Normal Labor

Normal Labor

Definition

Labor:

Labor is defined as the onset of rhythmic contractions and the relaxation of the uterine smooth muscles, which results in effacement or progressive thinning of the cervix, and dilation or widening of the cervix. This process culminates with the expulsion of the fetus and expulsion of the other products of conception (placenta and membranes) from the uterus.

WHO defines normal birth as: "spontaneous in onset, low-risk at the start of labour and remaining so throughout labour and delivery. The infant is born spontaneously in the vertex presentation between 37 and 42 completed weeks of pregnancy. After birth mother and infant are in good condition"

Normal labour :

Normal labour or eutocia is a physiological process by which fetus, placenta and membrane are expelled through the birth canal between 38 to 42 weeks. Labour is called normal if it fulfills the following criteria :-

Spontaneous in onset and at term

With vertex presentation

Without undue prolongation

Natural termination with minimal aid.

Without having any complications affecting the health of the mother and /or the baby.

Abnormal labour:

Any deviation from the definition of normal labour is called abnormal labour. Dystocia of labor is defined as difficult labor or abnormally slow progress of labor. Other terms that are often used interchangeably with dystocia are dysfunctional labor, failure to progress (lack of progressive cervical dilatation or lack of descent), and cephalopelvic disproportion (CPD). It is the consequence of four distinct abnormalities that may exist singly or in combination.

Uterine forces that is not sufficiently strong or appropriately coordinated to efface and dilate the cervix.

Forces generated by voluntary muscles during the second stage of labor that are inadequate to overcome the normal resistance of the bony birth canal and maternal soft parts.

Faulty presentation or abnormal development of the fetus of such character that the fetus cannot be extruded through the birth canal.

Abnormalities of the birth canal that form an obstacle to the descent of the fetus

Delivery:

Delivery is the expulsion or extraction of viable fetus out of the womb. It is not synonymous with labour. It can be take place without labour as in elective caesarean section. Delivery may be vaginal, either spontaneous or aided and or may be abdominal.

Premature labour:

Premature labour is defined as labour occurring before the 37th week of gestation.

True labour :

The contraction of true labour produce prograssive dilatation and effacement of the cervix resulting the birth of the baby.The features of true labour pains are:-

Contraction may be irregular at first then painful uterine contractions at regular intervals.

Contractions that gets longer, stronger, and closer together as time progresses.

Walking usually makes them stronger.

Presentation of show.

Often begin in the back and move to the front

Cervix changes by becoming thinner and starts to open (dilates)

Formation of the bag of water.

False (or "Practice") Labor:

It is usually appears prior to the onset of true labour pain by one or two weeks in primigravida and by a few days in multiparae. The feature of false labour are-

Dull in nature and usually confined to the lower abdomen and groin.

Do not get longer, stronger, or closer together

Can last several minutes in length

Walking does not make them stronger, may even cause them to stop

Lying down may make them go away

May be felt more in the front area and in the groin area

Beneficial in preparation for true labor

Very little change or no change; does not thin or open cervix.

TRUE LABOR VS FALSE LABOR

FACTOR TRUE LABOR FALSE LABOR Contractions Start in the back and sweep around to the abdomen.Produce progressive dilation and effacement of the cervix. Occurs regular intervalIncrease in frequency, duration, and intensity.Once started continue until the baby comesDoes not stop contraction by sedation -Located chiefly in abdomen-Do not produce progressive dilatation and effacement. -Are irregular -Do not increase in frequency, duration, and intensity.-Start and then stop for some time then start again-Tends to decrease number of contraction by sedation -It remains long.

Interval gradually shorted Show Is present. Not present. Cervix Becomes effaced and dilates progressively. The membranes feel tense during a contraction Usually uneffaced and closed. The membranes dont becomes tenseFetal Movement No significant change, even though fetus continues to move. May intensify for a short period or it may remain the same.