1. PREMONITORY SIGNS OF LABOR

a. Backache

b. Weight loss (1-3 lbs.)

c. Lightening

i. Fetal head descends into pelvis

ii. Around 14 days before labor

iii. Feeling that fetus has “dropped”

d. Easier breathing

e. Increased bladder pressure

i. Urinary frequency

ii. More pronounced w/ primigravida

f. Contractions

i. Starts w/ Braxton Hicks (irregular)

ii. Progresses in strength & regularity

g. Bloody show

i. Brownish, blood tinged mucus plug

1. Onset of cervical dilation & effacement

h. Energy burst

i. Gastrointestinal changes

j. Rupture of membranes

i. Can initiate labor or occur anytime during labor

2. FIVE FACTORS (“5 P’s”)

a. Affect & define labor & birth process

i. Passenger

1. Fetus & placenta

1. Fetal presentation

i. Part of the fetus that is entering pelvic inlet first

1. Occiput – back of the head

2. Mentum – chin

3. Scapula – shoulder

4. Breech – sacrum or feet

2. Lie

i. Relationship of maternal longitudinal axis (spine) to

fetal longitudinal axis (spine)

1. Transverse: Fetal long axis is horizontal