The Birth Process Chapter 12

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The Birth ProcessChapter 12
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Objectives

• Describe the womans physiologic and
  psychological responses to labor
• Describe fetal responses to labor
• Explain how each component of the birth process
  affects the course of labor and how these
  components interrelate
• Relate the mechanisms of labor to the process of
  birth

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Objectives

• Explain premonitory signs of labor
• Compare true labor with false labor
• Describe common differences in the labors of
  nulliparous and parous women
• Compare each stage of labor and the phases within
  the first stage

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Physiologic Effectsof theBirth Process

• Maternal response
• Reproductive system
• contractions
• uterine body
• cervical changes
• Cardiovascular system
• changes during contractions
• supine hypotension

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Physiologic Effects

• Maternal response
• Respiratory system
• increased rate/depth
• hyperventilation
• Gastrointestinal system
• thirst, dry mouth
• decreased gastric motility
• decrease PO intake

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Physiologic Effects

• Maternal response
• Urinary system
• decreased bladder sensation
• during labor
• empty bladder to enhance
• comfort and promote fetal
• descent
• post-partum diuresis
• Hematopoietic system
• î blood volume
• î WBC count during active labor
• î levels of clotting factors

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Physiologic Effects

• Fetal response
• Placental circulation
• decreased during contractions
• fetal protective mechanisms
• Cardiovascular system(stress)
• changes in pulse rate
• changes in pulse rhythm
• Pulmonary system
• fluid expelled during labor/delivery
• remaining fluid reabsorbed

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Componentsof theBirth Process

• Powers
• Uterine contractions(passive)
• Second stage pushing(active)
• Passage
• Bony pelvis
• Soft tissues
• Passenger
• Fetal head Presentation
• Fetal lie Position
• Attitude

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Components of theBirth Process

• Psyche
• Individual/cultural values
• Birth as an experience
• Impact of technology
• Interrelationship of the 4 Ps

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Normal Labor

• Theories of onset
• fetal factors
• maternal factors
• Premonitory signs
• braxton-hicks energy spurt
• lightening weight loss
• î vaginal secretions
• bloody show

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Normal Labor

• True labor vs. false labor
• Mechanisms of labor
• adaptation of fetus to maternal
• pelvis
• fetal position changes
• Stages and phases of labor

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Normal Labor

• First Stage(longest)
• Latent cervical changes,
• effacement, î UCs
• Active cervical changes, rapid
• dilatation, î pain, focus
• inward
• Transition strongest UCs, may
• lose control

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Normal Labor

• Second Stage
• pushing efforts actively aid
• descent
• regains self control
• Third Stage(shortest)
• delivery of placenta
• Fourth Stage
• uterus must stay firmly contracted
• physiologic changes may cause chills
• encourage parent/infant contact

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Normal Labor

• Duration of labor
• primiparous vs. multiparous
• VBAC
• history of rapid labor
• precipitous?
• medical interventions

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Final Thoughts

• Questions???
• Summary
• Next assignment
• READ Chapter 13
• VIEW Vaginal delivery on CD
• that comes with text