Precipitous Labor
Included In This Lesson
Outline
Overview
- Delivery of baby in 3 hours or less from beginning of labor to the end
Nursing Points
General
- More common in multiparous mothers
- Increased risk for those with a history of precipitous delivery
Assessment
- Rapidly progressing labor
- Strong close together contraction
- Feeling pressure to push early in labor
- “This baby is coming now!”
- Hemorrhage
- Tears
Therapeutic Management
- Prepare to potentially deliver baby if MD or midwife will not arrive in time
- Have supplies for delivery readily available
- Many ED’s and OB triage units have Precipitous Delivery Kits prepared
- Stay with mother, provide emotional support as pain is typically more intense and due to rapid progression and inability to administer pain meds so quickly
Nursing Concepts
- Safety
- Comfort
Patient Education
- Deep breathe
- Stay calm
- Focus on pushing
ADPIE Related Lessons
Related Nursing Process (ADPIE) Lessons for Precipitous Labor
Transcript
In this lesson I will explain precipitous labor and your role in providing care.
Let’s define what this is. Precipitous labor is a labor that from start to finish is under 3 hours. So labor starts and with in 3 hours we deliver a baby. This is really fast! Labor is usually 12 hours or longer for some just to give an idea. These patients are the ones that barely make it to the hospital. They deliver in the car, in the emergency room, or they are being wheeled in leaning to one side. That lean is never a good sign, it means there is a baby very close to being between her legs! So this is super fast! So who does this happen to? It can happen to anyone but those that have had multiple pregnancies and delivers are more at risk. There bodies have done this before and know what to do. Women with a history of precipitous delivery are also at risk to have this occur again.
Alright so when we assess this patient she is going to have rapid progression of labor. So contractions are close together and are strong. The patient might also have a feeling of intense rectal pressure. This is because the baby is so low in the perineum. So you might hear her saying things like “I have to push” or “This baby is coming now!” After delivery the patient needs to be assessed for a few things. This patient is at risk for hemorrhage because of the fast labor. The uterus in worn out from that very fast strong labor and bleeds. The patient also needs to be assessed for tears because the baby doesn’t have time to sit at the perineum and stretch the tissue. It flies out which tears the tissue.
Our management for this patient is going to be to quickly get prepared for delivery. I can’t tell you how many times these patients come in and quickly deliver within 5 minutes. Everything is chaos. There are many times that the labor nurse even has to delivery because the doctor doesn’t arrive in time. So all supplies need to be quickly gathered and set up. You never want to leave this patient. A baby is going to come flying out and you don’t want to miss that! Also these mothers need your support. Their body is moving quicker then their mind is so they are freaking out and need you to help keep them focused. If the patient wants pain medication and you can give it then do it. So she probably won’t be able to get an epidural if she is too far along so another option that some hospitals offer is nitrous oxide. So some laughing gas just to help take the edge of.
This patient needs some very quick education. She needs to deep breathe, stay calm, and focus on pushing when it is time. So these patients they come in and they are so out of control. All over the bed, screaming and they don’t know what is going on. Most of them want pain medication and aren’t able to get it. So you really have to get in their face, nicey, and say “hey you can do this focus and push!” After the baby delivers the mom is usually in shock. She just sits there stunned. This is the classic story. The baby usually also will be stunned. They just got evicted from their home and quickly! So I say the baby has the “help me Jesus look”. This means they just stare and are stunned, not really crying. So they need to be stimulated vigorously to breathe. So both mom and baby are a little shocked about what happened to them.
Safety and comfort are our concepts. We need to ensure safety during and after delivery as well as provide comfort to the mom as she gets through this and then processes what just happened.
Our key points for a precipitous labor is that it is a labor that from the start to end is under three hours so it is really fast! Multigravida women, so those that have had multiple babies are at risk. Their bodies have done this before and know what to do and they spit out a baby fast. Those that have a history of fast labor are at risk to do it again. If the women has a precipitous delivery she is at risk for hemorrhage because her body is like “whoa what just happened?” and can’t get it together and at risk for tears also because the baby didn’t have a chance to sit in the perineum and stretch the tissue. Remember it just flew out. Because the fetus flew out it could have bruising and also some respiratory difficulty because they didn’t get that squeeze during delivery to get all the fluid out.
Make sure you check out the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing.
Tiona RN
Concepts Covered:
- Studying
- Medication Administration
- Adult
- Emergency Care of the Cardiac Patient
- Intraoperative Nursing
- Microbiology
- Cardiac Disorders
- Vascular Disorders
- Nervous System
- Upper GI Disorders
- Central Nervous System Disorders – Brain
- Immunological Disorders
- Fundamentals of Emergency Nursing
- Dosage Calculations
- Understanding Society
- Circulatory System
- Concepts of Pharmacology
- Hematologic Disorders
- Newborn Care
- Adulthood Growth and Development
- Disorders of Pancreas
- Postoperative Nursing
- Pregnancy Risks
- Neurological
- Postpartum Complications
- Noninfectious Respiratory Disorder
- Peripheral Nervous System Disorders
- Learning Pharmacology
- Prenatal Concepts
- Tissues and Glands
- Developmental Considerations
- Factors Influencing Community Health
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Developmental Theories
- Basic
- Neonatal
- Pediatric
- Gastrointestinal
- Newborn Complications
- Labor Complications
- Fetal Development
- Terminology
- Labor and Delivery
- Postpartum Care
- Communication
- Basics of Mathematics
- Statistics
- Basics of Sociology
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of the Thyroid & Parathyroid Glands
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Respiratory
- Delegation
- Perioperative Nursing Roles
- Acute & Chronic Renal Disorders
- Respiratory Emergencies
- Disorders of the Adrenal Gland
- Documentation and Communication
- Preoperative Nursing
- Legal and Ethical Issues
- Oncology Disorders
- Female Reproductive Disorders
- Musculoskeletal Trauma
- Renal Disorders
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Integumentary Disorders
- Emergency Care of the Trauma Patient
- Urinary Disorders
- Musculoskeletal Disorders
- EENT Disorders
- Neurological Emergencies
- Disorders of Thermoregulation
- Neurological Trauma
- Basics of NCLEX
- Integumentary Important Points
- Multisystem
- Test Taking Strategies
- Urinary System
- Emergency Care of the Neurological Patient
- Central Nervous System Disorders – Spinal Cord
- Respiratory System
- Emergency Care of the Respiratory Patient
- Cognitive Disorders
- Anxiety Disorders
- Depressive Disorders
- Trauma-Stress Disorders
- Substance Abuse Disorders
- Bipolar Disorders
- Psychotic Disorders
- Concepts of Mental Health
- Eating Disorders
- Personality Disorders
- Health & Stress
- Psychological Emergencies
- Somatoform Disorders
- Prioritization
- Community Health Overview
- Gastrointestinal Disorders
- Integumentary Disorders
- Respiratory Disorders
- Neurologic and Cognitive Disorders
- Renal and Urinary Disorders
- Infectious Disease Disorders
- EENT Disorders
- Hematologic Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Endocrine and Metabolic Disorders
- Oncologic Disorders
- Behavior
- Emotions and Motivation
- Growth & Development
- Intelligence and Language
- Psychological Disorders
- State of Consciousness
- Note Taking
- Concepts of Population Health
- Basics of Human Biology