Māori Birthing Practices and Cultural Respect

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Questions and Answers

Which type of presentation can birth occur vaginally if mentum is anterior?

Vertex Presentation

Occiptoposterior Presentation

Face Presentation (correct)

Brow Presentation

What is a key characteristic of Brow Presentation?

It involves a fully flexed fetal position.

It typically occurs in vertex position.

It can always result in vaginal birth due to favorable diameter.

The diameter cannot descend into the pelvis. (correct)

How long after a stillbirth should remains be buried or cremated?

No longer than 5 days. (correct)

No longer than 7 days.

No longer than 3 days.

No specified time limit.

What is the position of the occiput in an Occiptoposterior presentation?

It lies adjacent to the sacro-iliac joint. Signup and view all the answers

Which statement about the required education for midwives under the Medicines Amendment Act (2013) is true?

Midwives need specific education to prescribe controlled drugs. Signup and view all the answers

What is the term for a fully deflexed Vertex Presentation?

Occipitofrontal Signup and view all the answers

What is the rotation degree of the occiput during long rotation as descent continues?

135° Signup and view all the answers

Which term refers to the dignity of the wahine and her whanau being maintained?

Mana Signup and view all the answers

What does Hau Ora encompass in relation to the wahine and her whanau?

All aspects of wellbeing Signup and view all the answers

What occurs during the short rotation of descent in fetal birth from the occipito-posterior position?

The sagittal suture rotates anteriorly. Signup and view all the answers

Which concept ensures the involvement of others in the birthing process?

Whanaungatanga Signup and view all the answers

Which term refers to the holistic model of healthcare developed by Mason Durie?

Te Whare Tapa Wha Signup and view all the answers

Which diameters are measured to diagnose fetal position during birth?

Bisacromial and bitrochanteric diameters Signup and view all the answers

What defines a first-degree tear during childbirth?

Injury to the perineal skin and/or vaginal mucosa. Signup and view all the answers

What is the responsibility of the midwife in terms of Manaakitanga?

To share the goal of a safe, healthy outcome Signup and view all the answers

Which of the following correctly describes a third-degree tear?

Involves both the external and internal anal sphincter. Signup and view all the answers

What does Pepara refer to in a cultural context?

Father Signup and view all the answers

Which of the following describes the role of kaumate?

Elders Signup and view all the answers

What is the outcome of deep transverse arrest during labor?

The occipito-frontal diameter gets trapped in the transverse outlet. Signup and view all the answers

What must happen within 5 working days following a delivery?

Notification of birth must be completed by the midwife Signup and view all the answers

Which muscles are cut during a mediolateral episiotomy?

Transverse perineal, bulbocavernosus, iliococcygenus, and pubococcygenus. Signup and view all the answers

What is a characteristic of a midline incision compared to other types?

It is associated with an increased risk of extension. Signup and view all the answers

What happens to the occiput during the short rotation phase of birth?

It rotates 45° or 1/8 of a circle anteriorly. Signup and view all the answers

Which hormone stimulates growth and the development of LH receptors in granulosa cells?

FSH Signup and view all the answers

What is the primary reason for the ovum's limited survival after ovulation?

It is prone to degradation within hours. Signup and view all the answers

How does syngamy prevent multiple sperm fertilizing an ovum?

Through a change in the electrical potential of the ovum. Signup and view all the answers

How long does the zygote typically remain in the ampulla of the fallopian tube?

24 hours Signup and view all the answers

What happens during the cleavage of the zygote as it moves towards the uterus?

The number of cells increases but not their total size. Signup and view all the answers

When does the first cell division into the two cell stage occur after fertilization?

30 hours Signup and view all the answers

What is the name of the solid cluster of blastomeres formed by day 3 after fertilization?

Morula Signup and view all the answers

At what gestation week can fetal breath movements first be detected?

10 weeks Signup and view all the answers

What is the separation timing for monochorionic-monoamniotic (MCMA) twins?

8-13 days Signup and view all the answers

What is the optimal timing for the MSS1 combined test?

9-10 weeks Signup and view all the answers

Which test involves taking 10-15mL of amniotic fluid for testing?

Amniocentesis Signup and view all the answers

What is the mortality rate of twin-to-twin transfusion syndrome (TTS) if left untreated?

80-90% Signup and view all the answers

What is formed when uterine secretions pass through the zona pellucida into the morula?

Blastocyst cavity Signup and view all the answers

Which structure develops into the fetal part of the placenta?

Trophoblastic layer Signup and view all the answers

What defines the region beneath the site of implantation?

