X Glossary

5 P’s of Labor: Essential factors that influence the process of labor and delivery including Power, Passageway, Passenger, Positioning, and Psych. (Chapter 10.4)

Absent FHR variability: The fetal heart rate shows very little or no fluctuation and appears flat or nearly flat. (Chapter 10.5)

Accelerations: Abrupt but temporary increases in the FHR above the baseline with an onset-to-peak of less than 30 seconds. (Chapter 10.5)

Acme: Refers to the peak of a contraction. (Chapter 10.4)

Active phase of labor: Phase of rapid cervical change. Contractions during this phase typically last between 40-90 seconds. (Chapter 10.3)

Acupressure: Based on the same principle as acupuncture but involves the therapist using their hands and fingers to stimulate specific body points, rather than needles. (Chapter 10.6)

Acupuncture: Used in traditional Chinese medicine; involves the insertion of fine needles into different areas of the body to address imbalances of energy (in the form of qi). (Chapter 10.6)

Adequate uterine contractions: Have enough duration, strength, and frequency to cause the cervix to dilate and efface and move the fetus through the maternal pelvis. (Chapter 10.4, Chapter 10.5)

Adoption: A legal process that transfers a child’s parental rights from their birth parent(s) to adoptive parent(s). (Chapter 10.11)

Adoption triad: Used to describe the individuals directly impacted by adoption, including adoptees, birth parents, and adoptive parents. (Chapter 10.11)

Amnioinfusion: A procedure that adds fluid to the amniotic sac. (Chapter 10.5)

Amniotic fluid embolus: A rare condition that occurs when an opening develops between the amniotic sac and the client’s venous system, allowing amniotic fluid and other fetal tissue to enter the maternal cardiovascular and respiratory systems. (Chapter 10.7)

Amniotomy: The artificial rupture of the membranes (AROM) by a midwife or obstetrician using an amniotic hook. (Chapter 10.7)

Android pelvis: A heart-shaped inlet that was historically thought to be associated with arrest of labor deep in the pelvis. (Chapter 10.4)

Anesthesia: Medication that temporarily induces a loss of feeling or awareness. (Chapter 10.6)

Anesthetics: Block nerves that transmit impulses to the brain and produce a loss of sensation. (Chapter 10.6)

Anthropoid pelvis: A long oval inlet and associated with occipital posterior deliveries. (Chapter 10.4)

Aromatherapy: Use of essential oils to aid in relaxation. (Chapter 10.6)

Arrest of labor: No progression in cervical dilation in clients who are at least 6 cm dilated with rupture of membranes despite four hours of adequate uterine activity or six hours of inadequate uterine activity with oxytocin augmentation. (Chapter 10.7)

Bloody show: A thick, bloody, mucus discharge that is released through the vagina as the cervix softens and thins. (Chapter 10.3)

Biofeedback: A process which cultivates a client’s sense of control over the labor process by promoting the feeling that their mind has control over their body. (Chapter 10.6)

Bishop score: A tool used to determine if the cervix is favorable for labor. (Chapter 10.7)

Braxton-Hicks contractions: Contractions that are mild, irregular (i.e., without a pattern), do not get more intense or more frequent, and do not cause cervical changes. They often go away when the woman walks, rests, or changes position. (Chapter 10.3)

Breech presentation: Position in which the fetal buttocks (or legs) enter the pelvis first. (Chapter 10.4)

Brow presentation: The neck is slightly flexed, and the forehead is the presenting part of the fetal head. (Chapter 10.4)

Caput succedaneum: Fluid underneath the fetal scalp that causes swelling. (Chapter 10.7)

Category I: Represents normal and reassuring fetal heart rate patterns that do not require interventions by the nurse or health care provider. (Chapter 10.5)

Category II: An indeterminate category, meaning it does not clearly indicate a normal or abnormal pattern. (Chapter 10.5)

Category III: Represents abnormal fetal heart rate patterns associated with an increased risk of fetal acidosis. (Chapter 10.5)

Cephalic presentation: The position of the fetus in the womb where the head is positioned to be delivered first during childbirth. (Chapter 10.4)

Cervical cerclage: Temporarily sewing the cervix closed to prevent preterm birth. (Chapter 10.10)

Cervical ripening: Occurs where the cervix becomes softer and thinner. (Chapter 10.3, Chapter 10.7)

