The Process of Birth

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The Process of Birth

• Introduction
• Intrapartum\Perinatal Period

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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

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Cervical Dilation
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B. Fetal Response to Mothers Labor

• Fetal Heart Rate
• Respiratory Rate
• Fetal Circulation

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Placental Circulation
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II. Components of The Birth ProcessCritical
Factors in Labor

• The Five Ps
• 1.The Powers
• 2. The Passage
• 3. The Passenger
• 4. Mothers position
• 5. The Psyche

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Powers

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

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Uterine Muscle Layers
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Uterine Response

• Contractions Measured in
• Frequency
• Duration
• Intensity
• Phases of Contractions
• Increment
• Acme
• Decrement

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Phases of Contractions
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B. Passage (The Pelvis)

• 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

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Female Pelvis
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Pelvic Measurements
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Comparisons of Pelvises
Gynecoid Android Anthropoid
Platypelloid
50 20 25
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C. Passenger ( Baby!)

• 1. Fetal head/Fontanels
• a. Posterior
• b. Anterior
• c. Bi-Parietal Measurement
• 2. Fetal Presentation
• a. Cephalic
• b. Breech
• c. Transverse

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Passenger (Continued)

• 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)

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Fetal Station
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Mothers 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
• Fergusons reflex

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Mothers Psyche !
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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

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True vs. False LaborCharacteristics

• 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

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C. Initial Maternal Assessments During Labor

• 1.PrenatalHistory ie Gestational Age?
  wt.gain,EDD/EDC, Lab Values, Bld.Type
• 2.Risk Factors Rubella status STDs, 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

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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

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Four Stages of Labor

• 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)

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