Rising level of fetal adrenocortical hormones especially cortisol in late pregnancy are a major stimulus for the placenta

to release a large amount of estrogens Rise in estrogens stimulates the -antagonise progestrones quieting influence on uterine muscle. -myomerial cell of the uterus to form abundant oxytocin receptors

greater contractile force

True Labour

at this point, the increasing emotional and physical stresses activate the mothers hypothalamus, which signal the for oxytocin release by the posterior pituitary.
frequent and vigorous contraction happens Both of this hormones are powerful uterine muscles stimulants Certain fetal cells begin to produce oxytocin causing the placenta release prostaglandins

Result in myometrium becomes increasingly irritable, weak, irregular uterine conctraction begins to occur. ( Braxton hicks contraction)

False labor

As the birth nears...

Braxton Hicks contractions occurring at irregular intervals, sometimes with some periods of regularity never becoming any stronger the intervals between contractions remain always the same FALSE LABOR

Braxton Hicks may go away after changing your activity

the cervix has not begun to dilate or thin out (efface). True labor begins with contractions occurring at regular intervals that become stronger as the intervals between them gradually shorten Sometimes contractions may start in the back and from there radiate around to the abdomen, while you may feel back pain and/or menstrual-type cramping instead of a real contraction. Contractions during true labor will intensify when walking and does not go away when you change your activity normal to notice a mucousy or blood-tinged discharge (Bloody show) Bag of waters (membranes) may rupture. Cervix begins to dilate and thin out (efface)

TRUE LABOR

During the latent phase irregular contractions become progressively better coordinated discomfort is minimal the cervix effaces and dilates to 4 cm difficult to time precisely, and duration varies, averaging 8 h in nulliparas and 5 h in multiparas. duration is considered abnormal if it lasts > 20 h in nulliparas or > 12 h in multiparas
During the active phase the cervix becomes fully dilated, and the presenting part descends well into the midpelvis On average, the active phase lasts 5 to 7 h in nulliparas and 2 to 4 h in multiparas The cervix should dilate 1.2 cm/h in nulliparas and 1.5 cm/h in multiparas If the membranes have not spontaneously ruptured, some clinicians use amniotomy (artificial rupture of membranes) routinely during the active phase. Women may begin to feel the urge to bear down as the presenting part descends into the pelvis

Stage 3placental stage Collectively called afterbirth Delivery of placenta and its attached fetal membranes Accomplished within 30 minutes Strong uterine conctractions that continues afterbirth compress the uterine blood vessels, limit bleeding, and shear the placenta off the uterine wall. It is important that all placental fragments be removed to continued uterine bleeding after birth (postpartum bleeding)

The 2nd stage-Expulsion-the time from full cervical dilation to delivery of the fetus On average, it lasts 2 h in nulliparas (median 50 min) and 1 h in multiparas (median 20 min) Strong contraction occur every 2-3 min and last about 1 min Crowning occurs when the largest dimension of the babys head distends to the vulva, episiotomy is done to reduce tissue tearing. The babys neck extends as their head exits from the perineum. Once the head is delivered, the rest of the babys body is delivered much more easily. After birth, the umbilical cord is clamped and cut

Second pregnancy

Descent 3/5
Inner pelvic adequate Descent Hodge 2

No Passage Problem

Fundal height X abdominal circumferences 37 X 95 = 3515g (3.515 kg)

Inner pelvic adequate Lowest Part Was head

No Passenger problem

contraction

4.00-7.00 am 10.00am

Twice/ 10min interval, Duration 25-30s

Descent 3/5 Descent Hodge 2

Thrice/ 10min interval Duration 25-30s

Inadequate Power