NUR 211 FINAL
COMPREHENSIVE STUDY GUIDE
2026
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True labor
• ● Contractions close together at regular intervals
• ● Last longer and more intense
• ● Consistent and bring about cervical change (dilation)
Factors affecting the labor process: 5 P
Passageway (birth canal)
• ● Gynecoid is the most optimal shape
• ● This type of pelvis allows early and complete internal fetal rotation during labor
• ● Cervix effacement: thinning of the cervix-the process of cervical effacement and
dilation is analogous to that of pulling a turtleneck over your head
Passenger
● Head:
o ○ Molding- the changed shape of the fetal skull at birth as a result of the
overlapping cranial bone goes down in about 3 days
o ○ Sutures play a role in helping identify the position of the fetus head
● Attitude
● Lie
● Presentation
o ○ Feeling head, sometimes hand/arm is in the way o ○ Shoulders will not fit
through the pelvis first
o ○ The head of the fetus is the 1st part of the fetus to enter the pelvic inlet
● Position ● Station
o ○ Cervical exams are based on the baby’s position by feeling the bony parts of
the pelvis
o ○ Document and relay to the provider
o ○ This will help determine if the baby is descending out of the mom ●
Engagement
Powers (contractions)
• ● Causes effacement
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• ● Frequency to how often the contractions occur and is measured from the beginning
of one contraction to the beginning of the next
• ● Duration refers to how long a contraction lasts and is measured from the beginning to
end
• ● Intensity refers to the strength of the contraction determined by manual palpitation
or by an internal intrauterine pressure catheter
• ● Primary: contractions, secondary: pushing
Position (maternal)
● Lithotomy: increase control of the provider and improves the ability to monitor the fetus
● Upright: decrease labor time, increase the rate of vaginal delivery, increase comfort, and
gravity of the fetus to move downward
○ Squatting
○ Standing
○ Walk around, sit up in different positions, birth ball
Psychological response
Factors promoting a positive birth experience
• ● Support- not being alone
• ● Sense of mastery self-confidence
• ● Trust in the staff caring for her
• ● Positive reaction to the pregnancy
• ● Personal control over breathing
• ● Preparation for the childbirth experience
● emotional, physical, and spiritual support during labor is the norm in most cultures
● Clear information about procedures Patient
• ● Help manage the labor process
• ● Feeling in control
• ● Less medical intervention required
• ● Less likely to require analgesia or anesthesia
• ● Less likely to have C-section
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