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Midwifery Care
Parenting
GLOSSARY of TERMS

This glossary is provided to help clients understand the terms that may come up during their care.

Amnion: Membrane which contains the waters surrounding the baby. Also known as "bag of water".

Amnionitis:  Inflammation of amniotic membrane, usually due to infection and associated with prolonged rupture of membranes (more than 24 hours before birth). This condition may be dangerous to both mother and baby.

Amniotic Fluid: Also called "waters", the fluid that surrounds baby in utero, provides protection and warmth, nourishment and weightless environment for baby. Ruptures before or during labor. It is continually replenished until baby is born. There is no such thing as a dry birth. 

Amniotic Fluid Embolism: A rare condition caused by entry of amniotic fluid or material into the mother’s bloodstream at the placental site and resulting in respiratory distress and shock, which can be fatal.

Amniotomy: Artificial rupture of the amnion (membranes).

Analgesics: Drugs that help relieve pain without causing unconsciousness.

Anaphylactic shock: Severe allergic reaction due to hypersensitivity to medications or proteins, i.e. penicillin. Can be fatal.

Antenatal or Antepartal: The which occurs before childbirth.

Apnea: A pause in breathing.

Arterial blood gases: Laboratory determination of acid-base balance (pH), carbon dioxide and oxygen in blood sample.

Back labor: Contractions felt almost entirely in the back. It is usually related to the position of the baby though more difficult tho handle and  is not harmful to mother or baby. The position of the baby may result in this labor being on the long end of the normal range of labor duration.

Bilirubin: A normal product of red blood cell breakdown. Bilirubin is yellow in color.

Bloody show: During pregnancy a mucous plug forms in the cervix which serves as a barrier keeping germs from entering the uterus. Before or during labor this is painlessly discharged, along with a small amount of blood. 

Bradycardia: Slowing of the heart rate.

Braxton Hicks contractions: Usually painless uterine contractions present from the earliest days of pregnancy that the mother may feel from about the fifth month on. They occur more frequently and become greater in intensity as the mother gets closer to the start of true labor.

Caput: An edematous swelling formed under the presenting part of the scalp of a newborn infant as a result of the pressure and/or trauma sustained during delivery.

Cardiac Arrest: Sudden, unexpected cessation of the heartbeat and circulation. Could result from extreme blood loss, shock, severe heart condition, allergy, overdose of drugs, or other severe medical complications.

Certified Nurse-Midwife (CNM): A CNM is an individual educated in the two disciplines of nursing and midwifery, who possesses evidence of certification according to the requirements of the American College of Nurse-midwives. Nurse-midwifery practice is the independent management of care of essentially normal newborns and women, antepartally (during pregnancy), intrapartally (during labor and birth), postpartally (in the weeks after the birth), and/or gynecologically occurring within a health care system that provides for medical consultation, collaborative management, or referral, and is in accord with the Functions, Standards and Qualifications for Nurse-Midwifery Practice as defined by the American College of Nurse-Midwives.

Midwives provide care for the normal mother during pregnancy and stay with her during labor, providing continuous physical and emotional support. A midwife evaluates progress and manages the labor and delivery. She evaluates and provides immediate care for the normal newborn. She helps the mother to care for herself and for her infant; to adjust the home situation to the new child; and to lay a healthful foundation for future pregnancies through family planning and gynecological services. Midwives are prepared to teach, interpret and provide support as an integral part of her service.

Cervix: The lowest portion of the uterus which extends into the vagina and thins out and opens during labor for the delivery of the baby.

Circumcision: Removal of all or part of the foreskin of the penis. This is a decision to be made by the parents. It is NOT considered a medical necessity by the American Academy of Pediatrics.

Colostrum: The first secretions of the breast. Colostrum has high protein content and provides some immunity properties.

Coma: A state of prolonged unconsciousness due to some injury or disease.

Congenital Anomalies: Developmental defects such as cleft lip, club feet, extra finger, problems with the heart, etc. Anomalies may be incompatible with life.

Convulsions: Episodes of involuntary muscular contractions and relaxations due to a variety of causes; seizure.

Cord Prolapse: Expulsion of the umbilical cord into the vagina with rupture of the membranes due to the presenting fetal part not being firmly fixed in the pelvis. Compression of the cord by the descent of the baby cuts off blood supply to the baby, causing fetal distress and possible death if not diagnosed and managed immediately.

