LABOR

Araceli Flores Surat, MAN

LABOR
 Process by which the fetus and products of conception
are expelled as the result of regular, progressive,
frequent, strong uterine contractions.
 Coordinated sequence of involuntary, intermittent uterine
contractions
THEORIES OF LABOR
1. UTERINE stretch theory
2. Oxytocin theory
3. Prostaglandin theory
4. Progesterone deprivation theory
5. Aging placenta/Placental age
PRELIMINARY SIGNS OF LABOR

1. Lightening
 Pelvic pain
 Easier breathing
 Shooting leg pain
 More vaginal discharge
 Frequent urination
 Back pain
 diarrhea
PRELIMINARY SIGNS OF LABOR
2. Increase in level of activity-
3. Slight loss of weight
4. Braxton Hicks contraction
4. Ripening of the cervix
DIFFERENCES BETWEEN TRUE AND FALSE
LABOR

Criteria True labor False labor

Uterine contraction Begins irregular-regular Begns and remains
irregular
location Felt first in the lower Felt first abdominalyy
back and sweep around and remain confined to
to the abdmen in wave the abdomen and groin

Pain Continue no matter what Often disappear with

is the woman’s level of ambulation and sleep
activity
Frequency, intensity, Increase frequency and Do not increase in
duration intensity duration, frequency or
intensity
Cervical dilatation Achieve cervical Does not achieve
dilatation cervical dilatation
TRUE LABOR
 Uterine contraction
 Show

 Rupture of membrane
COMPONENTS OF LABOR
 4P’s:
A. Passage – route that the feus must travel from the uterus
through the cervix and vagina to external perineum
Types of Pelvis:
1. Android- male pelvis

2. Anthropoid-oval; AD >TD

3. Platypelloid – flat, TD >APD

4. Gynecoid = females pelvis, round, APD=TD

B. PASSENGER
 Station
- Bones  Caput succedaneum
- Occiput  Position
- Sinciput  Mechanisms of labor
- Suture lines
- Fontanelles
- Diameter of the skull
- Molding
- Fetal presentation
- Fetal lie
- attitude
 Head – has the largest diameter
 Comprises of 8 bones:

a. 4 superior bones
- Frontal

- 2 parietal

- Occipital

b. Other 4 bones:
- Sphenoid bone

- Ethmoid bone

- 2 temporal bones
 DIAMETERS OF THE SKULL
 The shape of the skull causes it to be wider in its
anteropostrerior diameter than in its transverse diameter
 To fit to the birth canal, the fetus must present the
smaller diameter ( transverse diameter) to the smaller
diameter of the maternal pelvis
 The diameter of the anetorposterior fetal skull depends
on where the measurement is taken.
 suboccipitobregmatic diameter
 Approx. 9.5 cm

 From the inferior aspect of the occiput to the center of the anterior
fontanelle
 Narrowest diameter

 Occipitofrontal diameter
 From the bridge of the nose to the occipital prominence

 Approx 12 cm

 Occipitomental diameter
 Widest anteroposterior diameter

 Approx 13.5 cm

 Measured from the chin to the posterior fontanelle

FETAL PRESENTATION
 Denotes the body part that is in 1st contact to the cervix
 Types:

A. Cephalic

- vertex
- brow
- face
- mentum
B. Breech
- Complete

- Frank

- footling

C. shoulder
FETAL LIE
 Relationship between thelong axix of the fetal body and
the long axis of the woman’s body
ATTITUDE
 Degree of flexion the fetus assumes during labor
Types:
a. Good flexion
- Convex back

- Arms are flex and folded on the chest

- Thighs are flexed to the abdomen

a. Moderate flexion
- Chin is not touching the chest

- Military position
c. Partial extension
- Presents the brow of the head to the birth canal
d. Poor flexion
- Back is arched/concave
 Neck is extended

 Occipitomental diameter is being presented to the birth

canal/ face presentation
STATION
POSITION
 Is the relationship of the presenting part to a specific
quadrant of the woman’s pelvis
 1st letter = defines the landmark of the mother

- right (R) left (L)

2nd letter = denotes fetal landmark
- O- occiput
- M- mentum

- - A – acromium

- Sa – sacrum

- 3rd letter = defines whether the landmark points

- Anteriorly (A). Posterioly (P), Transversely (T)

MECHANISMS OF LABOR
MECHANISMS OF LABOR
E
D
F
IR
E
ER
E
C. POWER
 Increment
 Acme

 Decrement

 Frequency

 Duration

 Interval

 Cervical changes
D. PSYCHE