Normal Labour and Delivery Quiz

Podcast Beta

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the recommended action if the head of the baby no longer recedes between contractions?

Increase maternal comfort measures

Administer entonox to the mother

Call for more medical personnel

Prepare for immediate birth (correct)

What is a characteristic of normal labour?

Multiple pregnancy

Singleton pregnancy with baby in breech position

Occurs before 37 completed weeks

Starts spontaneously after 37 completed weeks (correct)

Which scenario does not warrant calling a midwife despite imminent birth?

Mother has a history of quick labors (correct)

Home birth is booked

Mother has no previous obstetric history

Safeguarding concerns with the mother declining transfer

What is defined as 'birth imminent'?

Regular contractions every 1-2 minutes with an urge to push Signup and view all the answers

What should be included in the maternity pack for a birth?

Sterile field and umbilical cord scissors Signup and view all the answers

What action should not be taken when the baby is born?

Palpate the cord for pulsations Signup and view all the answers

Which colour of amniotic fluid suggests caution?

Brown/green Signup and view all the answers

During the second stage of labour, what is the primary physiological change occurring?

Contractions become expulsive as the baby descends Signup and view all the answers

Which of the following is most important for supporting the mother during birth?

Maintaining comfort and dignity Signup and view all the answers

What is a significant cause for concern during labour?

Any amount of fresh bleeding Signup and view all the answers

In terms of positioning, which method is recommended during childbirth?

Upright or leaning forward Signup and view all the answers

What is the correct definition of crowning during childbirth?

When the head is the widest part to be born Signup and view all the answers

What should be the immediate action after the baby is born?

Dry the baby thoroughly Signup and view all the answers

What does the Maternity Action Tool assist in evaluating?

Overall birthing risks and readiness Signup and view all the answers

Which of the following is NOT a sign of 'birth imminent'?

Long, irregular contractions Signup and view all the answers

What happens during the first stage of labour?

The cervix dilates from 0-10 cm Signup and view all the answers

What typically occurs to the umbilical cord within 5 minutes after birth?

It goes white. Signup and view all the answers

What is a sign that the third stage of labour has not progressed appropriately?

The placenta does not deliver within 20 minutes. Signup and view all the answers

Which of the following actions can help facilitate the delivery of the placenta?

Emptying the woman's bladder. Signup and view all the answers

In the context of a water birth, what should be done if a midwife is not present?

Ask the woman to exit the pool. Signup and view all the answers

What is the purpose of creating a separate electronic Patient Care Record (ePCR) for the newborn?

To provide information for future medical care. Signup and view all the answers

Which of the following is a critical step to determine if birth is imminent during labour?

Conducting a holistic assessment. Signup and view all the answers

What should be submitted if a maternity/birth experience is not straightforward?

A Datix report. Signup and view all the answers

Which method is not effective for stimulating oxytocin to aid in placenta delivery?

Encouraging emotional distress. Signup and view all the answers

What is a critical sign indicating that birth is imminent?

Regular contractions every 1-2 minutes Signup and view all the answers

During which stage of labour does the cervix dilate from 0-10 cm?

First stage of labour Signup and view all the answers

What is considered a cautionary sign regarding the color of amniotic fluid?

Brown or green Signup and view all the answers

What typically occurs during the second stage of labour?

Full dilation of the cervix until the baby is born Signup and view all the answers

Which symptom does NOT indicate a normal labor condition?

Presence of fresh bleeding Signup and view all the answers

What is the immediate action after the birth of the baby?

Clamp and cut the umbilical cord Signup and view all the answers

What is a common misconception regarding the stages of labor?

The first stage involves a sudden onset of intense contractions Signup and view all the answers

What indicates that the fetal heart rate is within a normal range during labour?

120-160 bpm Signup and view all the answers

What is the maximum estimated blood loss that is typically expected during the third stage of labour?

200-300mls Signup and view all the answers

What action can support the natural delivery of the placenta?

Stimulating oxytocin through skin-to-skin contact Signup and view all the answers

Which statement reflects an immediate course of action if the placenta does not deliver within 20 minutes of birth?

Do a pre-alert to the hospital Signup and view all the answers

In the context of water births, what should be the first step if a midwife is not present?

Request the woman to exit the pool Signup and view all the answers

What is the recommended way of collecting information for the electronic Patient Care Record (ePCR) for a newborn?