Cesarean section (C-section): A surgical procedure performed to deliver a fetus through incisions made in the mother’s abdomen and uterus when a vaginal birth poses risks to the mother or fetus or when complications occur during labor. (Chapter 10.8)

Chanting: Rhythmic use of vowel sounds used to keep the throat open and relaxed. (Chapter 10.6)

Chorioamnionitis: Infection of the amniotic membranes. (Chapter 10.7)

Cleansing breath: A slow, deep inhalation through the nose and exhalation through the mouth. (Chapter 10.6)

Closed adoption: The identity of the birth parents and adoptive parents is not disclosed, and there is little or no contact before or after the adoption. (Chapter 10.11)

Closed glottis breathing: The client inhales deeply and then holds their breath while bearing down and pushing and counting to ten. (Chapter 10.6, Chapter 10.10)

Complete breech: Breech presentation in which the fetus presents bottom first with legs crossed. (Chapter 10.4)

Congenital heart defects: Structural problems with the heart that are present at birth. (Chapter 10.10)

Counter pressure: The act of providing sustained firm pressure to the client’s back, hips, sacrum, or other joints. (Chapter 10.6)

Cystic fibrosis: A genetic disorder that affects the respiratory and digestive systems. (Chapter 10.10)

Decelerations: Intermittent decreases in the FHR below baseline, classified as early, late, variable, and prolonged. (Chapter 10.5)

Decrement: The gradual lessening of the contraction. (Chapter 10.4)

Deep abdominal breathing: The process of expanding the abdomen on inhalation and then exhaling and relaxing the abdomen. (Chapter 10.6)

Delayed cord clamping: Waiting 30 to 60 seconds to clamp the umbilical cord. (Chapter 10.10)

Delivery table: Set up that contains sterile drapes, bulb syringe, cord clamp, sponges, syringe for local anesthesia, delivery equipment, and instruments to complete repairs to the perineum if necessary. (Chapter 10.10)

DIF: An acronym used to assess uterine contractions and refers to Duration, Intensity, and Frequency. (Chapter 10.4)

Dilation: The gradual opening of the cervix, measured in centimeters (cm), from 0 to 10 cm. (Chapter 10.4)

Disseminated intravascular coagulation (DIC): A rare and potentially fatal condition that can occur during pregnancy and the four stages of labor affecting the coagulation cascade with the release of all clotting and anticlotting factors leading to massive hemorrhage and organ failure. (Chapter 10.7)

Domestic adoption: The process of placing a child born in the United States with an adoptive family who are also citizens of the United States. (Chapter 10.11)

Doppler monitor: A handheld device that uses ultrasonic waves to detect FHR. (Chapter 10.5)

Doulas: Lay people who are trained to provide emotional, physical, and social support during pregnancy, labor, and postpartum. (Chapter 10.2)

Down syndrome (Trisomy 21): A chromosomal disorder caused by an extra copy of chromosome 21 that can cause physical abnormalities and intellectual disabilities of the newborn. (Chapter 10.10)

Duration:  Refers to the time from the beginning to the end of one contraction. (Chapter 10.4)

Dystocia: Lack of progress during labor. (Chapter 10.3, Chapter 10.4)

Early deceleration: A gradual, uniform decrease in FHR that returns to baseline and mirrors the uterine contraction. (Chapter 10.5)

Effacement: The gradual thinning and shortening of the cervix; measured from 0 percent to 100 percent. (Chapter 10.4)

Effleurage: Light stroking massage using the tips of the fingers in slow, long strokes on the client’s abdomen in rhythm with contractions. (Chapter 10.6)

Engagement: The widest part of the fetal presenting part has passed through the pelvic inlet and is at the level of the maternal ischial spines. (Chapter 10.4)

Epidural: A local anesthetic and an opioid are continuously infused through a catheter placed into the epidural space around the spinal nerves to block pain. (Chapter 10.6)

Episiotomy: Performed by the health care provider during the second stage of labor to quickly facilitate vaginal delivery or to prevent large, irregular tears of the vaginal wall. (Chapter 10.8)

External cephalic version (ECV): The fetus is manipulated through the external abdominal wall in an attempt to move it into a cephalic presentation. (Chapter 10.7)

External continuous monitoring: A noninvasive method used during labor to continuously monitor the well-being of the fetus and the progress of uterine contractions. (Chapter 10.4)

