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                            I.Physiological Adaptation of the Mother to Pregnancy
Document Text Contents
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- iodine
- Magnesium
- Selenium

175 mcg/day
320 mg/day
65 mcg/day

easily be met with a balanced diet that
meets the requirement for calories and
includes food sources high in the other
nutrients needed during pregnancy.

Pyridoxine ( B6)

10 mg/day
1.5 mg/day
1.6 mg/day
2.2 mg/day
2.2 mg day
17 mg/day

Vit stored in body. Taking it not needed –
fat soluble vitamins. Hard to excrete.

2.Sexual Activity
a.) should be done in moderation
b.) should be done in private place
c.) mom placed in comfy pos, sidelying or mom on top
d.) avoided 6 weeks prior to EDD
e.) avoid blowing or air during cunnilingus
f.) changes in sexual desire of mom during preg- air embolism
Changes in sexual desire:

a.) 1st tri – decrease desire – due to bodily changes
b.) 2nd trimester – increased desire due to increase estrogen that enhances lubrication
c.) 3rd trimester – decreased desire

Contraindication in sex:
1. vaginal spotting
1st trimester – threatened abortion

2nd trimester– placenta previa
2. incompetent cervix
3. preterm labor
4. premature rupture of membrane

3. Exercise – to strengthen muscles used during delivery process
- principles of exercise

1.) Done in moderation. 2.) Must be individualized
Walking – best exercise

Squatting – strengthen muscles of perineum. Increase circulation to perineum. Squat – feet flat on floor

Tailor Sitting – 1 leg in front of other leg ( Indian seat)

Raise buttocks 1st before head to prevent postural hypotension – dizziness when changing position

- shoulder circling exercise- strengthen chest muscles
- pelvic rocking/pelvic tilt- exercise – relieves low back pain & maintain good posture
- * arch back – standing or kneeling. Four extremities on floor

Kegel Exercise – strengthen pulococcygeal muscles
- as if hold urine, release 10x or muscle contraction

Abdominal Exercise – strengthens muscles of abdominal – done as if blowing candle

4. Childbirth Preparation:
Overall goal: to prepare parents physically and psychologically while promoting wellness behavior that can be used by
parents and family thus, helping them achieved a satisfying and enjoying childbirth experience.

a. Psychophysical
1. Bradley Method – Dr. Robert Bradley – advocated active participation of husband at delivery process. Based on imitation
of nature.


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1.) darkened rm
2.) quiet environment
3.) relaxation tech
4.) closed eye & appearance of sleep

2. Grantly Dick Read Method – fear leads to tension while tension leads to pain

b. Psychosexual
1. Kitzinger method – preg, labor & birth & care of newborn is an impt turning pt in woman’s life cycle

- flow with contraction than struggle with contraction

c. Psychoprophylaxis – prevention of pain
1. Lamaze: Dr. Ferdinand Lamaze
req. disciple, conditioning & concentration. Husband is coach

1. Conscious relaxation
2. Cleansing breathe – inhale nose, exhale mouth
3. Effleurage – gentle circular massage over abdominal to relieve pain
4. imaging – sensate focus

5. Different Methods of delivery:
1.) birthing chair – bed convertible to chair – semifowlers
2.) birthing bed – dorsal recumbent pos
3.) squatting – relives low back pain during labor pain
4.) leboyers – warm, quiet, dark, comfy room. After delivery, baby gets warm bath.
5.) Birth under H20 – bathtub – labor & delivery – warm water, soft music.

IX. Intrapartal Notes – inside ER
A. Admitting the laboring Mother:

Personal Data: name, age, address, etc
Baseline Data: v/s esppecially BP, weight
Obstetrical Data: gravida # preg, para- viable preg, – 22 – 24 wks
Physical Exams,Pelvic Exams

B. Basic knowledge in Intrapartum.

b. 1 Theories of the Onset of Labor
1.) uterine stretch theory ( any hallow organ stretched, will always contract & expel its content) – contraction action
2.) oxytocin theory – post pit gland releases oxytocin. Hypothalamus produces oxytocin
3.) prostaglandin theory – stimulation of arachidonic acid – prostaglandin- contraction
4.) progesterone theory – before labor, decrease progesterone will stimulate contractions & labor
5.) theory of aging placenta – life span of placenta 42 wks. At 36 wks degenerates (leading to contraction – onset

b.2. The 4 P’s of labor

1. Passenger
a. Fetal head – is the largest presenting part – common presenting part – ¼ of its length.
Bones – 6 bones S – sphenoid F – frontal - sinciput

E – ethmoid O – occuputal - occiput
T – temporal P – parietal 2 x

Measurement fetal head:
1. transverse diameter – 9.25cm
- biparietal – largest transverse
- bitemporal 8 cm
2. bimastoid 7cm smallest transverse


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