lOMoARcPSD|5734770
lOMoARcPSD|5734770
MATERNAL NEWBORN
LABOR & DELIVERY
Physiological changes
that precede labor
True vs. False Labor
BACKACHE True Labor: Contractions that may start
WEIGHT LOSS (1-3 POUNDS) irregularly, but become stronger, more
LIGHTENING (FEELING THAT BABY
frequent, and regular. Walking increases
HAS DROPPED LOWER IN PELVIS.
intensity of contractions. Comfort measures
CONTRACTIONS (IRREGULAR
(oral hydration, bladder emptying) do not
BRAXTON HICKS
stop contractions. Cervical changes present
CONTRACTIONS THAT BECOME
(dilation, effacement, blood show).
STRONGER AND MORE REGULAR)
BLOODY SHOW (BROWN OR BLOODY
Presenting part of fetus engaged in pelvis.
MUCUS DISCHARGE) False Labor: Painless, irregular, intermittent
ENERGY BURST contractions. Walking or position changes
GI UPSET decrease intensity/duration of contractions.
RUPTURE OF MEMBRANES (CLEAR,
Comfort measures (oral hydration, bladder
WATER FLUID; AMNIOTIC
emptying) often stop contractions. No
FLUID WILL CAUSE NITRAZINE
cervical changes. Presenting part of fetus
PAPER TO TURN BLUE, PAPER
not engaged in pelvis.
REMAINS YELLOW WITH URINE)
STAGES OF LABOR
FIRST STAGE: BEGINS WITH ONSET
OF LABOR, ENDS WITH COMPLETE SECOND STAGE: FULL DILATION TO BIRTH
DILATION. OF BABY.
LATENT PHASE: CERVIX 0-3CM; MILD
TO MODERATE CONTRACTIONS; MOM IS
THIRD STAGE: DELIVERY OF BABY
TALKATIVE AND EAGER. TO DELIVERY OF PLACENTA.
ACTIVE PHASE: CERVIX 4-7CM;
FOURTH STAGE: DELIVERY OF PLACENTA TO
MODERATE TO STRONG CONTRACTIONS; STABILIZATION OF MATERNAL VITAL SIGNS.
MOM IS ANXIOUS, RESTLESS, FEELING
HELPLESS.
TRANSITION: CERVIX 8-10CM; STRONG
TO VERY STRONG CONTRACTIONS; MOM
FEELS NEED TO PUSH OR HAVE A BOWEL
MOVEMENT (I.E. RECTAL PRESSURE),
FEELS LIKE SHE “CANNOT CONTINUE”.
, — Passenger
— Passageway
— Powers
— Position
lOMoARcPSD|5734770
— Psychological response
5 p’s
PASSENGER: CONSISTS OF FETUS AND PLACENTA.
• PRESENTATION (HEAD, CHIN, SHOULDER, BREECH)
• LIE (TRANSVERSE, PARALLEL/LONGITUDINAL)
• POSITION: LABEL WITH THREE LETTERS
◦RIGHT (R) OR LEFT (L)
◦OCCIPUT (O), SACRUM (S), MENTUM (M), OR SCAPULA (SC)
◦ANTERIOR (A), POSTERIOR (P), OR TRANSVERSE (T)
• STATION: (STATION 0 IS AT LEVEL OF ISCHIAL SPINES)
UPRIGHT, SITTING, KNEELING, SQUATTING
POSITION: PROMOTES FETAL DESCENT.
PASSAGEWAY: BIRTH CANAL
UTERINE CONTRACTIONS, PSYCHOLOGICAL
POWERS: RESULTING IN EFFACEMENT,
DILATION. RESPONSE: STRESS, ANXIETY CAN IMPAIR LABOR.
Pain management during labor
Non-pharmacological: Pharmacological:
• EFFLEURAGE: Stroking of mom’s • SEDATIVES (BARBITURATES): can
abdomen with fingertips during contractions. lead to neonate respiratory depression.
• SACRAL COUNTER-PRESSURE: heel Use only in early or latent phase.
of hand or fist is pushed against mom’s • OPIOD ANALGESICS: can lead to sedation,
sacral area to relieve back labor pain. tachycardia, hypotension, decreased FHR
• OTHERS: breathing techniques (start variability, neonate respiratory depression.
with cleansing breath), imagery, Naloxone is antidote. Use when cervix is
hydrotherapy, music, heat/cold. dilated at least 4cm and fetus is engaged.
