2. INTRODUCTION
Pregnancy is a biological process in which a woman carries a developing embryo or fetus
within her uterus.
It typically lasts around 40 weeks or nine months an dis divided into three trimesters.
Labor refers to the process by which the uterus contracts to push the baby out of the
mother’s body and into the outside world.
Labor is typically divided into three stages;
1.Stage one
2.Stage two
3.Stage three
3. As First Aider start with primary survey(DRABC)
Danger-Make the area safe and private
Response- check if she is –A-alert
V-voice(can explain the pain)
P-pain
U-unconscious
Airway-make sure the airway is clear
Breathing should be normal and clear
Circulation –if no bleeding stay with patient and re-assure until help arrive
4. SIGNS OF LABOUR
Regular contractions-Contractions are the most common signs of labor.They are usually
felt as a tightening and release of uterus and become more regular and stronger as
labor progresses.
Cervical dilation-As the cervix begins to dilate, it can cause some discomfort or mild
pain.
Bloody flow-This refers to the passing of a mucus plug ,which is a sign that the cervix is
starting to dilate ,it can cause some discomfort or mild pain.
Water breaking-This occurs when the amniotic sac surrounding the baby breaks, and
fluid leaks out.
Pelvic pressure-As the baby moves down into the birth canal, you may feel increased
pressure in your pelvis.
Back pain-Many women experience lower back pain during labor as the baby moves
downward.
5. STAGES OF LABOR
STAGE ONE
In this stage , a woman’s body begins to experience contractions ,which
,together with the pressure of the baby’s head ,cause the cervix(neck of the
uterus/womb)to open .
The contractions becomes stronger and more frequent until the cervix is fully
dilated(open) and about 4 in 10cm and ready for the baby to be born. During
this first stage ,the mucous plug that protects the uterus from infection is
expelled and amniotic fluid surrounding the baby leaks out from the vagina .
This stage can take several hours for a first baby but is normally shorter in
any subsequent pregnancies.
6. continuation
STAGE TWO
Once the cervix is fully dilated, the baby’s head will press down on the
mother’s pelvic floor, triggering a strong urge to push.
The birth canal stretches as the baby travels through it.
The baby’s head normally emerges first and the body is delivered soon
afterward.
The stage lasts for about an hour.
7. continuation
STAGE THREE
About 10-30 minutes after the baby is born ,the placenta (the organ that
nourishes the unborn baby) and the umbilical cord will be expelled from the
uterus.
The uterus begins to contract again, pushing the placenta cut, then it closes
down the area where it was attached; this reduces the bleeding.
8. EMERGENCY CHILDBIRTH
1. CALL 911 FOR EMERGENCY HELP-Give the 911 dispatcher details of the stage the
mother has reached, the length of each contractions and the intervals between
them. Follow the instructions of the dispatcher.
2. DURING THE FIRST STAGE-Help her sit or kneel on the floor in a comfortable
position. Support her with cushions or let her move around. Stay calm, and
encourage her to breathe deeply during her contractions.
3. MASSAGE HER LOWER BACK GENTLY-Using the heel of your hand. She may find
having her face and hands wiped soothing or you can spray her face with cool
water and give her ice cubes to suck.
4. WHEN THE SECOND STAGE STARTS-The mother will want to push. Make sure the
surroundings are as clean as possible to reduce the risk of infection. The mother
should remove any items of clothing that could interfere with the birth; Put clean
sheets be covered. Encourage her to stay as upright as possible.
9. continuation
5. AS THE BABY IS BORN-Handle him carefully-newborns are very slippery. Make sure he is
breathing, wrap him in a clean cloth, towel, or blanket and place him between his mother’s
legs so he is on the same level as the afterbirth.
6. AS THE THIRD STAGE BEGINS-Reassure the mother. Support her as she delivers the
afterbirth; do not cut the cord. Keep the placenta and the umbilical cord. Keep the
placenta and the umbilical cord intact because the doctor or ambulance crew need to check
that it is complete. If bleeding or pain is severe ,treat for shock .Help the mother lie down
and raise her legs.
10. CAUTION
Do not give the mother anything to eat because there is a risk that she may
vomit. If she is thirsty give her sips of water’.
Do not pull on the baby’s head or shoulders during delivery.
If the umbilical cord is wrapped around the baby’s neck as he is born, check
that it is loose ,and then very carefully ease it over the baby’s head to
prevent strangulation.
If newborn baby does not cry, open the airway and check breathing. Do not
slap the baby.
Do not pull or cut the umbilical cord, even when the placenta has been
delivered.
11. Postpartum complications and their
management
1. Postpartum hemorrhage ;This is excessive bleeding after childbirth ,usually defined as
blood loss greater than 500ml after vaginal delivery or greater than 1000ml after
cesarean delivery .
Management; administering uterotonics to help the uterus contract ,ensuring adequate
hydration and blood transfusion if necessary.
2. Endometritis; This is an infection of the lining of the uterus.
Management ;use antibiotics and supportive care
3.Urinary tract infection ;Women are at increased risk od developing UTI infection
Management ;use antibiotics
4. Perineal trauma (episiotomy); This includes tears or laceration to the perineum(the
area between the vagina and anus)during childbirth .
12. cont
Management; reduce pain ,sitz baths(hydrotherapeutic bath taken in a sitting position,
and sometimes stitches to repair the tears.
5. Deep vein thrombosis ;Women who have just given birth are at increased risk of
developing blood clots in their legs.
Management; early ambulation, compression stockings, and sometimes anticoagulant
medication.
6.Postpartum depression; This is a common mood disorder that affects women after
childbirth.
Management; psychotherapy and sometimes medication.
7. Breastfeeding difficulties ;some woman may experience difficulties with breastfeeding
,such as sore nipples or inadequate milk production.
13. Management :involves working with a lactation consultant and sometimes medication
to increase milk supply .
N/B colorless fluid immediately after birth is strong nutritious colorless milk and
should be fed to the infant .
