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Flashcards in Care of 2nd stage labour Deck (20)
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What are the aims for providing care?

protecting and promoting physiological processes
Preventing complications
positive experiences for mother
detecting deviation from normal and referral when needed.


What are the principles of care in the 2nd stage?

Maternal observations
Fetal observations
labour is progressing


What are the maternal observation in 2nd stage labour?

Timing contractions every 30 minutes for 10 minutes
Continue; temp, Pulse, Blood pressure, respiration rate
verbal and non verbal communication


Wha are the fetal observations in 2nd stage labour?

fetal heart rare every 5 minutes following a contraction


What do you do if no obvious signs of progressing labour?

decent, rotation and flexion of the presenting part by performing a VE as per guideline consent


What are the observations for second stage labour?

temp 4 hourly
pulse every 15 min
BP hourly
abdominal palpation to access decent and progress
assess per vaginum discharge
encourage regular bladder emptying


What is the passive stage of stage 2?

full dilation of the cervix in the absence on involuntary explosive contractions


What is the active stage of stage 2 labour?

the baby is visible, expulsive contractions with a finding a full dilatation of other signs of full dilatation


What is the definition of second stage delay in nulliparous women?

progress of decent of the presenting part is inadequate after 1 hour of active second stage


What is the definition of delay of second stage labour delay in multiparous wmone?

progress of descent of the presenting part is inadequate after 30 minutes of active second stage


What is the semi- recumbent position?

supported sitting, most common reduces pelvic outlet


describe left lateral position

if unable to abduct their hips, or if epidural in use


describe upright positions

squatting, kneeling, all fours, standing, using birthing ball

reduces second stage, fewer assisted births, fewer episiotomies, reduced pain in 2nd stage


describe lying flat on your back

increased risk of hypertension, reduce placental perfusion and fetal oxygenation, reduced uterine contractions


describe the birth of the head

swabbing perineum
covering anus with clean pad
unhurried active phase to safeguard the perineum
once the head has crowned, gently blowing with contractions to minimise active pushing


Why do you not check for the chord when the head is born?

causes maternal discomfort distraction: would cause delayed contraction
stopping blood flow to the baby


What can you do to untangle to the chord front eh babies neck?

the somersault manoeuvre


What do you do with the birth of the shoulder?

hands on the baby's head covering ears
Gentle downward tracking to assist the birth of anterior shoulder
Oxytocic agent if active management is the choice
gentle upward traction to deliver posterior shoulder
time of birth is noted and recorded


What do you do immediately after the birth?

dry baby
start skin to skin
keep mother and baby warm
Facilitate breastfeeding within the first hour


When do you clamp the chord?

Mothers preference, inform and allow to choose
Benefits of delayed cord clamping; facilitates adaption to extra utterine life
placental transfusion prevents anaemia in baby