I

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Im Going Into Labor!!!

• (What do I do now?)

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Labor

• Labor is the energy and effort used to push the
  baby out of the womb.
• Dilation is when the cervix dilates from 0 10
  cm.
• Effacement is the thinning of the cervix.
• Average length of labor for a first baby is 12
  20 hours.

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Reliable Indicators that labor has begun

• The Show Spotting of blood because of the mucus
  plug coming out when the cervix begins to dilate.
• Water Breaks Rupture of amniotic sac causing
  fluid leaks through cervix.
• Contractions Muscle contractions at regular
  intervals than cannot be walked off.

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Contractions

• Contractions are the rhythmic tightening and
  relaxing motions of the muscles of the uterus.
• Braxton-Hicks Contractions are called false
  labor. They can occur throughout the pregnancy
  and typically involve the back, not the uterus.
  They are not regular and can go away with
  exercise.

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Induced Labor

• A doctor causes labor to begin by injecting
  pitocin that begins contractions
• A doctor ruptures the amniotic sac to begin
  contractions.

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First Stage of Labor

• Contractions begin
• Cervix dilates to 7
• Average length is two to ten hours
• Longest Stage
• Contractions grow stronger, longer, and more
  frequent
• Fetal monitor attached

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Transition

• Regular, powerful, contractions every two to
  three minutes that last up to 60 to 90 seconds
• Last about 90 minutes
• Babys head enters birth canal
• Cervix dilates to 10

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Epidural

• Injection in back next to spinal canal.
• Numbs the lower half of the body
• Given when mother is partially dilated
• Usually to about 4 cm
• Depends on the anestheseologist
• External/Internal Monitoring

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Positions for Giving Birth

• Lie on back
• Squatting
• Lie on side
• Sitting
• Kneeling
• In water
• Purpose of contractions during the 1st stage of
  Labor to dilate the cervix

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Second Stage of Labor

• The second stage of labor is the birth of the
  baby
• Crowning is when the head of the baby can be
  seen.
• Sometimes forceps or a vacuum is used if progress
  is not being made and the baby is in the birth
  canal too long.
• Fontanelles are the soft spot on the babys head.
• The purpose of contractions during the 2nd stage
  of labor to push the baby out of moms body.

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Episiotomy

• An episiotomy is a surgical cut in the perineum
  to enlarge the vaginal opening to make birth
  easier and prevent tearing.
• The cut is stitched back together after delivery.

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Third Stage of Labor

• The third stage of labor is the delivery of the
  placenta.
• The placenta detaches from the uterine wall as
  the uterus shrinks.
• The placenta is expelled typically within 20
  minutes.

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Who does what?

• Obstetrician concerned with pregnancy and
  childbirth
• OBGYN Obstetrician/gynecologist specializes
  in pregnancy, childbirth and other female
  concerns
• Mid-Wife - A midwife is a health care
  professional who provides an array of health care
  services for women that can include medical
  histories and gynecological examinations,
  contraceptive counseling, prescriptions, and
  labor and delivery care. Providing expert care
  during labor, delivery, and after birth is a
  specialty of midwives that makes them unique.
• Labor and Delivery Nurse - They care for women
  during labor and childbirth, monitoring the baby
  and the mother, coaching mothers and assisting
  doctors. As a Labor and Delivery Nurse, youll
  prepare women, and their families, for the stages
  of giving birth and help patients with
  breastfeeding after the baby is born.

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Delivery Options

• Vaginal Delivery Baby is delivered vaginally
  through the birth canal. Preferred because it
  helps the baby expel the amniotic fluid and gain
  strength
• Cesarean Section Delivery - a surgical procedure
  in which one or more incisions are made through a
  mother's abdomen and uterus.
• Birthing Room used for regular, vaginal
  deliveries
• Operating room used for cesarean deliveries

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Anesthesia Complications
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Breech Delivery

• A breech delivery is when a baby is born feet or
  butt first.
• A feet first delivery is especially worrisome due
  to broken bones or displaced joints.
• Breech delivery is a concern because the cord and
  head must come at the same time pinching off the
  oxygen supply as the baby descends through the
  birth canal.
• Many breech babies use cesarean delivery.

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Other Deliveries

• Normal head down
• Posterior face up
• Transverse shoulder first
• Fetus doesnt drop C-section

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Cesarean Delivery Used When

• The labor is long and difficult and the life or
  the baby or mother is threatened.
• The fetal monitor shows a drop in heart rate.
• Placenta Previaplacenta is covering the opening
  to the cervix.
• The womans bone structure is too small to allow
  vaginal delivery.

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The Apgar Rating

• The Apgar rating is used to determine if
  emergency steps need to be taken with a newborn.
• The rating goes from 0 to 10 with a score of 7 or
  higher indicating a healthy newborn.

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Colostrum

• Colostrum is a yellow fluid rich in nutrients and
  antibodies produced by the breast in the first
  few days after childbirth.
• Colostrum protects the newborn from infections.
• Mothers are encouraged to give the new baby the
  colostrum.

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Sitz Bath

• Soaking the perineum for short periods of time
  after childbirth.
• Keeps area clean to prevent infection of
  episiotomy.

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Problems of Premature Infants

• Low birth weight
• Underdeveloped lungs
• Infections
• Slow development later in life
• Little or no sucking reflex