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    Labor Watch

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    Lawrence Steve Beronio Mapa
    The document provides information about labor and delivery for students, including: 1) The objectives of the lecture which are for students to understand the routines of birthing facilities and their responsibilities during labor and delivery. 2) An overview of the three stages of labor - first stage from onset of contractions until full cervical dilation, second stage from full dilation until birth, and third stage from birth until delivery of the placenta. 3) Details on the three phases of the first stage of labor - early labor, active labor, and transition - including expected cervical dilation, contraction intervals, and physical/emotional signs. 4) Guidelines for students on their responsibilities during labor and delivery, including preparing instruments,

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    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd

    Labor Watch

    Uploaded by

    Lawrence Steve Beronio Mapa
    602 views35 pages
    The document provides information about labor and delivery for students, including: 1) The objectives of the lecture which are for students to understand the routines of birthing facilities and their responsibilities during labor and delivery. 2) An overview of the three stages of labor - first stage from onset of contractions until full cervical dilation, second stage from full dilation until birth, and third stage from birth until delivery of the placenta. 3) Details on the three phases of the first stage of labor - early labor, active labor, and transition - including expected cervical dilation, contraction intervals, and physical/emotional signs. 4) Guidelines for students on their responsibilities during labor and delivery, including preparing instruments,

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    The document provides information about labor and delivery for students, including: 1) The objectives of the lecture which are for students to understand the routines of birthing facilities and their responsibilities during labor and delivery. 2) An overview of the three stages of labor - first stage from onset of contractions until full cervical dilation, second stage from full dilation until birth, and third stage from birth until delivery of the placenta. 3) Details on the three phases of the first stage of labor - early labor, active labor, and transition - including expected cervical dilation, contraction intervals, and physical/emotional signs. 4) Guidelines for students on their responsibilities during labor and delivery, including preparing instruments,

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    602 views35 pages

    Labor Watch

    Uploaded by

    Lawrence Steve Beronio Mapa
    The document provides information about labor and delivery for students, including: 1) The objectives of the lecture which are for students to understand the routines of birthing facilities and their responsibilities during labor and delivery. 2) An overview of the three stages of labor - first stage from onset of contractions until full cervical dilation, second stage from full dilation until birth, and third stage from birth until delivery of the placenta. 3) Details on the three phases of the first stage of labor - early labor, active labor, and transition - including expected cervical dilation, contraction intervals, and physical/emotional signs. 4) Guidelines for students on their responsibilities during labor and delivery, including preparing instruments,

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 35

    OBJECTIVES: At the end of the lecture the students will: Know the routines and SOPs of the different

    t affiliated hospitals and birthing centers. Know their responsibilities during labour. Assess patients needs during each phase of the first stage. Recognize any abnormal manifestations and refer. Able to give proper health teaching to patients and folks.

    LABOR WATCH

    LABOUR is described as the process by which the

    fetus, placenta and membranes are expelled through the birth canal. NORMAL LABOUR occurs at term and is spontaneous in onset with the fetus presenting by the vertex. The process is completed within 18 hours and no complications arise.

    THREE STAGES OF LABOUR


    FIRST STAGE: (Cervical Stage) The period from the

    onset of true labour contractions until full cervical dilatation and effacement is achieved. Two important events take place during the first stage : cervical dilatation and effacement.

    Cervical effacement/Obliteration/Taking up. It refers to the

    shortening of the cervical canal from a length of about 1 to 2 cm until it is paper thin. In primis, dilatation begins when the cervix is completely effaced. In multis, dilatation and effacement takes place at the same time. Effacement is expressed in percentage. Cervical dilatation refers to the enlargement or widening the cervical canal. Uterine contraction causes dilatation by pulling the cervix over the presenting part, called the Ferguson Reflex. The BOW and the fetal head also act as a wedge in dilating the cervix. It will be noted that there is increased amount of show as dilatation is completed since the last of blood tinged operculum is dislodged. Dilatation is expressed in centimeters.

    SECOND STAGE: (Expulsive Stage)This occurs

    from full cervical dilatation until the birth of the baby. The main event of this period is the birth of the baby. THIRD STAGE: (Placental Stage). This is the period from delivery of the baby to the expulsion of the placenta. FOURTH STAGE: (Immediate Postpartum Period). The period from delivery of placenta until the condition of the woman has stabilized.

    THREE PHASES OF FIRST STAGE OF LABOUR


    Early Active Transition

    PHASES OF FIRST STAGE OF LABOUR Early Active Transition

    CERVICAL DILATATION 0-3 cm 4-7 cm 8-10 cm

    INTERVAL

    DURATION

    TIME FRAME

    5-30 Mins. 3-5 Mins. 2-5 Mins.

    30-50 Seconds 60 Seconds 60 - 90 Seconds

    12-24 Hours 4 12 Hours 10mins. -1 Hr.

    I. EARLY FIRST STAGE LABOUR

    PHYSICAL SIGNS (Early First Stage Labour)


    Bloody show Cramping Pressure tightening Loose stools

    Backache Flu Resting Contractions

    EMOTIONAL SIGNS (Early First Stage Labour)


    Restless

    In control
    Confident Fear

    MANAGEMENT (What to do?)


