the process of birth
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The Process of Birth. Introduction Intrapartum\Perinatal 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 - PowerPoint PPT PresentationTRANSCRIPT
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
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The Process of BirthThe Process of Birth
IntroductionIntroduction
Intrapartum\Perinatal PeriodIntrapartum\Perinatal Period
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
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Physiologic Effects of Birth/Adaptation to Physiologic Effects of Birth/Adaptation to LaborLabor
Maternal Response-Alterations in:Maternal Response-Alterations in:
Cardiovascular Cardiovascular Hemopoietic SystemHemopoietic System Respiratory SystemRespiratory System Renal systemRenal system Integumentary SystemIntegumentary System Neurologic System Neurologic System G.I. System G.I. System Endocrine SystemEndocrine System Reproductive SystemReproductive System
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
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Cervical Dilation
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B. Fetal Response to Mother’s B. Fetal Response to Mother’s Labor:Labor:
Fetal Heart Rate:Fetal Heart Rate:
Respiratory RateRespiratory Rate
Fetal CirculationFetal Circulation
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
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II. Components of The Birth ProcessII. Components of The Birth ProcessCritical Factors in LaborCritical Factors in Labor
The Five P’s:The Five P’s:
1.The Powers1.The Powers
2. The Passage2. The Passage
3. The Passenger3. The Passenger
4. Mother’s position4. Mother’s position
5. The Psyche5. The Psyche
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
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PowersPowers
1. 1. Primary: Uterine ContractionsPrimary: Uterine Contractions
2. 2. Secondary: Secondary:
Abdominal and Intercostal MusclesAbdominal and Intercostal Muscles The Perineal MusclesThe Perineal Muscles
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
88Uterine Muscle Layers
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
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Uterine ResponseUterine Response
Contractions Measured in:Contractions Measured in: FrequencyFrequency DurationDuration IntensityIntensity
Phases of ContractionsPhases of Contractions:: IncrementIncrement AcmeAcme DecrementDecrement
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Phases of Contractions
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B. Passage (The Pelvis)B. Passage (The Pelvis) 1. Landmarks: 1. Landmarks:
The True PelvisThe True Pelvis ( divided into 3 ( divided into 3
sections)sections)
InletInlet CavityCavity OutletOutlet
2. Types of Pelvises2. Types of Pelvises
GynecoidGynecoid AnthropoidAnthropoid AndroidAndroid PlatypelloidPlatypelloid
3. Significant 3. Significant Measurement:Measurement:
Bi-ischial diameterBi-ischial diameter
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
1212Female Pelvis
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Pelvic Measurements
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50% 20% 25% 05%
Comparisons of Pelvises Gynecoid Android Anthropoid Platypelloid
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C. Passenger ( Baby!)C. Passenger ( Baby!) 1. Fetal head/Fontanels1. Fetal head/Fontanels a. Posteriora. Posterior b. Anteriorb. Anterior c. Bi-Parietal Measurementc. Bi-Parietal Measurement
2. Fetal Presentation2. Fetal Presentation a. Cephalic a. Cephalic b. Breechb. Breech c. Transversec. Transverse
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Passenger (Continued)Passenger (Continued) Fetal LieFetal Lie
Fetal AttitudeFetal Attitude
Fetal stationFetal station
Fetal Position:Fetal Position: a. side of Pelvis: a. side of Pelvis:
Referred to as: (R or L)Referred to as: (R or L) b. Fetal Presenting Part b. Fetal Presenting Part
Referred to as:( O,S,M Referred to as:( O,S,M or A)or A)
c. Anterior, Posterior or c. Anterior, Posterior or Transverse Lie : Transverse Lie : Referred to as:( A, P or Referred to as:( A, P or T)T)
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
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Mother’s Position in LaborMother’s Position in Labor Affects anatomical and physiologic Affects anatomical and physiologic
adaptation to labor( standing , adaptation to labor( standing , walking, sitting or squatting)walking, sitting or squatting)
Gravity can assist in the decent of Gravity can assist in the decent of baby/increases effacement and baby/increases effacement and dilation of cervixdilation of cervix
Ferguson’s reflexFerguson’s reflex
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Mother’s Psyche !Mother’s Psyche !
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Labor and DeliveryLabor and Delivery III. Normal LaborIII. Normal Labor
A. Premonitory Signs A. Premonitory Signs of Laborof Labor
1. Braxton Hicks 1. Braxton Hicks ContractionsContractions
2. Cervical Changes2. Cervical Changes 3.Bloody Show3.Bloody Show 4.Rupture of 4.Rupture of
MembraneMembrane 5. Sudden Burst of 5. Sudden Burst of
EnergyEnergy
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B.B. True True vs. vs. False False LaborLaborCharacteristicsCharacteristics
False LaborFalse Labor - no change in cervix- no change in cervix -discomfort in low -discomfort in low
abdomen and groinabdomen and groin -irregular contractions-irregular contractions -no increase in -no increase in
frequency or intensity frequency or intensity of contractionsof contractions
True LaborTrue Labor Progressive cervical Progressive cervical
dilatation and dilatation and effacementeffacement
Discomfort in back Discomfort in back and abdomenand abdomen
Contractions occur at Contractions occur at regular intervalsregular intervals
Progressive increase Progressive increase in frequency and in frequency and intensity of intensity of contractionscontractions
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C. Initial Maternal Assessments C. Initial Maternal Assessments During LaborDuring Labor
1.PrenatalHistory ie: 1.PrenatalHistory ie: Gestational Age? Gestational Age? wt.gain,EDD/EDC, Lab wt.gain,EDD/EDC, Lab Values, Bld.TypeValues, Bld.Type
2.Risk Factors: Rubella status; 2.Risk Factors: Rubella status; STD’s, Group B Step. STD’s, Group B Step. StatusStatus
3.Prior Obstetrical3.Prior Obstetrical History( GTPAL)History( GTPAL)
4. Asses Labor Progress4. Asses Labor Progress
5.?Education Preparation5.?Education Preparation
6. Educational needs of 6. Educational needs of this Mother/Familythis Mother/Family
7. ? Support System7. ? Support System
8.Maternal Allergies?8.Maternal Allergies?
9. Base line Vital Signs9. Base line Vital Signs
10. Status of the Baby10. Status of the Baby
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E. E. MMeecchhaanniissmm o of f LLaabboorr Cardinal Movements of the babyCardinal Movements of the baby 1. Engagement, Descent, Flexion1. Engagement, Descent, Flexion 2.Internal Rotation2.Internal Rotation 3.Extention-Beginning3.Extention-Beginning 4.Extention Complete4.Extention Complete 5.External Rotation(Restitution)5.External Rotation(Restitution) 6.External Rotation(Shoulder Rotation)6.External Rotation(Shoulder Rotation) 7.Expulsion7.Expulsion
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Prof. Carole A. Devine R.N.,MSProf. Carole A. Devine R.N.,MSN.N.
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Four Stages of LaborFour Stages of Labor
1.First Stage (Dilation 1.First Stage (Dilation StageStage))
Divided into three Divided into three phases:phases:
a. latenta. latent b. activeb. active c. transitionc. transition
2.Second Stage 2.Second Stage (Stage of Expulsion)(Stage of Expulsion)
3. Third Stage 3. Third Stage (Placental Stage)(Placental Stage)
4. Fourth Stage 4. Fourth Stage
(Recovery Stage(Recovery Stage))
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