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176 Cards in this Set

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Toxoplasmosis
"Toxoplasmosis is known to cause severe neurological damage to the fetus, but only if contracted after 10 wks. Mothers can minimize their chances of contracting toxoplasmosis by avoiding uncooked meat and any contact with cat feces," (p. 16)
What is varicella?
Varicella is chicken pox and can be extremely dangerous in pregnancy. p. 16
What is cytomegalovirus?
"Cytomegalovirus is a farily common infection--60% of the general population has antibodies--and is most damaging in the 1st trimester," p. 16
Define hyperemesis gravidarium.
Nausea and vomiting that is chronic and self perpetuating. May be unable to retain food or liquid and may require IV therapy. Theories of causes include emotional issues or elevated estrogen levels irritating the liver.
Hyperemesis gravidarium: herbal remedy
Ginger Root. Three times daily. Fresh grated in tea or ground in capsules.
Common complaints of early pregnancy: Fatigue. List 2 possible causes.
1. elevated hormone levels
2. anemia, esp. if combined with dizziness or nausea beyond the 1st trimester. (p. 17)
Urinary Tract Problems
(list symptoms)
Symptoms of UTI
1. stinging
2. urgency
3. pain after urination
may be nearly absent in pregnancy due to progesterone's softening effect on the urethra (p. 17)
Pyelonephritis
Define and Describe Consequences on Pregnancy
Pyelonephritis is a kidney infections. Kidney infections can lead to premature labor. (p. 17)
Teratogen. Define
"Any substance that can harm the fetus or cause fetal anomalies is called a teratogen," (p. 17)
Describe Continuity of Care and it's importance to midwifery practice.
"Midwives typically provide comprehensive, continuous prenatal care. By doing so, they get to know clients well enough to have some sense of what to anticipate at the birth. Careful prenatal assessement is the cornerstone of effective midwifery practice...Every mother's condition is unique and can only be appreciated by regular contact," (p. 17)
Health History: History of Abortion. Describe potential implications for pregnant woman and this pregnancy/birth.
--type of procedure(suction less traumatic than D &C, D&C more likely to cause scarring.
--emotional effects?
--any issues with bleeding or infection?
--did she receive rhogam if rh neg?
Gynecological Surgeries: cervical procedures used to remove abnormal cells may result in scarring that retards dilation. List 3 such cervical procedures
1. cone biopsy
2. cervical cauterization
3. cryosurgery
(p. 15)
Gynecological Surgeries: cervical procedures. List something a midwife can suggest to a client to help with scar tissues.
"Scar tissue can be softened by evening primrose oil massaged gently onto the cervix during the last few weeks of pregnancy," (p. 15)
Gynecological Surgeries: List the two problems with pregnancy/labor that are correlated with the LEEP procedure.
1. incompetent cervix
2.premature labor
Gynecological History: Fibroids: Describe the impact of Fibroids on childbearing.
"These benign uterine masses vary in size but tend to grow considerably during pregnancy...pregnancy may be affected by reduced intrauterine space or disrupted placental implantation and the immediate postpartum may be complicated by hemorrhage," ( p. 15)
Family History: List two conditions the midwife should ask about.
1. hypertension
2. diabetes
Herpes: What is the most dangerous trimester for the fetus for an initial outbreak of herpes?
The first trimester is the most dangerous time for an initial outbreak, (p. 16)
Herpes: True or False. Some midwives permit vaginal birth.
True. "If lesions are present externally, but not in the immediate path of the baby some midwives permit vaginal birth. Lesions must be covered with surgical adhesive film or spray on bandage," (p. 16).
Obstetrical History: List 9 things the midwife should ask about a woman's obstetrical history.
abruption, fetal distress, prior transports, hemorrhage, shoulder dystocia, neonatal asphyxiation, previous stillbirth, perceived losses/disappointments, child spacing (p. 14)
Contraceptive History: "If the mother used oral contraception immediately prior to pregnancy, she may be deficient in ___________ and should be advised to begin supplementation at once."
folic acid (p. 16)
Naegele's Rule
Naegele's Rule is a formula for calculating estimated date of delivery. Take the first days of her last menstrual period, count back three months and add one week. (p. 18)
Define LMP
the first day of a woman's last menstrual period.
