Physiological changes Secondary to pain In labor.
Discomfort during labor A = First stage B= later phase of 1st stage to 2nd stage C= 2nd stage actual birth
Discomfort in labor from: Cervical dilation & effacement - first station Uterine ischemia - throughout Perineal stretching - end of 1st & 2nd stage Fear Anxiety Tension
Process of Labor & Delivery To understand the complex process of L&D it is Important to examine each of the factors involved. These are frequently called the five or even 6 P’s. Passageway = pelvis & soft tissues Passengers = fetus & placenta Powers = Contractions & voluntary effort of mom (push) Position of mother = standing, walking, side lying, squatting, on hands & knees VS lithotomy Process = all parts working together & # 6 Psychological condition of mom
A = Vertex note the flexion B = Sinciput C = Face note extension D = Brow or Military
ROA & LOA WHY BEST
0 = ischeal spines
Placenta is also a passenger
Position of mother may also influence the secondary power of pushing. Walking, sitting, kneeling, squatting are all important aspects of position changes that are helpful. Squatting may increase size 20 - 40%. Hands & knees may help posterior fetus turn to anterior position. Remember back labor.