Summary Normal Labor and Delivery In-class activity

Normal Labor and Delivery In-class activity What is labor - - Involuntary uterine contractions that result in effacement and dilation of the cervix False labor vs true labor - - False labor cxns: - Irregular, do not become consistent - Stop with walking or with positional change - In abdomen only - Weak, do not get stronger - No cervical change - True labor cxns: - Regular and get closer together - Increase, despite movement - Back to front - Strength increases - Cause cervical change Cervical exam in labor 3 key parts: - 1) Dilation 2) Effacement 3) Station Dilation exam - - Determine how far the cervix has dilated - Fully dilated = 10 cm - Measured from 0-10 - How much is the os open - 1 finger is about 1 cm, 2 fingers on top of each other is 2 cm, 2 fingers sideways is 3, 3 sideways is 4, etc. and then if you only feel head then they are fully dilated Effacement - - Process of cervix softening and thinning out - Expressed as percentage Station - - Where the presenting part (usually the head) is in relation to the ischial spines (how high the baby is in the birth canal) - Station 0 is when the fetal vertex is at the level of the ischial spines What station is crowning - +3 Vaginal exam - - Written as: 3cm / 70% / -2 (dilation, effacement, station) - Primiparas: Effacement then dilation - Multiparas: Dilation then effacement Fetal presentation, fetal lie, position - - *Fetal presentation* = Fetal part most dependent in birth canal (vertex, brow, breech) - *Fetal lie* (either longitudinal or transverse - *Position* = where the infant's occuput is in relation to the left or right in maternal pelvis Vertex vs brow vs breech vs sideways vs face - - Vertex = head down (mc) - Brow = neck is flexed backwards - Breech = butt first - Shoulder = sideways - Face = completely sideways head first Fetal position - - Relation of back of fetal head to mothers pelvis - Left Occiput Anterior (LOA) to mom means occiput is towards the pubic symphysis and towards the left