The Birth Process. Mamie Guidera, CNM, MSN Carol O’Donoghue, CNM, MSN, MPH. Normal Labor and birth: Objectives . Introductions Physiologic labor and birth: the basics Phases of labor Birth video The P’s: Power, passageway, passenger, etc. Briefs:
Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.
Mamie Guidera, CNM, MSN
Carol O’Donoghue, CNM, MSN, MPH
Here’s the truth: Childbirth is not only a physiologic phenomenon, but a cultural/sociological experience. So before you walk onto the Labor Floor, ask yourself:
Length of first stage labor in healthy nulliparous and multiparous childbearing womenadapted from Albers L. (2007)bold = nullips, italics = multips
What are the signs and symptoms of impending labor? multiparous childbearing women
Fetal station and part
Importance of cervical statusPhysiological Preparation for Labor
Theoretical multiparous childbearing women
Stripping of membranes
Artificial rupture of membranes
Nipple StimulationInitiation of Labor
Dilatation multiparous childbearing women
What are the characteristics of each?
What are frequent maternal behaviors?
Pain management?Early or Latent Phase, Active phase, Transition…
Woman/Fetus multiparous childbearing women
Practice/ Pain Relief
PsycheThe Ps of Labor
Power: Contractions multiparous childbearing women
Passenger: Attitude multiparous childbearing women
Passenger multiparous childbearing women
Passenger: Lie multiparous childbearing women
Health care provider multiparous childbearing women
…let’s talk about this…
Woman giving birth
Beliefs, values, culturePsyche
From 10 cm to birth of baby multiparous childbearing women
Pushing or expulsion
DurationSecond Stage of Labor
Perineal management multiparous childbearing women
(keep your hands off
Ask mother to feel the baby’s head
Stay focused on woman, not tasksBirth
Causes release of potassium, bradykinin, histamin, serotonin
Impulses follow sensory-nerve fibers from paracervical and hypogastric plexus to lumbar sympathetic chain
Enter dorsal horn of spinal cord at T10-12, L1
Walking/Movement multiparous childbearing women
Birth Ball, toilet
Others?Pain Management in Active Labor
Kennell J, Klaus M, McGrath S, Robertson S, Hinkley C. multiparous childbearing womenContinuous Emotional Support During Labor in a US Hospital: A Randomized Controlled Trial. JAMA, May 1991; 265: 2197 - 2201.
Hodnett, ED et al (2007). Continuous support for women during childbirth (Review). Cochrane Database of Systematic Reviews 2007, Issue 3. Art No.: CD 003766.
Pathways of during childbirth (Review). Placement of Anesthetics for Labor Pain
Eltzschig H et al. N Engl J Med 2003;348:319-332
Lieberman & O’Donoghue, Am J Obstet Gynecol 2002, 186(5):S31-S68.
Leighton& Halpern Am J Obstet Gynecol 2002, 186(5):S69-77.
Gabbe (2002), 4th Ed.
Gabbe (2002), 4th Edition; Williams (2005), 22nd Edition
Williams Obstetrics (2005), 22nd Edition
Gabbe (2002), 4th Ed.; Williams (2005), 22nd Edition
ACOG Practice Bulletin 70 (2005); Williams (2005), 22nd Ed.
http://www.ahrq.gov/clinic/uspstf/uspsiefm.htm Accessed 6/30/08
Don’t just stand there.