Page 56 - 33Elctronic Book (3) Normal Labor

vulva to prevent infection. Shaving is not advisable for fear of lacerations and

infection.
• Enema: Prepare and administer enema as ordered to stimulate uterine
contractions. Enema should be given early in the first stage of labor and not

repeated for S hours. Appendix L (
)
• Bath: A bath or shower is given following an enema and trimming of hair. If
the time is limited, wash at least from the umbilicus to the knees. Instruct the

woman to wear a clean nightdress or gown, and avoid using cosmetics.
• Hair and nails: Inspect and comb hair, and cut and clean nails.
• Perinea} swabbing: Swab the perineum on admission, then every 6 hours,

before and after vaginal examination, before delivery and before
catheterization. Cover the vulva with sterile pad )Appendix M(

.
Posture of Woman in Labor
• The nurse should allow the woman to assume any comfortable position,
except the dorsal recumbent which may result in supine hypotension and lead
to fetal distress.

• The nurse should encourage the woman to walk in the room if she is not in
active labor and to lie down towards the end of the first stage of labor.

•
Care of Bladder
• The woman should be encouraged to pass urine every 2-3 hours during labor.

• The urine should be tested for the presence of glucose, protein and ketone
bodies.

• A full bladder causes poor uterine contractions, postpartum hemorrhage and
injury or vescio-vaginal fistula when the bladder is nipped between the fetal
head and the pelvis. It prevents the descent of the fetal head, increases pain

and causes unnecessary discomfort.
• Retention of urine occurs frequently in labor due to:
o Lack of muscle tone of the urinary bladder.

o Uncomfortable use of bedpan.
o Pressure on the urethra.
o Elongation of the urethra, which inhibits relaxation of the urethral sphincter.

Observation:

56

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