LABOR AND DELIVERY

(Childbirth)

1. INTRODUCTION

There comes a time in every pregnancy when all that's left to do is wait. The books have been read, the nursery
decorated, the car seat installed. "Once you get to 38 weeks of pregnancy, your baby could be born at any time,"
But even though most women give birth between 38 and 42 weeks — a fairly broad span — there's no way to
pinpoint when labor will begin. "Not knowing makes some women very anxious,"
If you're a first-time mom, you may not even realize when you're officially in labor. "Plenty of women head to
the hospital only to be told to go back home,”. It can be hard to distinguish Braxton Hicks contractions, also
known as false contractions, from the real thing. But if your contractions gradually become stronger, last longer,
and are getting closer together, chances are that labor has begun.

Even if you're in true labor, it may take a while before you're sure, so in the early stages of labor, you're better
off at home where you'll be more comfortable. After all, a first-time mom can expect to be in labor for 12 to 14
hours. Labor with subsequent pregnancies usually goes faster,"

When it does come time to check in to the hospital or birthing center, keep in mind that things don't always (or
more accurately, don't usually) go exactly as planned. You may not be able to get the epidural you wanted, or
you may end up needing a cesarean. "It's fine to have an idea of how you'd like the birth to go, but you need to
be flexible. Keeping in mind that labor is different for every woman, and for each of her pregnancies.

1.1 DEFINITION OF THE PROCESS

Childbirth includes both labor (the process of birth) and delivery (the birth itself); it refers to the entire process
as an infant makes its way from the womb down the birth canal to the outside world.

Childbirth usually begins spontaneously, about 280 days after conception, but it may be started by artificial
means if the pregnancy continues past 42 weeks gestation. The average length of labor is about 14 hours for a
first pregnancy and about eight hours in subsequent pregnancies. However, many women experience a much
longer or shorter labor.

1.2 PURPOSE

 Monitoring the physical, psychological, and social well-being of the mother throughout the childbearing
cycle.
 Providing the mother with individualized education, counseling, and prenatal care, continuous hands-on
assistance during labor and delivery, and postpartum support.
 Identify and develop appropriate and effective ways to reduce maternal and newborn mortality and
morbidity.
1.3 PRINCIPAL STEPS
 Labor room
Admitting the mother.
Establish rapport
Taking the vital signs of the mother every hour.
o Blood pressure
o Pulse Rate
o Respiration Rate
o Temperature
o Fetal Heart Tone/ Fetal Heart Beat
 Providing health teachings.
 Giving back massage if the mother is in pain.
 Assisting the mother to the delivery room.
 Actual Delivery
 Coaching the mother how to push and breathe properly.
 Giving vaccination (oxytocin) to the mother if the baby and placenta comes out.
 Taking vital signs of the mother every 15 minutes for an hour, and then every thirty minutes for another
hour and lastly every hour for the succeeding hours.
 Assisting the mother to the recovery room.
 Explaining the importance of breastfeeding to the mother.
 Monitoring the mother’s health for two hours or more if there is any complications before transferring
her to the designated room or ward.

2. RAW MATERIALS

3. EQUIPMENT
 Scrub Suit
 Scrub shoes
 Hair cap/ surgical cap
 Surgical Gloves
 Surgical masks
 Sphygmomanometer
 Stethoscope
 Pulse oximetry
 Thermometer
 IV Fluid
 Delivery Set Instruments
o 2 Scissors
o Needle holder
o Forceps tissue
o Instrument Clamp
o Plastic Clamp
o Sanitary pads
o Chromic gut cut (for suturing)
 10 cc syringe
 Oxytocin
 Lidocaine
4. DESCRIPTION OF THE PROCESS

4.1 STEP NO. 1

 First Stage: From the onset of true labor to the full dilatation of the cervix.

The first stage of labor is usually the longest part of labor. During the first stage of labor, contractions
help your cervix to thin and begin to open. During this stage, your cervix will widen to about 10
centimeters. This first stage of labor usually lasts about 12 to 13 hours for a first baby, and 7 to 8 hours
for a second child.

