Chapter 6 Maternity and Pediatric Nursing
The powers of labor - Are the forces that cause the cervix to open and that propel the fetus downward through the birth canal. The two powers are the uterine contractions and the mothers pushing efforts. Uterine contractions - Primary powers of labor during the first of the four stages of labor. They are involuntary smooth muscle contractions. The intensity and effectiveness of these contractions depend on walking, drugs, maternal anxiety and vaginal examination. Contractions allow the uterus to efface (thin) and dilate (open) to allow the fetus to descend into the birth canal. Effacement - Is determined by the vaginal examination and is described as a percentage of the cervical length. Before labor the cervix is about 2-3.8 cm long and 10cm( dilation is described in cm) when fully dilated. When the cervix is 100% effaced, it feels like a thin, slick membrane over the fetus. Dilation is determined during a vaginal examination. Both dilation and effacement are estimated by tough rather than being precisely measured. Phases of Contractions - 1. Increment: The period of increasing strength 2. Peak, or acme: The period of greatest strength 3. Decrement: The period of decreasing strength Contractions are described by their average frequency, duration, intensity, and interva
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