DOULA CERTIFICATION EXAM ACTUAL EXAM
name the six parts to a typical vertex delivery - ANSWER: 1. engagement
2. descent and flexion of fetal head
3. internal rotation
4. delivery by extension
5. restitution
6. external rotation
engagement - ANSWER: of the fetal head in the transverse (baby is laying
horizontally). baby's head is facing across the pelvis.
descent and flexion of fetal head - ANSWER: baby begins descending into pelvis and
extends or flexes. baby is still facing one side of mother.
internal rotation - ANSWER: fetal head rotates 90 degrees to the occipital-anterior
(baby is laying head down and facing back of mom)
restitution - ANSWER: fetal head turns 45 degrees to restore relationship with its
shoulders; which are still at an angle.
external rotation - ANSWER: shoulders repeat the corkscrew ,movements of the
head, which can be seen in the final movements of the fetal head.
station - ANSWER: refers to relationship of fetal presenting part to the level of the
ischial spines.
when the presenting part is at the ischial spines, the station is 0; synonymous with
engagement.
when the presenting part is above the spines, the distance is measured as minus
stations which range from -1 to -4 cm.
when the presenting part is below the spines, the distance is measured as plus
stations which range from +1 to +4 cm.
First Stage of Labor (1.1) - ANSWER: Latent Phase: Quiscent Phase; Prodromal Labor;
Pre-Labor
begins at point where woman perceives regular uterine contractions (these are
different from Braxton-hicks)
latent phase ends with onset of active first stage
First Stage of Labor (1.2) - ANSWER: Active Phase:
definition shifts slightly depending where you are.
USA: 5 cm dilation for multiparous women
, JPN: 7 cm dilation; contractions become stronger and longer, lasting about one
minutes and repeating every 2-4 hours.
Second Stage of Labor - ANSWER: Fetal Expulsion:
stimulated by prostaglandins and oxytocin. begins when the cervix usefully dilated
and ends when the baby is born.
beginning of normal second stage, the head is fully engaged in pelvis
fetal head continues descent into pelvis, below pubic arch, and out through the
vaginal Introits (opening).
- this is all assisted by mom pushing!!
this stage will vary by factors including parity (# babies woman has had), fetal size,
anesthesia, and presence of infection
Third Stage - ANSWER: Placenta Delivery:
the period from just after fetus is expelled until just after the placenta is expelled.
usually 10-12 minutes after baby is delivered.
3% of vaginal deliveries, the duration of this stage lasts longer than 30 minutes.
delaying clamping until at least one minutes after birth improves outcomes as long
as there is the ability to treat jaundice if it occurs.
obstetrician (OB) - ANSWER: doctor who has special training in women's health and
pregnancy
specialize in both caring for women during pregnancy and labor and delivering their
babies
some OB's have advanced training in caring for high risk pregnancies (maternal-fetal
medicine specialists / perinatologists)
family practice doctor (FP) - ANSWER: doctor who has studied family practice
medicine.
can treat many illnesses and conditions and treats men and women of all ages.
some FP docs are also trained to take care of the newborn after delivery
certified nurse midwife (CNM) - ANSWER: trained in nursing and midwifery
care for women during pregnancy, labor, and delivery
most CNM's:
- have a bachelors degree in nursing
- have a masters degree in midwifery
- are certified by the American College of nurse-midwives
most CNM's work with OB's
12 cervical ripening and induction procedures - ANSWER: 1. nipple stimulation
2. sexual intercourse
3. castor oil
4. enema
5. acupuncture or TENS
6. herbs
7. stripping or sweeping the membranes
name the six parts to a typical vertex delivery - ANSWER: 1. engagement
2. descent and flexion of fetal head
3. internal rotation
4. delivery by extension
5. restitution
6. external rotation
engagement - ANSWER: of the fetal head in the transverse (baby is laying
horizontally). baby's head is facing across the pelvis.
descent and flexion of fetal head - ANSWER: baby begins descending into pelvis and
extends or flexes. baby is still facing one side of mother.
internal rotation - ANSWER: fetal head rotates 90 degrees to the occipital-anterior
(baby is laying head down and facing back of mom)
restitution - ANSWER: fetal head turns 45 degrees to restore relationship with its
shoulders; which are still at an angle.
external rotation - ANSWER: shoulders repeat the corkscrew ,movements of the
head, which can be seen in the final movements of the fetal head.
station - ANSWER: refers to relationship of fetal presenting part to the level of the
ischial spines.
when the presenting part is at the ischial spines, the station is 0; synonymous with
engagement.
when the presenting part is above the spines, the distance is measured as minus
stations which range from -1 to -4 cm.
when the presenting part is below the spines, the distance is measured as plus
stations which range from +1 to +4 cm.
First Stage of Labor (1.1) - ANSWER: Latent Phase: Quiscent Phase; Prodromal Labor;
Pre-Labor
begins at point where woman perceives regular uterine contractions (these are
different from Braxton-hicks)
latent phase ends with onset of active first stage
First Stage of Labor (1.2) - ANSWER: Active Phase:
definition shifts slightly depending where you are.
USA: 5 cm dilation for multiparous women
, JPN: 7 cm dilation; contractions become stronger and longer, lasting about one
minutes and repeating every 2-4 hours.
Second Stage of Labor - ANSWER: Fetal Expulsion:
stimulated by prostaglandins and oxytocin. begins when the cervix usefully dilated
and ends when the baby is born.
beginning of normal second stage, the head is fully engaged in pelvis
fetal head continues descent into pelvis, below pubic arch, and out through the
vaginal Introits (opening).
- this is all assisted by mom pushing!!
this stage will vary by factors including parity (# babies woman has had), fetal size,
anesthesia, and presence of infection
Third Stage - ANSWER: Placenta Delivery:
the period from just after fetus is expelled until just after the placenta is expelled.
usually 10-12 minutes after baby is delivered.
3% of vaginal deliveries, the duration of this stage lasts longer than 30 minutes.
delaying clamping until at least one minutes after birth improves outcomes as long
as there is the ability to treat jaundice if it occurs.
obstetrician (OB) - ANSWER: doctor who has special training in women's health and
pregnancy
specialize in both caring for women during pregnancy and labor and delivering their
babies
some OB's have advanced training in caring for high risk pregnancies (maternal-fetal
medicine specialists / perinatologists)
family practice doctor (FP) - ANSWER: doctor who has studied family practice
medicine.
can treat many illnesses and conditions and treats men and women of all ages.
some FP docs are also trained to take care of the newborn after delivery
certified nurse midwife (CNM) - ANSWER: trained in nursing and midwifery
care for women during pregnancy, labor, and delivery
most CNM's:
- have a bachelors degree in nursing
- have a masters degree in midwifery
- are certified by the American College of nurse-midwives
most CNM's work with OB's
12 cervical ripening and induction procedures - ANSWER: 1. nipple stimulation
2. sexual intercourse
3. castor oil
4. enema
5. acupuncture or TENS
6. herbs
7. stripping or sweeping the membranes
