Maternity

Pregnancy is the process in which a  female carries a foetus from conception until it develops to the point where the baby is capable of living outside the womb. It starts with conception, the process of fertilization to form a zygote, and ends in childbirth, miscarriage, or abortion.

Pregnancy is considered to last approximately 40 weeks (280 days) from the last menstrual period (LMP), or 38 weeks (266 days) from the date of conception. However, a pregnancy is considered to have reached term between 38 and 42 weeks. Babies born before the 37 week mark are considered premature, while babies born after the 42 week mark are considered postmature.

Womens development during pregnancy

Womens development during pregnancy

During pregnancy, the mother undergoes many physiologic changes, be they cardiovascular, renal, haematological, metabolic or respiratory, changes that become very important in the event of complications.

First Stage of Labour
  1. This phase can take typically 12-14 hours if this is the first pregnancy.
  2. Show - mucous discharge from the vagina, which may be tinged with blood. Anything more than a tinge of blood be sure to get patient to hospital ASAP
  3. Contractions - coming at regular intervals and the cervix begins to dilate. Patient contractions will then gradually become stronger and more frequent, and last longer. While the experience of labour can vary widely, a typical one might start out with contractions coming every ten minutes, lasting 30 seconds each, and gradually increasing to every five minutes, lasting 40 to 60 seconds each.
  4. "waters breaking " refers to the rupture of the membranes surrounding the baby and the gush or the leaking of amniotic fluid through the vagina.

View 1st Stage of Labour Diagram

 

Management

Encourage mother to adopt a comfortable position, Entonox for pain relief, Transport to hospital as this might be your only opportunity 

Second Stage of Labour

The second stage of labour starts when the cervix is fully dilated and ends when the baby is born. If this is a second pregnancy then this process can be very quick.

Management

N.B - Try to consider modesty with certain ethnic minorities. It could be extremely worrying for a women to be attended by a male crew. Try to minimise this anxiety and if possible allow a female member of staff to deal with the patient. 

Delivery of the Baby

Click here to view stages of delivery

Birth Breech Birth

Third Stage of Labour

After the baby is born, the mother will continue to have contractions, but they will not be as uncomfortable as the contractions she experienced while she was in labour. The placenta will separate from the wall of the uterus. As this occurs, she may feel an urge to push as the placenta makes it's way into the birth canal, and the placenta will be delivered. Place the placenta into a bowl so that staff at the hospital can check it is intact. After the placenta has been delivered the mother may bleed a little but this should not be anymore than 200 - 300 mls. If the bleeding doesn't seem to be easing then gentle massage on the abdomen just above the umbilicus will start uterine contractions and the bleeding should begin to decrease.

Management
Childbirth Complications
Management of Cord Prolapse

GO DR SHAVPU ACBC

Secondary Survey

ASHICE (Consider)

Transport to Hospital

Professional Handover

Management of Shoulder Dystocia

GO DR SHAVPU ACBC

Secondary Survey

ASHICE (Consider)

Transport to Hospital

Professional Handover

Management of Breech Presentation

Under Construction

Further Reading

Care in normal birth

Bookmark and Share