Essentials of Maternity, Newborn, and Women's Health Nursing

Essentials Of Maternity, Newborn, And Women’s Health Nursing

Nursing Management During Labor and Birth

Desiree, a 28-year-old G2P1, is admitted to the labor and birth unit. Her birth plan indicates that she is planning natural childbirth without pharmacological interventions. She has attended childbirth education classes. Desiree is considered low risk based on her personal and family health history and physical exam. Her pregnancy has progressed without complications. She is approximately 38 weeks pregnant. Vaginal assessment reveals cervical dilation at 10 cm, 100% effaced, and +1 station. Position of the fetus is LOA. The external fetal monitor indicates a reassuring fetal heart rate at 130 beats per minute. Maternal status is stable. (Learning Objectives 1, 2, 6, and 9)

  1. Based on the vaginal assessment, identify the stage of labor and appropriate nursing interventions for this stage of labor.
  2. Explain how the nurse determined that the external fetal monitor would be appropriate for Desiree. What factors would necessitate a change to internal fetal monitoring during labor?
  3. Desiree says, “I’m not sure I can cope with the pain much longer.” How would you respond, considering her birth plan, stage of labor, and assessment data?




Essentials of Maternity, Newborn, and Women’s Health Nursing




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Essentials of Maternity, Newborn, and Women’s Health Nursing

Nursing Management During Labor and Birth

Every new life starts with an expedition, and the heart of this life-changing procedure lies the essential role of maternity, newborn, and women’s health nursing. Maternity, newborn, and women’s health nursing is a unique nursing field focusing on women’s care throughout their reproduction time. This nursing field demands a thorough comprehension of the specific physical, emotional, and social requirements for women and infants. Nurses working in the area must provide sympathetic care to women during labor and delivery, handle any complications during pregnancy and childbirth, and the nurse should provide education and support to new mothers (Altman et al., 2020). Nurses in this area significantly promote women’s health by averting illness through education and preventive care. This essay explores a case study of Desiree, a 28-year-old G2P1 admitted to the labor and birth unit, and from the case study, the paper will identify the stage of labor and appropriate nursing interventions for the stage of labor, how the nurse determined that the external fetal monitor would be appropriate for Desiree, factors that would necessitate a change to internal fetal monitoring during labor, and the respond considering her birth plan, stage of labor, and assessment data.

Stage of Labor Evaluation and Recognizing Vaginal Findings and Equating Nursing Intervention

Based on the vaginal evaluation findings, Desiree is in the second labor phase, the pushing stage. The cervical dilation of ten centimeters indicates that her cervix is fully dilated, while a hundred percent effacement suggests that the cervix has thinned out fully. The positive one station indicates that the baby’s head is subsided into the pelvis and is approximately one centimeter above the ischial spines. In this phase, the nurse must motivate Desiree to start pushing with each contraction to assist in facilitating the baby’s descent through the birth canal. The nurse must offer directions on effectual pushing methods like deep breathing, utilizing the abdominal muscles, and pushing during contraction. The nurse must also continuously observe the fetal heart rate to ensure it remains encouraging. The nurse needs to develop a supportive and reassuring environment for Desiree during this phase. The nurse should provide emotional support, offer encouragement, and praise her efforts. Position changes like squatting or side-lying may be advocated to help in the baby’s descent and offer comfort for Desiree. The nurse is also responsible for preparing for the imminent birth by ensuring that all appropriate tools and supplies are readily available. This involves setting up the delivery table, collecting sterile instruments, and ensuring the availability of emergency tools in case of any unexpected complications. The nurse must be prepared to offer immediate newborn care once the baby is delivered, involving drying and stimulating the newborn, initiating skin-to-skin contact, and evaluating the baby’s initial respiratory effort and overall condition. Comprehensively, the nurse’s role throughout the second phase is to support Desiree physically and emotionally, foster effectual pushing methods, observe fetal well-being, and prepare for the baby’s birth.

