The management of labour

Abstract

The management of labour commences at a patient’s first prenatal consultation and the importance of confidence, knowledge and preparation for childbirth has been discussed above (page 46). When admitted in early labour, a patient’s records are obtained and studied and she is asked to give her history of the onset of labour. Records are made of the time contractions commenced, their frequency and strength on admission, and whether there has been a ‘show’ or loss of blood or liquor. Pulse rate, temperature and blood pressure are recorded, the patient empties her bladder and the specimen of urine is examined. The abdomen is palpated, the fetal heart checked and the patient is told if all is well. It is usual to offer the patient a shower and empty the lower bowel with suppositories or an enema. Routine practices may differ but for some years in my units shaving has not been performed although pudendal hair if abundant may be trimmed with scissors. Vaginal examination is usual but not invariable (see page 50).