Epidural Block Spinal Block
Eliminates sensation from Eliminates sensation from nipples
umbilicus to thighs. Administer to feet. Used in cesarean births.
when mom is at least 4cm dilated. • Side effects: maternal hypotension,
• Side effects: maternal fetal bradycardia, headache from
hypotension, fetal bradycardia
lOMoARcPSD|5734770
MATERNAL NEWBORN
LABOR & DELIVERY
Physiological changes
that precede labor
True vs. False Labor
BACKACHE True Labor: Contractions that may start
WEIGHT LOSS (1-3 POUNDS) irregularly, but become stronger, more
LIGHTENING (FEELING THAT BABY
frequent, and regular. Walking increases
HAS DROPPED LOWER IN PELVIS.
intensity of contractions. Comfort measures
CONTRACTIONS (IRREGULAR
(oral hydration, bladder emptying) do not
BRAXTON HICKS
stop contractions. Cervical changes present
CONTRACTIONS THAT BECOME
(dilation, effacement, blood show).
STRONGER AND MORE REGULAR)
BLOODY SHOW (BROWN OR BLOODY
Presenting part of fetus engaged in pelvis.
MUCUS DISCHARGE) False Labor: Painless, irregular, intermittent
ENERGY BURST contractions. Walking or position changes
GI UPSET decrease intensity/duration of contractions.
RUPTURE OF MEMBRANES (CLEAR,
Comfort measures (oral hydration, bladder
WATER FLUID; AMNIOTIC
emptying) often stop contractions. No
FLUID WILL CAUSE NITRAZINE
cervical changes. Presenting part of fetus
PAPER TO TURN BLUE, PAPER
not engaged in pelvis.
REMAINS YELLOW WITH URINE)
STAGES OF LABOR
FIRST STAGE: BEGINS WITH ONSET
OF LABOR, ENDS WITH COMPLETE SECOND STAGE: FULL DILATION TO BIRTH
DILATION. OF BABY.
LATENT PHASE: CERVIX 0-3CM; MILD
TO MODERATE CONTRACTIONS; MOM IS
THIRD STAGE: DELIVERY OF BABY
TALKATIVE AND EAGER. TO DELIVERY OF PLACENTA.
ACTIVE PHASE: CERVIX 4-7CM;
FOURTH STAGE: DELIVERY OF PLACENTA TO
MODERATE TO STRONG CONTRACTIONS; STABILIZATION OF MATERNAL VITAL SIGNS.
MOM IS ANXIOUS, RESTLESS, FEELING
HELPLESS.
TRANSITION: CERVIX 8-10CM; STRONG
TO VERY STRONG CONTRACTIONS; MOM
FEELS NEED TO PUSH OR HAVE A BOWEL
MOVEMENT (I.E. RECTAL PRESSURE),
FEELS LIKE SHE “CANNOT CONTINUE”.
, — Passenger
— Passageway
— Powers
— Position
lOMoARcPSD|5734770
— Psychological response
5 p’s
PASSENGER: CONSISTS OF FETUS AND PLACENTA.
• PRESENTATION (HEAD, CHIN, SHOULDER, BREECH)
• LIE (TRANSVERSE, PARALLEL/LONGITUDINAL)
• POSITION: LABEL WITH THREE LETTERS
◦RIGHT (R) OR LEFT (L)
◦OCCIPUT (O), SACRUM (S), MENTUM (M), OR SCAPULA (SC)
◦ANTERIOR (A), POSTERIOR (P), OR TRANSVERSE (T)
• STATION: (STATION 0 IS AT LEVEL OF ISCHIAL SPINES)
UPRIGHT, SITTING, KNEELING, SQUATTING
POSITION: PROMOTES FETAL DESCENT.
PASSAGEWAY: BIRTH CANAL
UTERINE CONTRACTIONS, PSYCHOLOGICAL
POWERS: RESULTING IN EFFACEMENT,
DILATION. RESPONSE: STRESS, ANXIETY CAN IMPAIR LABOR.
Pain management during labor
Non-pharmacological: Pharmacological:
• EFFLEURAGE: Stroking of mom’s • SEDATIVES (BARBITURATES): can
abdomen with fingertips during contractions. lead to neonate respiratory depression.
• SACRAL COUNTER-PRESSURE: heel Use only in early or latent phase.
of hand or fist is pushed against mom’s • OPIOD ANALGESICS: can lead to sedation,
sacral area to relieve back labor pain. tachycardia, hypotension, decreased FHR
• OTHERS: breathing techniques (start variability, neonate respiratory depression.
with cleansing breath), imagery, Naloxone is antidote. Use when cervix is
hydrotherapy, music, heat/cold. dilated at least 4cm and fetus is engaged.
Epidural Block Spinal Block
Eliminates sensation from Eliminates sensation from nipples
umbilicus to thighs. Administer to feet. Used in cesarean births.
when mom is at least 4cm dilated. • Side effects: maternal hypotension,
• Side effects: maternal fetal bradycardia, headache from
hypotension, fetal bradycardia
