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Maternity Terms
Maternity
| Term | Definition |
|---|---|
| Family centered care | Refers to the collaborative partnership among the individual, family, and caregivers to determine goals, share information, offer support, and formulate plans for health care. It is generally understood to be an approach in which clients and their families are considered integral components of the health care decision-making and delivery processes. |
| Fetal accelerations | A deceleration is a transient fall in FHR caused by stimulation of the parasympathetic nervous system. Decelerations are described by their shape and association to a uterine contraction |
| Fetal decelerations | A deceleration is a transient fall in FHR caused by stimulation of the parasympathetic nervous system. Decelerations are described by their shape and association to a uterine contraction. |
| What is a sign of True labor | 1. Contracting timing Regular, becoming closer together, usually 4–6 minutes apart, lasting 30–60 seconds 2. Contraction strength become stronger with time, vaginal pressure is usually felt_ 3.Contraction discomfort Starts in the back and radiates around toward the front of the abdomen 4-Contraction discomfort Starts in the back and radiates around toward the front of the abdomen 5- Stay or go? Stay home until contractions are 5 minutes apart, last 45–60 seconds, and are strong enough so that a conversa |
| First stage of labor | The first stage is the longest; it begins with the first true contraction and ends with full dilation (opening) of the cervix. Because this stage lasts so long, it is divided into two phases, latent and active, each corresponding to the progressive dilation of the cervix |
| Second stage of labor | The second stage, the expulsive stage, begins when the cervix is completely dilated and ends with the birth of the newborn. The expulsive stage can last from minutes to hours. The contractions typically occur every 2 to 3 minutes, lasting 60 to 90 seconds and are strong by palpation. The woman is usually intent on the work of pushing during this stage. |
| Third stage of labor | The third stage, placental expulsion, starts after the newborn is born and ends with the separation and birth of the placenta. Continued uterine contractions typically cause the placenta to be expelled within 5 to 30 minutes. If the newborn is stable, bonding of infant and mother takes place during this stage through touching, holding, and skin-to-skin contact. |
| Fourth stage of labor | The fourth stage, the restorative stage or immediate postpartum period, lasts from 1 to 4 hours after birth. This period is when the mother’s body begins to stabilize after the hard work of labor and the loss of the products of conception. The fourth stage is often not recognized as a true stage of labor, but it is a critical period for maternal physiologic transition as well as new family attachment. Close monitoring of both the mother and her newborn are done during this stage |
| Please identify three high-risk conditions that may present at any time during the labor process: | Hypertonic uterine dysfunction Persistent occiput posterior Shoulder dystocia |
| Hypertonic uterine dysfunction | occurs when the uterus never fully relaxes between contractions. Subsequently, contractions are ineffectual, erratic, and poorly coordinated because they involve only a portion of the uterus and because more than one uterine pacemaker is sending signals for contraction. Women in this situation experience a prolonged latent phase, stay at 2 to 3 cm, and do not dilate as they should. Placental perfusion becomes compromised, thereby reducing oxygen to the fetus. These hypertonic contractions exhaust the mother |
| Persistent occiput posterior | is the most common malposition, occurring in up to 5% of laboring women. The reasons for this malposition are often unclear. This position presents slightly larger diameters to the maternal pelvis, thus slowing fetal descent. A fetal head that is poorly flexed may be responsible. In addition, poor uterine contractions may not push the fetal head down into the pelvic floor to the extent that the fetal occiput sinks into it rather than being pushed to rotate in an anterior direction |
| Shoulder dystocia | is defined as the obstruction of fetal descent and birth by the axis of the fetal shoulders after the fetal head has been delivered. Shoulder dystocia is a fundamentally mechanical problem. The incidence of shoulder dystocia is increasing due to increasing birth weight, with reports of it occurring in about one in every 200 (3%) vaginal births. |
| An episiotomy | : To prevent a tear of the perineum the provider chose to manually cut, with a sterile scissors. |
