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Elisabeth SommerauerMOM, module 2 week 8A Book for MidwivesRead Chapter 9 in A Book for Midwives located in MEMBER RESOURCES under Week 7.1. The 3 different parts, or stages of labor are?Stage 1: OpeningStage2: PushingStage 3: The birth of the placenta2. The 4 most important warning signs in labor include:?High feverHigh blood pressureLabor goes on too longHeavy bleeding3. List 3 signs that labor may be starting soon.?The baby drops lower in the bellyContractions get stronger and come more oftenThe mother feels differentThe bag of water breaksMucus plug comes outDiarrhea4. What are the 2 sure signs labor has begun??Labor contractions (longer and stronger and lower in the belly)(Bag of water breaks)5. When do the bag of waters usually break?Usually within labor or when it breaks before usually labor starts within two hours.Read Chapter 101. What occurs during the first stage of labor??During the first Stage of labor the cervix opens enough, to let the baby out of the womb. Labor contractions will push the baby down and pull the cervix open.Contractions push the babies head down hard against the cervix this helps to open the cervix and moves the baby toward the opening of the vagina.Contractions slowly pull the cervix open, between contractions the cervix relaxes2. The cervix must open from 0 cm to 10__ cm.?3. What occurs during the second stage of labor??Now the cervix is all the way open and contractions move the baby out of the womb into the vagina. The mother pushes, to help the baby out. 4. What occurs during the third stage of labor??The placenta usually separates from the wall of the mother’s womb in the first few minutes after birth. With a couple of pushes the placenta will usually come out of the vagina.The blood from the placenta gives the baby a few minutes to start breathing, 5. What does it mean to guard the labor??Means protecting labor from interference:Keeping rude and unkind people awayDo not use unnecessary drugs or procedures.6. List 2 ways you can guide a labor.Means: help the labor to stay on a healthy path.Keep her from dehydration: help her drink at least 1 cup each hourHave the women urinate once every 2hours: a full bladder can cause pain, problems with pushing, bleeding after childbirth all due to contractions that might get weaker.Rest between contractions: it will help her save her strength Change position every hour: help a women move during labor (squat, sit, kneel, or other positions) (She should not lay flat on her back)Change bedding under the mother when it gets wetKeep record of what happens during labor: what she eats, drinks, urinates, pulse, temp, blood pressureRead Chapter 111. In early labor, contractions generally last_30_ seconds and come every _15_to 20_ minutes.?2. Where are true contractions felt??They are felt low in the belly or back.3. During active labor a.) how often do contractions come and They start coming every 3 to 5 minutes apart.b.) how long do they last?In late labor they may last up to 1 ? minutes (with only 2-3 min) between them4. List 3 ways you can help a mother relax during labor.?Touch: firm hand pressing on lower back, massage feet or back between contractions, hot or cold cloths on the lower back.Sounds: making sounds in labor can help women to open, low sounds like growling animal noises, humming, some women chant or sing.(High pitch sounds usually do not help)Breathing: Slow gentle breathing- ask the women to take a long slow breath- mouth shaped like a kiss and slowly blowHee breathing- the women takes slow deep breath and blows out short and quick breaths while she makes soft hee heePanting- the woman takes quick shallow breathStrong blowing- the women blows hard and fast5. List 2 important aspects to check in early labor.?Check the mom and baby thoroughly for healthy and warning signs.(Position of the baby, babies heartbeat, mothers pulse, mothers temperature, mothers blood pressure)6. What color should the waters be when they break??Clear or a little pink.Green or yellow waters and clumps of stool are a warning sign.(If the water is darker and there are clumps of meconium get medical help)7. How long after the water breaks should a baby be born??The baby should be born within 24hrs, so 12hrs after the water breaks labor should start. (One day and one night)8. What should a maternal pulse be during labor??Between 60-100 (a fast pulse can be caused by different problems: infection, blood loss, dehydration, fear)A faster pulse is normal as long as it goes back to normalA very slow pulse can be a sign of severe blood loss and shock.9. What does it usually mean if the BP drops 15 points??If the blood pressure drops 15 points or more in the bottom number (diastolic) it can mean that the mother is bleeding heavily.10. If a woman is bleeding in labor, but does not have pain between contractions, what might it be??She might have placenta previa, which means the placenta is covering the cervix.