List medical and high risk factors for pregnancy. (13)
diabetes, thyroid disease, active tuberculosis, chronic lung disease, sever asthma, epilepsy, clotting abnormalities, rh neg with antibodies, severe anemia, acute viral infection, congenital heart disease, renal disease, extreme obesity (pp. 19-20)
List lifestyle and personal factors that are high risk in pregnancy. (5)
1. tobacco use
2. Malnutrition
3. Drug addiction
4. Moderate to heavy alcohol use.
5. Heavy caffeine use. (p. 20)
Define the dangers associate with diabetes to the fetus and woman.
"Fetal demise after 36 weeks, 5 x the normal incidence of fetal abnormalities, increased polyhydramnios, 30-50% higher incidence of preeclampsia, increased incidence of prematurity and newborn respiratory difficulties. (p. 19)
Describe the impact of active tuberculosis on childbearing.
1. slightly higher risk of premature labor
2. slightly higher risk of miscarriage
3. after birth: baby must be separated from the mother if the mother is infectious
High risk factors in pregnancy: epilepsy
Describe the impact of epilepsy on pregnancy.
"Dangers: Anticonvulsant drugs may cause folic acid deficiency, which when treated with folic acid may cause seizures. the infant may develop deficiency of coagulation factors,"(p. 19)
Afibrinogenemia, hypofibrinogenemia, excessive fibrinalytic activity are examples of __________________.
clotting disorders (p. 19)
High Risk Factors in Pregnancy: Clotting Disorders. Describe the impact of clotting disorders on pregnancy.
"Dangers: can lead to maternal bloodl loss, shock or death," (p. 19).
List two dangers to the fetus/baby when the mother is rh - with antibodies.
1. hemolytic anemia
2. fetal or neonatal death
(p. 20)
Name 5 dangers to the mom or baby associated with severe anemia, including hereditary anemia like Thalassemia B or sickle cell, or nutritional anemia (iron, B12 or folic acid.)
1. maternal infection
2. prolonged labor
3. IUGR
4. hemorrhage
5. fetal hypoxia during labor
List 4 dangers to the fetus associated with more than 10 cigarettes daily.
1. IUGR
2. miscarriage
3. congenital heart disease
4. fetal hypoxia in labor
Risk Factors: Lifestyle and Personal: Drug Addiction. List up to dangers to fetus or mother associated with drug addiction.
1. IUGR, 2. fetal hypoxia, 3. respiratory distress syndrome, 4. maternal malnutrition, 5. infection, 6. preeclampsia, 7. dysfunctional labor, 8. hemorrhage, 9. baby withdrawal from cocaine, crack or amphetamines, (p. 20)
High Risk Factors: Lifestyle and Personal: Heavy Caffeine Use.
What are the impacts of heavy caffeine use (in excess of 10 cups a day)?
"Dangers: Fetal malformations, heart defects, reproductive problems," (p. 20)
True Pelvis and False Pelvis. Describe the difference between the True and False Pelvis.
"The true pelvis includes all dimensions from the inlet downward and the false pelvis includes the illiac crests or hip bones, above. Though disconcerting, this terminology serves to illustrate that hip size is unreliable in predicting pelvic capacity," (p. 25).
Describe how you would do a bimanual exam to size the uterus and confirm EDD.
16 wks or less. "Press up firmly on the cervix while using your other hand to palapate the fundus. As you bring your hands together, you will get an idea of how large the uterus has grown. 10wks: around pubic bone, 12 wks: a few cms above pubic bone., 16 wks: midway between pubic bone and umbilicus (p. 23)
Prenatal care: check her urine: Ketones. What does the presence of ketones signal?
Ketones in the urine "signal inadequate food intake or dehydration," (p. 21)
Establishing baseline reflexes is suggested early in prenatal care.
Why?
"Since heightened reflexes can be a signal of preeclampsia, it's wise to establish baseline reflexes as soon as possible," ( p. 21)/.
Name the five steps/assessments that made when performing pelvimetry.
