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Intrapartum #2

Terms in this set (23)

First stage of labour
onset of regular contraction to until the cervix is completely dilated
Visceral pain
predominates during the first stage of labour
Dilation of Cervix
Pressure on Adjacent Structures
Hypoxia of Uterine Muscle during Contractions
Stretching of Lower Uterine Segment
4 pains in the 1st stage of labour
Dilation of the cervix - felt in lower abd in lumbar region
most of the pain comes from this in 1st stage of labour
Affective Factors - fatigue or sleep deprived

Behavioural Factors - tense

Cultural - where we grow up and how we grow up and the messages we hear about child birth - emotional or showing less emotions

Supportive Care - support systems

Cognitive Factors - knowledge of L&D

also you confidence and position of baby/mom
5 factors that influence pain perception
used to describe a concept how environment can influence women's perception of, reactions to, and management of labour pain
Gezelling
The lightening
Level of privacy
Temperature of the room
Noise level
People who are present - calm, peace, supportive, someone she can communicate with and cares about her, just their presence there
Quality of environment can influence a women ability to cope - 5 factors
Helps progress birth - faster
changing position in birth helps with this
Sitting up right
this helps the uterus get more oxygen
Rocking hips
This helps baby decent and helps mom get a breathing rhythm
Increased likelihood of a vaginal delivery
Decreased risk of a caesarean section
Reduced use of epidural analgesia
Increased Apgar score
Increased maternal satisfaction
Benefits of Continuous Labour Support (CLS) - 5 things
Cardiac Output - Increases with pain from contractions & anxiety

Blood Pressure - Increases during contractions and may increase with pain

Respiratory System - Oxygen demand and consumption increases & Respiration and pulse increase with pain

Musculoskeletal System - Decreased oxygen supply to muscles increase pain

Immune System - Increase in WBC

Blood Values - Maternal blood glucose level decreases

Natural endorphins released - reduce pain released by the pituitary gland
Maternal Physiologic Responses to Pain in Labour - 7 things
Non verbal pain - facial expressions, clenched jaws, fists - want the body to be relaxed so oxygen/blood goes to wear it should be

Verbal expressions - tone of voice

Dilated pupils

Feeling intensity/strength of contractions
Indications that the mom is in pain - 4 things
Upright & gravity enhancing positions
Rhythmic motion
Change position frequently
Nonpharmacologic Comfort Measures in Early Labour
OP - pushing on moms back - causes pain
fetus position that will cause mom the most pain
Squatting
Hands & knees position
Counter pressure - Pushing on moms sacrum helps push babies head off the back/nerves
Birthing ball
Hands-and-knees or a side-lying position in a tub
Receiving moms pain from an OP baby
Opioids (fentanyl, sufentanyl, morphine)
Classification of systemic analgesia used in 1st stage of labour (active phase)
Epidural block
Nerve block analgesia & anaesthesia used in 1st stage of labour
Nitrous oxide (entonox) laughing gas
gas that is self administrated for pain release
May be considered to be the most effective and flexible method of pain management during labour

Promotes good relaxation

Mother is fully awake and part of the birth process
Epidural Advantages - 3 things
Usually started after labour is well established; otherwise may prolong labour

May interfere with mobility, e.g. walking during the 1st stage of labour

May interfere with ability to push effectively in the 2nd stage of labour
Epidural disadvantages - 3 things
hypotension, N&V, fever, pruritis, intravascular injection, respiratory depression
Maternal complications of epidural
fetal distress secondary to maternal hypotension
epidural effects on fetus during labour
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