THE BASIC CONCEPT OF

NORMAL LABOR

By ocha intaniah puteri

CHILDBIRTH NORMAL CHILDBIRTH ‘IN PARTU’
UNDERSTANDING

 The process by which the baby, placenta and

amniotic membrane comes out of the mother's
uterus. Normal Delivery Occur at term of
gestation (> 37 weeks) No complications of
pregnancy ‘In Partu’ labor Contracting uterine
changes Changes in the cervix (opening,
thinning) Ending with the birth of the complete
placenta
3FACTORS CAUSING LABOR TO BEGIN

 Decreased progesterone levels

 Increased estrogen levels Release of oxytocin
from neurohipofisis
 Increased levels of fetal prostaglanding and
cortisol
 Increased uterine size followed by calcium
release from sarcoplasma reticulum
 The Lowest pressure fetus on the cervix and
lower uterine segment
 Aging of the placenta External factors
SIGNS & SYMPTOMS ‘INPARTU’
1. Cervical thinning and opening.
2. Uterine contractions that result in changes in
the cervix (frequency at least 2 times in 10
minutes).
3. Mucus discharge mixed with blood through the
vagina.
IMPORTANT FACTORS IN LABOR

 Passage (birth canal)

 pelvic cavity, cervix, vagina Type of mother's
pelvic cavity (image)Passage (birth canal) pangg
pelvic cavity, cervix, vagina Type of mother's
pelvic cavity
PASSENGER’ (FETUS AND PLACENTA)

 - Presentation, location, and position of the fetus

 - Position and position of the placenta

 - Estimated fetal weight, number of fetuses'

Power '(contraction)
 - frequency, duration, intensity

 psychological (emotional status)

 previous experience,

 system support,

 environment Position of mother's position at

delivery' labor progress
DURING CHILDBIRTH KALA I

 Cervical bleeding and opening accompanied by

expulsion of blood and mucus Starting from
regular uterine contractions to complete cervical
opening The duration depends on maternal
parity (12 hours primi, 8 multi hours) Consists of
a latent phase (± 8 hours) Lasts until the cervix
opens 4 cm Active phase
 Lasts until the opening of the cervix 10 cm

 Primi (1 cm / hour), multi (1-2 cm / hour)

 Contractions: adequate (3 x /> in sec)

STAGE II FETAL EXPULSION

Starting from the complete opening of the cervix

the birth of the fetus Old ± 50 '(primi), ± 20' (multi)
Symptoms and signs Mothers want to contract
along with the occurrence of contractions
Mothers feel there is an increase in pressure in
the rectum Perineum protruding Vulva, vagina
and sphincter ani Increased increased vaginal
secretion in the vagina Definite signs of complete
cervical opening Visible part of the baby's head
vaginal introitus, vulva opening
KALA III

 Release and release of Old Palsenta: 15 ’

 Bleeding ± 500 c Signs of detachment of the
placenta Changes in shape and height of the
uterus Long umbilical cord elongated Sudden and
brief blood flow Active management
Administration of oxytocin injections Controlled
cord tension Containment of the uterine fundus
KALA IV
-Length: 1-2 hours after the placenta is born
Monitor every 15 'in the first 1 hour and every 30'
in the next 1 hour.
- Uterine contractions
- TTV
- TFU Early detection of PP bleeding risk