| What is the average length of time of the third stage of labor for a multipara and primipara? | In the 3rd stage primipara will last about 30 min. And multipara 5-10 minutes |
| Immediately upon delivery of the infant, please identify three priority responsibilities for the nurse responsible for the newborn and why? | 1. the newborn is placed under a radiant warmer, dried, assessed, wrapped in warmed blankets, and placed on the woman’s abdomen for warmth and closeness. 2.Assess the newborn by assigning an Apgar (appearance, pulse, grimace, activity, and respiration) score at 1 and 5 minutes. 3.Secure two identification bands on the newborn’s wrist and ankle that match the band on the mother’s wrist to ensure the newborn’s identity |
| lochia | The lochia (vaginal discharge) is red, mixed with small clots, and of moderate flow. Lochia is postpartum bleeding and discharge. Your uterus is essentially “starting fresh” and shedding any blood, tissue and other materials from months of pregnancy. Lochia is made up of: Blood. |
| Fundus | This is the top of the uterus. The 'fundal' height helps assess the growth of the baby and how many weeks pregnant you are. The midwife or Doctor palpates the fundus to assess if baby is growing as they expect. |
| involution | which involves retrogressive changes that return it to its nonpregnant size and condition. Involution involves three retrogressive processes: 1. Contraction of muscle fibers to reduce those previously stretched during pregnancy 2. Catabolism, which shrinks enlarged individual myometrial cells 3. Regeneration of uterine epithelium from the lower layer of the decidua after the upper layers have been sloughed off and shed during lochial discharge |
| Subinvolution | refers to incomplete involution of the uterus or failure to return to its normal size and condition after birth. Typically, subinvolution occurs when the myometrial fibers of the uterus do not contract effectively, causing relaxation |
| uterine atony | The most common cause of PPH is uterine atony, failure of the uterus to contract and retract after birth. |
| Skin-to-skin bonding | Skin-to-skin contact is usually referred to as the practice where a baby is dried and laid directly on the mother's bare chest after birth, both of them covered in a warm blanket and left for at least an hour or until after the first feed. |
| engorgement | Engorgement is a postnatal physiologic painful condition in which distention and swelling of the breast tissue occurs as a result of an increase in blood and lymph supply as a precursor to lactation |
| colostrum | Prolactin stimulates the production of milk within a few days after childbirth, but in the interim, dark yellow fluid called colostrum is secreted. Colostrum contains more minerals and protein but less sugar and fat than mature breast milk. Colostrum secretion may continue for approximately a week after childbirth, with gradual conversion to mature milk. Colostrum is rich in maternal antibodies, especially immunoglobulin A (IgA), which offers protection for the newborn against enteric pathogens. |
| postpartum (baby) blues | postpartum mood disorder colloquially called the “baby blues” or “maternal blues,” which are characterized by mild depressive symptoms, anxiety, irritability, mood swings, loss of appetite, trouble sleeping, tearfulness (often for no discernible reason), increased sensitivity, and fatigue. |
| Immediately after the delivery process, lochia in the amount of 500ml. or greater is defined as a postpartum hemorrhage (PPH). Please identify three pharmacologic agents that may be used to stop or prevent this condition: | Uterotonic drug immediately after birth is an important intervention used to prevent PPH. Oxytocin (Pitocin); misoprostol (Cytotec); dinoprostone (Prostin E2); methylergonovine maleate (Methergine); and a derivative of prostaglandin (PGF2α), carboprost (Hemabate), are drugs used to manage postpartum hemorrhage |
| During assessment of a postpartum patient the nurse finds the uterus displaced to the right and slightly higher than anticipated (above the umbilicus). What is the likely cause of this and what would be the most appropriate nursing action? | Bladder distention |
| Please identify 2 things the nurse may identify in the maternal-newborn bonding experience that reassure that bonding is going well between the mother and infant: | Holding the infant close to the body and breast Feeding |
| lanugo | soft, downy hair on the body, particularly the face and back |
| vernix caseosa | Vernix caseosa, a white greasy film, covers the fetus |