Face presentation: Presentation in which the neck is fully extended. (Chapter 10.4)

Failure to descend: Defined as lack of change in the fetal station for at least two hours. (Chapter 10.8)

Ferning pattern: Refers to the microscopic crystalline appearance seen in cervical mucus or amniotic fluid when it is allowed to dry on a glass slide. (Chapter 10.3)

Fetal assessment: Evaluating the fetal heart rate (FHR) in response to uterine contractions (UC) by using intermittent monitoring or continuous electronic fetal monitoring. (Chapter 10.5)

Fetal attitude:  Refers to the presence of extension of the fetal head and neck. (Chapter 10.4)

Fetal bradycardia: FHR baseline less than 110 beats for ten minutes. (Chapter 10.5)

Fetal distress: When the fetus is not receiving sufficient oxygenation during labor. (Chapter 10.7)

Fetal dystocia: A problem of the passenger, meaning that the fetus is unable to descend through the maternal pelvis for birth. (Chapter 10.7)

Fetal heart rate baseline: The average beats per minute in a 10-minute segment, excluding periodic changes or marked variability. (Chapter 10.5)

Fetal lie: Refers to the relationship of the fetal spine to the mother’s spine. (Chapter 10.4)

Fetal position: Refers to the relationship of the presenting fetal part to the mother’s pelvic anatomic landmarks. (Chapter 10.4)

Fetal presentation: Refers to the position of the fetal part present in the lower part of the uterus. (Chapter 10.4)

Fetal scalp electrode: Affixes to the scalp of the fetus and monitors the fetal heart rate. (Chapter 10.5)

Fetal station: Refers to the level of the fetal presenting part in relation to the maternal ischial spines. (Chapter 10.4)

Fetal tachycardia: A sustained FHR baseline greater than 160 bpm for ten minutes. (Chapter 10.5)

Fetoscope: Similar to a stethoscope but uses bone conduction to better detect FHR. (Chapter 10.5)

FHR variability: Refers to the beat-to-beat fluctuations in the FHR baseline caused by stimulation of the fetal sympathetic and parasympathetic nervous systems. (Chapter 10.5)

First-degree laceration: A laceration of the labia and perineum affects the skin and subcutaneous tissue. (Chapter 10.10)

First stage of labor: The interval between the onset of labor and 10 centimeters (cm) cervical dilation. (Chapter 10.3)

Focal points: The client centers their attention on a picture or an object in the room and concentrates on breathing through the contraction. (Chapter 10.6)

Footling breech: Breech position in which the fetus presents one leg first. (Chapter 10.4)

Fourth-degree laceration: A laceration that includes damage to the pelvic floor and surrounding anal and rectal mucosa. (Chapter 10.10)

Frank breech: Breech position in which the fetus presents bottom first with legs straight up toward head. (Chapter 10.4)

Frequency: The time from the start of one contraction to the start of the next contraction. (Chapter 10.4)

Fully open adoption: There is direct contact among the birth parents, adoptive parents, and the child. (Chapter 10.11)

Fundal massage: Squeezing the uterus to stimulate it to contract and putting pressure on the blood vessels to help stop the bleeding. (Chapter 10.9)

Fundus: The uppermost part of the uterus. (Chapter 10.4)

Gate Control Theory of Pain: Theory exploring that pain perception is a dynamic process influenced by physical, psychological, and sociological factors and that a mechanism in the dorsal horn of the spinal column serves as a “gate” that either allows or prevents pain signals from reaching the brain. (Chapter 10.6)

General anesthesia: Induces a loss of feeling and complete loss of awareness which feels like a very deep sleep. (Chapter 10.6)

Gestational diabetes: A condition causing insulin resistance and hyperglycemia during pregnancy. (Chapter 10.7)

Gestational surrogacy: A process where a woman, called a surrogate or gestational carrier, carries and gives birth to a baby for another person or couple, called the intended parents. (Chapter 10.11)

Grand multiparity: At least five previous births at a gestational age of at least 20 weeks. (Chapter 10.7)

Guided imagery: Uses the mind-body connection to focus the client’s awareness on a positive safe place using all of their senses. (Chapter 10.6)

Gynecoid pelvis: A circular inlet that is considered most favorable for vaginal delivery. (Chapter 10.4)