1. assess the depth of the sacral curve
2.assess the size of the pelvic inlet
3. assess the contours and distance between the ischial spines
4. assess the angle or width of the pubic arch
5. assess the outlet dimension or the intertuberous diameter.
Name the four basic pelvis types
gynecoid
android
platypelloid
anthropoid
(p. 24)
Describe the android pelvis.
"prominent close set spines,tapering sidewalls, narrow pubic arch (less than 80 degrees), and close set tuberosities," (p. 25).
Name the four pelvic joints.
1. symphysis pubis joint
2. sacrococcygeal joint
3 and 4. two sacroiliac joints
Name and describe the "3 Ps"
1. passage is defined as the bony pelvis and musculature, 2. the passenger is the baby and how it is presenting, 3. the powers refer to uterine activity during labor (p. 25).
During a typical prenatal a midwife may make the following 4 physical assessments of the mother.
1. check her weight
2. check her urine
3. check her blood pressure
4. check her pulse
Fetal Lie. Define fetal lie and list the three possible fetal lies.
"Fetal lie--the relationship of the baby to the long axis of the mother's body,"
longitudinal, oblique or transverse (p. 28).
Define denominator
Whatever the presentation, the denominator is the part of the baby's body that is used to determine the position of the baby. (p. 28)
List the denominator for each of the following presentations:
cephalic, breech, shoulder
cephalic--occiput
breech--sacrum
shoulder--scapula
Define presentation.
Presentation describes part of the baby that is in the pelvis. In a longitudinal lie the presentation is either cephalic or breech. In a transverse lie the shoulder presents. (p. 28)
Define attitude.
Attitude describes the degree of fetal head flexion.
Define fetal position.
Fetal position describes the location of the denominator within the mother's pelvis. For example, a head down baby with it's occiput on the mother's right size is right occiput transverse (ROT) p. 30
What is the norma rate ofl Fetal Heart Tones?
120-160 beats per minute, in younger babies the FHT may be up to 170, (p. 30)
Check for variability: Variability typically occurs in response to _________(3) and is considered a sign of _____________ health.
FHR accelerates in response to palpation, uterine contractions or the baby's own movements and is a sign of neurological health.
What does a Complete Blood Count, or CBC comprise?
CBC typically test for red blood cell count, hemoglobin, hematocrit, white blood cell count (leukocytes) and platelets among other things.
Define hemoglobin. A woman's hemoglobin should be above _____ when pregnant.
Hemoglobin enables the transport of oxygen. Hemoglobin should be above 11.
Define Hematocrit.
Hematocrit is the precentage of red blood cells per total blood volume. Hematocrit values on the CBCshould be 33 or more, (p. 35).
Lab work: Syphilis Screen: describe the risk of syphilis to the pregnant woman and her fetus.
"Syphilis can casue miscarriage, prematurity, neonatal infection, fetal malformation or death," (p. 36).
Lab work: Syphilis Screen: A woman who does not have syphilis will have a ____ test result.
nonreactive or (NR)
Lab Work: Syphilis Screeen:
on lab results the abbreviation for the syphilis screen is____.
VDRL/RPR
A pap smear takes cells from which part of the cervix?
The squamo-columnar junction, where red endocervical cells lining the cervical canal meet the pink, mucosal cells covering the cervix and vagina. p. 36
What is HPV?
Human papilloma virus. "HPV is now the most prevalent sexually transmitted disease...There is no cure for the disease. Certain types of HPV are know precursors to abnormal cell growth." P. 36
What is condyloma accuminata?
condyloma accuminata are visible genital warts or flat lesions caused by HPV, they are generally painless and often go unnoticed. p. 36
Describe the most common difference between chlamydia infection in males and females.
Women are rarely symptomatic, but their male partners may have discharge or pain and burning with urination. p. 36
What are the risks to the baby when a woman has chlamydia?
"Chlamydia can infect the urinary tract, leading to premature labor. With delivery the baby has a 70 percent chance of infection, which can reslut in conjunctivitis or...pnemonia," p. 37
What does it mean if a woman's lab result states that she is HbsAG positive?
