Advanced Stage 2 Labor

-Read through vocabulary

-Work on the warmth relaxation exercise daily

CREATING A POSITIVE ENVIRONMENT IN LABOR

-Read through pg 81 for helpful phrases and tips about how to create a positive environment

COACHING

-Read through pg 82 for how to talk about contractions and helpful tips for dealing with pain during labor

LABOR REHEARSAL REVIEW NOTES

-Practice a labor rehearsal with contractions two minutes apart, lasting for one minute, using the positions outlined at the bottom of the page

RELAXATION TECHNIQUES

-We have talked about physical, mental, and emotional relaxation throughout the class. Read through pg 84 for a review of these techniques. If there are any that you feel you need particular help with, let me know, and try working on those this week.

WORKING WITH YOUR BODY

PREPARATION FOR BIRTH

  1. strength, stamina, healthy  muscles and bones; for strength and stamina; 

to tone and condition abdominal muscles, mobility in pelvis, room for baby to adjust; 

to strengthen the muscle which will help the baby keep its chin to chest (so the smallest part of the baby’s head will present first), less pain for mother, and less likely the muscle will be damaged during birth, also helps avoid incontinence; 

flexible perineum and pelvis, stronger muscles

  1. try various positions so you know the choices, they will feel different as the baby moves down through the birth canal, though
  2. squatting exercises, lots of kegels, good nutrition with healthy fats and oils, plenty of air to the perineum, no soap on the perineum, lotion and massage if desired, talk to birth team in advance, be patient, remind birth team of wishes at birth, ease the baby out, listen to care provider if she/he tells you to slow down your pushing
  3. learn how your body works, learn how to work with your body, exercises, good nutrition, drinking plenty of water/fluids, relax kegels during second stage, find the best position, use only the muscles you need and relax the rest, relax between contractions, good communication with birth team, comfortable place to birth

TRANSITION

  1. cold feet, burping, contractions one on top of another, contractions may slow down or stop, shaking, nausea, vomiting, hot/cold flashes; crabby, demanding, confused, gives up, asks for medication, complains
  2. ? about 1/3 difficult, 1/3 mild, 1/3 none ?
  3. stay calm and confident, keep positive attitude, remember that transition is normal, stand up/change position, take one contraction at a time, assist in any way you can, use active coaching, make mom as comfortable as possible, be enthusiastic and encouraging

THE URGE TO PUSH

  1. mom says/feels like she is going to have a bowel movement; mom says she has to push; mom grunts at the peak of the contraction (like if you are pushing out a large bowel movement); becomes uncomfortable and can’t relax through the contractions
  2. overwhelming - hurts not to push (can’t help but push); mild- could push or relax; wishful - tired and bored, wants to be done
  3. relax, conserve energy
  4. sing through a contraction, head and chin off chest

SECOND STAGE 

  1. urge to push, contractions space out, different sensations, mother is more focused
  2. choose most comfortable position, knees back, elbows up and out, chin to chest, push to the point of comfort and only through the contraction, hold breath until comfortable, and exhale at the point of most physical exertion, rest between contractions
  3. student workbook pg 44-45
  4. squatting
  5. lying on back
  6. classic or flat on back
  7. a) opens legs without putting too much pressure on the perineum

b) traps a cushion of air between the abdomen and uterus, which keeps the baby in a better alignment with the uterus, increases intra-abdominal pressure (making the push more effective)

c) shortens the birth canal and ensures proper alignment

 

8.  inhale, exhale completely; repeat; take third breath and hold as long as comfortable, exhale while pushing

9. comfortable

10. comfort

11. assist to comfortable position; remind her knees out, elbows up and out, chin on chest, push to the point of comfort; help her move between contractions; encourage her to open up and push down and out; remind her to relax completely between contractions; water and cool cloth; encouragement

12. tune into your body; choose an effective position; push to the point of comfort; hold your breath as long as comfortable; open up, push down and out; relax between contractions

13. fullness, pressure, burning, baby moving down, climax (orgasm)

14. advantages: faster birth, may prevent tearing toward the clitoris, some doctors believe they are easier to repair that tears, more room; disadvantages: can be unnecessary, can cut through muscle, more blood loss, more likely to cut blood vessels than a tear, may create a birth that is too fast for the baby, can be larger than tears, swelling, medication needed for repair

15. keep knees back with elbows up and out, push only as strongly as your body tells you, be willing to wait a few more contractions, massages, pressure, warm compress, oil

16. done without drugs

17. baby crowning, mother pushing, skin on perineum should be blanched white

18. nothing or a release of pressure if she is pushing

THIRD STAGE

  1. wait for the cord to stop pulsating and clamp
  2. mother: help expel placenta and shrink uterus; baby-allow the cord to regulate and supply baby with blood
  3. baby getting to know parents scent and taste- creates special feelings between family, love and feelings of commitment are formed, helps parents be more patient (in the wild, animals who do not bond with their baby after birth with reject them)
  4. generally 5-45 minutes
  5. baby on the abdomen, nuzzling at the breast, some mothers may give a little push as it comes out
  6. fluids lost; potassium (lack of can cause dizziness); raises blood sugar levels; replaces energy lost
  7. natural birth; breastfeeding; mom should feel good; sitting and standing okay; drink fluids; no nausea/dizziness
  8. restores circulation; realigns organs; helps expel blood clots
  9. as long as nursing, but not noticeable after several days for most
  10. relaxation
  11. ice or cold packs
  12. help pull in the tissue and aid in healing
  13. most birth attendants advise after two days
  14.