Signs of Labor, Stages of Labor, and Complications Time to be Born Time to be Born! Signs of Labor, Stages of Labor, and Complications

Ice, Ice, Baby!  Take an organizing breath—a big sigh as soon as the contraction begins. Focus your attention. Inhale slowly through your nose and exhale through your mouth Keep your mouth and shoulders relaxed. As the contraction decreases in intensity, gradually slow your breathing rate, switching back to breathing in through your nose and out through your mouth. When the contraction ends, take you’re finishing breath—exhale with a sigh.

Signs of Labor 1st Sign labor is near: “Lightening” Head of the fetus descends down into the pelvic cavity. Passage of a small amount of blood (release of mucus plug).--This is sometimes called a “bloody show” Amniotic sac breaks= “Water broke” Contractions- tightening and releasing of the muscles of uterus

Who Delivers the Baby? Obstetricians! Family Doctors Licensed Midwives Doctors that specialize in prenatal & postnatal care of the mother & baby Family Doctors Some general-practice doctors will handle the delivery, but if problems arise an obstetrician will need to be called Licensed Midwives Nurse-midwife Registered nurse with advanced training in normal pregnancy & birth Lay-midwife Special training in the care of pregnant women and deliveries but does not have a nursing degree

Stages of Labor (3 stages) Dilation of the Cervix Delivery of the Baby Delivery of the Placenta

1. Dilation of the Cervix Contractions every 15-20 minutes and last for 30 seconds (for natural births only) Baby moves to lower pelvis as cervix dilates (opens) Transition: Cervix will measure about 4 inches (10 centimeters) When this happens the first stage is over.

Think Question!- Discuss with your partner! What are some words of encouragement that could help the mother while going through transition? What were some things you know about when you were born?

2. Delivery of the Baby Head enters the birth canal (Crowning) and mother’s muscles push baby down. Once out of the uterus, newborn is covered with a thick substance called vernix-caseosa

3. Delivery of the Placenta About 20 minutes after labor, the mother has irregular contractions and passes the placenta. Known as the “afterbirth”

Labor & Birth

APGAR Scale Devised in 1952 by Dr. Virginia Apgar Simple and repeatable method to quickly assess the health of newborns 1-5 minutes after birth. The resulting score ranges from 0-10. The 5 criteria are: Appearance (skin color) Pulse (heart rate) Grimace (reflex irritability) Activity (muscle tone) Respiration. Scores: 7-10 are generally normal 4 to 6 fairly low Less than 4 = need medical assistance

Apgar Scale APGAR Scale 1 2 Appearance (skin color) Pulse (heart rate) 1 2 Appearance (skin color) Blue or pale Body pink Body & extremities pink Pulse (heart rate) Absent <100 >100 Grimace (reflex irritability) No response Cry when stimulated Cry or pull away when stimulated Activity (muscle tone) None Some flexion Flexed arms and legs that resist extension Respiration (breathing) Weak or irregular Strong, lusty cry

Newborn Characteristics Pointed head Face swollen or puffy Fingers and toes are cooler than body Milia- tiny, white bumps from plugged oil ducts Lanugo- fine hair that disappears soon after birth