The woman has gthe presence of surface antigens for hepatitis B. This woman has Hep B and has a high risk of transmitting the disears to her newborn. p. 37
How is Hepatitis B transmitted?
Hep B is "transmitted throught blood or blood by-products, saliva, vaginal secretions or semen.This disease is highly contagious," p. 37
Perinatal transmission of Hepatitis C is how common?
a. <1%
b 5%
c. 20%
d. 55%
e. 100%
Perinatal transmission is approximately 5% (depending on the amount of virus in the mother's bloodstream. But breastmilk is not affected," p. 37
The ELISA test is a screen for what disease?
HIV. The ELISA tet is highly sensitive, but has a false positive rate of up to 10%. p. 37.
Rubella antibody titre reveals lack of immunity to rubella, active immunity from illness or vaccination or a current or recent infection. What are the risk to the baby from rubella during pregnancy?
A baby in utero during a rubella infections has a "20% chance of heart, vision or hearing defects," p. 38
Rh Factor: approximately what percentage of the population is rh negative?
17% of women are rh negative
p. 38
Describe isoimmunization.
Isoimmunization can occur after the blood of an rh+ fetus enters the circulation of a rh- mother. The mother will produce antibodies against the pos blood which may render a future rh+ baby severly anemic. p. 38
An undiagnosed/untreated UTI can lead to a kidney infection.
What is another name for kidney infection?
pyelonephritis p. 38
Kidney infections put a woman at risk for what condition/complication?
pre term labor
p. 38
PPD screens for what disease?
tuberculosis
p.38
Genetic Screening: ethnic groups and risk
Greek/Italian ____________
Asian/Filipino____________
African/Black____________
Ashkenazi Jews
Northern European_________
Greek/Italian: A-Thalassemia
Asian/Filipino: B-Thalassemia
African/Black: Sicke Cell
A. Jews: Tay Sachs, Canvan
N. European: Cytstic Fibrosis
Alpha Fetoprotein Screening is the first layer of genetic screening. When is it offered and what does it test for?
--offered at 15-20 weeks
--tests for neural tube defects, anecephaly, microcephaly, hyrdocephaly, spina bifida and up to 20% of down syndrome.
What is a drawback of Alpha Fetoprotein Screening?
This test has a high false positive--up to 20% p. 39j
The triple screen combines what three screenings?
1. Alpha fetoprotein testing
2. hCG levels
3. unconjugated estrogen levels. More accurate than the AFP alone and lovwer flase positive rate of 5% p. 39
When is the optimal time to do an amniocentesis?
14 to 16 weeks. It is not performed before 14 weeks because there is not enough fluid. p. 39
What is the triple screen?
A screening for abnormalities that combines AFP with HCG levels and unconjugated estrogen levels. It is more accurate than the AFP alone and detects 65% of down syndrome, 80-85% of neural tube defects and has a false positive rate of 5%
If a woman has a positive triple screen, what is the next recommended test?
Amniocentesis
When is amniocentesis performed?
14-16 weeks
Chorionic Villus Sampline
Can be performed at 10-12 weeks; placental tissue is obtained through the cervix; has both high false positive and false negative rate
Glucose testing: A woman's blood is drawn _____after consuming _______mg of glucose.
Glucose testing: A woman's blood is drawn one hour after consuming 50mg of glucose
What is a "bad" reading of the glucose screen?
140
GBS: symptoms in the newborn
breathing problems or cessation, spinal meningitis
Fetal development: Embryonic Period. Define.
3-9 weeks from LMP or 1st-7th week post fertilization.
Fetal Period. Define
All development from embryonic period to birth.
Sperm and ovum fuse to form a __________.
zygote
What is the haploid number?
The 23 chromosomes of the sex cells
What is the diploid number?
46 chromosomes
What is a gamete?
Gametes are the sex cells.
What hormones may cause morning sickness?
hCG and estrogen
List four remedies/strategies for morning sickness.
1. crackers or yogurt before rising from bed
2. small meals throughout the day.
3. ginger
4. 50 mg Vitamin B6
List four remedies/strategies for heartburn.