| rooting reflex | This reflex starts when the corner of the baby's mouth is stroked or touched. The baby will turn his or her head and open his or her mouth to follow and root in the direction of the stroking. This helps the baby find the breast or bottle to start feeding. This reflex lasts about 4 months. |
| acrocyanosis | Persistent cyanosis of fingers, hands, toes, and feet with mottled blue or red discoloration and coldness is called acrocyanosis |
| caput succedaneum | Caput succedaneum (soft tissue swelling) is caused by edema of the head against the dilating cervix during the birth process. |
| Cephalhematoma | subperiosteal collection of blood secondary to the rupture of blood vessels between the skull and periosteum) occurs in 2.5% of all births and typically appears within hours after birth. |
| What is the acceptable range for the heart rate for an infant that is 12 hours old? | 110-160 beats per minute. |
| What is the expected range of respirations for the newborn? | 30 to 60 breaths/min |
| Please identify two ways in which we keep the newborn’s temperature stable during the postpartum stay in the hospital | -Try the newborn immediately after birth to prevent heat loss through evaporation. -Wrap the baby in warmed blankets to reduce heat loss via convection. -Skin-to-skin contact with mother as soon as stabilized. -Use a warmed cover on the scale to weigh the unclothed newborn. -Warm stethoscopes and hands before examining the baby or providing care. -Avoid placing newborns in drafts or near air vents to prevent heat loss through convection. -Delay the initial bath until the baby’s temperature has stabile |
| Please Explain why vitamin k is given to a neonate | Prophylactic treatment of newborns with intramuscular vitamin K . Vitamin K, a fat-soluble vitamin, promotes blood clotting by increasing the synthesis of prothrombin by the liver. A deficiency of this vitamin delays clotting and might lead to hemorrhage. Newborns are at risk for vitamin K deficiency and subsequent bleeding unless supplemented at birth. Vitamin K deficiency is an acquired coagulopathy in newborn infants because of an accumulatio |
| Please identify each of the five components of the Apgar score and how frequently it is done | A: appearance (color) P: pulse (heart rate) G: grimace (reflex irritability) A: activity (muscle tone) R: respiratory (respiratory effort) The RN evaluate a newborn’s physical condition at 1 minute and 5 minutes after birth. An additional Apgar assessment is done at 10 minutes if the 5-minute score is less than 7 points. The heart rate was found to be the most important diagnostic and prognostic of the five signs |
| GRAVIDA | The total number of times a woman has been pregnant, regardless of whether the pregnancy resulted in a termination or if multiple infants were born from a pregnancy |
| PARITY (G/TPAL) | Refers to the number of pregnancies, not the number of fetuses, carried to the point of viability, regardless of the outcome |
| FUNDAL HEIGHT | - Fundal height is generally defined as the distance from the pubic bone to the top of the uterus measured in centimeters. After 20 weeks of pregnancy, your fundal height measurement often matches the number of weeks you've been pregnant. |
| CERVICAL DILATION | Cervical dilation (cervical dilation) is the opening of the cervix, the entrance to the uterus, during childbirth, miscarriage, induced abortion, or gynecological surgery. Cervical dilation may occur naturally or may be induced by surgical or medical means. |
| CERVICAL EFFACEMENT | Cervical effacement (thinning). Effacement refers to the thinning of the cervix during labor. It’s also described as a softening, shortening, or even “ripening.” |
| FETAL PRESENTATION | Fetal presentation refers to the body part of the fetus that enters the pelvic inlet first (the “presenting part”). This is the fetal part that lies over the inlet of the pelvis or the cervical os. |
| FETAL STATION | Fetal station refers to the relationship of the presenting part to the level of the maternal pelvic ischial spines. Fetal station is measured in centimeters and is referred to as a minus or plus, depending on its location above or below the ischial spines. |
| CONTRACTION | A term usually applied to the periodic tightening and shortening of the muscle fibres in the womb (uterus) during labour which gradually bring about the expulsion of the baby |
| Baseline Fetal Heart Rate | Baseline fetal heart rate refers to the average FHR that occurs during a 10-minute segment that excludes periodic or episodic rate changes, such as tachycardia or bradycardia. It is assessed when the woman has no contractions, and the fetus is not experiencing episodic FHR changes |
