Charisse D.

Bulalaque
Assignment
LABOR AND DELIVERY CONCEPT

A. Identify at least 5 theories of labor. (5 points)

Uterine Stretch Theory
The uterine muscle stretches from the increasing size of the fetus, which results in release
of prostaglandins
Oxytocin Theory
The fetus presses on the cervix, which stimulates the release of oxytocin from the posterior
pituitary. Oxytocin stimulation works together with prostaglandins to initiate contractions.
Progesterone Deprivation Theory
Changes in the ratio of estrogen to progesterone occurs, increasing estrogen in relation to
progesterone, which is interpreted as progesterone withdrawal.
As pregnancy nears term, progesterone level drops, hence uterine contraction occurs.
Prostaglandin Theory
The fetal membrane begins to produce prostaglandins, which stimulate contractions.
When pregnancy reaches term, the fetal membranes, the fetal membrane begins to produce
prostaglandins, which stimulate contractions.
Theory of Aging Placenta
Rising fetal cortisol levels reduce progesterone formation and increase prostaglandin formation.
The placenta reaches a set age, which triggers contractions.
As the placenta ages it becomes less efficient.

B. Identify 3 Methods to manage pain in Childbirth. Give description of each Childbirth

Method. (5 points)

The Bradley (Partner-Coached) Method (develop by Robert Bradley)

The Bradley method of childbirth is based on the premise that pregnancy and childbirth are joyful,
natural processes and that a woman’s partner should play an active role during pregnancy, labor,
and the early newborn period. During pregnancy, a woman performs muscle-toning exercises and
limits or omits foods that contain preservatives, animal fat, or a high salt content. She reduces pain
in labor by abdominal breathing. In addition, she is encouraged to walk during labor and to use an
internal focal point as a disassociation technique.

The Psychosexual Method (develop by Sheila Kitzinger)

The psychosexual method of childbirth stresses pregnancy, labor and birth, and the early newborn
period are some of the most important points in a woman’s life. It includes a program of conscious
relaxation and levels of progressive breathing that encourage a woman to “flow with” rather than
struggle against contractions

The Dick-Read Method (develop by Grantly Dick- Read)

The premise is that fear leads to tension, which leads to pain. If a woman can prevent

fear from occurring or can break the chain between fear and tension or tension and pain, then she
can reduce the pain of labor contractions. A woman achieves lack of fear through education about
childbirth, and she achieves reduced pain by focusing on abdominal breathing during contractions
C. Summarize the stages of labor and delivery through the following table:
(20 points)

Stages Phases/ Salient Duration & Intensity of Nursing care

events interval of contractions (instructions,
Description contractions (IF Breathing
(IF APPLICABLE) techniques if
APPLICABLE) necessary)
stage 1 LATENT 10-30 sec/ 5-30 min Mild to moderate
PHASE Monitor vital signs,
the cervix fluid and electrolyte
begins balance, frequency,
effacing duration, and intensity
and dilating of uterine contractions
and and degree of
contractions discomfort (hourly, at
become minimum); urine
increasingly protein and glucose
stronger and with every voiding;
more frequent laboratory results;
preparedness; ROM

Provide comfort
measures –e.g.,
positioning in side
lying, back
massage/effleurage
(light abdominal
stroking in rhythm
with breathing during
a contraction to ease
mild/moderate
discomfort),
warm/cold
compresses, ice chips

Support coping
measures reassure,
explain procedures,
reinforce/teach
breathing techniques,
relaxation, focal point
Assist support person

ACTIVE 30-40 sec/ 3-5 min Moderate to strong

PHASE
cervical
dilatation
occurs
more rapidly
 TRANSITION 45-90sec/ 2-3 min strong Breathing technique
PHASE during transition
Contractions phase:
Take a deep breath
and exhale slowly and
completely.
At beginning of
contraction, take a
fairly deep
breath. Then engage
in shallow breathing.
If there is
an urge to push, puff
out every 3rd, 4th, or
5th
breath. Take deep
breath at the end of
contraction.
stage 2 EXPULSION
Crowning - 60-90 sec at 1.5 to 3 Monitor physical
the time min status; assess progress
span from of labor, perineal and
full rectal bulging,
dilatation increased vaginal
and cervical show
effacement –Assist in techniques
to birth of to foster expulsion –
the infant. encourage bearing
down focus on
vaginal orifice
(discourage breath
holding for more than
5 sec), position
squatting, side-lying,
Fowler’s as
appropriate
–Provide comfort
measures; support
coping measures;
assist support person

stage 3 PLACENTAL 5-10 minutes Maternal observe for

STAGE (maximum 30 signs and symptoms
from delivery minutes) of
of the baby to placental separation;
delivery of the assess amount of
placenta blood loss;
monitor blood
pressure, pulse, and
fundus frequently
stage 4 immediate DURATION:
recovery 1-4 HOURS Monitor maternal
period from blood pressure and
delivery of pulse; uterine
placenta to contractility tone and
stabilization of location; amount and
maternal color of lochia,
systemic presence of clots;
responses and condition of
contraction of episiotomy
the uterus every 15 min x 4 for
an hour
Monitor bladder
function
Provide comfort
Evaluate parental
interaction