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The Process of Birth. Introduction Intrapartum\Perinatal Period. Physiologic Effects of Birth/Adaptation to Labor Maternal Response-Alterations in:. Cardiovascular Hemopoietic System Respiratory System Renal system Integumentary System Neurologic System G.I. System Endocrine System

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The process of birth

The Process of Birth

Introduction

Intrapartum\Perinatal Period


Physiologic effects of birth adaptation to labor maternal response alterations in
Physiologic Effects of Birth/Adaptation to LaborMaternal Response-Alterations in:

  • Cardiovascular

  • Hemopoietic System

  • Respiratory System

  • Renal system

  • Integumentary System

  • Neurologic System

  • G.I. System

  • Endocrine System

  • Reproductive System



B fetal response to mother s labor
B. Fetal Response to Mother’s Labor:

  • Fetal Heart Rate:

  • Respiratory Rate

  • Fetal Circulation



Ii components of the birth process critical factors in labor
II. Components of The Birth ProcessCritical Factors in Labor

  • The Five P’s:

  • 1.The Powers

  • 2. The Passage

  • 3. The Passenger

  • 4. Mother’s position

  • 5. The Psyche


Powers
Powers

  • 1. Primary: Uterine Contractions

  • 2. Secondary:

  • Abdominal and Intercostal Muscles

  • The Perineal Muscles



Uterine response
Uterine Response

Contractions Measured in:

  • Frequency

  • Duration

  • Intensity

  • Phases of Contractions:

  • Increment

  • Acme

  • Decrement



B passage the pelvis

1. Landmarks:

The True Pelvis

( divided into 3 sections)

Inlet

Cavity

Outlet

2. Types of Pelvises

Gynecoid

Anthropoid

Android

Platypelloid

3. Significant Measurement:

Bi-ischial diameter

B. Passage (The Pelvis)




Comparisons of Pelvises

Gynecoid Android Anthropoid Platypelloid

50% 20% 25% 05%


C passenger baby
C. Passenger ( Baby!)

  • 1. Fetal head/Fontanels

    a. Posterior

    b. Anterior

    c. Bi-Parietal Measurement

  • 2. Fetal Presentation

    a. Cephalic

    b. Breech

    c. Transverse


Passenger continued

Fetal Lie

Fetal Attitude

Fetal station

Fetal Position:

a. side of Pelvis: Referred to as: (R or L)

b. Fetal Presenting Part Referred to as:( O,S,M or A)

c. Anterior, Posterior or Transverse Lie : Referred to as:( A, P or T)

Passenger (Continued)



Mother s position in labor
Mother’s Position in Labor

  • Affects anatomical and physiologic adaptation to labor( standing , walking, sitting or squatting)

  • Gravity can assist in the decent of baby/increases effacement and dilation of cervix

  • Ferguson’s reflex



Labor and delivery
Labor and Delivery

  • III. Normal Labor

  • A. Premonitory Signs of Labor

  • 1. Braxton Hicks Contractions

  • 2. Cervical Changes

  • 3.Bloody Show

  • 4.Rupture of Membrane

  • 5. Sudden Burst of Energy


True vs false labor characteristics

False Labor

- no change in cervix

-discomfort in low abdomen and groin

-irregular contractions

-no increase in frequency or intensity of contractions

True Labor

Progressive cervical dilatation and effacement

Discomfort in back and abdomen

Contractions occur at regular intervals

Progressive increase in frequency and intensity of contractions

True vs. False LaborCharacteristics


C initial maternal assessments during labor

1.PrenatalHistory ie: Gestational Age? wt.gain,EDD/EDC, Lab Values, Bld.Type

2.Risk Factors: Rubella status; STD’s, Group B Step. Status

3.Prior Obstetrical

History( GTPAL)

4. Asses Labor Progress

5.?Education Preparation

6. Educational needs of this Mother/Family

7. ? Support System

8.Maternal Allergies?

9. Base line Vital Signs

10. Status of the Baby

C. Initial Maternal Assessments During Labor


E m e c h a n i s m o f l a b o r
E. Values, Bld.TypeMechanism of Labor

  • Cardinal Movements of the baby

  • 1. Engagement, Descent, Flexion

  • 2.Internal Rotation

  • 3.Extention-Beginning

  • 4.Extention Complete

  • 5.External Rotation(Restitution)

  • 6.External Rotation(Shoulder Rotation)

  • 7.Expulsion


Four stages of labor

1.First Stage (Dilation Stage Values, Bld.Type)

Divided into three phases:

a. latent

b. active

c. transition

2.Second Stage (Stage of Expulsion)

3. Third Stage (Placental Stage)

4. Fourth Stage (Recovery Stage)

Four Stages of Labor


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