| Variability | Baseline variability is defined as irregular fluctuations in the baseline FHR, which is measured as the amplitude of the peak to trough in beats per minute (De Cherney et al., 2019). It represents the interplay between the parasympathetic and sympathetic nervous systems. |
| DECELERATION (3 types) | A deceleration is a transient fall in FHR caused by stimulation of the parasympathetic nervous system. Decelerations are described by their shape and association to a uterine contraction. They are classified as early, late, and variable only. |
| Early decelerations | are visually apparent, usually symmetrical, and characterized by a gradual decrease in the FHR in which the nadir (lowest point) occurs at the peak of the contraction. They rarely decrease more than 30 to 40 bpm below the baseline. |
| Late decelerations | are visually apparent, usually symmetrical, transitory decreases in FHR that occur after the peak of the contraction. They have a gradual waveform and can be recurrent, occurring with each contraction over a period of time. The FHR does not return to baseline levels until well after the contraction has ended. |
| Variable decelerations | present as visually apparent abrupt decreases in FHR below baseline and have an unpredictable shape on the FHR baseline, possibly demonstrating no consistent relationship to uterine contractions. The shape of variable decelerations may be of a U, V, or W, or they may not resemble other patterns. Variable decelerations usually occur abruptly with quick deceleration. They are the most common deceleration pattern found in the laboring woman and are usually transient and correctable. Variable decelerations are |
| VEAL/CHOP | The VEAL chop method for nursing stands for variable deceleration, early deceleration, accelerations, and late decelerations. And the chop stands for cord compression, head compression, oxygenated or OK, and placental insufficiency. It is a mnemonic that helps nurses determine the cause of fetal heart change during labor. |
| ACCELERATION | Accelerations occur when the fetal heart rate accelerates from its baseline level by at least 15 beats a minute and is sustained for at least 15 seconds. These changes in FHR are reassuring, as they indicate that the baby is getting enough oxygen, i.e., everything is okay, and no intervention is required. |
| RESTING TONE | Baseline pressure, or resting tone, is the uterine pressure in mm Hg while the uterus is relaxed. Resting tone is normally between 5 and 10 mm Hg in early labor and between 12 and 18 mm Hg in active labor. |
| EDC (EDD, EDB) | the due date. EDC stands for the old-fashioned “estimated date of confinement.” EDD is the more modern “Estimated Day of Delivery.” The key word here is “estimated.” |
| LMP | It is used for estimating an expected due date based on the woman’s last menstrual period (LMP). |
| Nagel’s Rule | The Naegele rule is a simple mathematical formula by which the estimated date of delivery (EDD) can be determined. The last menstruation period (LMP) is taken into account. |
| 4 Leopold’s Maneuver’s | Fourth Leopold Maneuver The person doing maneuver should face the feet of the patient while doing so. This maneuver is done to determine the degree of flexion of the head of the fetus. |
| UTERINE RESUSCITATION | Intrauterine resuscitative measures are commonly initiated during labor when the fetal heart rate (FHR) pattern is indeterminate or abnormal. The most effective use of these measures is directed at the presumed underlying cause. |
| Antepartum | Time from conception until labor |
| Postpartum | From delivery to 42 days or six weeks |
| Intrapartum | Time from onset of labor until delivery |
| Gestation | # of weeks since the LMP |
| LMP | First day of last menstrual period |
| EDC/EDD/EDB | Estimated date of confinement/delivery |
| Nagel’s Rule | Go back 3 months, add 7 days from LMP |
| Abortion | Medical definition of birth prior to 20 weeks or fetus-newborn less than 500 Gm |
| Stillbirth | A fetus born dead after 20 weeks gestation. |
| Nulligravida | A women who has never been pregnant. |
| Primigravida | A women who is pregnant for the first time |
| Multigravida | A women who is in her second or subsequent pregnancy. |
| Nullipara | a women who has not given birth at more than 20 weeks gestation |
| Primipara | A women who has had one birth at more than 20 weeks gestation, regardless of whether the infant was born alive or dead. |
| Multipara | A women who has had two or more births at more than 20 weeks gestation. |
| Preterm/Premature labor | labor that occurs after 20 weeks but ends prior to 37 weeks of gestation. |
| Late Preterm | Between 34.0 weeks & 36.6 wks |
| Early term | Between 37.0 weeks & 38.6 wks. |
| Full term | Between39.0 & 40.6 weeks |
| Late term | Between 41.0 weeks & 41.6 wks. |
