Question

Review the following scenario, and answer the questions. Create a Word document for your answers, submit via submission link.

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.

How can the nurse best describe to this patient the latent phase of labor?

How will the cardinal movements of labor facilitate the birth of the fetus?

Answer 1

Describe the latent phase to the patient----
Latent phase is the indicative phase by which you can determine that the labour process is going to start .latent phase starts with cervix softening and thinning ,cervix is going to be dilated in this phase.
It is the longest phase of labour stays from several days to weeks. Most important feature is the contraction which last for 30-45 seconds and contraction will be more stronger as active stage are come.
Patient will feel-
1)lower back pain, pains are like period which comes and goes, loose bowel and frequent urination.
2)blood stain discharge of mucous.
3) when the waters breaks or membrane ruptures a fluid coming out which is usually clear or little pinkish in colour .(abnormality can not be find if the colour is not like clear or little pinkish , then medical attention is needed).
After that means when cervix dilatation is become more than 5 cm tit enters into active phase of labour.

*The cardinal movement of labour facilitates the birth of the foetus —
There are total seven cardinal movements of labour which facilitates the birth of foetus. Cardinal movements are important as the baby has to come out through a small diameter of passage of birth canal of pelvis which is much smaller in comparison to the baby’s stature .Cardinal movement are nothing but the position change which are made by the baby only but there is no influence to the care provider or the mother. And the position change are due to reduce resistance of baby during labour .
The cardinal movements------
Firstly, engagement- when entering of biparietal diameter (from one ear tip another ear tip through forehead, widest part of baby head ) into mother’s pelvic inlet. This indicates the baby has enters into mother’s pelvis.

Secondly, Descent or lightening—when baby’s head enters deep into pelvic cavity. The occiput of the baby reaches the ischial spine level. It can be graded from -5 to +5 . When baby’s head reaches level of ischial spine it graded as 0 . When the baby’s head descends more than the ischial spine level it becomes positive.

Thirdly, Flexion—In this movement the baby faces the resistance . Baby’s head faces the resistance upon soft tissue of pelvis. The flexion of head occurs as the chin of baby comes closer to the chest. At this stage the smallest diameter of the baby’s head reaches the pelvis

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Fourthly, Internal rotation—as there is change in the diameter of the pelvis means in pelvic inlet there is widest part is present from right to left and on the pelvic outlet the widest part is present from front to back ,so there is internal rotation occurs . Internal rotation occurs as such that the baby’s face is against back of the mother and back of head against the pelvis front of the mother. This is known as anterior rotation. If anterior rotation is not happened then it is called as occipitoposterior rotation .

Fifthly, Extension—baby’s head has now passed the pelvis , the neck of baby is at pelvic arch.

Sixthly, External rotation— In this stage there is sudden pause. At that time the baby’s facedown position to facing position due to rotation by the baby own. There is an important stage known as restitution, where the arm of baby fits under pelvic arch. In this time if any difficulty is found it will be leads to shoulder dystocia which leads to brachial plexus injury. So this external rotation stage is important.

Seventhly, Expulsion—in this stage shoulder moves out from symphysis pelvis. Now the shoulder are born, than after rest of the body passes through out and the birth process of parturition process completed.