Include comprehensive details like gestation and presenting complaint Signup and view all the answers

What physiological principle can help with the positioning of a woman during the delivery of the placenta?

Implementing upright positioning to use gravity Signup and view all the answers

Which of the following options highlights a critical reason for submitting a Datix after a birth that is not straightforward?

To document potential incidents for review Signup and view all the answers

What is NOT a method to stimulate oxytocin for aiding in the delivery of the placenta?

Giving IV antibiotics Signup and view all the answers

What should be established to ensure the comfort and dignity of the mother during birth?

A warm environment and supportive techniques Signup and view all the answers

Which of the following items is NOT found in a maternity pack?

Surgical Scissors Signup and view all the answers

What action should be avoided when managing the umbilical cord immediately after birth?

Palpating the cord to check for pulsation Signup and view all the answers

What is the primary consideration when the birth is imminent and calling a midwife?

Booked for homebirth or medical concerns Signup and view all the answers

What is a critical step in the assessment of a newborn during the first minute of life?

Conducting ABCDE assessment Signup and view all the answers

Which method should be utilized to decide on the urgency of assessments during labor?

Iterative assessment with ongoing observation Signup and view all the answers

How should the baby be managed as the shoulders and body are being born?

Support the baby while lifting towards the mother’s abdomen Signup and view all the answers

What is the proper response if a mother experiences vaginal loss during labor?

Assess it alongside current risk factors Signup and view all the answers

Study Notes

Normal Labour

Starts spontaneously after 37 completed weeks
Singleton pregnancy
Cephalic presentation - baby's head is down
Contractions follow a wave-like pattern

Cause for Concern

Contractions prior to 37 weeks gestation
Multiple pregnancy (twins, triplets…)
Constant abdominal pain
Any amount of fresh bleeding

Stages of Labour

First Stage: Cervix dilates from 0-10cm, contractions become more frequent and strong
Second Stage: From full dilatation to the complete birth of the baby
Third Stage: From birth of the baby to the expulsion of the placenta + membranes

Birth Imminent

According to JRCALC: Regular contractions (every 1-2 minutes), urge to push, crowning

Crowning

When the widest part of the baby’s head is born
The head no longer recedes between contractions

Making the Call

Listen to the woman
Use the Maternity Action Tool
Be iterative in the assessment

Calling a Midwife

Limited use when birth is imminent
Exception: booked for homebirth, safeguarding or medical concerns, and mother declines transfer to hospital

Preparation for Birth

Ensure a warm environment
Have the Maternity Pack readily available
Prepare a safe space for the newborn (NLS area)
Gather all necessary equipment

Maternity Pack Contents

2 x Maternity Pads
2 x Poly Aprons
1 x New-Born Nappy/Diaper
1 x Self Seal Poly bag
1 x Umbilical Cord Scissors
2 x Hooded Baby Towels
1 x Sterile field
1 x Large Baby Hat
1 Adult ID Band
1 x Yellow Bag
1 x baby hat
4 x White Umbilical Clamps
1 x Baby ID Band
1 x Absorbent Inco Pad
10 x XRD Gauze Swabs (10x10cm)
1 x Blizzard Blanket

Supporting the Birth

Ensure comfort and dignity
Offer Entonox
Avoid the supine position
Keep a calm and reassuring demeanor
Encourage the woman to pant during crowning
Hold the baby as the shoulders and body are born

Baby - First Minute of Life

Keep the cord intact
Quickly and thoroughly dry the baby
Undertake ABCDE assessment
Use ‘Care of the Newborn’ card

Third Stage of Labour

Woman may experience contractions/pressure
Cord will lengthen
May be a gush of blood (does not exceed 200-300mls)

Management of the Third Stage

Encourage the woman to empty her bladder
Stimulate oxytocin (breastfeeding, skin to skin, calm environment)
Position change- gravity is your friend

Water Birth

Not within the scope of practice for ambulance clinicians
If a woman is in a pool, ask her to exit
If she declines, escalate early and explain the risks

Birth Documentation

Two ePCRs (one for the mother, one for the baby)
Include detailed information: mother's details, gestation, interventions, time of birth

Not a Straightforward Birth?

