Labour “in labour” …..when uterine contractions reach sufficient strength, duration and...

Labour“in labour”…..when uterine contractions reach sufficient strength, duration and frequency to cause effacement and dilatation of

the cervix.

Normal labour takes place at term. -a single fetus -presents by the vertex and -the delivery, followed by that of the

placenta and membranes, -is accomplished with in 4-24 hours, -with out artificial aid and without complication.

Possible causes for the onset of labour include:

-fetal pressure on the uterine wall-increasing tension on the uterine wall-changes in hormonal balance (fetal

adrenal cortex)

http://markgibsonphoto.com/images/N273W02W.JPG

Signs of labour for a pregnant woman

-regular contractions increasing in strength, duration and frequency.

-show (bloody mucus plug around cervix)

-rupture of the membranes (amniotic fluid escapes)

Terms used during labour:-contractions: shortening of the uterine muscle fibres. -during labour increase in strength duration and frequency

-strength: increase in intensity -duration: from the beginning of a contraction to the end of that contraction. -frequency: from the beginning of one contraction to the beginning of the next.

The cervix during labour

The cervix during labour:-effacement: or taking up of the cervix.-the cervix becomes part of the lower

uterine segment and flat

-dilatation of the cervix-the external os of the cervix increases in

diameter to full dilatation =10 cms.

The mechanisms of labour

The mechanisms of labour

Briefly outline the “mechanisms” of labour

( note only a general understanding is needed)

-a series of passive movements of the fetus in its passage through the birth canal.

-

pelvis: -inlet / outlet differing in size and shape -curve at the lower end.(Curve Of Carus) -cylindrical

Powers-uterine contractions

-abdominal muscles

Resistance-offered by the pelvis, cervix and the pelvic

muscles

Passengers:-fetus (flexible neck acts like a fulcrum) -fetal skull (shape and size)

http://www.youtube.com/watch?v=duPxBXN4qMg&feature=related

http://www.youtube.com/watch?v=YooksLV1tFc

http://www.youtube.com/watch?v=CgsDBqBgymY&feature=related

Stages of Labour

Stage one: from the onset of regular contractions to full dilatation of the cervix

Stage two: from full dilatation of the cervix to the birth of the baby

Stage three: from the birth of the baby to the delivery of the placenta.

Stage four: from the delivery of the placenta and membranes to 1-4 hours after the baby’s birth

-average durationFirst stage -primigravida = 10-12 hours -multigravida = 1-2 hoursSecond stage -primgravida =1-2 hours -multi gravida =½ hour Third stage: -average duration ½ hour (with ecbolic drugs = 5

minutes)

Factors which may influence a woman’s experience of labour include:

-previous experiences-tiredness-dehydration-position of the baby-environment-support people-

Nursing actions during labour to observe and record the maternal and fetal physical condition

-blood pressure -pulse -temperature

- urine output amount and urinalysis-vaginal loss (blood, mucus, amniotic fluid-contractions-pain-general wellbeing

1) www.google imagesnuclearfamily.wordpress.com/page/2/&usg=_

Emotional assessment (Maternal)-anxiety-mood-response to pain and labour

Nursing actions for fetal assessment

-fetal heart rate-amniotic fluid (colour)-

Nursing actions to assist a woman’s pain management during labour.

-distraction techniques-breathing techniques-music -counting-conversation-massage---

Nursing actions:-assist with hygiene needs, bath , back

rubs, change the bed linen, cold flannels to forehead, heat packs……….

-remind re elimination needs-support her support person-stay with her-give feedback re the progress of her

labour and her fetus-encourage……………..

http://www.youtube.com/watch?v=wRkyT9HQSEQ

http://www.youtube.com/watch?v=6QXb0vzuwWs&feature=related

Discuss:

What factors might influence a woman’s choice about where she would like to have her baby?

For example home versus hospital