HI, I am a fairly new (8mths) nurse to ob. On our unit we rotate between postpartum, labor-delivery, and nursery. I recently came out of orientation and have mostly been assigned to nursery, rarely getting to do labor. I finally got the chance to do labor this past week and I am not feeling very confident on cervical checks. I can tell you what 1cm and 9.5-10cm is without any problem. Anything between this is questionable to me. Of course we have the cervical dilation charts on the doors in the rooms, but, I can't always remember how far my fingers were spread during the exam. Also effacement, how on earth is that figured out??? The nurses on the unit just say it comes with experience, but how can I get the experience without knowing what I am feeling for? So on to station. I can tell if a baby is up in egypt or really low in the pelvis, however not at a -5 or +2 station. Does anyone have any tips or tricks to give me??? Please help!!!
Mar 21, '05
by Pixie Dust
There is a helpful little guide out there called the Pocket Dilation Guide (pocketdilationguide.com) that was developed by an L&D nurse. It's great. You can keep it right in your pocket so its there when you need it and you can place your fingers inside the centimeter circles so it feels very similar to the real thing. It also has effacement measurments on the back of it. Check it out. I've been doing L&D for 10 years and I still use it. Remember, we were all new at this once, it just takes time.
Last edit by Pixie Dust on Mar 21, '05
Mar 24, '05
I practice observation to assess labor progress MUCH more than dilatation. I limit my cervical exams as much as possible, instead watching for subtle changes in mom and baby's heart-rate. More often than not, I do NOT need to check a cervix to know when a lady is progressing quickly or is nearly dilated. Even with an epidural, I can see it already in the behavior of mom and the fetal responses and act accordingly. I think most experienced labor nurses can say that same; I am surely NOT unique.
Last edit by SmilingBluEyes on Mar 24, '05