Length of Pregnancy Length of Pregnancy • A full term pregnancy is 36-40 weeks. A full term pregnancy is 36-40 weeks. • Three trimesters of about 3 months Three trimesters of about 3 months each. each. • Deliveries before 36 weeks are Deliveries before 36 weeks are premature. premature. • Lungs not fully developed until after Lungs not fully developed until after 36 weeks 36 weeks
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Length of Pregnancy A full term pregnancy is 36-40 weeks. A full term pregnancy is 36-40 weeks. Three trimesters of about 3 months each. Three trimesters.
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Length of PregnancyLength of Pregnancy
• A full term pregnancy is 36-40 weeks.A full term pregnancy is 36-40 weeks.
• Three trimesters of about 3 months Three trimesters of about 3 months each.each.
• Deliveries before 36 weeks are Deliveries before 36 weeks are premature.premature.
• Lungs not fully developed until after 36 Lungs not fully developed until after 36 weeksweeks
Onset of LaborOnset of Labor
• Labor painsLabor pains
– False labor - Braxton-Hicks contractionsFalse labor - Braxton-Hicks contractions•Occur as early as 3-4 weeks (part of natural Occur as early as 3-4 weeks (part of natural
•No affect or relief with walkingNo affect or relief with walking
Onset of LaborOnset of Labor
• Labor painsLabor pains– True laborTrue labor
•Usually begin as aching in the small of the Usually begin as aching in the small of the backback
•Next, become cramp-like pains in the lower Next, become cramp-like pains in the lower abdomenabdomen
•Regular intervals that shorten - intensity Regular intervals that shorten - intensity gradually increasesgradually increases
• Intensify with walkingIntensify with walking
Labor and DeliveryLabor and Delivery3 Stages of Labor3 Stages of Labor
• First stage: Onset of contractions , First stage: Onset of contractions , dilation and effacementdilation and effacement
• Second stage: Expulsion of the infantSecond stage: Expulsion of the infant
• Third stage: Delivery of the placentaThird stage: Delivery of the placenta
First Stage of LaborFirst Stage of Labor
• Three PhasesThree Phases
LatentLatent
ActiveActive
TransitionalTransitional
Second Stage of LaborSecond Stage of Labor“Pushing”“Pushing”• Full dilation of the cervix to delivery of Full dilation of the cervix to delivery of
babybaby
• Deliver or transport?Deliver or transport?
• Pressure on the rectum(feels like a Pressure on the rectum(feels like a BM)BM)
• May have the urge to pushMay have the urge to push
• Perineum will begin to bulge - look for Perineum will begin to bulge - look for crowningcrowning
Third StageThird Stage
• Birth of the infant to delivery of the Birth of the infant to delivery of the placentaplacenta
• This may take up to 30 minutesThis may take up to 30 minutes
• Save placenta and bring to hospitalSave placenta and bring to hospital
Preparing for DeliveryPreparing for Delivery
• When to consider field deliveryWhen to consider field delivery
• Look for crowningLook for crowning
• Questions to askQuestions to ask
Preparing for DeliveryPreparing for Delivery
• Check for crowningCheck for crowning
• Spread legs apart gentlySpread legs apart gently
• Once pushing begins it can’t be Once pushing begins it can’t be slowed down slowed down
• Never attempt to hold mother’s Never attempt to hold mother’s legs together and don’t let her go legs together and don’t let her go the bathroom!the bathroom!
DeliveryDelivery
• You are only assisting the mother You are only assisting the mother
• Guide and support the infant as it is Guide and support the infant as it is bornborn
• Support the head with your hand as Support the head with your hand as it emergesit emerges
Delivering the InfantDelivering the Infant
• Check for the cord around the neckCheck for the cord around the neck
• Suction the mouth first, then nostrilsSuction the mouth first, then nostrils
• Let shoulders come out Let shoulders come out
• Use towels to dry and hold when it Use towels to dry and hold when it comes out- slippery little things!comes out- slippery little things!
Postdelivery CarePostdelivery Care
• Wrap in a clean, dry towel Wrap in a clean, dry towel
• Keep the face exposed and make Keep the face exposed and make sure the top of the head is sure the top of the head is covered(heat loss)covered(heat loss)
• Place baby on Mom’s abdomen if Place baby on Mom’s abdomen if the cord is long enoughthe cord is long enough
• Clamp and cut the cordClamp and cut the cord
Delivery of the PlacentaDelivery of the Placenta
• Placenta usually comes out by itself Placenta usually comes out by itself
• Never pull on the cordNever pull on the cord
• Gentle massaging of the uterus after Gentle massaging of the uterus after delivery of the placenta helps prevent delivery of the placenta helps prevent heavy bleedingheavy bleeding
• Breast feeding helps contract the Breast feeding helps contract the uterus uterus
Apgar Score Apgar Score
• AppearanceAppearance
• PulsePulse
• Grimace or irritabilityGrimace or irritability
• Activity or muscle toneActivity or muscle tone
• RespirationsRespirations
• Check at 1 and 5 minutes after birthCheck at 1 and 5 minutes after birth
HemorrhageHemorrhage
• If signs of shock, place Mom on left If signs of shock, place Mom on left side during transport side during transport
• High flow oxygen High flow oxygen
• Sterile pad over vagina replace as Sterile pad over vagina replace as necessary and save the padsnecessary and save the pads
• Save any tissue that may be passedSave any tissue that may be passed
Breech PresentationsBreech Presentations
• Frank Frank
• CompleteComplete
• FootlingFootling
Rare PresentationsRare Presentations
• LimbLimb
• FaceFace
• Prolapsed cordProlapsed cord
TwinsTwins
• Need to clamp two cords-label as 1Need to clamp two cords-label as 1stst and 2and 2ndnd
• Second usually delivers a few Second usually delivers a few minutes after the firstminutes after the first
• Record time of delivery and apgar Record time of delivery and apgar scores for both infantsscores for both infants