1. frequent, small meals
2. digestive enzymes
3. avoid food before lying down
3. less fat
Pruritis
Skin itchiness that occurs in the 3-14% of pregnancies. May be related to liver compromise.
Natural remedies and foods for pruritis. (9)
dandelion root, Yellow Dock, beets, dark greens, lemons, olive oil,brewer's yeast egg yolk, wheat germ
A pregnant woman needs _____calories/day and a nursing mom needs ______calories/day
pregnant: 3000
nursing: 4000
What can you apply to herpes lesions for healing and soothing? (6)
lysine ointment, cold milk, zinc oxide, A&D ointment, ice, calendula cream
What supplement and at what dosage is recommended for herpes?
Lysine, 500mg
What is the antecubital space?
Bend at the juncture of the upper and lower arm.
The systolic pressure reading measures what?
The systolic reading measures pressure in the arteries when the heart is actively pumping.
What does the diastolic reading measure?
The diastolic pressure measures the pressure in the arteries when the heart is at rest.
Herbal Remedies for Headache (3)
Hops, Skullcap and Chamomile
Describe the technique for CVAT
Woman sits, back fully exposed. Place your hand below the lowest rib, nearest her waist and adjacent to her spine on either side. Make a fist and gently strike your hand. If the woman jumps or indicates pain, refer to physician.
Varicose veins of the legs and vulva. Causes.
high levels of progesterone relaxes the smooth muscles and hinders venous return throughout the body. Heredity plays a role.
What vitamin may help with varicose veins?
Vitamin E, 800 IU
Constipation. Causes and remedies.
Causes: hormones or diet
Resovled by: fluid, fiber and exercise
Vaginal Infections: Yeast: Why are yeast infections more common in pregnancy?
Valginal alkilinity is increased in pregnancy.
Bacterial Vaginosis. List 3 potential complications arising from BV infection.
1. chorioamnionitis
2. PROM
3. preterm labor
Bacterial Vaginosis: signs and symptoms
fish odor, thin, grey or white discharge, seldom is the vagina inflammed or itchy.
The whiff test is a test for ________. How does the practitioner perform a whiff test?
BV. Touch a cotton swab saturated with discharge to KOH solution; if it lets off a potent fishy odor, it is BV.
Home/Natural protocol for BV
abstain from intercourse during treatment, insert a peeled, unnicked clove of garlic into the vagina, change 3 x daily, foolow with 5 days of acidophilus treatment
Trichomonas signs and symptoms.
foul smelling, highly irritatin, yellow green frothy discharge.
True or False. Trich is sexually transmitted.
True.
General dietary recommendations for vaginal infections.
dark green vegetables, high quality protein, whole grains, citrus, yogurt, brewer's yeast, acidophilus and fluids. Eliminate sugar, including excessive fruit.
Herpes: Under what conditions might a homebirth midwife consider a vaginal birth during a herpes outbreak at term?
1, The outbreak is non-primary
2. Sores are external
3. Sores are healing
4. Use adhesive surgical film or bandages.
List the 6 herbs for the vaginal infection douche described in Heart and Hands.
Comfrey, Mugwort, Peppermint, Yarrow, Rosemary and Alum
Rubella titre: A high titre may indicate_________ and a low titre indicates____________.
High titre 1:64 may indicate recent or current infection. A low titre 1:10 indicates susceptibility to infection.
Elevated TSH is correlated with ________.
Miscarriage and fetal or neonatal death.
What is chorioamnionitis?
Infection of the membranes.
What does the HA1c blood test for ? (also known as the HbA1c). What is the normal range?
HA1c test for the "average amount of glycohemoglobin or blood sugar, over the past 2 months." More accurate. Normal 4-6%
Gonorrhea: complications (4)
1. chorioamnionitis
2. PROM
3. premature labor
4. eye infection or blindness
Pap Smear: What are the two methods for performing a pap smear?
Slide method and thin prep method. In both methods our take your brush, spatula or cytology spongs and gently rotate 360 degrees at this juncture. Slid method, spread sample on the slide, spray with fixative, air dry, label. Thin prep: stir brush into the solution.
Define the squamo-columnar junction.
