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INTRAPARTUM: Labor and Birth

INTRAPARTUM: Labor and Birth. Maternal-Newborn and Child Nursing London, Ladewig, Ball, & Bindler Prepared by Mary Ann Gagen, Professor of Nursing. “Pa…I think it’s time to go!”. Process and Stages of Labor and Birth: Chapter 15. Critical Factors in Labor The birth passage The fetus

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INTRAPARTUM: Labor and Birth

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  1. INTRAPARTUM: Labor and Birth Maternal-Newborn and Child Nursing London, Ladewig, Ball, & Bindler Prepared by Mary Ann Gagen, Professor of Nursing

  2. “Pa…I think it’s time to go!”

  3. Process and Stages of Labor and Birth: Chapter 15 • Critical Factors in Labor • The birth passage • The fetus • The relationship between the passage and the fetus • Primary forces of labor • Psychosocial considerations • Table 15-1: p 310

  4. The Birth Passage • Implications of Pelvic types for Labor and Delivery • Table 15-2, p 310

  5. The Fetus • Head

  6. The Fetus • Attitude • Lie • Presentation Top: Fetal Attitude flexion, fetal lie longitudinal Bottom: Fetal Attitude flexion, fetal lie transverse

  7. Relationship between the passage and the fetus • Engagement • Station • Fetal position

  8. The Forces of Labor • Primary • Secondary • Phases of Contractions • Increment • Acme • Decrement • Characteristics of contractions • Frequency • Duration • Intensity

  9. Psychosocial Considerations • Motivation for pregnancy • Support • Preparation • Trust in staff • Maintaining control • Cultural influences • Table 15-3

  10. Physiology of Labor • Premonitory signs of labor • Lightening or quickening • Braxton Hicks Contractions • Cervical changes • Bloody show • Rupture of membranes • Sudden burst of energy • Other: diarrhea, nausea, etc • True vs False Labor Table 15-4: p 321

  11. Stages of Labor and Birth • First stage • Latent • Active • Transition • Second stage • Crowning • Positional changes of the fetus Table 15-5: Characteristics of Labor, p 323

  12. Stages: cont’d • Third stage • Placental separation • Placental delivery • Fourth stage • 1-4 hours

  13. Stages:cont’d • Maternal responses to labor • Cardio, B/P • Respiratory • Renal, GI • Immune/blood • Pain • Causes • Fetal responses

  14. Intrapartal Nursing AssessmentChapter 16 • Admission assessment • Data Collection • Assessments • Assessment Guide, pp 335 - 339

  15. Intrapartal Nursing Assessment, cont’d • Evaluating labor progress • Leopold’s Maneuvers • FHR and Pattern • Accelerations • Decelerations • Early • Late • Variable

  16. Evaluations of FHR Tracings

  17. Intrapartal Nursing Assessment cont’d • Contractions • Frequency • Intensity • Duration • Vaginal exam

  18. Nursing management The admission process The first stage of labor Family expectations Cultural beliefs Pain, modesty Promotion of comfort Clinical Pathways pp355 - 357 The Family in Childbirth:Needs and Care, Chapter 17

  19. Nursing management Second stage comfort Third stage Initial care of newborn Apgar Umbilical cord Warmth Newborn identification The Family in Childbirth: Needs and Care, cont’d

  20. Nursing management Fourth stage Delivery of placenta Enhancing attachment The Family in Childbirth: Needs and Care, cont’d

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