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What defines normal labor?
Crowning occurs when the entire baby has been born.
False
What is the 2nd stage of labor?
From full dilatation of the cervix to the complete birth of the baby.
Regular contractions occurring every 1-2 minutes and an urge to ______ indicate birth imminent.
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Match the following stages of labor with their descriptions:
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Which of the following is a cause for concern during pregnancy?
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The color of amniotic fluid can indicate the condition of labor.
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What is considered a 'red flag' observation during labor?
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What is the primary action to take when the head is fully born during childbirth?
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Crowning refers to the stage when the head begins to visibly appear during contractions.
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What should be included in the maternity pack?
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During the first minute of life, the cord should remain _____ until it is safe to clamp and cut.
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Match the following components of the maternity pack with their purposes:
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Which of the following is NOT a reason to call a midwife when the birth is imminent?
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It's advisable to palpate the cord for pulsation immediately after the baby is born.
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What is the role of Entonox during childbirth?
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What is the time frame in which the placenta should be delivered after the birth of the baby to avoid alerting for assistance?
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A woman who opts for a water birth can remain in the pool even if a midwife is not present.
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What color will the cord typically turn after five minutes?
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One method to encourage placenta delivery is to stimulate __________.
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Match the following actions with their purposes during the 3rd stage of labour:
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Which of the following is NOT a common experience during the 3rd stage of labour?
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A separate __________ must be created for the newborn documentation.
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Breastfeeding can help stimulate oxytocin to assist with the delivery of the placenta.
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Study Notes
Mechanism of Labour
- Normal labour initiates spontaneously after 37 weeks of completed pregnancy with a singleton fetus in cephalic presentation.
- Contractions follow a rhythmic wave pattern; no concerning signs should be present.
Concern Signals
- Premature contractions before 37 weeks raise concerns.
- Multiple pregnancies (twins, triplets) present higher risk.
- Constant abdominal pain and abnormal observational findings (derangements) indicate potential issues.
- Any amount of fresh bleeding is a red flag.
Stages of Labour
- First Stage: Cervical dilation from 0 to 10 cm. Contractions transition from irregular and spaced to strong, frequent. Amniotic fluid color indicates status: clear/straw colored is normal; brown/green is caution.
- Second Stage: Begins at full cervical dilation until birth of the baby. Expulsive contractions signal the urge to push, typically with the head visible during crowning.
- Third Stage: From birth of the baby to delivery of the placenta and membranes. Contractions may occur with monitoring for a brisk gush of blood, which should not exceed 200-300 ml. If the placenta is not delivered within 20 minutes, alert medical professionals.
Assessing Birth Imminent
- Signs of imminent birth include regular contractions every 1-2 minutes, a strong urge to push, and crowning of the baby's head.
Preparation for Birth
- Create a warm environment and gather necessary equipment.
- Assemble a maternity pack which includes maternity pads, newborn diapers, umbilical cord scissors, towels, and clamps.
Supporting the Birth
- Maintain the woman's comfort and dignity. Use pain relief strategies like Entonox.
- Encourage proper positioning; avoid supine position.
- Provide emotional support through eye contact and calm reassurance. Hold the baby as it is born, directing it toward the mother’s abdomen.
Immediate Newborn Care
- Keep the umbilical cord intact initially, dry the baby thoroughly, and perform an ABCDE assessment (Color, Tone, Breathing, Heart Rate).
- Wait for the cord to turn white (normally after 5 minutes) before clamping and cutting.
Water Birth Considerations
- Water births are outside the scope of ambulance clinicians. If a woman is in a pool, advise leaving and explaining risks. Document any discussions.
Documentation
- Create two ePCR reports: one for the mother and one for the baby, recording vital details such as names, DOB, gestation, and birth times.
Special Circumstances
- Use a holistic approach to assess imminent births, considering gestational details and history.
- Document any non-straightforward births or transfers using DATIX for quality and safety reviews to improve future responses.
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Description
This quiz focuses on the crucial aspects of childbirth, including the mechanisms of labor, assessing imminent birth situations, and preparing for the delivery process. It will cover immediate postnatal care and the specific considerations for newborns. Additionally, it will provide insights into water birth practices and required documentation.
