Self-Assessment Questions (SAQs) for Study Session 1

Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions below. Write your answers in your Study Diary and discuss them with your Tutor at the next Study Support Meeting. You can check your answers with the Notes on the Self-Assessment Questions at the end of this Module.

SAQ 1.1 (tests Learning Outcome 1.1)

Write each of the bold terms listed below on a small piece of paper. Roll up each piece and put them in a small basket or bowl.

Pick one at a time and try to define the term. Write your answers in your Study Diary. Finally, compare your answers with the definitions in this study session. You can repeat the exercise until you are familiar with all of the words.

true labour, effacement , dilatation, presenting part, show, rupture of fetal membranes, engagement, descent, first stage, second stage, third stage, fourth stage

Answer

Check your definitions of the bold terms by finding each of them in Study Session 1 and comparing what you have written in your Study Diary with our definition in this session. If any of your definitions were different from ours, try Activity 1.1 again until you get all of them right.

Read Case Study 1.1 and then answer the questions that follow it.

Case Study 1.1  Mrs Abeba

Mrs. Abeba is 30 years of age and is having her first baby. She has come to the Health Post because she began to get regular pushing-down pains about 3 hours ago. She says that the pains start in her back and move forward to the front of her abdomen, each pain lasts about 40 seconds, and they occur 2–3 times in every 8 minutes. When you examine her, you find that her cervix is fully effaced and the diameter is 4 cm. Mrs Abeba’s mother-in-law has told her she isn’t in labour because she hasn’t had a ‘show’.

SAQ 1.2 (tests Learning Outcomes 1.2 and 1.3)

  • a.What are the signs suggesting true labour from Mrs Abeba’s description and the physical examination?
  • b.What stage of labour has she reached and how do you know this?
  • c.What will you say to Mrs Abeba to help her recognise that she is really in labour?

Answer

  • a.Mrs Abeba is in true labour because her pains are signs of adequate uterine contractions: they are regular, frequent (2-3 every 8 minutes), and the duration is about 40 seconds, which is expected in true labour. Her cervix is effaced and dilated to 4 cm after 3 hours of contractions.
  • b.She is in the first stage of labour, at the cross-over point between the latent phase and the active phase, which occurs when the cervix is dilated to 4 cm.
  • c.Reassure Mrs Abeba that labour can begin normally without a ‘show’. Her contractions have been coming for 3 hours without stopping, and their strength and regularity are as expecedt in a normal labour.

SAQ 1.3 (tests Learning Outcomes 1.2)

Table 1.3 summarises the difference between true and false labour. Fill in the empty boxes with appropriate descriptions.

Table 1.3  True and false labour.

True labourFalse labour
Contractions occur at regular intervals
Duration of each contraction gradually increases
Intensity of contractions is unchanged
cervix progressively dilates
Discomfort usually relieved by anti-pain medication or with walking

Answer

The completed version of Table 1.3 is shown below.

True labourFalse labour
Contractions occur at regular intervalsContractions occur at irregular intervals.
Duration of each contraction gradually increases Duration remains unchanged – either long or short
Intensity of contractions becomes stronger and strongerIntensity remains unchanged
Cervix progressively dilatesCervix does not dilate
Discomfort cannot be stopped by strong anti-pain medicationDiscomfort usually relieved by anti-pain medication or by walking

SAQ 1.4 (tests Learning Outcomes 1.1, 1.4 and 1.5)

Which of the following statements is false? In each case, explain what is incorrect.

A  Lightening is when the baby floats higher in the abdomen shortly before labour begins.

B  The second stage of labour ends with the expulsion of the baby from the birth canal.

C  The fourth stage of labour lasts for 4 hours and begins when the placenta and fetal membranes have been expelled.

D  The overlapping of fetal skull bones during the descent through the mother’s pelvis is called flexion.

E  The fetal head is engaged when the occiput of the fetal skull reaches the level of the ischial spines in the mother’s pelvis.

F  During a normal birth, both the baby’s shoulders are born at the same time.

Answer

A is false. Lightening is when the baby drops lower in the abdomen before labour begins.

B is true. The second stage of labour ends with the expulsion of the baby from the birth canal.

C is true. The fourth stage of labour lasts for 4 hours and begins when the placenta and fetal membranes have been expelled.

D is false. The overlapping of fetal skull bones during the descent through the mother’s pelvis is called moulding (not flexion).

E is true. The fetal head is engaged when the occiput of the fetal skull reaches the level of the ischial spines in the mother’s pelvis.

F is false. During a normal birth, one of the baby’s shoulders is born first, followed by the other shoulder.

Summary of Study Session 1