PN 4002 Exam Prep
Active phase of 2nd stage: - ANSWER-From commencement of pushing until birth of
the baby.
Pressure on the rectum and elevator muscles provides stimulus for expulsive pushing
Allowing passive second stage: - ANSWER-Delayed pushing=higher spontaneous
vaginal birth rate
No difference in perineal trauma or SCN admission
Sl increased risk of low umbilical cord Ph
Decreased active second stage
Benefits of water immersion - ANSWER--Calming + relaxing
Feeling of weightlessness can relieve joint pressure
-Women may feel sheltered and protected
-Increased maternal satisfaction with their birth experience
Classification of perineal tears: - ANSWER-1 - tear in skin and underlying superficial
tissues (not muscle)
2 - into perineal muscle but not anal sphincter muscles
3 - through skin, superficial tissues, muscle and involves anal sphincter
4 -involves the perineal structures, EAS, IAS and rectal mucosa
Contraindications to a VE: - ANSWER--Vaginal bleeding including hx of bleeding in
pregnancy
-Placenta praevia
-Early rupture of membranes but not in labour
-Preterm labour
SHOULD BE SPECULUM
Define 2nd stage of labour - ANSWER-From full cervical dilation to the birth of the baby
Define FGM: - ANSWER-All procedures that involve partial or total removal of the
female external genitalia or other injury to the female genital organs for non-medical
reasons
Define pain + the causes of pain in labour: - ANSWER-Pain: unpleasant sensory
experience associated w actual or potential tissue damage
Pain in labour: caused by damage to the somatic or visceral tissues in labour caused by
the contraction of the uterine muscles, dilation of the cervix + descent of baby placing
pressure on the pelvis, vulva + perineum
, During 2nd stage: burning + stretching as the baby's head stretches the vagina, vulva +
peri
3rd stage: after pains
Definition of Labour - ANSWER-* regular & coordinated contractions of the uterus
* gradual effacement & dilation of the cervix
* expulsive contractions = expels baby
Describe common methods of non-pharmacological pain relief, including evidence, risks
and benefits - ANSWER-Breathing techniques: can reduce anxiety, induce sense of
calm + reduce tension
Heat: Blocks transmission of pain signals to the brain + provides sense of relaxation +
calm. Can be used where pain is felt most
Water:warm water helps to block transmission, running water may also provide
distraction + calming sensations. Water immersion can provide buoyancy + relieve
pressure + pain on the joints
TENs: low voltage electrical pulses are used to stimulate the nervous system:
- Blocks pain messages
-Stimulates + releases endorphins
-Provides a distraction
TENS: cannot be used in the back or shower + can interfere w ctg when an FSE has
been applied. Can be effective for posterior position baby
Describe common methods of pharmacological pain relief, including evidence, risks and
benefits. - ANSWER--Nitrous
-Morphine
-epidural
Describe factors that contribute to how women experience pain in labour and how the
midwife can help to reduce these factors - ANSWER-Complex factors interplay:
Physiological:
- Stage of labour + position of baby
-Length of labour + progress
-tired
-Induction can increase pain
Psychosocial:
- Woman's self-efficacy
-Tendency to catastrophes pain
-Level of anxiety
-Attachement pattern prior to labour
Active phase of 2nd stage: - ANSWER-From commencement of pushing until birth of
the baby.
Pressure on the rectum and elevator muscles provides stimulus for expulsive pushing
Allowing passive second stage: - ANSWER-Delayed pushing=higher spontaneous
vaginal birth rate
No difference in perineal trauma or SCN admission
Sl increased risk of low umbilical cord Ph
Decreased active second stage
Benefits of water immersion - ANSWER--Calming + relaxing
Feeling of weightlessness can relieve joint pressure
-Women may feel sheltered and protected
-Increased maternal satisfaction with their birth experience
Classification of perineal tears: - ANSWER-1 - tear in skin and underlying superficial
tissues (not muscle)
2 - into perineal muscle but not anal sphincter muscles
3 - through skin, superficial tissues, muscle and involves anal sphincter
4 -involves the perineal structures, EAS, IAS and rectal mucosa
Contraindications to a VE: - ANSWER--Vaginal bleeding including hx of bleeding in
pregnancy
-Placenta praevia
-Early rupture of membranes but not in labour
-Preterm labour
SHOULD BE SPECULUM
Define 2nd stage of labour - ANSWER-From full cervical dilation to the birth of the baby
Define FGM: - ANSWER-All procedures that involve partial or total removal of the
female external genitalia or other injury to the female genital organs for non-medical
reasons
Define pain + the causes of pain in labour: - ANSWER-Pain: unpleasant sensory
experience associated w actual or potential tissue damage
Pain in labour: caused by damage to the somatic or visceral tissues in labour caused by
the contraction of the uterine muscles, dilation of the cervix + descent of baby placing
pressure on the pelvis, vulva + perineum
, During 2nd stage: burning + stretching as the baby's head stretches the vagina, vulva +
peri
3rd stage: after pains
Definition of Labour - ANSWER-* regular & coordinated contractions of the uterus
* gradual effacement & dilation of the cervix
* expulsive contractions = expels baby
Describe common methods of non-pharmacological pain relief, including evidence, risks
and benefits - ANSWER-Breathing techniques: can reduce anxiety, induce sense of
calm + reduce tension
Heat: Blocks transmission of pain signals to the brain + provides sense of relaxation +
calm. Can be used where pain is felt most
Water:warm water helps to block transmission, running water may also provide
distraction + calming sensations. Water immersion can provide buoyancy + relieve
pressure + pain on the joints
TENs: low voltage electrical pulses are used to stimulate the nervous system:
- Blocks pain messages
-Stimulates + releases endorphins
-Provides a distraction
TENS: cannot be used in the back or shower + can interfere w ctg when an FSE has
been applied. Can be effective for posterior position baby
Describe common methods of pharmacological pain relief, including evidence, risks and
benefits. - ANSWER--Nitrous
-Morphine
-epidural
Describe factors that contribute to how women experience pain in labour and how the
midwife can help to reduce these factors - ANSWER-Complex factors interplay:
Physiological:
- Stage of labour + position of baby
-Length of labour + progress
-tired
-Induction can increase pain
Psychosocial:
- Woman's self-efficacy
-Tendency to catastrophes pain
-Level of anxiety
-Attachement pattern prior to labour
