Between which weeks gestation is a baby considered full term?
38-42 weeks. (Txt book says 37).
What are two physiological changes that must occur for birth to proceed smoothly?
- Effacement and dilation of cervix.
2. Strong and regular contraction - myometrial tone change.
Identify and explain the stages of labour:
1st stage: (passive - active - transitional)
0 - 10cm.
2nd stage: 10cm - birth.
3rd stage: delivery of placenta - control of bleeding.
4th stage: early post birth, 1-2 hours.
Explain what you might expect of contractions and changes in the cervix in early labour:
Contractions: mild and irregular.
Cervix: starts to soften, efface, dilate, move from posterior to anterior.
Define effacement:
Thinning of the cervix. Inner and outer OS thin into lower uterine segment.
Describe what differences you might encounter in the effacement of the cervix in a primip compared to multip
Primip= effaces as dilates, may take longer. Multip= effaces before dilates.
lip of cervix
Define forewaters:
Waters of baby’s head, puts even pressure on cervix and cushions baby’s head.
Explain the significance of the purple line:
Indication of the progress of labour/ cervical dilation. Purple line which develops superiority from anus.
Describe what might be expected of contractions or the contraction pattern in the second stage of labour:
Strong, regular (5/10), lasting 45 seconds - 1 minute.
Softening of uterus…
How does “directed” pushing or coaching compare to spontaneous or physiological pushing in second stage of labour.
Directed = midwifery, health professional lead. Spontaneous = woman lead.
Give an explanation as to how the placenta separates during a physiological 3rd stage and what are the signs of separation?
- The uterus contracts to expel the placenta.
Signs:
- Trickle of blood.
- The umbilical cord appears white.
- The umbilical cord stops pulsating.
- The umbilical cord appears to lengthen.
- The woman may experience an urge to push.
- Fundus is firm and rises slightly.
Describe the active management of the 3rd stage of labour:
- Syntocinon injection in the mothers thing after the anterior shoulder of baby has presented.
- Immediate cord cut and clamp.
- Controlled cord traction to remove placenta.
Describe physiological management of the third stage of labour:
- Potential delayed cord clamping.
2. Allow for the signs of separation.