Decidua basalis Signup and view all the answers

During which stage does surfactant production begin in fetal development?

Weeks 21-25 Signup and view all the answers

What is the purpose of the trophoblastic layer before the placenta forms?

Nourish the fertilized ovum Signup and view all the answers

Which layer of cells develops into the nervous system and skin?

Ectoderm Signup and view all the answers

At which day after fertilization does the blastocyst begin implantation?

Day 6 Signup and view all the answers

What forms the bilaminar disc around day 7?

Both hypoblast and epiblast cell layers Signup and view all the answers

Study Notes

Whakapapa and Acknowledgement

Acknowledgement of the woman and her whanau is crucial.
Whakapapa provides context and respect.

Karakia and Te Reo Māori

The use of Karakia (prayers) and Te Reo Māori is encouraged during the birthing process.
Language and cultural practices should be respected.

Whanaungatanga

The importance of involving whanau in the birthing process.
Others involved, such as midwives, should be included.

Mana, Hau Ora, and Tikanga Whenua

Maintaining the dignity of the woman and her whanau is essential.
Promoting physical, spiritual, emotional and mental wellbeing is key.
Connecting to land, life, and nourishment is a core principle.
Knowledge and support from elders are necessary.

Te Whare Tangata and Mokopuna

The woman is acknowledged and respected as a person.
Recognizing the role of the mokopuna (future generations)
Importance of creating a supportive and healthy environment.

Manaakitanga and Te Whare Tapa Wha

Midwives, as key persons, share the goal of a safe and healthy birth with the woman and her whanau.
The Te Whare Tapa Wha model of holistic healthcare provides support.

Cultural Competence

Midwives must recognize the impact of their own culture and beliefs on their practice.
Acknowledge different cultures to provide individualized care.
Acknowledge and understand the dynamics of power within health care relationships.

Adoption

The interim order is submitted 12 days after birth.
The final order occurs at least 6 months later.
Social workers and state agencies are involved.
Individuals can request birth parent information after 19 years of age and block contact with birth parents after 20 years of age.

Registration

Notification of birth (BDM9) is required within 5 working days of delivery.
Both parents complete a registrar of birth (BDM27) within 2 months of birth, including personal details and citizenship.
A death certificate (BDM167) is compulsory for stillbirths, registered within 3 days of disposal.
Cases reported to the Coroner must be notified to the Registrar.
BDM9, BDM167, and BDM27 are legally necessary for stillbirths.

Prescribing

Midwives with the necessary education can prescribe controlled drugs.
Morphine and fentanyl are permitted.
Pethidine is allowed during labour and immediately postpartum.

Fetal presentation

Descriptions of various fetal presentations (vertex, face, brow).
Specific measurements and locations.
Descriptions of complications (e.g. occipito-posterior, deep transverse arrest).

Birth injuries

First, second, third, and fourth-degree tears.
Specific details about each tear grade.

Midline and Anterior Episiotomy

Descriptions of the surgical incision.
Explanation of how to suture the incision.

Maternal Health Indicators

FSH, LH and the functions of the hormones.
Ovum and sperm survival in the reproductive tract.
Descriptions of stages in the development of the blastocyst.
Descriptions of the development of trophoblast & inner cell mass.
Descriptions of the decidua and implantation.
Pregnancy and gestational weeks.
Maternal serum and blood markers for screening
Descriptions of amniocentesis and CVS procedures.
Assessment of preterm, late preterm, and extremely preterm pregnancies.

Maternal conditions

Complications like preeclampsia, gestational hypertension, diabetes, and anaemia.

Delivery of the Placenta

Latent phase, Detachment phase, and Expulsion Phase.

Types of Birth

Description of different types of birth (vaginal, caesarean) and complications.

Variations in Pregnancy and Delivery

Variations in pregnancy and delivery, such as; complications, infections & diseases that must be understood and addressed in a timely fashion.

Newborn conditions

Neonatal conditions, such as; jaundice, encephalopathy and congenital conditions.

Infections

Causes and management of various infectious diseases in pregnancy and immediately postpartum.
Examples of infections, and management.

Other important conditions

Maternal and fetal conditions that must be addressed during pregnancy, and labour, and for immediate follow-up care.
Examples, and descriptions.

Medications

List of medications, their dosages, routes of administration, and side effects.

Variations in newborn conditions

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Description

Explore the significance of Māori cultural practices in the birthing process, including the role of whakapapa and whanau. This quiz emphasizes the importance of karakia, te reo Māori, and holistic well-being in maternal care. Delve into the principles of manaakitanga and the supportive environments created for mothers and future generations.