1. Basic Observations as detailed earlier (Blood evident
in urine = normal after rupture of membranes)
2.Contractions - Fundal Dominance = when contraction begins at the top of the fundus
in one of the cornua and spreads across and down. Lasts longer in the fundus where it it
most intense but the peak is felt across the entire uterus. Contraction fades from all
areas together (equally). This pattern permits the cervix to dilate and the sronglhy
contracting fundus to expel the fetus.
3.Uterus - Polarity occurs. The upper pole contracts
srongly and retracts to expel the fetus and the lower
pole contracts slightly and dilates to allow expulsion
to take place.
4.Cervix - Cervical Dilatation occurs as a result of uterine action and counter pressure
from presenting part (or intact membranes) via fetal axis pressure. Pressure applied
evenly to the cervix causes the fundus to respond by contraction and retraction
5.Passenger - Fetus flexes its head = optimal fetal position for delivery -
known as flexion
6.Pain Relief - Hydrotherapy - takes pressure off joints, relaxing (Dianne Garland). Entonox - nitrous oxide, doesn't
take away pain, helps focus on breathing, good distraction, helps mother to relax, no lasting effects, can promote
feelings of dizziness and nausea
7.Promote regular micturition to keep bladder empty as a full bladder can
prevent the uterus from contracting effectively