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Maternity Nursing, Labor & Delivery / Newborn
Labor and Delivery Terms
Para: Para refers to the number of live births a woman has had (it might be a stillbirth, or twins, or even triplets) past the 20-week gestation period (Zimmerman, p. 116).
Gravida: this refers to the number of times a woman has been pregnant, whether she actually gave birth, had an abortion or a stillbirth (Zimmerman, p. 116).
Amniotic Sac: this is a membrane around which the fetus is surrounded. It is a strong series of membranes that is visible after 7 weeks of gestation. (Jurkovic, et al., 2011).
Cervical Effacement: this phrase refers to the measurement of the expansion of the cervix as the baby gets closer to being born. When the cervix is 50% effaced, it is halfway to being ready for the baby to be born (Jurkovic, et al., 2011).
Cervical dilation: Slowly but surely the cervix begins to open (called dilation) to prepare for the eventual birth of the baby (Jurkovic, et al., 2011).
Station: Station refers to the "relationship of the fetal presenting part to the level of the ischial spines" -- basically this means how far the baby is "down" in the pelvis (Nursing Ethics).
Engagement: this is the point at which the baby's head pokes down through the pelvic canal prior to birth (Jurkovic, et al., 2011).
Position: The various physical positions or postures that a woman about to give birth may decide to take during delivery; it may be called "maternal birthing positions" and may entail squatting, kneeling on all fours, standing, or other positions (American Journal of Maternal/Childbirth Nursing -- MCN).
The Three Stages of Labor: a) [dilation] first comes the shortening of and the dilation of the woman's cervix as the labor phase begins; b) [expulsion] next, the descent of the infant down the birth canal concludes the second phase; c) [placental] finally the birth of the placenta takes place (afterbirth) (Zimmerman, et al.).
Presentation: this is the actual position of the fetus at the time that the woman is delivering her baby; as the attending obstetrician puts his finger through the opening in the cervix, he knows what part of the baby's body is coming down, normally the head (Encyclopedia Britannica).
PROM: This acronym means premature (or prelabor) rupture of membranes; generally the membranes rupture prior to the woman going into labor; sometimes the tear in the membranes seals over (Encyclopedia Britannica).
SROM: The spontaneous rupture of membranes (sometimes referred to as "The waters go"); this happens at full term and the rupture is usually at the lower part of the uterus, over the cervix, that causes a sudden surge of fluid (Jurkovic, et al.).
AROM: this is the artificial rupture of membranes (when a doctor is inducing labor) (Jurkovic, et al.).
The Three Parts of a Contraction: First, the pregnant woman experiences contractions in the follicular phase, once or twice a minute (they last up to 15 seconds) (the first stage can be divided into early latent phase, and ensuing active phase); next, in ovulation the contractions increase to three or four a minute during the active phase of labor (3-4 centimeters of cervical dilation are shown)…and the third phase of contractions is the luteal phase, during which time the frequency and intensity of the contractions are lowered (Zimmerman / Medscape).
Three Assessments of a Contraction: Susan Orshan's book explains that there are three points at which assessments of contractions is done: the frequency of contractions; the intensity of contractions, and the duration (which is linked to the time contractions began) (Orshan, 2007).
Fetal Monitoring: early decelerations: when monitoring the fetal heart tones, there is the early decelerations -- the baby's heart rate starts so slowly, slightly decrease; this is caused by the fact that the baby's head is now in the birth canal, hence the vagus nerve is being compressed which in turn causes the decrease in heart rate (Orshan, 2007).
Fetal Monitoring: late decelerations: When the contractions began for the mother the baby's heart rate lowered but when the contractions stopped, the heart rate of the baby went back pretty much to normal. But once again if the baby's heart rate slows down Orshan (2007) suggests putting mom on her side. Late decelerations are not necessarily a good thing; that's why careful monitoring of the whole process of childbirth needs to careful and consistent.
Fetal Monitoring: variable decelerations: in this case the umbilical cord becomes compressed and so the baby's heart rate slows down (basically the baby is not receiving enough oxygen); these decelerations are not to be taken lightly (Orshan, 2007).
Pre-op care for a mother scheduled for a Cesarean birth would include: the mother should be made fully aware of the realities and the potential dangers of Cesarean birth. The general anesthesia she will undergo needs to be understood and accepted by the family. The baby will only receive a small amount of the anesthesia and will not be put to sleep. The mother must be in good physical condition, staying mobile and active to avoid blood clots; if she is anemic (blood tests will identify this) she will need to take iron tablets (Zimmerman, 2010).
Post-op care for the mother giving birth through Cesarean method: during the recovery period mother will have her vital signs checked and monitored; the firmness of her uterus and her flow of blood are monitored frequently. After moving into the regular room, from the recovery room, mother will have the IV until her intestines once again are working correctly. Relief for pain is given (Duramorph); walking may be painful with the stitches, but it is important as part of the post-op activities to breathe freely and move about (Zimmerman, 2010).
Post Partum / Stage 4 of Labor: The fourth stage is when mother's body begins to stabilize after the trauma of childbirth; the mother's well-being must be monitored often and thoroughly; she is emotionally drained so love, attention, and connection with her baby and her family are vital.
Post Partum / Involution: the body reverts back to what it was in the pre-pregnant stage; the genital organs revert back to their previous state of being during involution (Zimmerman).
Post Partum / Sub-Involution: this is a condition that is characterized by the presence of pelvic infection and some remaining placental materials, which can delay the normal post partum involution (Orshan).
Post Partum Afterpains: these pains or cramps are the result of the contractions the uterus is going through as it shrinks back to the approximate size it was before pregnancy; they don't last very long and for first-time moms they likely will have better uterine muscle tone and the cramps will go away fairly quickly. (Zimmerman).
Post Partum Lochia: this is basically the normal bleeding that goes along with giving birth; the body prepares the mother for this by increasing the amount of blood by about 50% during pregnancy so there generally is no fear of blood shortages in the mother's body. When the placenta is separated from the uterus, blood vessels in the attached area of course begin to bleed, and the blood flows into the uterus. (Zimmerman).
Post Partum Rubra: this is the bright red bleeding that occurs immediately after childbirth (Heller, et al., 2008).
Post Partum Serosa: four or five days after delivering a baby, the mother may experience a serious discharge from the vaginal area; it will be a pink or brownish discharge (Heller, et al.).
Post Partum Alba: this is the final discharge from the vagina after childbirth, and the amount of yellowish-white flowing decreases and the leukocytes are increasing; this usually stops after three weeks but can last up to six weeks (Heller, et al.).
Colostrum: this is the first milk that a post partum mother secretes for her baby; it contains more lactaiburmin and lactoprotein than mother's milk will contain later; the first milk from mother after birth contains antibodies that help the baby get some immunity (Heller, et al.).
Engagement: When the baby first moves its head during labor, and its head (the widest part) enters into the pelvic inlet, it's called engagement (Heller).
Mastitis: this is an infection of the breast; the mother is not used to a baby sucking and tugging on her nipple so they get sore; they may be cracked and that allows an opening in the breast and allows staphylococcus aureus (typically the bacteria that gets into the breast) to get in. This can be painful for the mother but only about 10% of new mothers get mastitis (Heller).
Postpartum Depression: first the new mother kind of gets the blues in a few days and weeks after giving birth; she may become edgy, cry a lot, have anxiety and mood swings; she can also become quite depressed and blue several weeks after the birth, have trouble sleeping, lose or gain weight in significant amounts (Volpe, 2008).
Postpartum Psychosis: this is a more serious case of postpartum depression; the mother has acute disorders in this instance…[continue]
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