1. Labor and delivery

2. Objectives Distinguish the differences of the 4 stages of labor. Describe the 5 P’s of normal delivery. Diagram and explain the three types of decelerations on a fetal monitor during labor. Analyze the different types of pain relief available for laboring women.

3. Having my Baby…… Signs of labor Stage one Stage two Stage three Stage four

4. Signs of Labor Preliminary signs of labor Lightening Increase in level of activity Braxton Hicks contractions Ripening of the cervix

5. Passenger Structure of fetal skull Diameters of fetal skull Molding

6. Passenger Fetal presentation and position Attitude Engagement Station Fetal lie

7. Passenger Types of fetal presentation Cephalic Breech Shoulder

8. passenger Position Relation of the presenting part to a specific quadrant of a woman’s pelvis Right anterior Left anterior Right posterior Left posterior

9. Passage way of Labor Mechanisms of Labor Descent Flexion Internal rotation Extension External rotation Expulsion

10. Powers of Labor Cervical changes - SVE Effacement Dilatation Normal Vaginal Birth with Cervical Effacement and Dilatation (Dilation) - Medical Animation

11. Stages of Labor First Stage Latent phase Active phase Transition phase

12. Maternal and Fetal Assessment Nurse Role Assessment of stage one History Check urine Physical exam Leopold’s maneuvers Rupture of membranes? Vaginal exam Pelvic adequacy

13. Nursing Care: First Stage Respect contraction time Change positions Voiding and bladder care Support Pain management

14. Nursing Care: Promoting Comfort Reducing anxiety Coping strategies Comfort measures Positioning Childbirth method Pharmacologic pain relief

15. Deceleration Patterns C. Variable decelerations caused by cord compression B. Late decelerations caused by uteroplacental insufficiency A. Early decelerations caused by head compression A. Early decelerations caused by head compression

16. Comfort and Pain Relief of labor Support from doula or coach Alternative therapies Relaxation Focusing and imagery Breathing Herbal preparations Be culturally sensitive

17. Pain relief for laboring clients Injection of local anesthesia to block specific nerve pathways Epidural Nursing care –consent and make that call! Vitals and observation during administration Spinal IV meds Stadol Nubain pg 369

18. Procedure, part 1

19. Nursing Care: Second Stage Preparing for birth Positioning for birth Pushing Perineal cleaning Episiotomy Birth Cutting and clamping the cord

20. End of Second Stage of Labor Second stage Period from full dilatation and cervical effacement to birth of the infant Third Stage Placental separation Placental expulsion

25. Nursing Care: Third and Fourth Stage Oxytocin Placental delivery Perineal repair Assessment Aftercare

26. End of Third Stage Labor

28. What is the fourth stage?

31. C Section

32. C section

33. Questions????????????????