This stage is broken down into three phases:

1. Early Phase

Your cervix opens to 4 centimeters. You will probably spend most of early labor at home. Try to keep
doing your usual activities. Relax, rest, drink clear fluids, eat light meals if you want to, and keep track of
your contractions. Contractions may go away if you change activity, but over time they'll get stronger.
When you notice a clear change in how frequent, how strong, and how long your contractions are, and
when you can no longer talk during a contraction, you are probably moving into active labor.

2. Active Phase

Your cervix opens from 4 to 7 centimeters. This is when you should head to the hospital. When you have
contractions every 3 to 4 minutes and they each last about 60 seconds, it often means that your cervix is
opening faster (about 1 centimeter per hour). You may not want to talk as you become more involved in
dealing with your contractions. As your labor progresses, your bag of waters may break, causing a gush
of fluid. After the bag of waters breaks, you can expect your contractions to speed up.
 Slow, easy breathing is usually helpful at this time. Focusing on positive, relaxing images or music may
also be helpful. Changing positions, massage, and hot or cold compresses can help you feel better.
Walking, standing, or sitting upright will help labor progress. Relaxing during and between contractions
saves your energy and helps the cervix to open.

3. Transition Phase to Second Stage

Your cervix opens from 7 to 10 centimeters. For most women, this is the hardest or most painful part of
labor. This is when your cervix opens to its fullest. Contractions last about 60 to 90 seconds and come
every 2 to 3 minutes.

There is very little time to rest and you may feel overwhelmed by the strength of the contractions. You
may feel tired, frustrated, or irritated, and may not want to be touched. You may feel sweaty, sick to
your stomach, shaky, hot, or cold. Although you may find slow, easy breathing to be most effective
throughout labor, you may also find an uneven breathing pattern most helpful at this time.

4.2 STEP NO. 2

 Second Stage: From full dilatation of the cervix to the delivery of the baby.

Your baby moves through the birth canal

Your health care provider may ask you to push with each contraction. The contractions continue to be
strong, but they may spread out a bit and give you time to rest. The length of the second stage depends
on whether or not you've given birth before and how many times, and the position and size of the baby.

The intensity at the end of the first stage of labor will continue in this pushing phase. You may be
irritable during a contraction and alternate between wanting to be touched and talked to, and wanting
to be left alone. It isn't unusual for a woman to grunt or moan when the contractions reach their peak.

4.3 STEP NO. 3

 Third Stage: From the delivery of the baby to the expulsion of the placenta

Afterbirth
After the birth of your baby, your uterus continues to contract to push out the placenta (afterbirth). The
placenta usually delivers about 5 to 15 minutes after the baby arrives.
4.4 STEP NO. 4

 Fourth Stage: From the expulsion of the placenta to the recovery of the mother.

Recovery
Your baby is born, the placenta has delivered, and you and your partner will probably feel joy, relief, and
fatigue. Most babies are ready to nurse within a short period after birth. Others wait a little longer. If
you are planning to breastfeed, we strongly encourage you to try to nurse as soon as possible after your
baby is born. Nursing right after birth will help your uterus to contract and will decrease the amount of
bleeding.

5. CONCLUSION
Childbirth is an incredible process which most women get to experience in their lifetime. The pain may last for a
while but joy comes with the delivery of your baby.

Pregnancy and birth can be a very special time in the life of a woman. The nine months of pregnancy, as well as
labor and delivery, are filled with many physical and psychological changes, as well as changes in lifestyle. Each
change poses a challenge that can be met successfully when the woman shares her feelings and experiences
with a partner or other supportive person and with her physician, midwife, nurse, and childbirth educator. The
importance of health care throughout pregnancy is emphasized, because proper health care increases the
likelihood of a healthy pregnancy, a healthy baby, and satisfied parents.

Having a successful natural birth, as well as a happy birth, no matter what, begins well before the woman is in
labor by reading books about the whole pregnancy experience, having a positive pregnancy, with very little to
no morning sickness, supportive family and friends, as well as a husband that is involved will help to improve the
quality of labor. Women who are stressed and terrified about giving birth correlates with having a bad
experience. Natural childbirth is highly recommended in my opinion and should be considered more often.
Women need to take back control and start pursuing what is really best for her and the child.