Professional Documents
Culture Documents
Care Of-Women in Labour
Care Of-Women in Labour
Explanation:
1. Anatomy and physiology of labor in birth and post-partum period
The study of structure and relationship between the different body parts is anatomy and
the study of the function of the body parts is physiology.
At the parturition period i.e. a week ago the delivery date several physiological changes
occur in response to the hormones. After the pregnancy progesterone for the several
months inhibits uterine contraction but when pregnancy enter to the seventh month
progesterone level plateau and then it drops. In this period estrogen levels get rises.
Because of the rise of the estrogen to the progesterone myometrium become more
sensitive to stimuli that promote contraction of the uterine muscle. After the eight month
of the pregnancy fetal cortisol rises and it increases the formation of the estrogen
secretion and it further increases the calmness of the progesterone secretion. Some
women may feel weak and irregular at this period because of the progesterone declining.
These kinds of condition could be relieved by rest or hydration. A common sign known
as bloody show is observed at pregnancy period. A plug of mucous get accumulated at
the cervical canal blocking the path of the uterus. In about 1 or 2 days plug loosen and get
expel out with the small amount of blood. And posterior pituitary boost the secretion of
the oxytocin which stimulate the contraction of labor. At this stage sensitivity of
myometrium increases by the production of oxytocin which further stimulate more
painful uterine contraction. After that secretion of prostoglands and oxytocin increases
whose combination are known as Pitocin. Finally myometrium and cervix stretches by
the full fetus in vertex. These labor get increases in this period and labor is attributed as
myometrial hypoxia during the uterine contraction. Uterus is the organ where fetus
develops and grow. Placenta provides the all the necessary nutrients needed for the
development and growth of the fetus. As the fetus grows the size of the uterus get
increases. When the labor starts uterus contract and relaxes to give the birth to the baby.
The fetus remains at the uterus and develop, and at the time of labor fetus moves down to
the vagina from the front door of the uterus. Labor begin after the dilation of the cervix.
After the birth of the child the size of the placenta decreases to the size of melon. This
helps placenta to detach from the wall of the uterus and delivered after the birth of the
baby.
2. Analyze psychological and sociological aspects which influence progress and
outcome during the intra period for the woman, baby and her family.
Woman and baby must be give a key priority at the intra period of the women. At this
stage woman may not be able to do the needed physical work so family member must
take care of the baby and the mother. Woman and baby both needs a healthy and
balanced diet food for the promotion of the physical and social health. The year after the
birth is the significant transition period. As she get enter into the motherhood role, she
undergo through the different psychological and sociological changes. She have to work
to meets the emotional and physical needs of the infants and other family members. In the
intra period woman are more vulnerable to the health related diseases. In global context,
about 136 million of women suffer from the excessive bleeding after the birth of the
child. Large number of death news could be observed at this due to various health related
problems. So family must provide the effective care at this stage.
These duties may compromised to maintain her self-care and unhealthy behavior such as
smoking, sedentary life style is developed in this phase. We observe people not giving
much attention to the care of the woman at post-partum period. Family member also give
more priority to the infants than the woman which may affect the psychological and
sociological well-being of the woman. Those woman must be provided with the
advocacy, empathy and constant emotional support. They must be encouraged and
assurance must be given to maintain the psychological and sociological wellbeing of both
mother and the infant. The social needs of the woman could be divided into two
categories. Woman at post-partum period must not be allowed to remain alone and
frequently health care professional must be visited. Family could encourage doctors,
nurse or midwife to visit the infants and mother at the home. Regular checkup of both
infants and mother must be done to determine the infant and mother health state.
5. Demonstrate the skills required to care for woman and her baby during labor and early
post-partum
Skills required during the labor
It is important to have the proper skills for safe and clean delivery of the baby. When
women is admitted to the labor ward of the hospital, maternity records including the birth
plan should be reviewed along with abdominal palpation, monitoring of the fear and
diagnosis of the labor. The person who is responsible for the care of the mother should be
aware of the cultural and religious beliefs of the women. In normal labor, blood pressure
should be frequently checked and minimum of half-hourly heart rate recording should be
made in the first stage of labor. Prior to the vaginal examination, abdominal palpation
should be undertaken and in every few hours vaginal examination should be undertaken
in normal labor or more frequently. The reason for the rupturing the membrane should be
clearly documented while noting the color of the liquor. Light diet should be given the
clients who were on low risk while only water should be offered for high risk client. As
per the choice of the client, pain relief should be regularly reviewed and the position in
labor should be discussed with the mother and her choice must be accommodated as far
as possible.
Skills required during the early post-partum
During post-partum, encourage should be given to the women to ask the question during
the examination and listening skills should be developed to reflect and clarify what client
is saying. The rest and sleep routine of the women should be properly taken care of and
should help her to avoid hard physical labor. Personal hygiene of the mother should be
maintained and infant feeding and breast care should be discussed. Only prescribed
medicines should be given when breastfeeding. Some women, when unsure and hesitant,
voice their concern in an indirect manner instead of directly voicing their issue. Hence, it
is essential skill to understand the body language and verbal sign women is showing. At
the end, it is important to remind her that she can ask any question regarding the post-
partum care and make sure she feels supported.
7. Safely manage, administer, record and monitor effects of common medicines used in
midwifery care
Midewifery are accountable for all the action and while administering medication
midwife should think through the issue and should apply their professional judgment and
expertise for the best interest of patients. They should be aware of the interrelationship
with the multidisciplinary administration team. The patient plan of care should be taken
care of and the therapeutic use of medicine including the side effects, normal dose,
contradiction and precaution. The clear procedure should be followed to ensure the right
person receiving right drug in right time, in the right dose. The prescription written on
medicine dispensed must be checked and when uncertainty arise about the prescription, it
must be clearly clarified before administering the medication. The identity of the patient
to whom the medicine is administered must be made certain and also the expiry date of
the medicine should be administered. The second practitioner should be appointed where
complex calculation is required in order to ensure the correct quantity of medication
which helps to minimize the risk of error. The clear, immediate and accurate record of all
medicine must be administered which is refused by the patient ensuring the legitimity of
the signature. All the medicines should be stored in accordance with the patient
information and label on the instruction must be strictly followed. Nurse in Charge
working in the clinical area must kept the drug refrigerators, medicine trolley and keys of
the medicine in line with local policy. The drug keys should be returned to the nurse in
charge at the end of each shift. Midwife should be aware of the legislation which exists in
relation to controlled drugs namely ketamine and morphine and should be familiar with
the local trust policy regarding collection, storage, administration and ordering of
controlled drugs. The epidural or intravenous medication must be avoid unless midwife
hasnt documented competence assessment and additional training in accordance with the
trust policy. When there is no direct supervision, midwife must have the skill and
knowledge for effective and safe practice. Local trust policy need to be followed when
administering oral liquid medication and must use enteral syringes if it is available.
Unless appropriate training has not been received, midwife should avoid taking part in
the collection, prescription, administration and storage of the cytotoxic agents. Further,
midwife who havent receive appropriate training and certified must avoid checking
intrathecal chemotherapy drugs prior to administration. For the management of patients
own medicine, local Trust guidance should be followed. Finally, no attempt should be
made to disguise medication and in case if it is asked to do, midwife should refuse and
immediately report the case to senior nurse.