Maternal and

Fetal
Responses
to Labor
Maternal and Fetal Responses to
Labor
✘ Labor is a local process that involves the abdomen
and reproductive organs, but because it is such an
intense process, it has systemic physiologic effects
on both a woman and her fetus.
✘ Its intensity is so great that almost all body
systems are affected by it.

Maternal & Child Health Nursing

Care of the childbearing & childrearing Family
Eight Edition, Volume 1, page 343

2
 The maternal physiologic effects
and psychological responses
Pregnancy has effects on many systems of the
birthing parent. During labor, there are yet
further effects which may require the nurse to
deliver specific care to their patient. Knowing
and recognizing what is normal and what is not
normal can help to ensure safe provision of care.

Maternal & Child Health Nursing

Care of the childbearing & childrearing Family
Eight Edition, Volume 1, page 343 3
 1.
The Response to
Pain
Maternal & Child Health Nursing
Care of the childbearing & childrearing Family
Eight Edition, Volume 1, page 343
 The response to pain
✘ Cultural factors can strongly influence a woman’s
experience and satisfaction with labor.
✘ To make labor a positive experience, be prepared to
adapt care to the woman’s specific needs. If a woman has
traditions that run counter to hospital protocols, address
these differences and make arrangements to
accommodate her desires, beliefs, or customs, if possible,
such as advocating for special foods to eat, ballroom
dancing in order to remain upright, or saving the placenta
for the mother to take home.

5
 2.
The Response to
fatigue
Maternal & Child Health Nursing
Care of the childbearing & childrearing Family
Eight Edition, Volume 1, page 343
 The response to fatigue
✘ By the time the date of birth approaches, a woman is
generally tired from the normal discomforts of pregnancy
and has not slept well for the past month
✘ Sleep hunger from this type of discomfort can make it
difficult for a woman to perceive situations clearly or to
adjust rapidly to new situations.
✘ It can make the process of labor loom as an overwhelming,
unendurable experience unless she has competent people
with her to offer support, reassurance, and comfort.

7
 3.
The Response to
Fear
Maternal & Child Health Nursing
Care of the childbearing & childrearing Family
Eight Edition, Volume 1, page 343
 The response to fear
✘ All women appreciate a review of the labor process early in
labor as a reminder that childbirth is not a strange,
bewildering event but a predictable and well-documented
one.
✘ The sense of lack of control combined with pain may cause
the patient to begin to worry for her infant and may make her
afraid she will not meet her own behavioral expectations.
✘ Explain and repeat as necessary that labor is predictable but
also variable.

9
✘ Contractions last a certain length and reach a
certain intensity but always have a rest period in
between so she can have a break from pian.
✘ Fear of labor this way releases adrenaline, and
adrenaline interferes with oxytocin release and
so can limit the effectiveness of uterine
contractions.

10
 Fetal
Response
s
To
Labor 11
 Fetal responses to labor

✘ The pressure and circulatory changes

that occur with contractions not only
affect the mother but also can cause
detectable physiologic changes in the
fetus as well.

12
 The following are the fetal responses to
labor

THE NEUROLOGIC SYSTEM

Uterine contractions exert pressure on fetal

head results in increased intracranial
pressure. Decreased fetal heart rate by 5 bpm
during a contraction. This decrease appears
on the fetal monitor as an early deceleration
pattern (normal during labor)

13
Maternal
danger
signs of
labor
14
 High or low blood pressure
✘ A woman’s blood pressure rises slightly in the second
(pelvic) stage of labor because of her pushing effort.
✘ A systolic pressure greater than 140 mmHg and a diastolic
pressure greater than 90 mmHg.
✘ An increase in the systolic pressure of more than 30 mmHg
or in the diastolic pressure of more than 15 mmHg
✘ It should be reported just as important to report a falling
blood pressure because it may be the first sign intrauterine
hemorrhage.

15
 Abnormal pulse
✘ A maternal pulse rate greater than 100
beats/min during labor is unusual and should
be be reported because it may be another
indication of hemorrhage.

16
 Inadequate or prolonged
contraction
✘ If they become less frequent, less intense, or
shorter in duration, this may indicate uterine
exhaustion (inertia).
✘ Uterine contractions lasting longer than 70
seconds are becoming long enough to
compromise fetal well-being because this
interferes with adequate uterine artery filling.

17
 Abonormal lower abdominal
contour
✘ If a woman has a full bladder during labor, a
round bulge appears on her lower anterior
abdomen.
✘ First, the bladder may be injures by the pressure
of the fetal head pressing against it.
✘ Second, the pressure of the full bladder may not
allow the fetal head to descend.

18
 Increasing apprehension
✘ A woman who is becoming increasingly
apprehensive despite clear explanations of
unfolding events may not be “hearing” because
she has a concern that has not been met.
✘ Increasing apprehension also needs to be
investigated for physical reasons because it can
be a sign of oxygen deprivation.

19
 Fetal
danger
signs of
labor
20
High or low fetal heart
rate
✘ FHR of more than 160 beats/min (fetal
tachycardia) or less than 110 beats/min (fetal
bradycardia) is a sign of possible fetal
distress.
✘ An equally important sign is a late or
variable deceleration pattern revealed on a
fetal monitor.

21
Meconium staining
✘ Meconium staining, a green color in the
amniotic fluid, reveals the fetus has had a
loss of rectal sphincter control, allowing
meconium to pass into the amniotic fluid.
✘ It may indicate a fetus has or is experiencing
hypoxia.

22
 Hyperactivity
✘ Fetal hyperactivity may be a subtle sign that
hypoxia is occurring because frantic motion
is a common reaction to the need for oxygen.

23
 Low oxygen
saturation
✘ Oxygen saturation in a fetus is normally
40% to 70%.
✘ A fetus can be assessed for this by a catheter
inserted next to the cheek (under 40%
oxygenation needs further assessment)/

24