Factors influencing the labor
Physiologically, when the gestational age is mature enough, a series of symptoms arise as the signal starting for labor. Here are several factors causing the timing of labor. These factors work together to produce a very strong, regular, rhythmic uterine contraction that ends with the birth of the fetus and placenta. Here, we have submitted the factors also what things are should be known to the mother before labor.
The following are several factors, including:
- Passage or we call it as the birth canal
- The birth canal that must be passed by the fetus consists of the pelvic cavity, pelvic floor, cervix, and vagina. So that the fetus and placenta can surely go through the birth canal without any obstacles, here the condition of the birth canal must be normal. The normal pelvic cavity is the top of the pelvis, the sacrum is wide and curved, the promontorium is not protruding forward, the two spina ischiadica are not protruding inward, the arcus pubis is quite wide (90-100 cm), the size of the conjugata vera (size of the back face the top of the pelvis from below the symphysis to the promontorium) are 10-11 cm, the size of the transverse diameter (the size of the transverse pelvis) 12-14 cm, oblique diameter (the size of the pelvis of the pelvis) 12-14 cm, the lower pelvis face size transverse 10-10.5 cm. Birth cans are considered abnormal and may cause labor barriers when the pelvis is completely narrow, partially narrow, tilted, like a funnel. These conditions indicate a tumor in the pelvis.
- The bottom of the pelvis consists of muscles and various tissues, namely the pelvic muscles inside and cover the lower pelvis. Soft tissue consists of a stretch of the lower uterine segment, cervix, pelvic floor muscles, vagina, and vaginal introitus. Before the labor coming, the uterus consists of the uterine body and uterine cervix. When labor begins with uterine contractions, the uterine body changes into two parts, the thick, passive and thin-walled upper part which gradually thickens. If there is stiffness in the tissue, this muscle will easily rupture. Abnormalities in the birth canal are caused by a stiff cervix (in old primi, deformed cervix or skiatrik), hanging cervix, congenital cervix, cervical edema (mainly due to narrow pelvis), septal vaginal discharge, and presence of a tumor in the vagina
- The way of birth is very important so that the labor process will run well and normally. If the birth canal condition seems not normal, labor will experience several obstacles.
- Power is the strength or energy that pushes the fetus out of the womb. This power comes from the contraction of the uterus. Contractions that occur will be involuntary so that this becomes a factor affecting the labor. Normal uterine contractions are the sudden onset of slow but regular, the longer it gets stronger until the peak is strongest then gradually decreases to weak. There are two kinds of uterine contractions. They are uterine contractions fake and uterine contractions labor.
- Uterine contractions fake is caused by the contraction of the abdominal wall muscles increasing pressure on the intraabdominal, while uterine contractions labor comes from the head of the fetus. This presses the pelvic floor causing a straining reflex similar to straining during defecation. Straining or granting provides very helpful strength in overcoming the resistance of the pelvic floor muscles.
- Childbirth will run normally if the mother and her energy are good
- Uterine contraction anomalies and energy can be caused due to hypotonic (uterine atony) and hypertonic (uterine tetania)
If the mother has a bad psychic, it will make and affect uterine contraction as well as the opening process less smoothly. So, the chances of labor will be hampered. Fear and anxiety are the main factors that cause pain in labor and affect uterine contractions and cervical dilation.
- It consists of a fetus and placenta. The fetus that moves along the birth canal is a sign of factors that affect the labor.
- Abnormalities that often inhibit are head size and shape abnormalities such as hydrocephalus or anencephalus, location abnormalities such as the location of the face or the location of the forehead, abnormalities of the fetal position such as latitude or breech.
In determining birth or delivery, the helpers are needed to facilitate labor. Competencies possessed by helper are needed in facilitating the delivery process and preventing neonatal maternal deaths. With good knowledge and competence, it is expected that errors and malpractice in providing care do not occur.
The role of helper is to anticipate and deal with complications that may occur for the mother and fetus. This depends on the ability and readiness of the helpers in facing the labor process. With the help of helpers, labor will be controlled.
Some basic needs during labor
- Physical and psychological support
Physical and psychological assistance is not only given by midwives or doctors, but also given to husbands, families, and friends. Physical and emotional support must be by aspects of maternal affection:
- Safe, following the evidence and contribute to the safety of the mother’s life;
- Accessible to mothers safely, safely, safely and comfortably;
- Respect cultural, religious, mother or family practices as decision-makers;
- Using simple maintenance methods before using advanced technology; and
- Ensuring that the information provided is adequate can be understood by the mother.
- Needs for fluids and nutrients
During the labor process, mothers need to drink and it is strongly recommended to drink sweet and energetic drinks. Giving food and drinking during labor is the right choice because it provides more energy and avoids dehydration (dehydration can prevent contractions or are irregular and less effective) as well as maintain the mother’s health.
- Need for elimination
During labor occurs in the sacrum plexus by the lowest part of the fetus causing urinary retention also frequent urinating. Meeting the needs of elimination during childbirth needs to be facilitated so that it can assist childbirth and a comfortable mother. Therefore, the mother needs to eliminate spontaneously and naturally at least once every 2 hours during labor, while catheterization cannot be done.
- Position ambulation
During labor, position selection can help the mother stay calm and relaxed. Give a choice of safe and comfortable labor position. Supine sleep does not need to be done continuously during labor, meanwhile, the mother can stand up and walk around. If it is not possible to walk, encourage the mother to sleep on her left side.
- Reducing pain and pain
Here is several Pain Approval as that can be done:
- An existence that can support labor;
- Position setting;
- Relaxation and breathing exercises;
- Rest and privacy;
- A description of the processor improvements to be made;
- Caring touch