HELLP syndrome: A complication associated with preeclampsia that can cause life-threatening bleeding issues during labor and postpartum evidenced by hemolysis, elevated liver enzymes, and low platelet count. (Chapter 10.7)

Hemophilia: A rare genetic disorder that affects the blood’s ability to clot properly. (Chapter 10.10)

High chest breathing: The process of expanding the chest while inhaling and then letting the chest fall when exhaling. (Chapter 10.6)

Hydrotherapy: Using water to provide pain relief during labor. (Chapter 10.6)

Hypnosis: Works by inhibiting neuronal communication between the sensory cortex, amygdala, and limbic system and decreasing the conduction of pain sensations. (Chapter 10.6)

Immediate postpartum hemorrhage: When hemorrhage occurs during the third stage of labor or the first hour after birth. (Chapter 10.9)

Increment: The buildup of the contraction. (Chapter 10.4)

Insufficient uterine contraction patterns: Contractions that do not cause cervical dilation, effacement, or fetal descent. (Chapter 10.4)

Intensity: Refers to the strength or force of uterine contractions during labor, including classifications of mild, moderate, and strong. (Chapter 10.4)

Intermittent auscultation (IA): Refers to a technique of listening to and counting the fetal heart rate for a specific amount of time during specified intervals throughout labor to assess fetal well-being. (Chapter 10.5)

Internal continuous monitoring: An invasive method used during labor to continuously and accurately monitor the fetus’s heart rate and uterine contractions. (Chapter 10.4)

Interval: Refers to the time of uterine relaxation between contractions. (Chapter 10.4)

Intrauterine fetal demise (IUFD): Stillbirth commonly caused by fetal hypoxia. (Chapter 10.7)

Intrauterine growth restriction: When the estimated weight of the fetus is less than the 10th percentile for gestational age. (Chapter 10.7)

Intrauterine pressure catheter: Placed inside the uterus and measures the duration, intensity, and frequency of uterine contractions, as well as the resting tone of the uterus. (Chapter 10.5)

Intrauterine resuscitation: Interventions to help restore fetal blood flow and oxygenation. (Chapter 10.5)

Inversion of the uterus:  A life-threatening complication that refers to the uterus turning inside out and protruding through the vagina. (Chapter 10.9)

Labor: The body’s natural process of childbirth. (Chapter 10.3)

Labor augmentation: The process of stimulating the uterus to increase the frequency, duration, and intensity of contractions after the onset of spontaneous labor contractions. (Chapter 10.7)

Labor fatigue: If the client can no longer continue pushing. (Chapter 10.8)

Labor induction: Stimulation of uterine contractions prior to the spontaneous onset of labor. (Chapter 10.7)

Late decelerations: Decelerations in the FHR below the baseline that start during a uterine contraction and continue after completion of the contraction. (Chapter 10.5)

Latent phase of labor: Characterized by gradual cervical dilation that starts on perception of regular uterine contractions and ends when rapid cervical change initiates. The uterine contractions in this phase typically last between 3-45 seconds. (Chapter 10.3)

Left mentum anterior (LMA): Position in which the fetal chin is facing the mother’s abdomen slightly to the left. (Chapter 10.4)

Left mentum posterior (LMP): Position in which the fetal chin is facing the mother’s spine, slightly to the left. (Chapter 10.4)

Left occiput anterior (LOA): Position with the occiput slightly facing the mother’s left side. (Chapter 10.4)

Left occiput posterior (LOP): Position where the back of the fetal head slightly faces left. (Chapter 10.4)

Lightening: Refers to the fetal head dropping into the maternal pelvis; also known as engagement of the fetal head. (Chapter 10.3)

Local anesthesia: Induces a loss of feeling in a small area of the body. (Chapter 10.6)

Longitudinal lie: Refers to the fetal spine lining up vertically with the mother’s spine with the fetal head down in the maternal pelvis. (Chapter 10.4)

Low transverse incision:  The most common type of cesarean incision that is made horizontally just above the pubic hairline. It is considered to be cosmetically favorable and generally associated with less pain and a lower risk of complications. (Chapter 10.8)

Marked FHR variability: The fetal heart rate varies significantly from beat to beat with frequent fluctuations in the fetal heart rate greater than 25 bpm. (Chapter 10.5)

Massage: A physical manipulation of tissue that can be provided in different ways, depending upon the preference of the laboring client. (Chapter 10.6)

