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6 Cards in this Set
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First stage of labour |
The longest part of labour. At this stagge the cervix gradually opens up(dilates). Dilation of the cervix can only be assessed by an internal examination which can only be carried out by trained midwife or obstetrician. The dilation of the cervix usually takes between 8 - 10 hours and tends to last longer with the first baby. Show - A pink (bloodstained) mucous vaginal discharge lost from the cervix as it begins to dilate Regular contractions - Each time a contraction comes the uterus hardens and the mother feels pain in the abdomen and lower back. The pains, each lasting up to a minute and a half, ysually begin to be noticed at around 20 minute intervals and become more and more frequent. Admission to hospital is usually advised when they are coming every 10 minutes. Contractions can be very painful later in the first stage Rupture of the Membranes - Refered to as breaking of the waters, a suden uncontrollable loss of watery fluid from the vagina |
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Second stage of labour |
Where the baby descends through the birth canal to the outside world. Acute expulsion of the baby through the birth canal. It should not last for more than 2 hours but may be as short as 5 minutes. Labour is normally quicker in women who have had a previous pregnancy. Women with a history of rapid or precipitate labour should not be moved at all Ruptuure of the membranes - unless ruptured earlier Changes in contractions - They become stronger and more frequent 1 in 3 minutes - 1 in 2 minutes). The mother bears down with each pain. When she bears down she involuntarily takes a deep breath, holds it and bears down with her abdominal muscles, as in opening the bowels. This helps the uterus to expell the baby In the case of second or later pregnancies, do not transport the mother if the journey time to hospital is likely to take longer than her estimate based on the previous delivery time |
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Third stage of labour |
The expulsion of placenta and membranes may take between 15-20 minutes. After a pause, the cord will lengthen and pains will return. The mother may also experiance the urge to bear down as the placenta is delivered. This indicates that the placenta and membranes have seperated from the uterus and have entered the birth canal. A gush of blood can be expected but this should not usually exceed 200 - 300ml. Any loss estimated at 500ml or more is known as a post-partum haemorrhage (PPH) |
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Managing first stage of labour |
Encourage the mother to adopt the most comfortable position. This will probably be sitting or laying on her side in a left lateral position Provide entonox for pain relief. Inhalation should commence as the contraction is felt, before the pain is fully established |
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Managing second stage of labour |
Ask control to contact midwife and a second vehicle with a paramedic if you have not moved from the home address Parking safely and informing control if en route to hospital and a delivery appears imminent Preparing the strecher or bed with incontinencepads. Overlay with a sterile sheet from the obstetrics pack Having a towel or napkin ready in which to wrap the baby Opening and laying out the maternity pack Supporting the mother semi-recumbrant with pillows under her buttocks. The mother should not lay on her back because of the risk of supine hypotension Encourage the mother to continue taking Entenox to relieve the pain and discomfort Providing a blanket for warmth and modesty |
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Managing third stage of labout |
Not pulling the cord during delivery of the placenta as it may rupture, making delivery of the placenta difficult, causing excessive bleeding Allowing mother to expel the placenta naturally Delivering the placenta directly into a bowl or plastic bag and retaining all discharge for inspection by a doctor or a midwife If haemorrhage continues after placenta delivery or if it is estimated to reach 300ml, performing fundal massage may help reduce post-partum haemorrhage. This is achieved by feeling for the top of the uterous at approximately the umbilical region. Massage with a circular motion. The uterus should become firm as gentle massage is applied Note: Breast feeding will also help in reducing haemorrage but this would be at the discretion of the mother, not all mothers wish to or are able to immediately breast feed |
