Microteaching

Normal labour
 Introduction
• The first stage of labour usually starts with the onset
of regular uterine contractions and culminates in the
complete dilation of the cervix.
• There are number of premonitory sins and
symptoms that may alert a midwife to a women’s
approaching labour.
• A women may exhibit any , all or none of these ,bit it
is useful to keep them in mind when seeing a women
late in pregnancy so that appropriate counselling ,
guidence and care can be given .
 Definition of labour
• Labour may be defined as rhythmic contractions and
relaxations of the uterine muscles with
progressive ,effacement ,and dilatation of the
cervix ,leading to expulsion of the products of
conception ,
• Labour is described as the process by which
fetus ,placenta and membranes are expelled through
the birth canal.
• Labour can and does occur at any time during
pregnancy ,but takes place most frequently at term or
about 40 weeks after the normal menstrual period
 Stages of labour
• First stage –
 the first stage of labour is that of dilatation of cervix .
 Its begins with regular rhythmic contractions and is complete when the cervix is fully
dilated and effaced .
• Second stage –
 Expulsion of the fetus .
 Its begins with complete dilatation of the cervix through complete birth of the baby .
• Third stage –
 In this stage is that separation and expulsion of the placenta .
 Its last from the birth of the baby through the delivery of the placenta and
membranes with contractions and retractions of uterus .
• Fourth stage –
 After delivery of the placenta this is the observational time during which ,the vital
signs must stabilize and may tendency for immediate hemorhage must be controlled.
Signs and symptoms of impending labour

• Lightening
• Cervical changes .
• Premature rupture of membranes .
• Bloody show .
• Energy spurt .
• Gastrointestinal upsets .
 Causes of onset of labour
• Oxytocin stimulation .
• Progesteron withdrawal .
• Estrogen stimulation.
• Fetal cortisol .
• Prostaglandin stimulations .
Physiological changes during labour