Labor & Birth Reading Guide
1. What are fontanels and what is their function?
· Lowdermilk pg. 326
· Flat bones of skull, formed during embryonic period
· Enable head to pass thru birth canal
2. Be able to identify and name the bones and suture lines in the fetal head.
I’ll try & send this graphic separately, it made the file too large to send, rats
· Lowdermilk pg. 449, 450-1-2
Presentation = part of the fetus that enters the pelvic inlet 1st and leads thru the birth canal during labor
Cephalic = head presents 1st, 96% of births
Vertex = occiput presents 1st/aka cephalic presentation
Breech = buttocks or feet present 1st, 3% of births
Lie = relation of fetal spine…show more content… What is the passageway composed of?
Lowdermilk pg 452.
Mother’s rigid bony pelvis and soft tissues of the cervix, the pelvic floor, the vagina, and the introitus (the external opening to the vagina).
*Must measure passageway for size and shape to ensure for appropriate passage of fetus.
5. Describe the difference between primary and secondary powers of labor. What is each responsible for?
Lowdermilk pgs 455-6
Primary Powers are involuntary contractions of the uterus that are responsible for the effacement and dilation of the cervix and descent of the fetus.
Secondary Powers are voluntary contractions or “bearing down” that aid in the expulsion of the fetus. The bearing down helps compress the uterus on all sides and is of considerable importance in aiding in expulsion.
Effacement- Means the shortening and thinning of the cervix during stage 1, expressed as a %
Dilation-is the enlargement or widening of the cervical opening and the cervical canal that occurs when labor begins. (1-10 cm) (scarring from previous preggo’s can impede)
Ferguson reflex- Maternal urge to bear down caused by the release of oxytocin r/t stretch receptors in the posterior…show more content… Intense, sharp, burning, localized pain from stretching perineal tissue & pelvic floor, lacerations to soft tissue (cervix, vagina, perineum). Somatic pain is transmitted by pudendal nerve thru S2 to S4 spinal nerves & parasympathetic system.
2. Briefly discuss how each of the following factors affect pain:
· Lowdermilk pg. 468-9, 470-1
Physiological = sympathetic nervous system is stimulated in response to pain resulting in catecholamine levels, B/P, heart rate. Pain can cause hyperventilation and respiratory alkalosis, pallor, diaphoresis, N/V, ↓placental perfusion and prolonged labor.
Culture = some cultures consider it shameful to express pain (Amish, Asians) so it’s hidden. Religious mothers accept pain as a necessary part of having a baby, African American mothers express pain openly, Arab mothers are vocal and prefer meds.
Anxiety = as anxiety over pain there is lessened perceptual field, writing, crying, groaning, gesturing. Mild anxiety is normal. Excessive anxiety causes catecholamine secretion which muscle tension and causes >