labor process

8/8/2019 Labor Process

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Types of P lacental D elivery:Types of P lacental D elivery:

1.1. D uncanD uncan2.2. SchultzSchultz



Degree of Laceration of PerineumDegree of Laceration of Perineum

11 st st degreedegree ± ± involves the vaginal mucousinvolves the vaginal mucousmembranes and perineal skin.membranes and perineal skin.

2 2 n

d n

d degreedegree ± ± plus the muscleplus the muscle33 rd rd degreedegree ± ± plus the external sphincter of plus the external sphincter of the rectumthe rectum

44 thth degreedegree ± ± plus the mucous membranes of plus the mucous membranes of the rectumthe rectum



D egrees of LacerationD egrees of Laceration



Nursing InterventionNursing Intervention

P alpate fundus immediately after delivery of P alpate fundus immediately after delivery of placenta, massage gently if not firm.placenta, massage gently if not firm.P alpate fundus at least 15 minute for first hour.P alpate fundus at least 15 minute for first hour.Observe lochia for color and amount.Observe lochia for color and amount.Inspect perineum for bleeding.Inspect perineum for bleeding.Offer fluid as indicated.Offer fluid as indicated.P romote beginning relationship with the babyP romote beginning relationship with the babyand parents through touch and privacy.and parents through touch and privacy.

Administer medication as ordered Administer medication as ordered



FOURTH STAGE OF LABORFOURTH STAGE OF LABOR(Stage of Recovery)(Stage of Recovery)

First 2 hours to 4 hours postpartum is theFirst 2 hours to 4 hours postpartum is themost crucial stage for the mother due tomost crucial stage for the mother due tounstable vital sign, unexpected bleeding andunstable vital sign, unexpected bleeding and

pain.pain.



Endometrial Surface / Lochia¶sEndometrial Surface / Lochia¶s

Lochia Color Days Release Consistency

Rubra D ark red 1-3 days Blood and cellular debris

Serosa P inkish brown 4-10 days Serum, blood tissue

Alba Yellowish white 11-21 daysD ecidua, epithelial cell,mucus



Rubin¶s Postpartum PhRubin¶s Postpartum Ph asesases

1.1. TakingTaking- -in Phasein Phase-- 11--3 days after delivery3 days after delivery-- the mother is self the mother is self- -centeredcentered

1.1. Taking hold PhaseTaking hold Phase-- 3 days to 2 weeks3 days to 2 weeks-- the mother strives for independencethe mother strives for independence1.1. Letting go PhaseLetting go Phase

-- 10 days or 2 weeks to 6 weeks10 days or 2 weeks to 6 weeks-- the mother integrates her new rolethe mother integrates her new role



Nursing InterventionNursing InterventionP alpate fundus every 15 minutes for first 1P alpate fundus every 15 minutes for first 1- -22hours, massage gently if not firm.hours, massage gently if not firm.Check mothers vital sign.Check mothers vital sign.

Check lochia for color and amount, every 15Check lochia for color and amount, every 15minutes for the first 1minutes for the first 1- -2 hours.2 hours.Inspect perineum every 15 minutes for first 1Inspect perineum every 15 minutes for first 1- -22hours.hours.

Apply ice to perineum if swollen. Apply ice to perineum if swollen.Encourage mother to void particularly if fundus isEncourage mother to void particularly if fundus isnot firm or displaced.not firm or displaced.



THE END«. THE END«.

HERALD CLARENCE M. AMBAYEC, R HERALD CLARENCE M. AMBAYEC, R

labor process

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