McRoberts maneuver: The process of flexing the laboring client’s legs until their thighs touch their abdomen. (Chapter 10.8)

Mechanisms of birth: A specific series of movements to navigate the pelvis (also known as cardinal mechanisms). (Chapter 10.3)

Meconium aspiration: When the fetus inhales meconium-stained amniotic fluid (MSF). (Chapter 10.7)

Meconium-stained amniotic fluid (MSF): Brown or green staining of amniotic fluid due to the fetal passage of meconium. (Chapter 10.7)

Mentum: Protruding part of the chin. (Chapter 10.4)

Mentum anterior: Position in which the fetal chin is facing the mother’s abdomen. (Chapter 10.4)

Mentum posterior: Position in which the fetal chin is facing the mother’s spine. (Chapter 10.4)

Mentum transverse (MT): The fetal head is down with the chin facing the spine, but the face is lying sideways in the birth canal. (Chapter 10.4)

Minimal FHR variability: The fetal heart rate shows slight fluctuations of 5 bpm or less. (Chapter 10.5)

Moderate FHR variability: Considered normal and indicates fluctuations in FHR between 6 and 25 bpm above or below baseline. (Chapter 10.5)

Molding: Compression of these cranial bones, sutures, and fontanelles during labor and delivery. (Chapter 10.4)

Multiparous: A woman who has given birth more than once. (Chapter 10.3)

Myomectomy: Surgical removal of uterine fibroids. (Chapter 10.7)

Nadir: Lowest point. (Chapter 10.5)

Nesting: Sudden burst of energy in preparation for impending labor. (Chapter 10.3)

Neural tube defects: A type of birth defect that occurs when the neural tube, which eventually develops into the baby’s brain and spinal cord, does not form or close properly during early fetal development. (Chapter 10.10)

Non-longitudinal lie: The fetal spine is not lined up vertically with the mother’s spine and includes oblique lie and transverse lie. (Chapter 10.4)

Nulliparous: A woman who has never given birth to a live baby. (Chapter 10.3)

Oblique lie: The fetal spine lines up diagonally with the mother’s spine. (Chapter 10.4)

Obstetric forceps: Metal instruments that are used to rotate the fetal head or otherwise assist in the vaginal delivery of the fetus. (Chapter 10.8)

Occiput: Position in which the back of the skull (near the occipital bone) is the leading presenting fetal part. (Chapter 10.4)

Occiput anterior: Position in which the fetal occiput is close to the maternal symphysis pubis, and the face is pointed towards the mother’s spine. (Chapter 10.4)

Occiput posterior: Position that mean the fetal occiput is close to the maternal spine, and the face is pointed toward the maternal symphysis pubis. (Chapter 10.4)

Occiput transverse (OT): Position in which the fetal head is down, and the chin is tucked but the head is lying sideways in the birth canal. (Chapter 10.4)

Oligohydramnios: Too little amniotic fluid. (Chapter 10.7)

Open adoption: The birth parent(s) and adoptive family know each other’s identities and have regular contact that may include phone calls, emails, video calls, and in-person visits. (Chapter 10.11)

Open glottis breathing: The client inhales deeply and then slowly exhales as they bear down to push. (Chapter 10.6, Chapter 10.10)

Operative vaginal birth: Forceps- or vacuum-assisted birth. (Chapter 10.6)

Oxytocin: The most commonly used medication for labor induction. (Chapter 10.7)

Panting: A pattern of breathing using two short breaths and one long breath that sounds like “hee-hee-hoo.” (Chapter 10.6)

Passageway: The maternal pelvic structures of bone and soft tissues. (Chapter 10.4)

Passenger: Third aspect of labor and is the fetus. (Chapter 10.4)

Pelvic dystocia: A problem of the passage, meaning that the pelvic outlet does not allow the passage of the fetus for birth. (Chapter 10.7)

Perineal hygiene: May include pouring warm water over the perineum or using wet washcloths to cleanse the perineum moving from the pubic hair line to the anus using a front-to-back motion. A separate area of the washcloth should be used for each stroke to prevent contamination from the rectum to the vaginal area. (Chapter 10.10)

Periodic changes in the FHR: Accelerations and decelerations of the FHR in relation to the FHR baseline. (Chapter 10.5)

