Mnemonic cardinal movements labor4/30/2024 ![]() Labor initiation is species specific, and the mechanisms of human labor are unique. The physiology of labor initiation has not been completely elucidated, but the putative mechanisms have been well reviewed by Liao and colleagues. This chapter describes the physiology and normal characteristics of term labor and delivery. ![]() More specifically, labor requires regular, effective contractions that lead to dilation and effacement of the cervix. ![]() Labor is defined as the process by which the fetus is expelled from the uterus. Factors that affect the average duration of the first and second stage of labor progress will be reviewed, and an evidence-based evaluation of strategies to support the mother during labor and facilitate safe delivery of the fetus will be presented. This chapter will review the characteristics and physiology of normal labor at term. The duration of the second stage of labor can be affected by a number of factors including epidural use, fetal position, fetal weight, ethnicity, and parity. The latent phase of labor is characterized by a slower rate of cervical dilation, whereas the active phase of labor is characterized by a faster rate of cervical dilation and does not begin for most women until the cervix is dilated 6 cm. These hormones upregulate transcription of progesterone, progesterone receptors, oxytocin receptors, and gap junction proteins within the uterus, which helps to facilitate regular uterine contractions. Although the exact trigger for human labor at term remains unknown, it is believed to involve conversion of fetal dehydroepiandrosterone sulfate (DHEAS) to estriol and estradiol by the placenta. Assisting with procedures during labor (e.g.The initiation of normal labor at term requires endocrine, paracrine, and autocrine signaling between the fetus, uterus, placenta, and the mother.Emotional support and education, during delivery as well as postpartum (initial care, breastfeeding, recovery).Assessing and monitoring clients’ vital signs during labor.Here are some primary responsibilities of L&D nurses: Expulsion: Following delivery of the head and shoulders, the rest of the baby’s body is delivered relatively easily and quickly.External rotation: After the head is delivered, it rotates again so that the baby’s face is turned towards one of the mother’s inner thighs, allowing the shoulders to align with the pelvic outlet.Extension: As the baby’s head passes under the pubic bone, it extends backwards, with the chin leaving the chest, so that the head can fully emerge.Internal rotation: The baby’s head rotates about 90 degrees to align with the long axis of the body as it moves down the pelvis, typically from an orientation where the baby is facing sideways to facing the mother’s back.Flexion: As the baby’s head descends and encounters resistance from the pelvic bones and soft tissues, it naturally tucks its chin toward its chest, presenting the smallest head diameter to the birth canal.This occurs throughout labor, aided by uterine contractions, amniotic fluid pressure, and maternal pushing. ![]()
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