    Distracting Sleep Eat/Drink Rest Walk Watch T.V./Read Shop/Run Errands

    II. ACTIVE FIRST STAGE LABOR

    Physical Signs (Active First Stage Labour)


    Contractions demand full attention Retreat in wards Irritable Walk become slow Leg pains Water might break Less aware of surroundings Bleed more Nauseated Backache

    Emotional Signs (Active First Stage Labour)


    Serious Full Attention Tired Discouraged Losing confidence

    MANAGEMENT (What to do?)


    Manage Pain: Relax Breath Rock Visualization Music Massage Groan
    Dim lights Shower

    Freedom of movement
    Hot/cold packs Conserve Energy

    Let Labour Take over


    Change positions

    Positions for Labour


    Upright Position: gravity can help encourage the baby

    to move down into mothers pelvis and to keep her as active as possible.

    Squatting encourages baby to descend quickly and

    makes pushing easier. Kneeling(on something soft supported by birth partner) and; Leaning/Resting your hand (on birthing ball or bed) can help stretch your pelvic ligament or the slight rocking movement back and forward may help to ease pain.

    Standing and standing with bended knees, gravity will

    help baby move downward Sitting Upright is the best position if youve been standing for long time and feel tired or if you had an epidural and want to remain upright and have limited movement. Lying on the side if you had an epidural or if the baby is coming too quickly, this position can slow things down.

    III. TRANSITION PHASE OF EARLY STAGE OF LABOUR

    PHYSICAL SIGNS :
    (Transition Phase of First Stage Labour)
    Shaking Sweating Rectal pressure/urge to push Tremble

    Nausea
    Vomiting Groaning

    Loss of modesty
    Unpleasable Hot/cold

    Backache

    EMOTIONAL SIGNS : (Transition Phase of Stage Labour)


    Cant take it anymore Cant go on Overwhelmed Confused Out of control

    MANAGEMENT (What to do?)


    Support Squat/Kneel/Lean

    Comfort Measures
    Open up/ Release

    Students Responsibilities

    Students Responsibilities Handle:


    Prepare the instruments needed or open pack

    Primi Set G1-G2 -2 forceps 1 bandage scissors 1 needle holder 1 suture scissors Multi Set G3 and above - 2 forceps 1 bandage scissors

    Don gloves
    Drape the patient after perineal prep has been done Arrange the instruments

    Fill the syringe with anesthesia


    Open the suture and cut 1/3 by 2/3 or per doctors

    preference

    Assist:
    Position patient at D.R. table.

    Adjust light
    Provide O.S., syringe, xylocaine 2%, rubber ear syringe

    and suture to the sterile pack. Provide D.R. chair to the doctor if needed. Check and regulate IVF. Check FHB and BP Provide the needs of Handle Record the time of birth and the delivery of placenta.

    Circulating:
    Adjust Kelly pad when needed.

    Remove O.B. Pad/ Adult Diaper


    Do perineal preparation aseptically Gather relevant information from the patient.

    Prepare I.D. band for the baby.


    Work and provide the needs of baby care Record the time of baby out together with the assisting

    nurse.

    Baby Care:
    Prepare the crib or Basinet

    Open light/ Heat lamp


    Check suction machine and attached suction tip (NGT

    F8) Gather needed materials from folks e.g. baby dress, wrap, diaper and adult diaper for the mother. Don gloves Stand at the side of the patient while holding 1 sterile O.S. Observe the time of baby out.

    Students responsibilities as soon as the baby is out: Baby Care:


    While holding one of the babys legs, wipe the nose

    and mouth. Wipe also the body with the sterile towel provided. Suction with rubber syringe when needed. Once pulsation stops, clamp the umbilical cord 2cm from the base. Cut. Remove the first towel and initiate Skin to Skin contact of the baby with the mother. Cover the babys head (bonnet) and body with a clean baby wrap. Place I.D. band; 1 at the left leg and 1 at the right wrist.

    Observe until the baby is able to hold and suck

    correctly at the mothers breasts. Inject Vitamin K at the left vastus lateralis and Hepa B vaccine at the right vastus lateralis. Measure head, chest, abdominal circumference and length of the baby. Check weight and temperature by anal route. Apply ophthalmic ointment from inner to outer canthus.

    Handle:
    Offer 2 forceps to the doctor one at a time, then

    bandage scissors. Wait until the placenta is delivered. In delivering the placenta: *Wait for the signs of placental separation, before pulling the cord. Assist the doctor while doing episiorrhaphy. Do final perineal cleaning and flushing. Transfer the patient out of D.R. via stretcher after adult diaper has been fixed.

    Assist:
    Inject Oxytocin 10 units I.M. to the mother. Check BP after the placenta is out.

    Check for uterine contraction


    Apply ice pack per doctors order.

    Circulating:
    Help in the cleaning and transferring out of patient. Maintain the tidiness and cleanliness of the unit.

    Thank you!!!

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