(It’s a bright red bleeding, once the cervix is open she can breathe to death very fast so do not wait until the bleeding gets worse)11. If a mother feels pain between contractions and her womb remains hard, what might it be??It might be that the womb is torn, the womb is infected, the placenta is detached from the wall of the womb.12. List 5 signs the labor is progressing.?Contractions get longer and stronger and closerThe womb feels harder, when you touch it during contraction.Amount of show (discharge) increases Bag of water breaksThe mother burps, sweats and vomits or her legs shakeThe mother wants to push13. When has labor become too long for a first time mom?Labor has become too long for her when strong contractions last more than 24hrs14. When has labor become too long for a second time mom?When her contractions last longer than 12hrsRead Chapter 121. List 5 ways you know second stage is impending.?The mother has an uncontrollable urge to pushMom becomes more sleepy or focusedPurple line appears between the mother’ s buttocks (as they spread apart from The pressure of the babies head)The mothers outer genitals or anus begin to bulge out during contractionsThe mother feels the babies head move into the vagina.2. After the head is born, how long should it be until the body is born?Usually it slips out with two pushes.3. How long should the second stage last?It can last from a few minutes up to two hours.4. If a woman is bleeding while pushing, what 2 concerns might you consider??Detached placenta (a sudden gush of blood from the vagina, very fast or very slow babies heart beat, tense or sore womb, shock)Torn womb (contractions may stop, she may feel very strong constant pain)5. When should you cut the cord?There is no need to cut the cord right away, leaving the cord attached will help the baby to have enough iron in his blood. (the cord will be fat and blue right after birth and you will feel the pulsing) when the placenta separates from the wall of the womb the cord will get thin and white and stop pulsing.Now the cord can be cut.Read Chapter 131. What occurs during the third stage of labor??The placenta is born.2. What are 3 ways a woman can hemorrhage??Fast heavy bleeding: the mother may lose a lot of blood at once or blood may flow heavily for several minutes, often she will quickly feel faint and weak.A slow trickle: a steady bleeding, or even just a trickle can mean the mom is in dangerHidden bleeding: blood collects in the vagina, the women may feel faint and weak, her pulse will speed up or slow down, her womb may rise and the belly fills with blood(this blood is dark and usually thick)3. List 3 ways you might know the placenta has separated.?A small gush of blood coming from the vagina. (a handful of blood)The cord looks longer. (The womb rises.4. A cord should have 3 vessels: 2 _small____ and 1 _large_____.?5. What is the most common reason a woman bleeds after birth??Because the womb will not contract/so the womb stays soft (reasons: bladder is full, a piece of placenta or membrane is still in the womb, the womb needs more oxytocin, or more stimulation, the womb is infected)(Contractions will stop the bleeding)(Piece of placenta left inside, torn vagina)6. What 5 aspects of the newborn should you assess immediately??Breathing, heartbeat, muscle tone, reflexes, color)7. A baby’s heartbeat after birth should be _120__-__160__.?8. a.) What color is a baby when it is born and Blue or purpleb.)how long should this last?1 or 2 minutesRead Chapter 141. List 6 things you should do and help a mother do following birth.?Clean mom’s genitals, legs and bellyCheck the mother’s genitals for tears and other problemsHelp the mother urinateHelp the mother eat and drinkWatch the mother’s feelings about her babyWatch the mother for infectionHelp with breastfeeding2. What can tell you a lot about the health of a newborn?The general appearance (the way the baby looks)(Is the baby small or lager, thin or fat, are arms, legs, feet, hands the right size, is the baby tense or relaxed, active or still, listen to babies cry)3. How often should you check a mother and a newborn following the immediate postpartum period?Check it every 2 to 6 hours after birth or more if the baby has problems.4. A baby should breathe 30_-60_ BPM.?5. What is the best way to keep a baby warm following birth??Skin to skin with the mother.(Cover them both with blankets and make sure to cover baby’s head)6. Most babies weigh between _2.5 kg____ and 4kg___. ................
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