Evaluation of External Fetal Monitor Fitness for Desiree and Consideration for Transitioning to Internal Monitoring During Labor

The nurse determined that the external fetal monitor would suit Desiree based on numerous factors. Desiree is considered low risk, as highlighted by her personal and family health history, physical assessment, and development of pregnancy without complications. This indicates that the likelihood of fetal distress or complications throughout labor is relatively low. In addition, Desiree’s birth plan highlights a preference for natural childbirth without pharmacological intervention, indicating that she deserves minimal medical interventions unless needed. The external fetal monitoring offers progressive observation of the fetal heart and uterine contraction, permitting the healthcare team to assess the fetus’s well-being and recognize any signs of distress (Yang et al., 2021). In Desiree’s case, the monitor suggests a favorable fetal rate of 130 beats per minute, indicating that the baby is abiding labor well. Since Desiree’s labor is continuing smoothly, her vital signs are stable, and there are no indicators of fetal distress, the external fetal monitoring is suitable for observing the progress of labor and the well-being of both the mother and the baby.

Moreover, certain factors may constrain a change to internal fetal monitoring throughout labor. If any concerns develop regarding the fetal well-being, like abnormal fetal heart rate sequences or signs of distress, the healthcare provider may go for internal monitoring. In addition, if the external monitor becomes undependable because of factors like maternal movement or obesity, it may be appropriate to switch to internal monitoring for more precise readings. Other indications for internal monitoring include the need for accurate measurement of uterine contractions, evaluation of fetal scalp blood pH, or if the membranes have not fractured (Gibb & Arulkumaran, 2023). The healthcare provider creates the decision to switch to internal monitoring based on the specific situations and the need for more detailed and precise information about fetal well-being during labor.

Respond to Desiree Considering her Birth Plan, Stage of Labor, and Assessment Data

One would respond to Desiree by recognizing her concerns and providing reassurance and support. One would say, Desiree, I comprehend that the pain can be intense during labor, and it is normal to feel overwhelmed at this phase. You have done a fantastic job and are continuing well in your labor. Recall that your birth plan reflects your preference for logical childbirth with no pharmacological interventions, and here we are to support you in achieving that. You have taken part in childbirth education classes, providing numerous coping mechanisms and methods to manage the pain. We encourage you to attempt distinct positions, relaxation methods, and breathing exercises that you have learned to assist you in coping with the discomfort. In addition, your evaluation data shows reassuring signs like a stable fetal heart and mild cervical dilation. This highlights that you and your child are doing well. We are here to offer progressive support, reassurance, and guidance during your labor. You are doing great, and we have complete confidence in your ability to handle the pain. Let us work jointly and keep moving forward toward the birth of your baby.” By recognizing her concerns, evoking her of her birth plan, offering reassurance, and providing practical suggestions, one may aim to empower Desiree and assist her in regaining confidence in her ability to handle the pain of labor.


In conclusion, the essentials of maternity, newborn, and women’s health nursing play a crucial role in equipping inclusive care to individuals like Desiree during labor and birth. By assessing the labor phase and identifying and recognizing vaginal findings, nurses can evaluate the progress of labor and determine suitable nursing interventions. In addition, assessing the fitness of the external fetal monitor ensures advanced fetal rate monitoring, maintaining the safety of Desiree and her baby. Comprehending and respecting Desiree’s birth plan, phase of labor, and evaluation data are crucial in offering individualized care support, empowering her to handle the pain and achieving her goal for logical childbirth. Applying these nursing principles and skills helps improve maternal and newborn outcomes while encouraging an emphatic birth experience.




Altman, M. R., McLemore, M. R., Oseguera, T., Lyndon, A., & Franck, L. S. (2020). Listening to women: recommendations from women of color to improve experiences in pregnancy and birth care. Journal of Midwifery & Women’s Health65(4), 466-473.

Gibb, D., & Arulkumaran, S. (Eds.). (2023). Fetal Monitoring in Practice-E-Book. Elsevier Health Sciences.

Yang, X., Zhang, K., & He, J. (2021). Application and clinical analysis of remote fetal heart rate monitoring platform in continuous fetal heart rate monitoring images. Journal of Healthcare Engineering2021.

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