Placenta accreta: Implantation of the placenta into the muscle tissue of the uterus. (Chapter 10.9)

Placental abruption: Occurs when the placenta or part of the placenta separates from the uterine lining, which may lead to significant maternal-fetal blood loss, intrauterine fetal demise, or maternal death. (Chapter 10.7)

Placenta previa: The placenta is located on the lower aspect of the uterus near the internal cervical os. (Chapter 10.7)

Platypelloid pelvis: Short oval inlet. (Chapter 10.4)

Polyhydramnios: Excessive amniotic fluid. (Chapter 10.7)

Positioning: Frequent movement changes by the mother promote normal physiological progression of labor and fetal descent through the pelvis. (Chapter 10.4)

Postpartum hemorrhage (PPH): Total blood loss greater than or equal to 1,000 mL or blood loss and signs or symptoms of hypovolemia within 24 hours after birth. (Chapter 10.9)

Power: Refers to the strength of the uterine contractions that move the fetus through the pelvis during labor, as well as the maternal pushing efforts during delivery of the fetus. (Chapter 10.4)

Precipitous labor: Labor and delivery that is extremely rapid, usually less than three hours from start of the contractions to birth. (Chapter 10.7)

Preeclampsia: A serious disorder that occurs after 20 weeks of gestation that causes new-onset high blood pressure greater than 140/90 mm Hg and proteinuria. (Chapter 10.7)

Presenting part: The fetal part present in the lower part of the uterus. (Chapter 10.4)

Preterm labor: Labor occurring from 20 weeks’ gestation to 36 6/7 weeks gestation. (Chapter 10.7)

Preterm prelabor rupture of membranes (PPROM): Refers to rupture of amniotic membranes prior to the 37th completed week of gestation and before spontaneous labor. (Chapter 10.7)

Primiparous: A woman who has previously given birth once. (Chapter 10.3)

Prolapsed cord: The umbilical cord lies beside or in front of the fetal presenting part. (Chapter 10.7)

Prolonged decelerations: Isolated, sporadic decelerations of at least 15 bpm from the FHR baseline that last two to ten minutes from onset to return to baseline. (Chapter 10.5)

Prolonged second stage of labor: Defined as more than three hours of pushing in nulliparous individuals and two hours of pushing in multiparous individuals. (Chapter 10.7, Chapter 10.8)

Psyche: Refers to the psychological emotional state of the mother giving birth and plays an important role during labor and delivery. (Chapter 10.4)

Pudendal block: A type of regional anesthesia caused by injection of a local anesthetic into the pudendal nerve that provides sensation to the perineum, anus, vulva, and clitoris. (Chapter 10.6)

Rebozo: A long piece of cloth. (Chapter 10.10)

Regional anesthesia: Induces a loss of feeling in a specific part of the body. (Chapter 10.6)

Relaxin: One of the hormones that prepares the woman’s body for birth, softens the ligaments of the pelvis, which then causes a shift in the pelvic floor anatomy to accommodate the changes in diameter needed for birth. (Chapter 10.4)

Restitution: The fetal shoulders turn to the left or right oblique diameter of the pelvis to allow for easier passage under the maternal pubic arch. (Chapter 10.3)

Right mentum anterior (RMA): Position in which the fetal chin is facing the mother’s abdomen slightly to the right. (Chapter 10.4)

Right mentum posterior (RMP): Position in which the fetal chin is facing the mother’s spine slightly to the right. (Chapter 10.4)

Right occiput anterior (ROA): Position in which the occiput slightly facing the mother’s right side. (Chapter 10.4)

Right occiput posterior (ROP): Position in which the back of the fetal head slightly faces right. (Chapter 10.4)

Rooming-in: The newborn remains with the mother and partner instead of spending some extended time in a nursery. (Chapter 10.2)

Rupture of membranes (ROM): Rupture of the amniotic sac prior to the onset of labor. (Chapter 10.3)

Second-degree laceration: A laceration that affects the skin, subcutaneous tissue, and muscle of the perineum, as well as the vagina. (Chapter 10.10)

Second stage of labor: Stage of labor that commences at 10 cm cervical dilation and ends on delivery of the neonate. (Chapter 10.3)

Semi-open adoption: An agency caseworker, lawyer, or other mediators passes information like photos and letters between the birth parent(s) and the adoptive family. (Chapter 10.11)

