I.

Introduction
A. Background of the Study

Pregnancy, The events that lead to pregnancy begin with conception, in which the sperm
penetrates the egg produced by an ovary. The zygote (fertilized egg) then travels through the woman's
fallopian tube to the uterus, where it implants itself in the uterine wall. The zygote is made up of a
cluster of cells formed from the egg and sperm. These cells form the fetus and the placenta. The
placenta provides nutrients and oxygen to the fetus. Pregnancy also known as gravidity or gestation, is
the time during which one or more offspring develops inside a woman. It usually lasts around
40 weeks from the last menstrual period (LMP) and ends in childbirth. This is just over nine lunar
months, where each month is about 29 days. When measured from conception it is about 38 weeks.
An embryo is the developing offspring during the first eight weeks following conception, after which,
the term fetus is used until birth. Prenatal care improves pregnancy outcomes. Every pregnancy is
different, and there's wide variation in the length of labor. Every pregnancy is different, and there's
wide variation in the length of labor. For first-time moms, labor often takes between ten and 20 hours.
For some women, though, it lasts much longer, while for others it's over much sooner. Labor generally
progresses more quickly for women who've already given birth vaginally.

A spontaneous vaginal delivery is defined as the delivery of a baby through the vagina. In order for a
vaginal delivery to occur, the baby must be in a head down position. A spontaneous vaginal
delivery (SVD ) is a vaginal delivery that happens on its own, without requiring doctors to use tools to
help pull the baby out. This occurs after a pregnant woman goes through labor, which opens, or
dilates, her cervix to at least 10 centimeters.

Stage one: During labor,contractions in your uterus open your cervix and move the baby into position
to be born. Begins with regular uterine contractions and ends with complete cervical dilatation
at 10 cm. This is stage is divided into three phases: A. Early Labor Phase B. Active Labor Phase c.
Transition Phase

Stage two: The second stage is the actual birth, when the baby is pushed out by the contractions. This
pushing stage can be as short as a few minutes or as long as several hours. You are more likely to have a
fast labor if you have given birth before.

Stage three: After your baby is born, your body still has some work to do. This is the third stage of labor,
when the placenta is delivered. You will still have contractions. These contractions make the placenta
separate from the inside of the uterus, and they push the placenta out. Your medical staff will help you
with this. They will also watch for any problems, such as heavy bleeding, especially if you have had it
before.

Stage four: no more expulsions of conceptions of products for this stage as this is generally accepted as
Post Partum juncture. This phase is from the placental delivery to full recovery of the mother

The postnatal period, also referred to as the puerperium, begins immediately after delivery and
extends for about six weeks. During this period, the mother's body begins the return to pre-pregnancy
conditions that includes changes in hormone levels and uterus size.
B. Rationale for choosing the Study

General Objective

This case study aims to broaden the knowledge , promote skills and comprehend attitude to the
patient and especially to the nursing student who might have handle or will handle this kind of
delivery. To provide the necessary nursing care and proper intervenetion for the wellness of patient
having Normal Spontaneous Delivery with this case study effective nursinfg care based on the Nursing
Process and 11 Core Competencies or 11 Key Area of Responsibilities . This study includes information
for the newborn and the significant others.

Specific Objectives:

With this case we will be able to :

Provide Safe and Quality nursing care by gathering all the data and information about the patient we
were able to attend to all her needs and problems .

Because of the Ethico-Moral Responsibility we will be rendering consistent nursing care consistentwith
the paients bill of rights, confidentiality of information and privacy

Gain Personal and Professional Development by being more competent with taking care of the patient
, interviewing her , regarding the procedure and the situation with on-going practice

Provide Health Education by presenting the basic health teachings to the mother and significant
others. We will be able to provice them how to take care of the health of the mother and the new
born.

Conduct a Research on the internet or any published articles or book about the latest procedures and
other methods regarding Normal Spontaneous Delivery

Provide Collaboration and Teamwork by establishing collaborative relationship with colleagues ad

with the other members pf the health team

C. Significance of the Study

To the Client and Significant others:

In this study we will be able to provide the significant others awareness about the mothers
present health condition and that will help them take care of the mother during all of the phases of
postpartum to not have any complications after delivery and help the mother to recover.
 To the Nursing Students:

We, nursing students chose the case of Mrs. Lanas ,Miriam F. as our case to be studied.
This case helps the group to design a nursing care plan appropriate for the patients condition. We
could also provide information and health teaching to the postpartum patient. We gain new
learning from the experience in conducting the case study. This case study would also equip the
group with knowledge skills and attitude on how to manage future patients with the same
condition

To the Staff Nurses and clinical instrustors:

In this case study it will help the staff nurses in improving the quality and safe nursing
care. And to the clinical instructor with the health team will bestow the abilities, skills and
knowledge they have about Normal Spontaneous Delivery.

D. Scope and Limitation

This case study focuses on a pregnant woaman who went through a normal spontaneous
delivery this July 26, 2016. She was admitted in the delivery room on the same day at 6:15 am till
8: 29 in the morning. Since we were assigned to the delivery room our services mainly focus on
monitoring the vital signs of the mother , observing the progression of labor, assisting in the
deliveries , doing cord care and implementing the unang yakap program by the DOH and injecting
immunizations for the newborn
This study will not include abnormalities in pregnancy, cesarean delivery and abortion.
E. Theoretical Framework
The Dynamic Nurse-Patient Relationship
Ida Jean Orlando

According to Orlando (1926 2007) nursing process discipline is rooted in the interaction
between a nurse and a patient at a specific time and place. A sequence of interchanges involving
patient behavior and nurse reaction takes place until the patients need for help, as he perceives it,
is clarified. The nurse then decides on an appropriate action to resolve the need in cooperation
with the patient. This action is evaluated after it is carried out. If the patient behavior improves, the
action was successful and the process is completed. If there is no change or the behavior gets
worse, the process recycles with new efforts to clarify the patients behavior or the appropriate
nursing action. She proposed that patients have their own meanings and interpretations of
situations and therefore nurses must validate their inferences and analyses with patients before
drawing conclusions.

Professional Nursing Function Organizing people

- By supplying the need of the patient we demonstrated the proper breathing and bearing the
process, by doing this we relieved some of the patients pain

Presenting Behavior Problematic Situation

- Every 30 minutes we monitor the patients vital sign , and we ask about how the patients
feeling

Immediate Reaction Internal response

- The patient was in pain during labor so we instructed her to lay on her left side or left lateral
recumbent
- When the patients bag of water broke we provided her care and we instantly checked for the
crowning of the babys head

Deliberative Nursing Process Reflective inquiry

- During the labor we demonstrated the proper breathing so the patient can push the baby out
- Since the patients is gaving a hard time giving birth the midwife did an episiotomy and we
assisted with the episiorraphy

Improvement Resolution

- After the delivery we implemented unang yakap and took care of the baby .
- The patient is now post partum , after the patient was out of the delivery room we checked the
fundus and vital signs to see if its starting to stabilize