# data[].attributes.body
The terms "labor" and "delivery" are used to describe the birthing process. The uterus contracts and the cervix (the opening of the uterus) changes to prepare a woman's body to give birth. The baby is then born, followed by the placenta.

PRELIMINARY SIGNS OF LABOR

1.      Lightening

2.      Braxton-Hicks Contractions

3.      Nesting Instinct

4.      Ripening of the cervix

5.      Weight loss (1-3 pounds)

6.      Bloody show

7.      Rupture of membranes

PRELIMINARY SIGNS

• SUBTLE SIGNS

• INDICATES IMMINENT LABOR

• MUST EDUCATE PATIENTS FOR THEM TO DETECT THESE SIGNS

SIGNS OF TRUE LABOR

1. UTERINE CONTRACTIONS

Duration- from beginning of one contraction to the end of the same contraction (from 20 to 30 sec to a range of 60 to 90 sec)

Frequency- from beginning of one contraction to the beginning of another contraction Interval

intensity – it becomes stronger

2. SHOW

3. RUPTURE OF THE MEMBRANES

COMPONENTS OF LABOR

1. THE PASSAGE or the woman’s pelvis

2. THE PASSENGER or the fetus

3. The POWERS OF LABOR or uterine factors

4. A WOMAN’S PSYCHE

Pelvic Shape: Gynecoid (deep and wide)
Obstetric/True Conjugate - measurement of the inlet because it has the smallest diameter

pelvic inlet - ap is smaller than transverse, true or obstetric conjugate, measurement of the ap must be at least 11 cm, the head is in a lateral position

pelvic outlet - also called the inferior pelvic aperture, ap is greater than transverse, the occiput is under the symphisis pubis, measurement of the transverse must be at least 10 cm

diagonal conjugate (1.5 constant)

13 cm – 1.5 cm = 11. 5 (obstetric conjugate)

the most favorable is the position that presents the smallest diameter of the head – flexed or flexion

if the head is extended – occipitomental 13.5 cm

occipitofrontal – 12cm

suboccipitobregmatic – 9.5 cm smallest presenting diameter of the fetal skull, because if this is the presenting diameter it will fit the maternal pelvis

FETAL PRESENTATION

CEPHALIC

BREECH

SHOULDER

FETAL ATTITUDE

Good (full flexion)

Moderate (military)

Poor

Very poor

vertex - full flexion
sinciput - moderate flexion (military attitude)
brow - partial extension
face - poor flexion, complete extension

MECHANISMS OF LABOR

DESCENT

FLEXION

INTERNAL ROTATION

EXTENSION

EXTERNAL ROTATION (RESTITUTION).

EXTERNAL ROTATION (SHOULDER ROTATION)

EXPULSION

# data[].attributes.headline
SIGNS OF PREGNANCY (PRESUMPTIVE, PROBABLE, POSITIVE)

# data[].attributes.subject
SIGNS OF PREGNANCY (PRESUMPTIVE, PROBABLE, POSITIVE)

# data[].attributes.body
PRESUMPTIVE - Breast changes, Nausea, vomiting, Amenorrhea, Frequent urination, Fatigue, Uterine enlargement, Quickening, linea nigra, Melasma , Striae Gravidarum

breast changes is one of the earliest

Striae Gravidarum – stretch marks, Red streaks on the abdomen

linea nigra / linea alba - Dark line pigmentation on the abdomen

Melasma or Chloasma - Dark pigment on the face ; “mask of pregnancy,”

quickening – fetal movement felt by women (16-20 weeks)

PROBABLE - chadwick’s sign, goodel’s sign, hegar’s sign, Sonographic evidence of gestational sac, Ballottement, braxton-hicks contraction, fetal outline felt by examiner

CHADWICK’S SIGN – change in the color of vagina or cervix (PINK TO VIOLET)

GOODEL’S SIGN – softening of cervix, cervix consistency- tip of the nose, ear lobe, butter

HEGAR’S SIGN – softening of lower uterine segment (above the cervix)

BALLOTTEMENT - the fetus can be felt to rise against the abdominal wall (occurs in 16 weeks)

BRAXTON-HICKS contraction - Periodic uterine tightening occurs NOT TRUE CONTRACTION (20 weeks)

FETAL OUTLINE felt by EXAMINER - Fetal outline can be palpated through abdomen (20 WEEKS)

POSITIVE - Evidence on Ultrasound of fetal outline, fetal heart audible, fetal movement by examiner

FETAL HEART (10-12 weeks) if using a Doppler ultrasound/ UTZ (highly sensitive stethoscope that can detect sound)

Evidence on Ultrasound of fetal outline

FETAL MOVEMENT FELT BY THE EXAMINER - Fetal movement can be palpated

# data[].attributes.body
The egg that will become your baby divides rapidly into many cells within 24 hours of fertilization. The embryo grows into a fetus by the eighth week of pregnancy.

o   Ovum – from ovulation to fertilization

o   Zygote - from fertilization to implantation

o   Embryo – from implantation to 5-8 weeks

o   Fetus – from 5-8 weeks until term

Pre-embryonic Period (the OVUM)

first 2 weeks, beginning with fertilization

ends at implantation, which occurs on day 7 postconception

Embryonic Period

weeks 3 through 8

begins with blastogenesis

Fetal Period

from week 8 through birth

Period of post-differentiation of organs

FERTILIZATION - Fertilization (also referred to as conception and impregnation) is the union of an ovum and a spermatozoon.

IMPLANTATION - Implantation is when a fertilized egg, or blastocyst, has attached to the lining of the uterine wall.

EMBRYONIC AND FETAL STRUCTURES / DEVELOPMENT

1.      Decidua

2.      Chorionic villi

3.      Placenta

4.      Umbilical cord

5.      Amniotic membrane

6.      Amniotic fluid

# data[].attributes.body
Pregnancy is always linked to alterations in a pregnant woman's psychological functioning. It is usually associated with ambivalence, frequent mood changes, varying from anxiety, fatigue, exhaustion, sleepiness, depressive reactions to excitement.

CULTURAL INFLUENCES

FAMILY INFLUENCES

POSITIVE INFLUENCES

NEGATIVE INFLUENCES

INDIVIDUAL INFLUENCES

COMMON PSYCHOSOCIAL CHANGES/ TASKS THAT OCCUR WITH PREGNANCY

1st Trimester

• TASK: Accepting the Pregnancy

Ambivalence

2nd Trimester

• TASK: Accepting the Baby

Narcissism and introversion

3rd Trimester
• TASK: Preparing for the Baby and End of Pregnancy (Preparing for Parenthood)

EMOTIONAL RESPONSES TO PREGNANCY

AMBIVALENCE

GRIEF

NARCISSISM (self-centeredness)

INTROVERSION VS EXTROVERSION

BODY IMAGE AND BOUNDARY

STRESS

COUVADE SYNDROME (men are experiencing same physical symptoms like her pregnant wife due to stress, anxiety and empathy)

EMOTIONAL LABILITY (mood changes and mood swings)

CHANGES IN SEXUAL DESIRE

1st trimester

Decrease in libido

2nd trimester

As blood flow to pelvic area increases to supply the placenta, libido and sexual enjoyment rise markedly

3rd trimester

Sexual desire remain high or may decrease

# data[].attributes.body
I learned that the body of a pregnant woman goes through a range of physiologic changes throughout pregnancy. Hormonal changes, an increase in total blood volume, weight gain, and an increase in fetus size are all variables that cause these alterations. All of these elements have an effect on the pregnant woman's physiological systems, including her musculoskeletal, endocrine, reproductive, cardiovascular, respiratory, gastrointestinal, and renal systems.