attitude
degree of body flexion or extension of the joints and the relationship of fetal parts to one another.
dilation
the opening or enlargement of the external cervical os
doula
is a Greek word meaning "woman servant" or "caregiver." It now commonly refers to a woman who offers emotional and practical support to a mother or couple before, during and after childbirth.
duration
refers to how long a contraction lasts and is measured from the beginning of one contraction to the end of that same contraction.
effacement
the cervix effaces (thins) to allow the presenting fetal part to descend into the vagina.
engagement
signifies the entrance of the largest diameter of the fetal presenting part (usually the fetal head) into the smallest diameter of the maternal pelvis.
frequency
refers to how often the contractions occur and is measured from the beginning of one contraction to the beginning of the next contraction.
intensity
refers to the strength of the contraction determined by manual palpation or measured by an internal intrauterine pressure catheter. The catheter is positioned in the uterine cavity through the cervix after the membranes have ruptured.
lie
the relationship of the long axis (spine) of the fetus to the long axis (spine) of the mother. There are two primary lies: longitudinal (which is the most common) and transverse.
lightening
occurs when the fetal presenting part begins to descend into the maternal pelvis. The uterus lowers and moves into a more anterior position. The shape of the abdomen changes as a result of the change in the uterus.
molding
The changed (elongated) shape of the fetal skull at birth as a result of overlapping of the cranial bones
position
describes the relationship of a given point on the presenting part of the fetus to a designated point of the maternal pelvis
presentation
refers to the body part of the fetus that enters the pelvic inlet first (the "presenting part"). This is the fetal part that lies over the inlet of the pelvis or the cervical os.
The three main fetal presentations are cephalic (head first), breech (pelvis
station
refers to the relationship of the presenting part to the level of the maternal pelvic ischial spines. Fetal station is measured in centimeters and is referred to as a minus or plus, depending on its location above or below the ischial spines
Premonitory Signs of Labor
Cervical Changes- As labor approaches, the cervix changes from an elongated structure to a shortened thinned segment
Lightening - The uterus lowers and moves into a more anterior position.
Increased Energy Level (nesting) -Thought to be the result of an i
Factors Affecting the Labor Process
Traditionally, the critical factors that affect the process of labor and birth are outlined as the "five P's":
Passageway (birth canal)
Passenger (fetus and placenta)
Powers (contractions)
Position (maternal)
Psychological response
These critical factors
maternal pelvic quadrants
*The first letter defines whether the presenting part is tilted toward the left (L) or the right (R) side of the maternal pelvis.
*The second letter represents the particular presenting part of the fetus: O for occiput, S for sacrum (buttocks), M for ment
Labor is typically divided into four stages
dilation, expulsive, placental, and restorative
The female pelvis is classified according to four main shapes:
gynecoid, anthropoid, android, and platypelloid.
Labor is typically divided into four stages that are unequal in length.
the first stage, the fundamental change underlying the process is progressive dilation of the cervix. It is further divided into three phases: latent phase, active phase, and transition.
The second stage of labor is from complete cervical dilation (10 cm)
1. When determining the frequency of contractions, the nurse would measure which of the following?
a. Start of one contraction to the start of the next
contraction
b. Beginning of one contraction to the end of the same
contraction
c. Peak of one contracti
a. Frequency is measured from the start of one contraction to the start of the next contraction. The duration of a contraction is measured from the beginning of one contraction to the end of that same contraction. The intensity of two contractions is meas
2. Which fetal lie is most conducive to a spontaneous vaginal birth?
a. Transverse
b. Longitudinal
c. Perpendicular
d. Oblique
b. A longitudinal lie places the fetus in a vertical position, which would be the most conducive for a spontaneous vaginal birth. A transverse lie does not allow for a vaginal birth because the fetus is lying perpendicular to the maternal spine. A perpend
3. Which of the following observations would suggest that placental separation is occurring?
a. Uterus stops contracting altogether.
b. Umbilical cord pulsations stop.
c. Uterine shape changes to globular.
d. Maternal blood pressure drops.
c. After the placenta separates from the uterine wall, the shape of the uterus changes from discoid to globular. The uterus continues to contract throughout the placental separation process and the umbilical cord continues to pulsate for several minutes a
4. As the nurse is explaining the difference between true versus false labor to her childbirth class, she states that the major difference between them is:
a. Discomfort level is greater with false labor.
b. Progressive cervical changes occur in true labo
b. Progressive cervical changes occur in true labor. This is not the case with false labor.
The shortest but most intense phase of labor is the:
a. Latent phase
b. Active phase
c. Transition phase
d. Placental expulsion phase
c. The transition phase of the first stage of labor occurs when the contractions are 1 to 2 minutes apart and the final dilation is taking place. The transition phase is the most difficult and, fortunately, the shortest phase for the woman, lasting approx
A laboring woman is admitted to the labor and birth suite at 6-cm dilation. She would be in which phase of the first stage of labor?
a. Latent
b. Active
c. Transition
d. Early
Cervical dilation of 6 cm indicates that the woman is in the active phase of the first stage of labor. In this phase, the cervix dilates from 3 to 7 cm with 40% to 80% effacement occurring.
During the latent phase, the cervix dilates from 0 to 3 cm. Durin
Which assessment would indicate that a woman is in true labor?
a. Membranes are ruptured and fluid is clear.
b. Presenting part is engaged and not floating.
c. Cervix is 4 cm dilated, 90% effaced.
d. Contractions last 30 seconds, every 5 to 10 minutes.
True labor is characterized by contractions occurring at regular intervals that increase in frequency, duration, and intensity. These contractions bring about progressive cervical dilation and effacement. Thus, a cervix dilated to 4 cm and 90% effaced ind