THE POWERS OF LABOR

CAILING, CARLOM, DAPANAS

The second important requirements for a successful labor
are effective powers of labor. This is the force supplied by
the fundus of the uterus, implemented by uterine contrac-
tions, a natural process that causes cervical dilatation and
then expulsion of the fetus from the uterus. After full di-
latation of the cervix, the primary power is supplemented
by use of the abdominal muscles. It is important for women
to understand they should not bear down with their ab-
dominal muscles until the cervix is fully dilated. Doing so
impedes the primary force and could cause fetal and cervi-
cal damage.
 UTERINE CONTRACTIONS
• The mark of effective uterine contractions is rhythmicity and progressive
lengthening and intensity.

During pregnancy, the uterus begins to contract and relax periodically as if it is

rehearsing for labor (Braxton Hicks contractions, or false labor). These
contractions are usually mild but can be strong that a woman mistakes them for
true labor. As a rule, even if a woman thinks what she is feeling cannot be true
labor, she needs to phone or e-mail her primary care provider to have the
contractions further evaluated in case she is mistaking preterm labor for practice
contractions.
o The mark of Braxton Hicks contractions is
that they are usually irregular and are
painful but do not cause cervical dilation.
 ORIGINS
• Like cardiac contractions, labor
contractions begin at a “pacemaker” point
located in the uterine myometrium near one
of the uterotubal junctions. Each contraction
begins at that point and then sweeps down
over the uterus as a wave. After a short rest
period, another contraction is initiated and
the downward sweep begins again. In early
labor, the uterotubal pacemaker may not be
working in a synchronous manner. This
makes contractions sometimes strong,
sometimes weak, and perhaps irregular. This
mild incoordination of early labor improves
after a few hours as the pacemaker becomes
more attuned to calcium concentrations in
the myometrium and begins to function
smoothly.
• In some women, contractions appear to
originate in the lower uterine segment
rather than in the fundus. These are
reverse, ineffective contractions, and
they may actually cause tightening
rather than dilatation of the cervix.
That contractions are being initiated in
a reverse pattern is difficult to tell from
palpation. It can be suspected if the
woman tells you she feels pain in her
lower abdomen before the contraction
is readily palpated at the fundus. It is
truly revealed only when cervical
dilatation does not occur.
PHASES
• A contraction consists of three phases: the increment, when the intensity of the contraction
increases. The acme, when the contraction is at its strongest, and the decrement when the
intensity decreases.
CONTOUR CHANGES
• As labor contractions progress and become regular and strong, the uterus gradually
differentiates itself into two distinct functioning areas: an upper portion, which
thickens, and a lower segment, which becomes thin-walled, supple, and passive so
the fetus can be pushed out of the uterus easily.
• The contour of the overall uterus also changes from a round, ovoid structure to an
elongated one with a vertical diameter markedly greater than the horizontal
diameter.
CERVICAL CHANGES
• The changes in the body of the uterus are two changes that occur in the cervix:
effacement and dilatation.
EFFACEMENT- Is shortening and thinning of the cervical canal. The canal is approximately 1 to 2 cm long.
As the baby's head drops down into the pelvis, it pushes against the cervix. This causes the cervix to relax
and thin out, or efface.
o In primiparas, effacement is accomplished before dilatation begins.
o In multiparas, dilatation may proceed before effacement is complete.

(A) The beginning of (C) Effacement is

labor. almost complete.
(B) Effacement is (D) After complete
beginning; dilation is effacement, dilation
not apparent yet. proceeds rapidly.
DILATATION
• Refers to the enlargement or widening of cervical canal from an
opening a few millimeters wide to one large enough (approximately
10cm) to permit passage of a fetus.
 PSYCHE

• Refers to the psychological state or feelings that a

woman brings into labor.