| Post term | Between 42.0 weeks & beyond |
| Viability | the capacity to live outside of the uterus The threshold is between 23- and 25-weeks gestation |
| First Trimester | Presumptive signs Pregnancy confirm Primary organ development for the fetus |
| Second Trimester | Morning sickness subsides Tranquil feeling Quickening occurs |
| Third Trimester | Anxious for pregnancy to end Awkward due to increasing weight Physical and psychologic changes |
| Pregnancy Length | Lasts 9 calendar months 10 lunar months 40 weeks 280 days |
| Signs of Pregnancy: Presumptive or Subjective Changes: The symptoms the women experiences & reports | Amenorrhea Nausea & Vomiting (NVP) Urinary Frequency Breast Tenderness Quickening: a fluttering sensation felt by the mother |
| Probable or Objective Changes | Hegar's Sign McDonald's Sign Goodell's Sign Chadwick's Sign Braun von Fernwald's Positive pregnany test |
| Hegar’s Sign | softening of the isthmus of the uterus |
| McDonald's Sign | ease in flexing uterus against cervix |
| Goodell’s Sign | softening of the cervix |
| Chadwick’s Sign | deep red to bluish-purple color of mucus membranes of cervix vagina & vulva |
| Braun von Fernwald’s sign: | softening at the implantation site Positive pregnancy test |
| Positive Signs of Pregnancy | Hearing fetal heart tones Visualizing the fetus Palpating fetal movement |
| Normal Physical Changes of Pregnancy: Uterus | Uterus Increases in size & Weight Braxton Hick contractions, |
| Normal Physical Changes of Pregnancy: Cervix | Increase glandular tissue Mucous plug is formed Increased blood flow leads to: Goodell’s sign (softening of cervix) Chadwick’s sign- (bluish coloration) |
| Normal Physical Changes of Pregnancy: Ovaries | Ovum production ceases Corpus luteum persists and secretes hormone until weeks 6-8 |
| Normal Physical Changes of Pregnancy: Breast | Size and nodularity increase Increase tenderness Superficial veins Increase pigmentation of areola and nipples occurs Colostrum production |
| Normal Physical Changes of Pregnancy: Respiration | Hyperventilation occurs Tidal volume increases: airway resistance decreases Diaphragm is elevated Abdominal to thoracic |
| Normal Physical Changes of Pregnancy: Cardiovascular System | Blood volume increases (40%-45%) Systemic and pulmonary vascular resistance decreases Cardiac output increases (30%-50%) Pulse increases (10-15bpm) B/P (decreases mid-pregnancy) Physiological anemia of pregnancy RBC, hemoglobin and plasma increases Decrease in Hct Vena cava Dizziness, lightheadedness, pallor and clamminess Left lateral position |
| Normal Physical Changes of Pregnancy: Urinary Tract | Urinary frequency GFR and renal plasma flow increase Glycosuria (GDM) |
| Normal Physical Changes of Pregnancy: GI System | Nausea and vomiting Ptyalism (excessive salivation) Delayed gastric emptying- constipation Hemorrhoids |
| Psychologic Responses of the Mother to Pregnancy | Ambivalence Acceptance of pregnancy Introversion Mood Swings Changes in Body Image |
| Four Classic Pelvic Types | Gynecoid Android Anthropoid Platypelloid |
| Gynecoid | Inlet rounded all diameters adequate, outlet adequate, favorable for vaginal delivery. |
| Android: | Heart-shaped, outlet capacity reduced, not favorable for vaginal delivery. |
| Anthropoid: | Inlet oval shaped, mid-pelvis & outlet adequate, favorable for delivery. |
| Platypelloid: | Inlet oval shaped, mid-pelvis reduced, outlet capacity inadequate. |
| Fetal Head | composed of three major parts: Face Base of the skull (cranium) Vault of cranium (roof) |
| Fetal Attitude | General flexion is the relation of the fetal body parts to one another. |
| Fetal Lie: | is the relationship of the fetal spine to maternal spine |
| Types of Fetal presentations | Cephalic Breech Shoulder: |
| Cephalic: | fetal head (97% term births) Vertex: occiput, smallest diameter presenting (flexed) Sinciput : Occipitofrontal diameter (top of head) Brow: Occipitomental diameter (largest diameter) Face: Submentobregmatic diameter (complete extension) |
| Breech | (3% of all term births) the sacrum is the landmark. Complete: Buttocks & feet present, legs are flexed Frank: buttocks presents, hips bent, legs extended up Footling: single or double footling presents (standing) |
| Shoulder: | fetus in a transverse lie position with shoulder or scapula presenting as a landmark. |
| Fetal Engagement | largest diameter passes through the pelvic inlet. |
| Floating or Ballottable | freely moving above the inlet |
| Station: | Relationship between the Ischial spines & presenting part |