Submit a Datix report

Summary

Assess each situation holistically using the Obstetric Emergencies Card
Call for help early
Prepare an area for birth and NLS
Do not waste time calling a midwife unless booked for a homebirth or safeguarding issues
Create a separate ePCR for the newborn
Submit a Datix for any maternity/birth that isn’t straight-forward

Normal Labour

Starts spontaneously after 37 completed weeks of gestation
Singleton pregnancy
Cephalic presentation (baby's head is down)
Contractions follow a wave-like pattern
No red flags or abnormal observations present

Concerning Labour

Contractions prior to 37 weeks gestation
Multiple pregnancy
Constant abdominal pain
Abnormal observations
Any amount of fresh bleeding

Stages of Labour

First Stage: Cervix dilates from 0-10 cm
- Contractions start irregular and spaced in the latent phase. As labour progresses, contractions become stronger, longer and more frequent.
- Membranes may rupture but not always.
- Amniotic fluid colour matters:
  - Clear, straw coloured, or pink is okay.
  - Brown or green indicates caution.
Second Stage: From full cervical dilatation to complete birth of the baby
- Baby descends through the cervix into the birth canal
- Contractions become expulsive
- Woman may feel an urge to push and bear down with contractions.
- Presenting part of the baby (normally the head) becomes visible followed by the baby's birth.
Third Stage: From birth of the baby to expulsion of the placenta and membranes.
- Woman may experience contractions/pressure
- Cord lengthens
- There may be a brisk gush of blood (not exceeding 200-300 ml).
- If the placenta does not deliver within 20 minutes of birth, a pre-alert is necessary.

Birth Imminent

Regular contractions (every 1-2 minutes)
Urge to push
Crowning

Crowning

Widest part of the baby's head is born.
Head does not recede between contractions, and will be fully born (chin out) with the next contraction.

Making the Call

Listen to the woman
Consider the whole picture: gestation, parity, obstetric history, current risk factors, vaginal loss, and birth imminent signs.
Use the Maternity Action Tool.
Assessment should be iterative as things can change quickly.

When to Call a Midwife

Calling a midwife is of limited use when birth is imminent.
2 exceptions:
- Woman is booked for homebirth
- Safeguarding or medical concerns and the mother declines transfer to hospital

Preparing for Birth

Environment should be warm.
Assemble the maternity pack.
Prepare the NLS area.
Ensure resources are available at the scene.
Gather necessary equipment.

Supporting the Birth

Remember comfort and dignity
- Offer Entonox
- Avoid supine position
- Maintain eye contact, use warm touch, and a calm voice
- Keep hands poised as baby births.
- Encourage the woman to pant during crowning.
- Hold the baby as the shoulders and body are born, then lift the baby towards the woman's abdomen.

Baby - First Minute of Life

Keep the cord intact, regardless of baby's condition
Quickly and thoroughly dry the baby
Undertake ABCDE assessment (color, tone, breathing, heart rate).
Use 'Care of the Newborn' card on JRCALC+.

Baby in Good Condition

Wait for cord to go white.
Then clamp and cut the cord.
Avoid palpating the cord for pulsation as it may stop blood flow to the baby.

Management of the 3rd Stage

Encourage the woman to empty her bladder.
Stimulate oxytocin (breastfeeding, skin to skin, calm environment).
Position change; gravity is helpful.
Bring the placenta to the hospital for inspection.

Water Birth

Some women use hydrotherapy for pain relief in labour/during birth.
This is outside the scope of practice for ambulance clinicians.
If a woman is in a pool on arrival (and a midwife is not present), ask her to exit the pool.
If she declines, escalate early and document the discussion, explaining risks to her and her baby.

Birth Documentation

Complete two ePCRs (one for mother, one for baby).
Include as much information as possible:
- Mother's details: name, DOB, ethnicity.
- Gestation, parity, presenting complaint, estimated blood loss.
- Time of head delivered, time of birth.
- Any interventions or manoeuvres performed.

Non-Straightforward Birth or Transfer

For non-straightforward births or transfers with no concerns/red flags, report a DATIX.

Summary

Determining birth imminence requires a holistic assessment.
Use the Obstetric Emergencies Card to help with your assessment.
Be prepared; call for help early, set up the area for birth and NLS.
Don't waste time calling a midwife unless booked for homebirth or due to safeguarding issues.
Remember to create a separate ePCR for the newborn.
Submit a DATIX for any maternity/birth that is not straightforward.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Test your knowledge on the stages of normal labour, potential concerns, and the signs of imminent birth. This quiz covers key concepts such as cephalic presentation, contractions, and the process of calling for midwife assistance. Prepare to enhance your understanding of childbirth and maternal care.