Various stages of labour, role of midwife in caring for a woman in labour
Time: 15:00
What event marks the official beginning of the first stage of labour?
[a] The rupture of the amniotic membranes ("water breaking").
[b] The "bloody show" or loss of the mucus plug.
[c] The onset of regular, painful uterine contractions that cause cervical change.
[d] The mother feeling the first urge to push.
The second stage of labour commences with __________ and ends with __________.
[a] The onset of contractions; full cervical dilatation.
[b] The birth of the baby; the delivery of the placenta.
[c] Rupture of membranes; full cervical dilatation.
[d] Full cervical dilatation; the birth of the baby.
A woman in labour is 8 cm dilated, feeling shaky, irritable, and has an intense urge to push. The midwife recognizes that she is likely in which phase of the first stage?
[a] Latent phase.
[b] Active phase.
[c] Transition phase.
[d] Pushing phase.
What is the midwife's priority action during the fourth stage of labour?
[a] Documenting the time of birth.
[b] Assisting the mother with her first meal.
[c] Suturing any perineal lacerations.
[d] Assessing the uterine fundus for tone and monitoring for postpartum haemorrhage.
Active management of the third stage of labour typically includes the administration of which medication immediately after the birth of the baby?
[a] An antibiotic to prevent infection.
[b] An analgesic for pain relief.
[c] A uterotonic agent like oxytocin.
[d] A tocolytic agent like terbutaline.
How does a midwife assess the intensity of a uterine contraction by palpation?
[a] By measuring the time between contractions.
[b] By asking the mother to rate the pain on a scale of 1-10.
[c] By feeling the firmness of the uterine fundus at the peak of the contraction.
[d] By observing the mother's facial expressions.
The "cardinal movements" of labour describe the process of:
[a] The mother changing positions during labour.
[b] The fetus adapting and moving through the maternal pelvis.
[c] The placenta separating from the uterine wall.
[d] The cervix dilating and effacing.
A key role of the midwife in the active phase of the first stage of labour is to:
[a] Encourage the mother to rest and sleep between contractions.
[b] Prepare for immediate delivery.
[c] Provide continuous emotional support, comfort measures, and monitor progress.
[d] Administer an epidural anaesthetic.
A midwife notes a sudden gush of blood from the vagina and lengthening of the umbilical cord. These are signs of:
[a] The onset of the second stage of labour.
[b] A postpartum haemorrhage.
[c] Imminent birth of the baby.
[d] Placental separation.
The term "effacement" refers to the:
[a] Opening of the cervical os, measured in centimeters.
[b] Thinning and shortening of the cervix.
[c] Descent of the fetal head into the pelvis.
[d] Rotation of the fetal head during birth.
For a low-risk woman in the active phase of labour, what is the recommended frequency for intermittent auscultation of the fetal heart rate?
[a] Every 5 minutes.
[b] Every 15 to 30 minutes.
[c] Every 60 minutes.
[d] Only when the mother reports a change in fetal movement.
The fourth stage of labour is defined as the:
[a] Time from delivery of the placenta to 24 hours postpartum.
[b] The first 30 minutes after the birth of the baby.
[c] The first 1 to 4 hours after the delivery of the placenta.
[d] The entire 6-week postpartum period.
A midwife's role as a patient advocate is best demonstrated by which action?
[a] Making all decisions for the labouring woman.
[b] Following the physician's orders without question.
[c] Supporting the woman's informed choices and communicating her birth preferences to the team.
[d] Limiting family members at the bedside.
What is the midwife's first action if the uterine fundus is found to be soft and boggy during the fourth stage of labour?
[a] Administer a bolus of IV fluids.
[b] Document the finding and reassess in 15 minutes.
[c] Notify the physician immediately.
[d] Massage the fundus firmly until it becomes firm.
A graphical record used to chart the progress of labour, including cervical dilatation and fetal descent, is called a:
[a] Labourgram.
[b] Birth plan.
[c] Partograph or Partogram.
[d] Fetal monitor strip.
During the second stage of labour, the midwife's role in guiding pushing efforts includes:
[a] Insisting the woman hold her breath for as long as possible while pushing.
[b] Requiring the woman to lie flat on her back.
[c] Encouraging the woman to push spontaneously with her contractions in a position of comfort.
[d] Instructing the woman to push continuously, even between contractions.
Which non-pharmacological comfort measure is an essential part of midwifery care during labour?
[a] Administering epidural anaesthesia.
[b] Providing a detailed explanation of the physiology of pain.
[c] Encouraging freedom of movement and position changes.
[d] Ensuring the room is kept completely silent.
The third stage of labour ends with the:
[a] Birth of the baby.
[b] First breastfeeding session.
[c] Repair of any perineal tears.
[d] Complete delivery of the placenta and membranes.
A midwife's responsibility after the placenta is delivered is to:
[a] Discard it immediately as medical waste.
[b] Inspect it to ensure it is intact and complete.
[c] Send a routine sample to the laboratory for analysis.
[d] Give it to the family without inspection.
The latent phase of the first stage of labour is typically characterized by:
[a] Rapid cervical dilatation from 6 to 10 cm.
[b] Intense, frequent contractions and a strong urge to push.
[c] Mild, irregular contractions and slow, early cervical dilatation (0-5 cm).
[d] The birth of the baby.
What is the primary purpose of applying perineal support or a warm compress during the final moments of the second stage?
[a] To speed up the delivery of the baby.
[b] To assess the fetal heart rate.
[c] To reduce the risk of perineal trauma and tearing.
[d] To clean the perineum before birth.
During which stage of labour does the midwife have a crucial role in promoting immediate skin-to-skin contact and the initiation of breastfeeding?
[a] First stage, active phase.
[b] Second stage.
[c] Third stage.
[d] Fourth stage.
A woman in active labour is discouraged from pushing before her cervix is fully dilated primarily to:
[a] Conserve her energy for later.
[b] Prevent cervical edema and potential tearing.
[c] Allow the fetal heart rate to recover.
[d] Ensure the physician is present for the birth.
The term "crowning" occurs in the second stage and signifies that:
[a] The cervix has reached full dilatation.
[b] The placenta has detached from the uterine wall.
[c] The largest diameter of the fetal head is visible at the vaginal introitus and does not recede.
[d] The baby has fully emerged from the birth canal.
A core philosophy of midwifery care during labour is to:
[a] Intervene early and often with technology to ensure safety.
[b] View labour as a high-risk medical event for all women.
[c] View childbirth as a normal physiological process and empower the woman.
[d] Ensure the process is as quick as possible by augmenting all labours.
Legislation in nursing, profession and related organisations.
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