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, Passageway Maternal Pelvis (size and shape)
Gynecoid (round)=approximately 50%
Soft tissues (lower uterine segment, cervix, pelvic floor muscles, vaginal canal)
Passengers Fetus and Placenta
Fetal head Size and ability of the fetal head to change shape (molding) are important
characteristics
Fetal attitude Relation of fetal body parts to one another
(general flexion=most common; when not in this position progress can be
impeded)
Fetal presentation The part of the fetus that enters the pelvis first
EX:
cephalic
breech
shoulder
Station The relationship of the presenting part to the maternal ischial spines; measures
the degree of descent of the fetus.
*zero station=maternal ischial spine
*negative station=further inside birth canal
*positive station=further down the birth canal
Fetal Lie Relationship between fetal spine to maternal spine (longitudinal or transverse)
Fetal position Relationship between presenting part and maternal pelvis
(ex: Right, Occiput, Anterior)
Powers Primary powers: uterine contractions; intensity, duration, frequency
Secondary powers: Effectiveness of maternal pushing
Position during labor Upright is optimal
Changing positions is encouraged
If the woman needs to lay in bed, frequent position changes are encouraged; this
facilitates labor progression and reduces pain
Psychological response (labor) Preparation for birth (physical)
Sociocultural influences
Previous birth experience (good or bad)
Social support
Emotional status (mental wellbeing)
Premonitory signs of Labor Lightening
return of urinary frequency
low backache
Stronger Braxton hicks contractions
Weight loss of 1-3.5lbs
Surge of energy
Increased vaginal discharge or bloody show
Cervical changes (softening, shortening, opening)
Possible rupture of membranes
Physiology of Labor Hormones (estrogen&progesterone)
Progesterone facilitates cervical changes
Estrogen stimulates uterine contractions