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The Process of Birth

The Process of Birth. Introduction IntrapartumPerinatal 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

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  1. The Process of Birth Introduction Intrapartum\Perinatal Period

  2. 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

  3. Cervical Dilation

  4. B. Fetal Response to Mother’s Labor: • Fetal Heart Rate: • Respiratory Rate • Fetal Circulation

  5. Placental Circulation

  6. 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

  7. Powers • 1. Primary: Uterine Contractions • 2. Secondary: • Abdominal and Intercostal Muscles • The Perineal Muscles

  8. Uterine Muscle Layers

  9. Uterine Response Contractions Measured in: • Frequency • Duration • Intensity • Phases of Contractions: • Increment • Acme • Decrement

  10. Phases of Contractions

  11. 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)

  12. Female Pelvis

  13. Pelvic Measurements

  14. Comparisons of Pelvises Gynecoid Android Anthropoid Platypelloid 50% 20% 25% 05%

  15. C. Passenger ( Baby!) • 1. Fetal head/Fontanels a. Posterior b. Anterior c. Bi-Parietal Measurement • 2. Fetal Presentation a. Cephalic b. Breech c. Transverse

  16. 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)

  17. Fetal Station

  18. 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

  19. Mother’s Psyche !

  20. 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

  21. 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

  22. 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

  23. E. Mechanism 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

  24. 1.First Stage (Dilation Stage) 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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