Management of labour

-Managing labour should start with :

1-appropriate antenatal education.

2-Advice on suitable food and drink to eat in the
early stages of labour to maintain energy levels
3-positions and activities to encourage a forward
rotation of the head if there is op.
4-An upright position might help to facilitate more
effective contractions or an alternative position
might help to improve pelvic diameters when the
position of the baby is posterior
5- maintain hydration, to encourage voiding
6- and to suggest non-pharmacological ways to relieve pain.
7-Recognition and detection of abnormal progress in labour
8-An abdominal examination can provide vital information
about the labour with regard to the lie, presentation,
position and descent of presenting part
9- the length, strength and frequency of contractions
whereby any change in the pattern of the contractions
should be
10 -On VE the midwife is assessing the presence and degree
of moulding of the fetal skull, the presence and position of
caput succedaneum in relation to sutures and fontanelles
and the dilatation of the cervix noting any thickening and
its application to the presenting part.
11-Any changes to the colour of the liquor if the membranes
have previously ruptured
12- CTG , fetal heart rate will give some indication as to how
the fetus is coping with the progress of labour.
13-Psychological as well as physical support is important
-The management of prolonged labour is a collaborative
effort involving the woman and her partner, the midwife,
obstetrician, and anaesthetist.
14- an ARM has been done to augment labour at appropriate
time before oxytocin infusion
15- An assessment will be made 2–4 hrs after ARM or
commencing oxytocin to ascertain the likelihood of a
successful vaginal birth.
signs of successful :

1- optimal contractions of four each 10 min lasting

>40 s,
2- the woman is pain free
3-well hydrated
4- empty bladder
-augment labour in multiparae or in women with
prior caesarean section must be made by an
experienced obstetrician because of the very real risk
of hyper stimulation and uterine rupture.