Stages of pregnancy: labor
Braxton Hicks contractions
- are sporadic uterine contractions - are not usually felt until the second or third trimester of pregnancy - can be confused with the contractions which occurs during labor
Contractions
- are the tightening and relaxing of the uterus Are not Braxton Hicks contractions if: - the contractions are regular and get progressively stronger and closer together - the contractions last more than 30 seconds and get progressively longer, up to 90 seconds
Stage 1: dilation stage
- begins with the onset of regular uterine contractions - extends until the cervix dilates to a diameter approximately the size of the fetus's head - dilation is necessary for the fetus to move through the birth canal. - commonly lasts eight to 24 hours, but can be as short as a few minutes - involves the rupture of the amniotic sac: " The water breaking" Epidural Block, the local anesthetic delivered to block pain from the waist to the feet, may be given during the first stage
Stage 3: placental stage
- involves the expulsion of the placenta from the uterus - contractions of the uterus cause the placenta to tear away from the uterine wall - lasts from a few minutes to 30 minutes Average labor and delivery time is 12 to 14 hours, but any length of time up to 24 hours is considered normal.
Labor
- is the period during which contractions occur and result in the expulsion of the fetus from the uterus - occurs in three stages
Stage 2: expulsion stage
- lasts from the time of maximum dilation until the baby exits the vagina - may last for my minute to an hour or more - involves contractions of the abdominal muscles assisting the uterine contractions - can also be called the "pushing" stage - Is when "crowning" occurs: when the baby's head becomes visible at the opening of the vagina - Is usually the most painful stage An episiotomy may be performed. It is a small incision in the skin below the vagina which prevents tearing of the vagina tissues as a baby emerges.
Stages of labor
Include three: - Stage 1: dilation stage - Stage 2: expulsion stage - Stage 3: placental stage
Types of birth
Include: - Vaginal: baby delivered through the birth canal - Caesarean: fetus is delivered through an incision in the mothers abdomen
Signs of labor
Include: - effacement: ripping of the cervix - dilation: opening of the cervix - bloody show: loss of mucous plug - nesting: spurts of energy - rupture of membranes: water breaks - contractions: labor pains
Newborns
Are evaluated soon after birth to assess their physiologic condition by an assessment called Apagar score - - - the test is named for Virginia Apgar, the physician who developed the test - the test also stands for appearance, pulse, grimace, activity and respiratory effort
Apgar Rating Scale
Each characteristic is rated on a scale of 0 to 2 - 2 denotes normal function, 1 denotes reduced function, 0 denotes seriously impaired function - total Apgar score is the sum of the scores from the five characteristics - an Apgar score of 8 to 10 is considered normal at 1 to 5 minutes after birth
Caesarean delivery
May be recommended if: - breech presentation (fetus' feet or buttocks) - unfavorable shape of pelvis - large fetus (over 8 lbs.) - premature rupture of amniotic sac - active genital herpes - fetal distress (significant increase or decrease in fetal heat rate) - prolonged pregnancy (more than 42 weeks)
Example of Apgar Rating Scales
Physiologic condition: 0: appearance (skin color): White or blue, pulse rate: no pulse, grimace: no response, activity: no movement, muscles flaccid, respiratory effort: no respiration 1: appearance (skin color): limbs blue, body pink, pulse rate: 100 bpm, grimace: facial grimaces, slight body movement, activity: limbs partially flexed, little movement poor muscle tone, respiratory effort: slow, irregular respiration 2: appearance (skin color): pink, pulse rate: >100 bpm, grimace: facial grimaces, extensive body movement, activity: active movement, good muscle tone, respiratory effort: good, regular respiration; strong cry