Question

A 28-year-old primigravida at 41 weeks’ gestation is admitted to the L&D unit for early labor at 2 cm, 70% effaced, and 0 station.

1. How can the nurse best describe to this patient the latent phase of labor?
2. How will the cardinal movements of labor facilitate the birth of the fetus?

Answer 1

Labour is a process which might invoke the fear of unknown experience, specially in primigravida. Labour is a complicated process which requires careful monitoring of the mother and the baby for safe delivery. As health care workers the progress of labour is assesd by per vaginal examinations. The entire labour is divided into 3 stages.stage 1 is from regular rhythmic contractions to full cervical dilatation.

Stage 2. Full cervical dilatation to delivery of the baby.

Stage 3.delivery of the baby to delivery of placenta

So it is clearly understood that Mrs x is in first stage. First stage is further divided into 2.

The latent phase.

The start of labour is called the latent phase. This is when your cervix becomes soft and thin as it prepares to open up, or dilate, to allow for your baby to be born.

This begins with contractions, which may be irregular and vary in frequency, strength and length. You may get lots of regular contractions and then they may slow down or stop completely.

When you have a contraction, your womb tightens and then relaxes. For some people contractions may feel like extreme period pains. Some women say they feel pain in their back and thighs instead of, or as well as, pain in the front of their bump.

Care during latent phase.

Try to be upright and active as much as possible when not resting.

Try to rest and sleep if your labour starts at night.

Drink plenty of fluids, and water. empty your bladder regularly.

Have small, regular snacks such as toast, biscuits or a banana.

Try any relaxation and breathing exercises you've learnt, perhaps in antenatal or hypnobirthing classes. Your birth partner could help with massage.

Take paracetamol according to the instructions to doctors orders. paracetamol is safe to take in labour.

Have a warm bath or shower.

A birthing ball can be used to mobilise whilst seated.

Use a TENS, or transcutaneous electrical nerve stimulation, machine. This attaches to your back with sticky pads and sends out tiny electrical impulses to block pain signals sent from your body to your brain. This will increase your natural endorphin.

Cardinal signs of labour.

Descent. Descent takes place throughout the labour regular rhythmic contraction, rupture of membrane and the exertion of maternal effect progress the labour.

Flexion. As descent takes place flexion increases. With increased flexion the suboccipito frontal diameter which was 10 cm becomes sub occipito bregmatic diameter which is 9.5 cmc and occiput becomes the leading part.

Internal rotation of the head. The occiput meets the pelvic floor resistance and rotates forwards until it comes under the symphysis pubis. The occiput slips beneath the sub public arch and crown g takes place.

Crowning. Crowning occurs when the head no longer recedes back with contractions..

Extension of the head. Once crowning has occurred, the fetal head can extend pivoting around the public bone. This releases the sinciput the face and the chin, sweeps the perinium and head is born by extension.

Restitution. The twist in the neck of the fetus which resulted from internal rotation of the head is corrected by an u twisting movement called restitution.

Internal rotation of the shoulders. The anterior shoulder first meets the pelvic floor resistance and rotates anteriorly to lie under the symphysis pubis. The posterior shoulder sweeps the perineum and the shoulders are born.

Lateral Flexion. The body of the fetus is born by lateral flexion as the spine bends sideways through the birth canal.