| Contractions: | rhythmic tightening & shortening of uterine muscle. Three phases of each contraction: Increment (Building up) Acme (Peak of contraction) Decrement(Letting up) Period of relaxation: allows for uterus to rest Restores Uteroplacental circulation Respite for the mother Frequency: Beginning of one ctx. to the beginning of next. Duration: Length of contraction Intensity: Strength of contractions |
| Bearing Down | pushing phase |
| First Stage of Labor: Latent Phase: | Early Labor, 0 to 4 cms. (now to 6cms.) Mild, irregular contractions, 3 to 30 min apart, 20-40 sec duration. |
| First Stage of Labor: Active Phase | : 5 to 7 cms. regular contractions 2-5 min apart, 40-60 sec duration, moderate intensity. |
| First Stage of Labor: Transition Phase | 8 to 10 cms. Strong contractions 2-3 min apart, 60-90 sec, rectal pressure, & bloody show. |
| FOUR Forces of fetal descent: | Pressure of amniotic fluid Direct pressure on fundus Contraction of abdominal muscles Extension & straightening of fetus |
| Positional Changes of the Fetus: Descent | progress of the presenting part through the pelvis |
| Positional Changes of the Fetus: Flexion | descending head meets resistance from cervix, brings chin in, small diameter |
| Positional Changes of the Fetus: Internal Rotation | the head rotates from transverse (side) to the face now looking down |
| Positional Changes of the Fetus: Extension | occiput passes under the symphysis pubis, emerges by extension, first the occiput, then the face, then the chin. |
| Positional Changes of the Fetus: Restitution | Baby head rotates to position it occupied when it was engaged in the inlet |
| Positional Changes of the Fetus: External Rotation | 45-degree turn realigns the head with the back & shoulders. The shoulders then engage and descend , anterior shoulder first then posterior shoulder. |
| Positional Changes of the Fetus: Expulsion | After the shoulders deliver the body is lifted up towards the mother. This is the end of the second stage |
| Factors Affecting Labor & Birth | The Five P’s: Passenger (fetus & placenta) Passageway (birth canal) Powers (primary & secondary)Powers: contractions cause the dilatation & effacement of the uterus. Secondary: expulsion of the fetus, urge to push Position of the mother Psychologic response |
| What is premature rupture of membranes (PROM) | Prelabor rupture of membranes (PROM) is the spontaneous rupture of the amniotic sac, sometimes called the bag of waters, before the onset of true labor. |
| preterm prelabor rupture of membranes (PPROM), | which is defined as rupture of membranes prior to the onset of labor in a woman who is less than 37 weeks’ gestation. |
| What is prolonged rupture of membranes? | Prolonged rupture of membranes is arbitrarily defined as rupture of membranes for greater than 18 hours. If asymptomatic, the infant should be observed in the hospital for 48 hours. |
| GBS status | Group B streptococcus (GBS) is a Gram-positive organism that colonizes in the female genital tract and rectum and is present in 10% to 30% of all healthy women (King et al., 2019). These women are asymptomatic carriers but can cause GBS disease of the newborn through vertical transmission during labor and horizontal transmission after birth. 6. What are complications of GBS with a newborn? Neonatal clinical manifestations include pneumonia and sepsis. 7. How is GBS treated? Identified GBS carrier |
| Leopold's maneuver | Leopold maneuvers are a method for determining the presentation, position, and lie of the fetus using four specific steps. This method involves inspection and palpation of the maternal abdomen as a screening assessment for malpresentation. The flat palmar surfaces of the nurse’s hands with the fingers together palpate the uterus. A longitudinal lie is expected, and the presentation can be cephalic, breech, or shoulder. |
| Gestational diabetes | a condition characterized by an elevated level of glucose in the blood during pregnancy, typically resolving after the birth |
| What is induction of labor | Induction is a deliberate initiation of uterine contractions that stimulates labor. |
| What are some methods used to induce patients? | Elective induction may be accomplished by oxytocin (Pitocin) infusion. Also nipple stimulation will also help pick up contractions. |
| What is the Bishop score? | The Bishop score is used to determine maternal readiness for labor and evaluates cervical status and fetal position. The bishop score is indicated before the induction of labor. The five factors are assigned a score of 0 to 3. And the total score is calculated. A score of 6 or more indicates a readiness for labor induction. The five factors are: Dilation of cervix Effacement of cervix Consistency of cervix Position of cervix Station of presenting pain. |
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