THEORIES OF LABOR ONSET

Uterine Stretch theory

The idea is based on the concept that any hollow body organ when stretched to its capacity will inevitably contract to expel its contents. The uterus, which is a hollow muscular organ, becomes stretched due to the growing fetal structures. In return, the pressure increases causing physiologic changes (uterine contractions) that initiate labor.

Oxytocin theory

Pressure on the cervix stimulates the hypophysis to release oxytocin from the maternal posterior pituitary gland. As pregnancy advances, the uterus becomes more sensitive to oxytocin. Presence of this hormone causes the initiation of contraction of the smooth muscles of the body (uterus is composed of smooth muscles).

Progesterone deprivation theory

Progesterone is the hormone designed to promote pregnancy. It is believed that presence of this hormone inhibits uterine motility. As pregnancy advances, changes in the relative effects estrogen and progesterone encourage the onset of labor. A marked increase in estrogen level is noted in relation to progesterone, making the latter hormone less effective in controlling rhythmic uterine contractions. Also, in later pregnancy, rising fetal cortisol levels inhibit progesterone production from the placenta. Reduce progesterone formation initiates labor.

Prostaglandin theory

In the latter part of pregnancy, fetal membranes and uterine decidua increase prostaglandin levels. This hormone is secreted from the lower area of the fetal membrane (forebag). A decrease in progesterone amount also elevates the prostaglandin level. Synthesis of prostaglandin, in return, causes uterine contraction thus, labor is initiated.

Theory of Aging Placenta

Advance placental age decreases blood supply to the uterus. This event triggers uterine contractions, thereby, starting the labor.

TRUE LABOR VS. FALSE LABOR

The way a contraction feels is different for each woman and may feel different from one pregnancy to the next. Before "true" labor begins, you may have "false" labor pains, also known as Braxton Hicks contractions. These irregular uterine contractions are perfectly normal and may start to occur from your fourth month of pregnancy. They are your body' s way of getting ready for the "real thing." What do Braxton Hicks contractions feel like? Braxton Hicks contractions can be described as tightening in the abdomen that comes and goes. These contractions do not get closer together, do not increase with walking, do not increase in how long they last or how often they occur, and do not feel stronger over time

Timing of contractions

False Labor: Often are irregular and do not get closer together True Labor: Come at regular intervals and as time goes on, get closer together. Contractions last about 30-70 seconds.

Change with movement False Labor: contractions may stop when you walk or rest, or may even stop when you change position True Labor: Contractions continue, despite movement or changing positions Strength of contractions

False Labor: Contractions are usually weak and do not get much stronger (may be strong first, then get weaker) True Labor: Contractions steadily increase in strength Pain of contractions

False Labor: contractions are usually only felt in the front of the abdomen or pelvic region True Labor: Contractions usually start in the lower back and move to the front of the abdomen

ANGELES UNIVERSITY FOUNDATION Angeles City COLLEGE OF NURSING A.Y. 2011-2012

THEORIES OF LABOR ONSET FALSE LABOR VS. TRUE LABOR

(REPORT)

SUBMITTED BY: JUSTIN B. MERCADO BSN III-1 GROUP 1

SUBMITTED TO: MRS. KAREN DAVID SEMBRANO

JUNE 28, 2011