The Birth Process
Mamie Guidera, CNM, MSNCarol O’Donoghue, CNM, MSN, MPH
Normal Labor and birth: Objectives
IntroductionsPhysiologic labor and birth: the basics
Phases of labor Birth video The P’s: Power, passageway, passenger, etc.
Briefs: American birth & (some of the) influences:
Where births take placeCultural expectations of pain managementA word on Fetal Monitoring
Here’s the truth: Childbirth is not only a physiologic phenomenon, but a cultural/sociological experience. So before you walk onto the Labor Floor, ask yourself:
o Where/how did you first learn about how a baby is born? What do you know about your own birth?
o Who (family member, friends, healthcare provider) or what (your medical training, book, television show, movie) has influenced your perception of labor? What birth stories come to your mind first?
o Is there such a thing as “good” pain? If you are an athlete, have you ever sought out physical discomfort? Why?
o Have you ever been in pain? How did you deal with it?
o What do you think is the role of the healthcare provider in birth?
Birth in the United States
Site of birth Hospital Birth Center Home
Model of birth Medical Model Midwifery Model
Stages of Labor
First stage: early, active, transition Dilatation
Second stage Pushing and birth
Third stage Delivery of placenta
Fourth stage Postpartum
True vs False Labor:
Williams Obstetrics (22nd edition)
True Labor: Contractions occur at
regular intervals Intensity gradually
increases Discomfort is in the
back and abdomen. Cervix dilates. Discomfort is not
stopped by sedation
Contractions are irregular
Intensity remains the same
No cervical dilatation
Discomfort relieved by sedation
The Ps of Labor
Woman/Fetus Power Passageway Passenger Position Psyche
Providers/Support Persons: Patience Persistence Practice/ Pain Relief Psyche
The PassagePelvic Bones and Pelvimetry
The PassagePelvic Bones and Pelvimetry
Passenger: Attitude
Passenger: Presentation
Passenger: Presentation
Birth
Perineal management (keep your hands off
Mirror
Ask mother to feel the baby’s head
Stay focused on woman, not tasks