Defining sign of labour
presence of regular uterine contractions that become progressively stronger, frequent, and longer
Positive sign of labour
regular contractions with cervical changes - cervix moving from posterior –> anterior, shortening, thinning (effacing) and dilating
Maternal Prep for Labour
Fetal Prep for Labour
Oxytocin
produced by posterior pituitary gland, optimizes rhythmic contractions, promotes calm, reduces fear and stress, promotes attachment
Beta-Endorphins
secreted by posterior pituitary gland, provides analgesia and adaptive responses to stress and pain
Catecholamines
epinephrine, norepinephrine, dopamine- released in response to fear, stress and perceived danger. Supports newborn transition to extrauterine life. Primary mediators that prepare fetus for birth and support multi-organ transition.
Cortisol
Stress hormone, elevated during labour, may promote contractions, increase central oxytocin effects on mat adaptations, attachment, postpartum mood. Prepares fetus for birth- promotes lung maturation and clearance of fetal lung fluid
True Labour
False Labour
5 Ps of Labour
Passenger Passage Powers Position Psyche
Passenger
Fetus- size, presentation, lie, attitude, position
Passage
Mat pelvis- bones, soft tissues, cervix, pelvic floor, vagina
Powers
Contractions, voluntary bearing down efforts
Position
Woman’s position as she labours
Psyche
Woman’s strength, PMHx, ability to cope, perception of pain, level of fear/anxiety, values & beliefs, intentions
6 bones of fetal skull
two parietal, two temporal, occipital, frontal
fontanelles
anterior- diamond shaped, posterior - triangular
Primary powers
uterine contractions
Secondary powers
maternal pushing efforts
Position changes
relieve fatigue, increase comfort, improve circulation, gravity, opening pelvic diameters
7 Cardinal movements
First Stage
onset of regular contractions and ends when cervix fully dilated
Latent Phase (First Stage)
Starts when contractions become regular and painful, cervical effacement and dilation commences, complete at 3cm. Lasts 6-8h, contractions q5-30mins