PREPARATION OF

WOMEN IN LABOUR
ROOM
 In true labour, painful uterine contractions come at
regular intervals, but at irregular intervals in false
labour.
 In true labour, intensity of pain progresses with
advancement of labour, but intensity remains
same in false labour.
 Interval between pains gradually becomes short in
false labour.
 There is presence of bulging of forewaters in true
labour, but absent in false labour.
 The pain felt in true labour is in abdomen , back, and
groin , while in false labour , pain usually felt in
lower abdomen.
 Cervical dilation and effacement is presence in true
labour and absent in false labour.
 Pain is not relived by sedation or enema in true
labour, while in false labour pain is relieved by
these methods.
 For a safe delivery , the labour room has to be
prepared before conduction of the delivery .
✓ Effective cleaning of labour room should be done. It
reduces the transfer of airborne organisms and
spread of infection.
✓ Visitors and unnecessary people should not be allowed to
come in and out of the labour room. This can be a source
of infection.
✓ High standard of cleanliness should be maintained. Beds
and rooms should be cleaned thoroughly before
admitting the client, on the regular basis.
✓ The provision of good source of artificial light should be
made.
✓ All the arrangement of necessary drugs, equipements,
articles, and machines have to be made ready prior.
Delivery kit should be ready and cleanliness and sterility
of the articles should be taken care of.
✓ Emergency equipements and drugs should be also made
available , so as to be ready for any untoward
PREPARATION OF WOMEN
❖A women is admitted in the hospital when she
is in true labour .she brings with her all the
records of her previous antenatal checkups.
❖Women with problems in pregnancy may be
admitted to hospital for some time prior to
labour.
❖It is done to provide the women with quiet
and secured place to sleep as tierd and
exhausted women will have less resistant to
combat infection.
❖A general and vaginal examination is done to diagnose
the onset of the true labour.
❖ Perineal area is shaved and washed . A sterile pad is put
on the vulva.
❖ If there is no bowel movement for past 24 hours, enema
is given to the women.
❖ Generally, woman is made to wear loose hospital gown,
when she is admitted in the labour unit.
❖ This is a very crucial period for women in which she face a
lot of anxiety.
❖ Emotional support is provided to the mother by exercising
skill in imparing confidence, expressing caring and
dependability as well as being an advocate for the
childbearing women, if needed.
❖ The fetal membranes should also be preserved intact
unless is a positive indication for their rupture.
ASSESSEMENT AND OBSERVATION OF WOMEN IN
LABOUR : IN PARTOGRAM
When the women first time comes for getting admitted
in the labour room, it is also to be ensured that she is
truly in the progress of her labour.
The mother is also screened for any complication to
herself or her baby.
During assessment , following things are noted;
Age –above or below
Parity status- primi, multi parity
Previous obstetric history- complication (lscs, instrumrnt or
forceps delivery)
SALIENT FEATURES OF LABOUR SHOWN ON
PARTOGRAM ANALYSIS:
a. Frequency and intensity of contraction
b. Status of the membranes
c. Urinanalysis
d. Vital signs
e. Descent and engagement of the presenting part
f. Effacement and dilatation of cervix
g. Station of the presenting part
h. Moulding and caput succedaneum
i. Fetal heart rate
A. FREQUENCY AND INTENSITY OF
CONTRACTION:
The contractions come at regular intervals , and
increase in frequency, duration and intensity in
the case of true labour.
In false labour, contractions are irregular and
do not intensify.
Uterus should always feel softer between the
contractions.
Contractions also tell the examiner about the
progress of labour.
B. STATUS OF THE MEMBRANES:
Assessment is done of the membranes to
check whether membranes are ruptured or
not.
To rule out the doubt, the women is told to
bear down and fundal pressure is applied.
If the membranes are present, they will bulge
out. In the case of ruputured membranes ,
there is high risk of intrauterine infection.
C.URINANALYSIS:
Urine which is passed during the labour
should be tested for gulcose, ketones, and
proteins.
Ketones can occur as a result of starvation
or maternal distress.
Gulcose is found in the urine only after after
intravenous administraton of gulcose.
A significant protenuria may indicate pre-
eclampsia.
D.VITAL SIGNS:
 Ifthe pulse rate is increased to more than 100 beats
per minute, it indicates anxiety, pain, infection or
haemorrhage.
 Temperature also gets increased in the case of
infection to the mother .
 An elevated respiratory rate is an indicative of
shock and anxiety.
 Blood pressure also has to be measured regularly.
E.DESCENT AND ENGAGEMENT OF THE
PRESENTING PART:
Descent of the fetus occurs throughout the
labour.
The fetal head usually engages before the
beginning of the labour in primiparous
women.
An unengaged head in a primigravida in
labour, indicates the possibility of
cephalopelvic disproportion.
F. EFFACEMENT AND DILATATION OF CERVIX:
 The effacement and dilatation of the cervix tells, in
which stage and phase of the labour , women is in.
 Progress of dilatation and effacement tell about
the progress of labour.
G. STATION OF THE PRESENTING PART:
 Assessment of the progress of labour is also done
by noting the level of presenting part with the
maternal ischial spines.
 The distance of the presenting part above or below
the ischial spines (-3,-2,-1, 0 station at ischial spine, +1,
+2, +3) is expressed in centimeters.
H. MOULDING AND CAPUT SUCCEDAENUM :
 Moulding can be assessed by feeling the amount
of overlapping of the skull bones.
 A caput suuccedaenum may form over the
presenting part.
I. FETAL HEART RATE:
 The fetal heart rate is assessed by fetal stethoscope
or doopler device.
 It tell about the status of the baby.
 Normal fetal heart rate is 120- 160 beats per minute.
 If FHS is less than 120 or over 160, it is indicative of
fetal distress.
 Fetal tachycardia
 Fetal bradycardia
 A pathological CTG
 Poor fetal blood sampling results
 Passage of meconium stained aminiotic fluid
BIBLIOGRAPHY
•Adele Pillitteri (2003), ‘’Maternal child health nursing care of child bearing sand child
rearing family’’, 5th edition, Philadelphia: Lippincott company. P.no28-30.

•Burns, M.Gravew S.K (1999), “Understanding nursing research,” 3rd edition, W.B Saunders
publication, London. P.no56-59.

•Christopher. J. Carey and Rayburn (1996), “Text book of Obstetric and Gynecology,” 3 rd
edition, New Delhi :Warvey Pvt. Ltd. P.no74- 78.

•Bobak. Jenson (1995), “Maternity and gynaecology care,” 3rd edition, Miscoure Mosby
company. P.no875.

•Corinne. H. (1986), “Normal and therapeutic nutrition,” 7th edition, Mac Millian. P.no187-
190.
JOURNAL
•Carolyn Y Fang, et al, (2005) ‘’Describe factors influencing soy food consumption or
nonconsumption, and identify women’s sources of information about soy foods’’, Journal of the
American dietician association vol:105(10). P.no1552- 1558.

•Albertazzi, et al, (1998), “Complementary and alternative therapies for the menopause related
symptoms”, Archives of international medicine, vol:166(14). P.no345-348.

•AZ adbakht, et al, (2007), “Soy inclusion in the diet improves features of the metabolic syndrome”,
American journal of clinical nutrition, vol:85(3). P.no735– 741.

•Gregory, et al, (2003), “Treating the climatric symptoms in Indian women with an integrated
approach to yoga therapy menopause, vol:15(5). P.no 860-870.

•Germain, et al, (2001), “Can acupuncture ease the symptom of menopause”, Holistic nursing
practice, vol:17(6). P.no295-299.