The squamo columnar junction is the usual site for abnormality, where the red, columnar cells lining the cervical canal meet the pink, mucosal cells covering the cervix and the vagina.
Pelvimetry: What is an adequate obstetrical conjugate?
>10.5 cm
Pelvimetry: What five things are you assessing when your do pelvimetry?
1.the depth of the sacral curve
2. the size of the pelvic inlet
3. the contour of and distance between the ischial spines
4. the angle or width of the pubic arch
5. the outlet dimension or intertuberous diameter
List 5 iron rich foods listed in Heart and Hands?
Organ meats, pumpkin seeds, dried fruit, almonds, greens
List the four pelvis types.
Gynecoid, anthropoid, platypelloid and android.
Describe the gynecoid pelvis.
round space, equally deep and wide, the most common pelvis type.
Describe the anthropoid pelvis.
"Notably deeper than it is wide, a tall oval with great depth in the sacral curve but more narrow in width than the average gynecoid(roomier at the bottom than at the top, it encourages the baby to enter the pelvis posteriorly.)"
Describe the platypelloid pelvis.
"wider than it is deep, a wide oval, with less depth in the sacral curve but more width than the average gynedoid."
Describe the android pelvis
"prominent, close set spines, tapering sidewalls, narrow pubic arch and close set tuberosities. The android is sometimes called the funnel pelvis because it gets more and more narrow towards the outlet...pure android types are quite rare."
Name 3 non-dairy sources of calcium.
Sesame seeds/tahini
dark greens
orange juice with added calcium
Discuss chorionic villus smpling
performed at 10-12 weeks; greater risks of miscarriage and infection; placental tissue is obtained through the cervix; high false positive and false negatives; may cause fetal anomolies
What are the risks to babies who contract GBS? (3 listed in Heart and Hands)
apnea, meningitis, death
GBS:alternatives to antibiotics in labor (6 listed in Heart and Hands)
1. hibiclens
2. probiotics
3. echinacea
4. garlic
5. EHB by NFFormulas
6. Tea Tree Oil suppositories
Common complaints of pregnancy: minor headaches. List natural means of alleviating.
hops, skullcap, chamomile, massage, yoga, chiropractic, hydration.
Common complaints of pregnancy: backache: self help pracices.
exercise, pelvic rocks, good posture, pillow support while sleeping, bellyband for pendulous abdomen, chiropractic adjustment.
varicose veins of the legs and vulva: list causes
high levels of progesterone relax the smooth muscles and hinder venous return particularly in the extremeties; hereditary factors also play a role
What supplement may be useful for varicose veins?
Vitamin E, 600 units
yeast infection: causes and self -help remedies.
"Yeast is a naturally occuring vaginal organism that tends to overgrow in pregnancy because of increased vaginal alkalinity, which in turn is caused by elevated progeserone levels" insert suppositories iwth acidophilus; cotton underwear
Bacterial Vaginosis: describe symptoms.
fishy odor, especially after sex, seldom vaginal irritation or itching, thin, gray or white discharge taht adheres to vaginal walls.
BV: 3 dangers to childbearing
1. chorioamnionitis
2. PROM
3. premature labor
What is the whiff test?
The whiff test checks for BV. Touch a cotton swab saturated with discharge to a bit of KOH solution; if it lets off a potent fishy odor it's bacterial vaginosis.
BV: self help protocol from Heart and Hands.
insert a peeled, unnicked clove of garlic into the vagina, changing 3 x daily. Follow this with 5 days of acidophilus treatment. Abstain from sex during treatment.
Trichomonas characteristics and symptoms
malodorous, highly irritating, yellow green frothy discharge.
_________ is the treatment for Trich. It is or is not contraindicated in pregnancy.
Flagyl
Is contraindicated in pregnancy
What is vertical transmission?
transmission of an infection or disease from mother to child.
List several foods that contain the amino acid arginine, which exaccerbates the herpes virus.
nuts, nut products, seeds, chocolate
Counseling techniques: mirror the mother's feelings. Describe.
by recieving impressions and reflecting them back without judgment or distortion.
