MIDTERM PERIOD

WEEK 7

1.Definition of Labor

2.Theories of Labor

3.Components of Labor

4.Difference Between True and False Labor

5.Mechanism of Labor

6. Stages of labor
Introduction:
Learning about the factors that initiate labor and delivery is important so
that nursing students will know how to assist a laboring woman. Knowing
how to describe the differences between true and false contractions is
also an important thing to consider so that nursing students will be able to
give the right information to the laboring woman and in return, the
expectant mother could have enough time to prepare herself for her
delivery. Furthermore, rendering the corresponding nursing management
during the different stages of labor alleviate the pains of a laboring
woman, help her to cope more effectively during the process until she
delivers her baby. In this way, complications can be prevented and
delivery will be less stressful for the mother and her newborn.
I. Definition of Labor:
>are the series of events by which uterine contractions and abdominal
pressure expel a fetus and placenta from the uterus
II.Theories of Labor
> Labor usually begins between 37 and 42 weeks of pregnancy, when a
fetus sufficiently mature to adapt to extrauterine life, yet not too large to
cause mechanical difficulty with birth
1.The uterine muscle stretches from the increasing size of the fetus,
which results in release of prostaglandins
2.The fetus presses on the cervix, which stimulates the release of
oxytocin from the posterior pituitary gland
3. Oxytocin stimulation works together with prostaglandins to
initiate contractions
4.Changes in the ratio of estrogen to progesterone occurs,
increasing estrogen in relation to progesterone, which is
interpreted as progesterone withdrawal
5. The placenta reaches a set age, which triggers contractions
6. Rising fetal cortisol levels reduce progesterone formation
and increase prostaglandin formation
7. The fetal membrane begins to produce prostaglandins,
which stimulate contractions
 III. The Components of Labor
1.The passage
 Refers to the route a fetus must travel from the uterus through the
cervix and vagina to the external perineum
 Known as the woman’s pelvis
 Should be of adequate size and contour
2. The passenger (the fetus)
 Should be of appropriate size and in an advantageous position and
presentation
 The body part of the fetus that has the widest diameter is the head
3. The powers of labor (uterine contractions) are adequate
4. The psyche, or a woman’s psychological state which may either
encourage or inhibit labor.
> This can be based on her past life experiences as well as her present
psychological state

IV.Difference Between True and False Contraction

FALSE CONTRACT. TRUE CONTRACT.

> Begin & remain irregular >begin irregular but become
regular & predictable

>Felt first abdominally >felt first in lower back

and remain confined to the and sweep @ the
abdomen and groin abdomen in a wave
FALSE CONTRACT. TRUE CONTRACT.
>Often disappear with > Continue no matter
ambulation and sleep what the woman’s level of
activity

> Do not increase in > Increase in duration, frequency

duration, frequency & and intensity
intensity

> no show > presence of show

V.Mechanisms (Cardinal Movements) of Labor
1.Descent
>The downward movement of the biparietal diameter of the fetal head
within the pelvic inlet
Nulliparas: descent occurs during 2nd stage
Multiparas: descent usually begins with engagement
Occurs due to :
1.Pressure of amniotic fluid
2.Direct pressure on the breech by the fundus during
contractions
3. Bearing-down of maternal abdominal muscles
2.Flexion
 As descent is completed, and the fetal head touches the
pelvic floor, the head bends forward onto the chest, causing
the smallest anteroposterior diameter
 Due to resistance from the cervix, pelvic walls, or pelvic floor
 Chin is brought towards the chest
 Shifts from longer occipitofrontal
diameter (12cm) to shorter
Suboccipito bregmatic diameter (9.5cm)
3. Internal Rotation
 As the head flexes at the end of descent, the occiput rotates so
the head is brought into the relationship to the outlet of the
pelvis.
 This movement brings the shoulders, coming next into the
optimal position to enter the inlet
4.Extension
> As the occiput of the fetal head is born, the back of the neck stops
beneath the pubic arch and acts as a pivot for the rest of the head
>The head extends and the foremost parts of the head, the face
and chin are born
5. External Rotation
6. Expulsion
END OF WEEK 7 PART 1