Chapter 3 - Theories of Labor Onset and Signs of Labor PDF

CARE OF MOTHER, CHILD, ADOLESCENT | NCM 107 CHAPTER 3: THEORIES OF LABOR ONSET AND SIGNS OF LABOR THEORIES OF LABOR ONSET & SIGNS OF LABOR SIGNS OF TRUE LABOR THEORIES OF L...

CARE OF MOTHER, CHILD, ADOLESCENT | NCM 107 CHAPTER 3: THEORIES OF LABOR ONSET AND SIGNS OF LABOR THEORIES OF LABOR ONSET & SIGNS OF LABOR SIGNS OF TRUE LABOR THEORIES OF LABOR ONSET Signs of true labor involve uterine and cervical changes. It is believed that labor is influenced by a combination of 1. UTERINE CONTRACTIONS factors originating from the mother and the fetus. The surest sign that labor has begun is productive uterine These factors include the following: contractions. 1. Uterine muscle stretching, which results in release of Because contractions are involuntary and come without prostaglandins. warning, their intensity can be frightening in early labor. 2. Pressure on the cervix, which stimulates the release of Helping a woman appreciate that she can predict can control oxytocin from the posterior pituitary. the degree of discomfort she feels by using breathing exercises 3. Oxytocin stimulation, which works together with offers her a sense of control. prostaglandins to initiate contractions. 2. SHOW 4. Change in the ratio of estrogen to progesterone (increasing estrogen in relation to progesterone stimulates As the cervix softens and ripens, the mucus plug that filled the uterine contractions) cervical canal during pregnancy (operculum) is expelled. 5. Placental age, which triggers contractions at a set point The exposed cervical capillaries seep blood as a result of 6. Rising fetal cortisol levels, which reduce progesterone pressure exerted by the fetus. formation and increase prostaglandin formation. The blood mixed with mucus, takes on a pink tinge and is 7. Fetal membrane production of prostaglandin, which referred to as “show” or “bloody show”. stimulates contractions. Women need to be aware of this event so that they do not think they are bleeding abnormally. SIGNS OF LABOR 3. RUPTURE OF MEMBRANES PRELIMINARY SIGNS OF LABOR All pregnant women should be taught these signs so that they Labor may begin with rupture of the membranes, experienced can recognize when labor is beginning. either as a sudden gush or as scanty, slow seeping of clear fluid from the vagina. 1. LIGHTENING Two risks associated with ruptured membranes are: Descent of the fetal presenting part into the pelvis. 1. Intrauterine infection In primiparas, it occurs approximately 10 to 14 days before 2. Prolapse of the cord which can cut off the oxygen supply labor begins. to the fetus. As the fetus sinks lower in the pelvis, the mother may In most instances, if labor has not spontaneously occurred by experience shooting leg pains from the increased pressure on 24 hours after membrane rupture and the pregnancy is at the sciatic nerve, increased amounts of vaginal discharge, and term, labor is induced to help reduce these risks. urinary from pressure on the bladder. DIFFERENTIATION BETWEEN TRUE AND FALSE LABOR This changes a woman’s abdominal contour as the uterus CONTRACTIONS becomes lower and more anterior. Gives a woman relief from the diaphragmatic pressure and FALSE CONTRACTIONS shortness of breath. Begin and remain irregular In multiparas, it usually occurs on the day of labor or even after Felt first abdominally and remain confined to the abdomen labor has begun and groin 2. INCREASE IN LEVEL OF ACTIVITY Often disappear with ambulation and sleep Do not increase in duration, frequency or intensity A woman may awaken on the morning of labor full of energy. Do not achieve cervical dilatation This is related to an increase in epinephrine release that is initiated by a decrease in progesterone produced by the TRUE CONTRACTIONS placenta. Begin irregularly but become regular and predictable Additional epinephrine prepares a woman’s body for the work Felt first in lower back and sweep around to the abdomen in a of labor ahead. wave 3. BRAXTON HICKS CONTRACTIONS Continue no matter what the woman’s level of activity. Increase in duration, frequency, and intensity In the last week or days before labor begins, a woman usually notices extremely strong Braxton Hicks contractions which she Achieve cervical dilatation may interpret as true labor contractions. Remind her that if false contractions have become strong enough to be mistaken for true labor, true labor must not be far away. 4. RIPENING OF THE CERVIX Is an integral sign seen only on pelvic examination. Throughout pregnancy, the cervix feels softer than normal, similar to the consistency of an earlobe (Goodell’s sign) At term, the cervix becomes still softer (described as “butter- soft”) Ripening is an integral announcement that labor is very close at hand. LAMAGON | BSN 2A