Crowning: Baby's head is at the vaginal opening and is "crowned" by it. 

Dilation: The opening of the cervix for delivery of the baby. Measured in centimeters from 0 to 10.

Doula: A professional labor support person or postpartum helper.

EDD/EDC: Estimated date of delivery or confinement. Estimated date of baby's birth. It is not exact. Best to think it will be two weeks later, then the waiting won't be too painful. 

Effacement: The thinning and shortening of the cervix. Measured in percentages from 0 to 100.

Effluerage: Firm, but gentle massaged used synchronously with the breathing techniques to assist in relieving pain. 

Engagement: Entrance of the fetus into the pelvis and birth canal.

Endotracheal tube: A plastic tube placed into the trachea through the mouth or nose to assist with breathing.

Engorgement: Excessive fullness, usually referring to the breasts.

Episiotomy: An incision made into the perineum to temporarily enlarge the vaginal opening at the time of delivery of the baby. Such an incision requires repair by suture.

Family-Centered Care: Care which has as its central focus the needs and desires of the mother and those persons she considers her family. It is always directed toward strengthening the family’s inner resources so that all may be better able to participate in the pregnancy and birth and experience deep and enduring satisfaction which may be reflected in the parenting of the child.

Fetal Distress: Significant drop in baby’s heart rate and/or irregularity of the heart rate usually coupled with staining of the amniotic fluid with stool, indicating that the baby is being deprived of adequate oxygen supply.

Fetal heart tones: The baby’s heartbeat heard through the abdominal wall. The measurement of the heart rate of the fetus. Almost twice as fast as an adult's and is checked at intervals by the staff. The range of normal is 110-160 beats per minute. 

Fetus: A word meaning unborn child from the end of the fifth week of pregnancy until birth. 

Fundus: Top rounded portion of the uterus. Felt during labor to perceive contraction or relaxation of uterine muscles. It is located postpartally in relation to umbilicus to check on involution (return to non-pregnant uterus size). 

General Anesthesia: Complete loss of sensation with loss of consciousness when the anesthetic acts on the brain. This type of anesthesia is usually accomplished following administration of inhalation or intravenous anesthetic. Commonly used for surgical procedures; may be used for Cesarean section.

Gravida: A pregnant woman.

Hyperbilirubinemia (Jaundice): Excessive bilirubin (pigment) in the blood resulting in yellowing of skin and whites of the eyes. Bilirubin is usually broken down and excreted in urine and stool. The newborn is lacking the enzyme necessary for this breakdown and therefore bilirubin may buildup in the bloodstream. Jaundice is normal in many newborns. Excessive jaundice, however, may be caused by blood incompatibility, infection, or liver malfunctions and requires treatment to prevent possible brain damage to the newborn.

Hyperventilation: State of oxygen-carbon dioxide imbalance caused by improper breathing. Signs of this condition are: tingling, numbness, tightness of the face, hands, feet. Remedy: shallow slow breathing and relax, or re-breath your carbon dioxide by tightly cupping your hands around nose and mouth. Another remedy is to hold your breath for a few seconds after a contraction. 

Immaturity: The condition of being born at a point of development incompatible with life outside the uterus without supportive measures, usually prior to 37 weeks of pregnancy.

Induction: The process of starting labor by artificial means.

Intravenous Injection (IV): Medication given into a vein through a needle. The medication can be given full strength in a short time or diluted in sterile fluids and given over an extended time.

Involution: The process by which the uterus returns to its normal size and position after birth, usually takes six weeks. 

Labor: A series of uterine contractions which efface and dilate the cervix, thins out the birth canal and births the baby. The contractions also cause detachment and expulsion of the placenta and tissues. 

Lactation: 1) the time during which a mother is secreting milk; 2) the process of secretion of milk.

Lateral position: A body position of lying on one's side. The left lateral position has been found to improve labor, circulation and kidney output. Highly recommended for pregnant women with an increasing blood pressure. 

Lightening: The sensation the mother feels when the baby drops down, or gradually settles into the pelvis.

Local Anesthesia: injections of a preparation, such as Novocain or Lidocaine, to cause loss of sensation (numbness) in a body area.

Lochia: Vaginal secretion following birth, starting out red and progressing to brown color then tapers off to a white. 

