Mechanism of Labor Essay Example for Free

Mechanism of Labor Essay A good midwife will always aid in conduction of a vaginal delivery and not hastily conduct it without knowing about the mechanism that is occurring inside the pelvis. Hence it is very essential to learn about mechanism of normal labor, its principles and steps to distinguish it from an abnormal one Definition: The series of movements that occur on the head in the process of adaptation, during its journey through the pelvis, is called mechanism of labor. 1 Principles The principles are common to all mechanisms 1. Descent occurs throughout 2. The part that leads and first meets the resistance of the pelvic floor will rotate until comes under the symphysis pubis 3. The part that escapes under the symphysis pubis will pivot around the pubic bone 4. During the mechanism, the fetus turns slightly to take advantage of the widest available space in each plane of the pelvis, i. e. transverse at the brim and antero-posterior at the outlet 2 Mechanism In normal labor, the head enters the brim more commonly through the available transverse diameter and to a lesser extent through one of the oblique diameters. Accordingly, the position is either Occipito lateral or oblique Occipito anterior. The left Occipito anterior position is commoner than the right Occipito anterior position as the left Occipito diameter is encroached by the rectum. 1 The engaging antero-posterior diameter of the skull is suboccipito bregmatic (9. 5 cm) and the engaging transverse diameter is biparietal 9. 5 cm. 1 As the Occipito Anterior position is the commonest the mechanism of labor will be described for Left Occipito Anterior or Right Occipito Anterior position When the fetus presents in left or right Occipito anterior position the way the fetus is normally situated can be described as follows: * The lie is longitudinal * The presentation is cephalic * The position is ROA or LOA * The attitude is one of flexion * The denominator is the occiput * The presenting part is the posterior part of the anterior parietal bone 2 Positional movements There are several basic positional movements which take place when the fetus is in a cephalic vertex presentation. These are as follows: 1. Engagement 2. Descent throughout 3. Flexion 4. Internal rotation of the head 5. Crowning 6. Delivery of the head by extension 7. Restitution 8. Internal rotation of the shoulders 9. External rotation of the head 10. Birth of the shoulders and body by lateral flexion Although the mechanisms of labor are listed separately, some of these overlap or occur simultaneously (internal rotation of the shoulders and external rotation of the head) 1. Engagement Engagement takes place when the biparietal diameter of the fetal head has passed through the pelvic inlet. In primigravidae, it usually occurs during the latter weeks of pregnancy. In multigravidae, as the muscle tone is lax engagement may not occur until labor actually begins. 2. Descent Descent occurs throughout the mechanisms of labor and is therefore both requisite to and simultaneous with other mechanisms. Descent is a result of a number of forces including contractions and maternal pushing effort with contraction of her abdominal muscles 3. Flexion Flexion is essential to further descent. The pressure exerted down the feta l axis will be transmitted to the occiput. The effect is to increase flexion, which results in the substitution of the smaller suboccipito bregmatic diameter 9. 5 cm. the occiput becomes the leading part. Flexion occurs when the fetal head meets the pelvic floor resistance which increases with descend. 4. Internal rotation of the head Internal rotation brings the anteroposterior diameter of the fetal head into alignment with the anteroposterior diameter of the maternal pelvis. This is accomplished by rotation of the occiput to the anterior portion of the maternal pelvis. In a well flexed vertex presentation, the occiput leads and meets the pelvic floor first and rotates anteriorly through one- eighth of a circle (45 degrees) this causes a slight twist in the neck of the fetus, as the head is no longer in direct alignment with the shoulders. As the fetal head now lies in the widest (anteroposterior) diameter of the pelvic outlet, an easy escape is facilitated. The occiput slips under the pubic arch and crowning occurs when the head no longer recedes between contractions and the widest transverse diameter i. e. biparietal is born. 5. Crowning After internal rotation of the head further descent occurs until the subocciput lies underneath the pubic arch. At this stage, the maximum diameter of the head (biparietal diameter) stretches the vulval outlet without any recession of the head even after the contraction is over. This is called â€Å"crowning of the head†. 6. Delivery of the head by extension Once crowning has occurred, fetal head can extend. The suboccipital region impinges under the symphysis pubis and acts as a pivotal point. The fetal head is now positioned so that further pressure from the contracting uterus and maternal pushing serves to further extend the head as the vaginal orifice opens. A couple of forces act on the fetal head. The driving force pushes the head in a downward direction while the pelvic floor offers a esistance in the upward and forward direction. The downward and upward forces neutralize and remaining forward thrust helps in extension. The successive parts of the fetal head to be born through the stretched vulval outlet are vertex, brow and face. 7. Restitution It is the visible passive movement of the head due to untwisting of the neck sustained during internal rotation. With restitution the occiput moves 45 degrees or one eighth of a circle towards the side from which it started and is again in alignment with the shoulders1 8. Internal rotation of shoulders The anterior shoulder reaches the pelvic floor and rotates anteriorly by one eighth of a circle. The shoulders come to lie in the anteroposterior diameter of the pelvic outlet 9. External rotation of the head External rotation of the head occurs as the shoulders rotate 45 degrees internally causing the head to rotate another 45 degrees. The movement can be seen clearly as the head turns at the same time. External rotation occurs in the same direction as restitution. 10. Birth of the shoulders and body by lateral flexion The anterior shoulder comes into view at the vaginal orifice, where it impinges under the symphysis pubis, while the posterior shoulder distends the perineum. This enables a smaller diameter to distend the vaginal orifice than if both the shoulders were born simultaneously. After the shoulders are delivered, the remainder of the body is born by lateral flexion. The mechanism of labor is different for different positions. Most of the movements in the mechanism occur simultaneously and at times may not be clearly visible during the delivery. Hence the midwife should be very careful and cautious and keep in mind the steps of normal mechanism of labor while conducting delivery References 1. D. C Dutta, Textbook of Obstetrics, 6th Edition, New Central Book Agency, Calcutta 2004, Pp: 125-129 2. Annamma Jacob, A Comprehensive Textbook of Midwifery, 2nd Edition, Jaypee brothers Medical Publishers, New Delhi, 2009, Pp :187-190 3. www. wingkingskull. com cited on 31st January 2012 4. http://pregnancy. about. com/od/laborbasics/ss/fetalpositions_2. htm cited on 27th January 2012