Herbs and Homeopathy in pregnancy: herbs contraindicated in pregnancy.(6 from Heart and Hands)
goldenseal, ephedra, cotton root bark, blue cohosh, pennyroyal and birthroot
Nutritional teas/beverages. (5)
1. nettle
2. dandelion leaf
3. raspberry leaf
4. red clover
6. lemon and water
Herbs and Homeopathy in Pregnancy: Nausea (1 herb and 4 homeopathics)
ginger and pulsitilla, sepia, nux vomica and ipecacuanha
Herba and Homeopathy in Pregnancy: Anemia: 6 remedies
dandelion, nettles, kelp,parsley, yellow dock, floradix herbs plus iron
Herbs and Homeopathy in pregnancy: heartburn: 3 remedies
slippery elm lozenges, papaya tablets and raw almonds
Herbs and Homeopathy in pregnancy: sleep difficulties: self-help practices and remedies (7)
deep relaxation, exercise, eye pillow with lavender and flax, valerian tincture, hops tincture, skullcap tincture, aconite 30C
Herbs and Homeopathy in pregnancy: nerve pain: remedy
St. John's Wort oil ir gtoerucyn 30C
Herbs and Homeopathy in pregnancy: Hemorrhoids: remedies (5)
red clover, nettle, grated raw potato inserted or as compress, witch hazel extract, hamamelis 30C
Herbs and Homeopathy in pregnancy: constipation: self help practices and remedies (4)
hydration, vegetables and whole foods, pshyllium seeds, prune juice
Herbs and Homeopathy in Pregnancy: Diarrhea: two home remedies.
rice water: cook white rice iwht a four to one ratio of water to rice. drink the excess water. and Tea x 3. Use the same tea bag and make three cups of tea. Only drink the last cup.
Herbs and Homeopathy in pregnancy: breech: two remedies
puls
Herbs and Homeopathy: Two remedies for breech
pulsatilla 30C
moxabustion
Herbs and Homeopathy: Preterm labor (3)
hydration, magnesium, mag phos 30C (non metal cup, 7 pellet in a half cup of hot water, stir 100x, sip, contx should slow or stop in 1 hr)
Herbs and Homeopathy: postdates: 3 remedies
1. evening primrose oil
2. caulophyllum 30C
3. cimcifuga 30c
Counseling techniques (3)
1. pacing the mother's rhythms
2. active listening
3. positive reinforcement
What is the ultimate aim of midwifery counseling?
eliciting responsibility
Describe a maneuver used to correct lack of flexion during the end of pregnancy.
"If the head is not too far into the pelvis, facing the mother's feet, press the occiput down into the pelvis while pulling the sinciput toward you, tucking the baby's chin to its chest"
Define occiput and sinciput
occiput: back of the head
sinciput: forehead
What kind of information can you get from an internal exam near term?
1. check cervix for dilation and effacement
2. note station
3. note increase of vaginal lubrication or softening of the musculature
What does an uneffaced cervix feel like? What does a 50% effaced cervix feel like?
uneffaced: "thick, firm, and about an inch long."
effaced: "mushier with a less distinguishable neck, half an inch or so in length."
What causes incoordinate labor?
"The uterus is comprised of 3 layers,: the external longitudinal layer, the middle connective layer and the internal, circular layer. In incoordinate labor only certain muscle segments contract, when all must work together in order to pull open the circular muscles of the cervix."
False labor seldome results in dilation but may facilitate ______, _________ and ____________.
descent, engagement and effacement
Define 0 Station.
When the top of the head is exactly level with the ischial spines.
How do you assess station?
"Insert two fingers sideways, but bend only the middle one, placing it on the spine while extending the index finger to find the presenting part..If you must move your index finger up to touch the presenting part, the station is negative."
What is the elevator exercise?
"pelvic floor muscles are pulled upward in stages, like an elevator ascending and stopping at each floor. Pause for ten seconds at each 'floor' for 5 floors and descend floor by floor with 10 sec pauses.
Describe vaginal massage and when it might be useful.
useful if the muscles are extremely strong or tight. Use olive oil for lub, mother places thumb agains the floor of the vagina and moves from side to side in a half circle, with steadily increasing pressure. Deep breathing facilitates relaxation and release.