Shoulder dystocia: When the fetal shoulder gets stuck behind the maternal symphysis pubis or sacral promontory, preventing the delivery of the fetus. (Chapter 10.8)

Shoulder presentation: Presentation in which the fetus is in a transverse lie and the shoulder enters the pelvis first. (Chapter 10.4)

Sickle cell disease: A genetic blood disorder characterized by the presence of abnormal hemoglobin, known as hemoglobin S. This abnormal hemoglobin causes red blood cells to become stiff, sticky, and shaped like a crescent or “sickle.” (Chapter 10.10)

Sickle cell trait: When a person inherits one normal hemoglobin gene (hemoglobin A) and one sickle cell gene (hemoglobin S). This means they carry the sickle cell gene but do not have the disease. (Chapter 10.10)

Sinusoidal FHR pattern: Refers to a wavelike pattern with regular frequency (three to five per minute) and amplitude. (Chapter 10.5)

Smudging: Burning sacred herbs to cleanse, purify, and connect with the spirit world.

Spinal block: Involves injecting a local anesthetic and opioid into the third, fourth, or fifth lumbar space into the subarachnoid space, but a catheter is not inserted for further medication to be infused (as is done during an epidural). (Chapter 10.6)

Sterile water injections: Procedures typically used by midwives to relieve back pain during labor based on the gate control theory of pain. (Chapter 10.6)

Subgaleal hematoma: Bleeding between the skull and the scalp. (Chapter 10.8)

Tachysystole: Contractions occur too frequently or last longer than two minutes. (Chapter 10.5)

Tay-Sachs disease: A rare genetic disorder that affects the nervous system and is more common in people of Ashkenazi Jewish descent. (Chapter 10.10)

The Four T’s of PPH: Tone, Trauma, Tissue, and Thrombin. (Chapter 10.9)

Third-degree laceration: A perineal tear extends to or through the anal sphincter. (Chapter 10.10)

Third stage of labor: The period between delivery of the neonate and delivery of the placenta. (Chapter 10.3)

Tocodynamometer: Pressure sensitive contraction transducer that records the pressure force produced by the contorting abdomen during uterine contractions. (Chapter 10.4, Chapter 10.5)

Tocolytic medication: Medications used to relax the uterus that help facilitate blood flow to the uterus. (Chapter 10.5)

Transcutaneous electrical nerve stimulation (TENS): The application of electrical currents to the surface of the skin, which blocks pain signal transmission and releases endorphins. (Chapter 10.6)

Transverse lie: The fetal spine is horizontal to the mother’s spine, similar to a plus (+) sign. (Chapter 10.4)

Uterine atony: Lack of proper contraction of the uterine muscles. (Chapter 10.9)

Uterine contractions: A pattern of rhythmic tightening and relaxation of smooth muscle fibers of the uterus that cause downward pressure on the fetus. (Chapter 10.4)

Uterine dystocia: Caused by lack of power, meaning that uterine contractions or the maternal pushing effort is inadequate to cause cervical changes that progress to birth. (Chapter 10.7)

Uterine rupture: Tearing or an opening in the muscle of the uterus. (Chapter 10.7)

Uterine tachysystole: Refers to more than five uterine contractions in ten minutes or a contraction length of two or more minutes within a 30-minute period. (Chapter 10.5)

Uteroplacental insufficiency: A lack of oxygenated blood coming from the uterus to the placenta. (Chapter 10.5)

Uterotonic: Medications that promote uterine contractions. (Chapter 10.7, Chapter 10.10)

Vaginal birth after cesarean (VBAC): Clients who have had a previous C-section may have the option in subsequent births to attempt a trial of labor and vaginal delivery. (Chapter 10.8)

Variable decelerations: Abrupt decelerations of FHR of at least 15 bpm below the baseline that last at least 15 to 30 seconds. (Chapter 10.5)

Vertex presentation: The most common type of cephalic presentation, meaning the fetal head is down in the maternal pelvis with its neck flexed and the chin tucked into its chest, thus minimizing the diameter of the fetal head to conform to the maternal pelvis. (Chapter 10.4)

Vertical incision: Incision made vertically along the midline of the abdomen, usually starting just below the umbilicus and extending down to the pubic bone. (Chapter 10.8)

Waterbirth: The immersion of the client in water during the second stage of labor and delivery of the fetus. (Chapter 10.6)