False labor

Intensity always remains to be the same

No cervical dilatation

Sedation can relieve discomfort

Contractions at irregular intervals

Pain Management In Active Labor

Hydrotherapy

Backrubs

Analgesia

Birth ball

Waling/movement

Medications

Several drugs are used to help ease the pain of labor and delivery. Although these drugs are generally safe for the mother and baby, as with any drugs, they have the potential for side effects.

An epidural block continuously administers pain medication to the area around your spinal cord and spinal nerves through a catheter inserted into the epidural space

Anesthetics block all feeling, including pain. They also block muscle movement. General anesthetics cause you to lose consciousness. If you have a cesarean delivery, you may be given general, spinal, or epidural anesthesia.

Non Drug Options

Non-drug methods for relieving pain include acupuncture, hypnosis, relaxation techniques, and changing position frequently during labor.

Even if you choose non-drug pain relief, you can still ask for pain medications at any point during your delivery

Fetal Assessment

Fetal Assessment During Labor

What to asses

Fetal heart rate (FHR): the primary assessment.

The amniotic fluid

Fetal Heart Monitoring

Methods of fetal heart monitoring

Intermittent auscultation

Electronic fetal monitoring

Internal

External

FHR Patterns

Normal patterns

Baseline FHR=120-160bpm(beat/min.)

Tachycardia

Baseline FHR above 160bpm

Bradycardia

Baseline FHR less than 120 bpm

*Baseline FHR=10 minutes*

Contradiction Pattern

Normal contradiction

This happens in 5 or less contradictions in 10 minutes which last for in 60 seconds in the active phase

Contradiction intensity

Happens in the second stage 30 mmHg in early labor to 70-90 mmHg

Periodic changes

These are accelerations or decelerations which happens in the FHR that are in relation to uterine contractions and do persist over time.

Management

Early deceleration: An early deceleration represents an autonomic response to changes in intracranial pressure or cerebral blood flow caused by intrapartum compression of the fetal head during a uterine contraction and maternal expulsive efforts.

Variable deceleration: Reflects the fetal autonomic reflex response to transient mechanical compression of the umbilical cord

Late deceleration : Is a reflex fetal response to transient hypoxemia during a uterine contraction.

Situations Where The Fetal Heart Rate Pattern Is Abnormal

This means the fetus is not getting enough oxygen

The cause should be found

Steps taken to ensure the baby get enough oxygen

Id the procedure is not successful and the fetus has problems the baby should be delivered immediately

The child will most likely be delivered through cesarean or vacuum delivery or forceps

Reference

Buckley, S. J. (2015). Executive summary of hormonal physiology of childbearing: evidence and implications for women, babies, and maternity care. The Journal of perinatal education, 24(3), 145.

King, T. L., Brucker, M. C., Fahey, J., Kriebs, J. M., & Gegor, C. L. (Eds.). (2015). Varney's midwifery (p. 3). Burlington, MA: Jones & Bartlett Learning.

Simpson, K. R. (2016). Research about nurse staffing during labor and birth is greatly needed and long overdue. Nursing for women's health, 20(4), 343-345.

https://www.webmd.com/baby/guide/normal-labor-and-delivery-process#3