Religion in American Film Essay -- Essays Papers

Religion in American Film American’s nation-wide did a disbelieving double take when they were heard that Jim Carrey was going to be playing the role of God in Universal Pictures summer 2001 movie Bruce Almighty. Millions of American’s have found themselves near-obsessed with the engrossing epic Lord of the Rings, Dogma has been welcomed into the Cult Films Hall of Fame, and Mel Gibson’s The Passion stirred an overwhelming amount of religious, cultural, and ethnic criticism. When looking at the recent array of films that either present or suggest religious themes – whether it be allegorically, evangelically, or satirically – we find ourselves asking the question â€Å"why now?† Is the reason for this upsurge sociological, psychological, philosophical, or historical? Is there perhaps a political or economic reason as to why American’s today are so eagerly consuming films that are looking at the timeless battle between good & evil, questioning organized belief s ystems, or presenting religion in new and contemporary ways? From critical analysis and research done on this subject, as well as much pondering and theorizing, it could be said that the question of â€Å"why now† is more philosophical, and value oriented, than anything else. The religious content that is present in modern American films is indicative of a more general discussion & questioning of values and resonates with the post-modern, religiously pluralistic mindset that American’s have come to embody. It is a common mis-conception that films are merely entertainment, and serve no other purpose than to provide for the viewer a two-hour escape from reality. This is a serious under-estimation of the power, purpose, and potential of film, because film, upon reflection, revea... ...garet R. Seeing and Believing: Religion and Values in the Movies. Boston: Beacon Press, 1996. Johnston, Robert K. Reel Spirituality: Theology and Film in Dialogue. Grand Rapids: Baker Academic, 2000. Stone, Bryan P. Faith and Film: Theological Themes at the Cinema. St.Louis: Chalice Press, 2000. Valenti, F. Miguel. More Than a Movie : Ethics in Entertainment. Colorado: Westview Press, 2000 Detweiler, Craig, and Barry Taylor. A Matrix of Meanings: Finding God in Pop Culture. Grand Rapids: Baker Academic, 2003. Putnam, Robert D. Bowling Alone: The Collapse and Revival of American Community. New York: Simon & Schuster, 2000 http://www.hollywoodjesus.com/bruce_almighty.htm For the purposes of this study, it is helpful to look specifically at the way in which Christ and Christianity are being presented, through the various methods, in contemporary film.