Malpresentation: Any part of the baby other than the vertex (top of the baby’s head) or the breech (the bottom), which enters the pelvis first, (i.e. face or shoulders). NOTE: Breech CANNOT be delivered at the birth center. 

Membranes: Also called amniotic sac/amnion. Two membranes form around the baby as he/she develops; it holds baby in a weightless fluid environment. 

Molding: The shaping of a baby's head as it accommodates to the birth passage in the process of delivery. 

Multip (Multipara): A woman who has had several children. 

Nullip (nullipara): A woman who has not given birth regardless of number of pregnancies. 

Pap Smear: Screening test for cervical cancer. The cervix is lightly scraped with a plastic spatula to obtain cells for microscopic examination.

Placenta: The organ which supports the life functions of the fetus and produces hormones. Also called afterbirth. 

Placental Abruption: Separation of the placenta from the wall of the uterus before the birth of the baby, therefore cutting off the blood supply to the baby. Abruption can occur before or during labor, and is usually associated with complications of pregnancy, such as high blood pressure or severe trauma, and may require immediate cesarean birth.

Placenta Previa: Placenta which implanted low in the uterus and is either partially or totally covering the internal opening of the uterus (internal cervical os). Such a condition may cause bleeding from the placenta, which may be life-threatening to the baby.

Postmaturity: Failure of the placenta to function optimally when pregnancy has continued well past the due date, usually beyond 42 weeks. May result in fetal distress or baby showing characteristics of nutrition deprivation.

Precipitate Labor: Labor and delivery lasting less than three hours, often associated with tumultuous contractions, either spontaneous or induced. Such labor may cause trauma to the baby as it cannot so rapidly adapt to the process of being born.

Pre-eclampsia: A complication of pregnancy in which there is: increase in blood pressure, excessive weight gain (sudden), and protein in the urine. Requires hospitalization for treatment and prevention of seizures. 

Presentation: Description of the fetus in terms of its lower most part. i.e. vertex or head down; breech or buttocks or feet down. 

Preterm labor: Labor starting before 37 weeks gestation.

Primip (primipara): A woman who has given birth to her first child. 

Respiratory Distress Syndrome: Breathing difficulty in the early hours or days after birth due to incomplete lung development. Usually present in immature babies, and requires careful monitoring and treatment of the baby.

Retained Placenta: Placenta that is not able to be expelled spontaneously following the birth of the baby.

RH Factor: An antigen (protein substance) which in 85% if the population is present in the blood (Rh Positive). In 15% of the population, the antigen is absent (Rh Negative). If the Rh negative expectant mother receives or has received in the past Rh positive antigen, antibodies may form in the blood. These do not affect the mother, but may cause a harmful blood incompatibility if the baby she carries has Rh positive blood.

Rhogam: A medication administered to an Rh negative mother after giving birth to an Rh positive baby, to prevent the development of antibodies in the mother, which could affect future pregnancies.

Rim/Lip: Cervix almost completely dilated, not yet time to push. 

Rupture of Circle of Willis aneurysm: Refers to a congenital ballooning of an artery at the base of the brain. This is a very rare condition and can be caused by pregnancy. Aneurysm may rupture at any time due to stress and is usually only diagnosed after it has occurred. Usually is fatal. 

Serology: Blood test used to screen for the presence of syphilis, a venereal disease which, if untreated, can be harmful to the unborn infant and the mother.

Shoulder Dystocia: Difficult delivery caused by the bony shoulders of the infant getting stuck on the bony pelvis of the mother. Shoulder dystocia is associated with maternal obesity, oversized infants and maternal diabetes.

Station: Indicates the degree to which the presenting part of the baby has descended into the pelvis. It is stated in numerical terms of (+) or (-) above a line called (0). The line is at the level of the two prominent bones experienced in sitting (ischial spines). Minus (-) 1 or 2 is above the line and plus (+) 1 or 2 is towards the birth canal. 

Subcutaneous Injection: Medication given beneath the skin with a needle and syringe.

Umbilical cord: Cord connecting the fetus to the placenta, provides for passage of nutrients, oxygen for the baby and allows wastes to be eliminated. 

Uterine Rupture: Tearing of the wall of the uterus. Usually associated with previous uterine surgery, cesarean section, trauma to the uterus, or extremely prolonged labor.

Uterus: A hollow, pear shaped organ which houses the fetus and alters to allow it to grow and develop. The top part is called fundus; the bottom part protruding into the vagina is called cervix.