Doula Training All Possible Questions and Answers with complete solution

0-4 centimeters dilation is considered - early labor. apgar - Activity- (muscle tone)- absent or arm/ legs flexed or active movement. Pulse-absent or below 100 bpm or above 100 bpm Grimace(reflex irritability)- no response or Grimace or Sneeze,cough,pulls away. Appearance- (skin color)- Blue grey, pale all over/ Normal except for extremities/ Normal over entire body Respiration- Slow/irregular or good/crying APGAR - The APGAR is a quick assessment of overall newborn well being. B.R.A.I.N. - B-Benefits What are the benefits of option proposed? Whether the decision is beneficial for you or your baby? R-Risk What are the risks of the proposed options? Whether these decisions negatively impact you or your baby? A-Alternative Any other options? Are there any other available alternative measures that may be more beneficial? I-Intuition What is your intuition telling you? Do you have any inkling about the decisions you Take? N -No What would happen if you choose not to do anything? Breech position - the baby's buttocks and/or feet, will be in place to be delivered first. Cephalopelvic Disproportion (CPD) - when a baby's head or body is too large to fit through the mother's pelvis.Consumer Advocacy - The act of informing and supporting a person so that he or she can make the best possible decisions for himself. Cord Prolapse - the umbilical cord drops (prolapses) through the open cervix into the vagina ahead of the baby. The cord can then become trapped against the baby's body during delivery. CPR stands for - Comfort, Praise, and Reassure Description of episiotomy - Just before the baby is born, the obstetrician numbs the vaginal area opening and makes one of two cuts: 1.) A mediolateral cut is angled down away from the vagina and into the muscle. 2.) A midline cut is made straight down between the vagina and anus. The cut is stitched closed after the baby and placenta have been delivered. Dilation of 4-7 centimeters - occurs during active labor. Dilation of 7-10 centimeters - is the transition phase Epidural - anaesthetic, used especially in childbirth to produce loss of sensation below the waist . In particular introduced into the space around the dura mater of the spinal cord . episiotomy - A procedure in which the skin between the vagina and anus is cut. (This area is called the perineum.) It is done occasionally to enlarge the vaginal opening so that a baby can be more easily delivered. Examples of Comfort - 1.) Gently massage hands and feet 2.) Speak softly 3.) Help mother change positionsExamples of Praise - 1.) Your doing a great job 2.) I'm so proud of you 3.) That's it, you've got it. 4.) They are getting stronger, but you are in control. Examples of Reassure - 1.) Your body is doing everything it knows to do. 2.) Your working beautifully through the contractions. 3.) Your doing exactly what you need to be doing. 4.) Yoiu are focusing 5.) Hang in there 6.) Your body is limp, loose, it's heavy. Fetal distress - Condition when the baby is not receiving enough oxygen or is experiencing some other complication. First stage - Labor: LATENT PHASE - 1.) Ask "What is going through your mind during these contractions?" 2.) Say "You're going to do exactly what you need to do to birth this baby". 3.) Suggest modifying thoughts, or reinforce coping thoughts, images. 4.) Feedback, not false praise. 5.) Assist with muscle relaxation. First stage - Labor: LATENT PHASE - 6.) Focus eyes on her during contractions- undivided attention 7.) Respond to her comments-don't ignore what she says. 8.) remind her of comfort measures and positions, drinking and peeing. 9.) Describe to her "how" to relax. First stage - Labor: LATENT PHASE - Characteristics/ emotions: *Dilation, 0-4 cm. *Cervix continues ripening, effacing, begins dilating. *Progressing contractions, possibly with bloody show. *Possible rupture of membranes.*Woman may need to begin using coping measures for contractions. *Excited, sociable, confident, optimistic or anxious, distressed. Forceps - Forceps are an instrument used in helping in the delivery of newborns during difficult labors. They look somewhat like a large set of tongs. The forceps are applied to either side of the baby's head and the physician uses them to help pull the baby from the vagina. While a forceps delivery does increase the chances of injury to the woman's pelvic floor and potential trauma to the baby(including some bruising on the fact) H.I.P.A.A. - Health Insurance Portability and Accountability Act Was enacted to insure the privacy and confidential handling of medical information for all patients in the U.S. Heparin or Saline lock I.V. - A type of vein access that is used for many low risk mothers in labor at a hospital. It allows immediate access to the vein in the event of a complication, to delivery IV pain medications like Stadol, Demerol, etc., should the mother request epidural anesthesia, require a cesarean section (c-section) or have a postpartum hemorrhage.This catheter can also be used to deliver other medications like antibiotics for brief periods of time should the mother be group B strep positive or have had her water broken for more than 18 hours. Some hospitals have a protocol to only use saline in the IV, this keeps the IV flushed and opened. Some hospitals still use heparin, a blood thinner, as they are starting this type of IV access. This is not always the case. Since the saline lock can be converted to a full scale IV at any point, this is often written into the birth plans of mothers wanting and natural childbirth. How the body works to birth a baby: - 1.) Uterus contracts-First stage 2.) Regular contractions dilate(Open) and efface (thin) the cervix. 3.) Baby Descends, moves down 4.) Baby is born- Second stage- 5.) Placenta is delivered-Third stageInformed Consent - To give permission for a procedure, after being given and understanding information about a procedure, benefits, risks, possible complications and alternatives. Mal-Presentation position - An abnormal position of a baby's body or head during childbirth. Notice of Privacy Practices - All persons you collect information from either directly or indirectly is to be notified of their rights to privacy and what you do with their information. It must be signed by the patient or the patient must sign on a HIPAA consent form that they have r/c a copy of your privacy practices prior to signing a HIPAA consent. Pitocin - Pitocin is a liquid medication that is a synthetic form of the naturally occurring hormone, oxytocin. Pitocin is diluted with a standard saline solution an introduced into your body by I V drip. The medication is regulated on a medication pump. This is an attempt to minimize complications and to help your doctor or midwife mimic normal labor as much as possible. Placenta previa - In this condition, the placenta is attached too low in the uterine wall and blocks the baby's exit through the cervix. Planning your pregnancy may help you to: - 1.) conceive more easily 2.) have a healthier pregnancy 3.) avoid or minimize pregnancy complications 4.) give birth to a healthier baby 5.) recover more quickly and easily after giving birth 6.) have a more pleasant postpartum (post birthing) experience 7.) minimize your child's risk of future adult health problems. Pre Labor - 4.) Encourage clear liquids 5.) Time contractions, 4 or 5 at a time, every few hours or when labor seems to have changed. 6.) Begin to prepare the client mentally" you get to make the decision to work with your body".Pre-Labor - 1.) Encourage mom to do things that will distract her, if possible get out, finish project, have friends in 2.) Encourage restful activities, alternate with distraction; bath, music, laying down, massage, dark room, etc. 3.) "Give yourself permission to labor and birth your baby" Pre-Labor - Characteristics/ emotions: *Cervix ripens, effaces and moves forward. *Non-progressing contractions; possible "restless" backache *Soft bowel movements *Menstrual-like cramps *May be tired, discouraged, anxious, if it is long and/or painful *May overestimate progress, start comfort techniques, go to hospital too early *May focus more than necessary on the contractions