A summary of your self-analysis Essay

Audience Analysis (Rating: 1 (2) 3 4) Explanation: My audience is a mixture of students and ordinary people of various ages. They are the masses that form the greater number of the society who prefers plain and simple language, and whose culture, needs and interests are facilitated by their interpersonal relationship and by their basic daily activities. I encircle 2 because I rank 4 as the audience composed of scholars and 3 composed of professionals and well educated people. They are the most important audience as they are the people who are aware of the issues confronting the society and are highly capable of judging me. I chose 3 because they are not my audience yet. Written Communication (Rating: 1 2 (3) 4) Explanation: I chose 3 because I see my self as between 4 and 2. Given the 4 as very good, I would not rank my self this high as I am fully aware I still need to improve in written communication. However, I chose 3 in the sense that I can write short magazine article, write formal letters, and written communication such memorandum for various department of the company. I chose 3 simply to emphasize where I am in the scales of 1 to 4 being 1 as basic and four as very good. Oral Communication (Rating: 1 (2) 3 4). Explanation: I am not good enough in oral communication but I can communicate fairly well. Given that 1 need improvement which means basic, I do need improvement too but as I said, I can communicate orally but not as effective as I do in the written communication. So though not really basic which means 1, I need further improvement in oral communication so I encircle 2 as my rating in this aspect. Visual Communication (Rating: 1 2 (3) 4) Explanation: I can say that I have skill in this type of communication; I can use visual aids effectively in such a way that my audience understands well the ideas that I conveyed to them. However, I could not say that I do not need improvement at all, am not not perfect and I need to continually improve my skill. So I encircle 3 to emphasize on this regard. Self-image and the image that you project (Rating: 1 2 (3) 4) Explanation: I am quite good at projecting my self but I feel that I need to do. Yes, I can project the image that I wanted my audience to identify me but I still could not say I am really good in this, so I in the rating of 1 to 4 I would chose 3 being 1 as the basic and 4 as that do not need improvement. Effectiveness of dealing with feelings—your own and others (Rating: 1 (2) 3 4) Explanation: Unfortunately, I am quite weak in dealing with my own feelings much more that of others. I still have to address my weakness particularly my temperament and emotional impulses. In this case I rate my self 2 there are still a lot in me that I need to improve. Based on your self-evaluation, please answer the following questions: What are your major communication strengths? Please list. Among my major communication skills are the following, 1. ) I am a good listener. Citing the work of Covey, Poulter, Brooks and Goldstein (2001) pointed out that it is â€Å"difficult, if not impossible, to engage in effective communication †¦if we fail to listen† (p. 49). 2. ) I can write well and express my ideas through writing. 3. ) I can also effectively convey ideas through using visual aids. 4. ) I can project the image that I wanted people to identify me. What are your major communication weaknesses? Please list. 1. ) I am weak in dealing with my emotional impulses which often affect my communication with others. 2. ) I am also weak in oral communication 3.), and in dealing with 3 and 4 audience category What are your goals for improving your leadership communication skills? Please list. The goals that I want to pursue to improve my leadership communication are: 1. ) I need to overcome my emotional impulses and to manage well my temperament, through asking my self what is it that I really wanted to achieve. 2. ) Improve my oral communication skills by learning from great poets and speakers through studying their speeches. 3. ) Enhance my listening and writing ability through determining who my audience is and how will I level my communication to my audience. How will you obtain feedback to ensure that you are making progress on your goals? Please explain. I would say that the best way for me to obtain feedback apply the Leadership Practices Inventory Assessment & professional development plan. This leadership assessment developed by Kouzes and Posner specialized in getting feedback and I would say that it is the best way of obtaining feedback to ensure that I am making progress on my goals. Reference Poulter, S. B. , Brooks, R. , & Goldstein, S. (2001) Raising Resilient Children New York: McGraw-Hills.

Essay on Emily Dickinson and Her Poetry - 3197 Words

Emily Dickinson and Her Poetry Emily Dickinson is one of the great visionary poets of nineteenth century America. In her lifetime, she composed more poems than most modern Americans will even read in their lifetimes. Dickinson is still praised today, and she continues to be taught in schools, read for pleasure, and studied for research and criticism. Since she stayed inside her house for most of her life, and many of her poems were not discovered until after her death, Dickinson was uninvolved in the publication process of her poetry. This means that every Dickinson poem in print today is just a guess—an assumption of what the author wanted on the page. As a result, Dickinson maintains an aura of mystery as a writer. However, this†¦show more content†¦Arguably a poem is much more personal than an essay or a work of fiction—the subject matter often deals with thoughts and emotions that are not only from the poet, but also very meaningful to him or her. Should the poet – should Dickinso n – be considered just another author and cast aside when studying the poems? Dickinson has been the subject of years of study, yet she remains quite mysterious. Even with all of their peculiarities, her poems continue to impress and delight. But being impressed with a Dickinson poem may not be enough to some—perhaps to truly enjoy a Dickinson poem, one must know the person behind the poem, the thoughts of the poet and what she intended her words to mean. Others may feel the exact opposite, saying that the poem in itself is enough. After reading the work of Dickinson along with the various criticisms of her poems, one may be inclined to settle somewhere in the middle of these two beliefs. Dickinson the woman, the historical figure, is important when looking at her poems, but the information generally presented about her can mislead the eager neophyte. 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