Self-Assessment Questions (SAQs) for Study Session 5
Now that you have completed this study session, you can assess how well you have achieved its Learning Outcomes by answering the questions below Case Study 3.1. 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 5.1 (tests Learning Outcomes 5.1, 5.2 and 5.3)
Which of the following statements is false? In each case, explain what is incorrect.
A Full dilatation of the cervix to 10 cm is the most important sign that the second stage of labour is beginning.
B In second stage, the mother’s genitals tend to bulge during contractions and relax between contractions.
C Crowning is the name given to the moment when the baby’s head is completely born.
D In a normal delivery, the baby moves down the birth canal facing the front of the mother’s body, with its back towards her backbone.
E While it is still in the birth canal, the baby’s heartbeat tends to get faster during a contraction.
F Let the mother choose the position that she feels most comfortable in when she gets the urge to push in the second stage of labour.
Answer
A is true. Full dilatation of the cervix to 10 cm is the most important sign that second stage of labour is beginning.
B is true. In second stage, the mother’s genitals tend to bulge during contractions and relax between contractions.
C is false. Crowning is when the top of the baby’s head stretches the vaginal opening to the size of your hand and it stays in the opening even between contractions.
D is false. In a normal delivery, the baby moves down the birth canal facing the back of the mother’s body, with its own back towards her belly.
E is false. While it is still in the birth canal, the baby’s heartbeat tends to get slower (not faster) during a contraction.
F is true. You should let the mother choose the position that she feels most comfortable in when she gets the urge to push in the second stage of labour.
SAQ 5.2 (tests Learning Outcome 5.3)
List four warning signs that second stage labour may not be progressing normally.
Answer
Warning signs that second stage may not be progressing normally include:
- Fetal heartbeat stays above or below the normal range (120-160 beats per minute) even between contractions of the mother’s uterus.
- A sudden gush of amniotic fluid leaves the vagina, which may indicate a cord prolapse or placental abruption.
- A multigravida mother has been pushing for 1 hour without the baby moving down the birth canal, or a primigravida mother has been pushing for 2 hours with no good progress.
- Baby is not descending and there are signs that it is developing caput or excessive moulding of the fetal skull.
SAQ 5.3 (tests Learning Outcome 5.4)
Imagine that the baby’s head has been born and you are waiting for the next contraction to deliver the baby’s shoulders. What should you do if you find that the umbilical cord is wrapped around the baby’s neck?
Answer
First, try to loosen the cord and slip it over the baby’s head. If you cannot loosen it and it is preventing the baby from being delivered, clamp the cord in two places (or tie it with very clean string) and cut it in between the clamps. Be careful not to cut the mother or the baby’s neck.
SAQ 5.4 (tests Learning Outcomes 5.4 and 5.5)
Rearrange the following actions into the correct order during delivery of the baby and immediately afterwards.
A Once the baby’s head is born, help it to breathe by clearing its nose and mouth.
B Wash your hands well and put on sterile gloves and other protective clothing.
C To prevent tearing of the mother’s birth vagina or perineum, deliver the baby’s shoulders one at a time.
D Press one hand firmly over the mother’s perineum.
E When the baby has been completely delivered, put it on the mother’s abdomen and dry it with a clean cloth.
F Clean the mother’s perineal area with antiseptic.
G Clamp or tie the cord in two places and cut it in between the clamps.
H Use your other hand to apply gentle downward pressure on the top of the baby’s head to keep it flexed (bent downwards).
I Cover the baby to keep it warm and give it a chance to breastfeed straight away.
J Use a piece of cloth or gauze to cover the mother’s anus in case any faeces come out with the baby.
K Check that the cord is not around the baby’s neck.
Answer
The correct sequence is as follows:
B Wash your hands well and put on sterile gloves and other protective clothing.
F Clean the mother’s perineal area with antiseptic.
D Press one hand firmly over the mother’s perineum.
J Use a piece of cloth or gauze to cover the mother’s anus in case any faeces come out with the baby.
H Use your other hand to apply gentle downward pressure on the top of the baby’s head to keep it flexed (bent downwards).
A Once the baby’s head is born, help it to breathe by clearing its nose and mouth.
K Check that the cord is not around the baby’s neck.
C To prevent tearing of the mother’s birth vagina or perineum, deliver the baby’s shoulders one at a time.
E When the baby has been completely delivered, put it on the mother’s abdomen and dry it with a clean cloth.
I Cover the baby to keep it warm and give it a chance to breastfeed straight away.
G Clamp or tie the cord in two places and cut it in between the clamps.
SAQ 5.5 (tests Learning Outcome 5.5)
What do you do to help bonding between the mother and her newborn baby?
Answer
To help bonding between the mother and her newborn baby you place the baby on the mother’s abdomen as soon as it is born, and give it an early opportunity to breastfeed. Do not separate the mother and her baby during at least the first hour after the birth.
Summary of Study Session 5