Nur 113 Chapter 14 Childbirth Preparation

-allow the child to visit mom in the hospital to help relieve separation anxiety
-prepare the preschooler 2 to 3 mths in advance (ie. if moving from their crib to a new bed)
-maybe jealous of the new baby

-Sibling education classess-
-what happens during birth
-what they can expect a newborn to look and act like
- review how babies grow and things to do to help their mom: such as eating healthy foods w/ her & not leaving toys on the floor she could trip over and fall.
-tour of hospital nursery

may need reassurance that their parents will continue to love them after the new baby arrives

may be interested in learning about newborn care and receiving assurance that their life will not be totally changed after this new family member's birth.

Bradley(Partner-coached) Method
partner is the Husband

Bradley Method

Bradley Method

THE PSYCHOSEXUAL METHOD (KITZINGER)

-conscious relaxation and
-levels of progressive breathing that encourage a woman to “flow with” rather than struggle against contractions

Dick-Read Method (Fear - Tension - Pain)

through Education about childbirth and Relaxation

by focusing on Abdominal breathing during contractions

Lamaze Philosophy
(psychoprophylactic method: as it focuses on preventing pain in labor (prophylaxis) by use of the mind (psyche).

1. Conscious Relaxation:
2. Cleansing Breath:
3.*consciously controlled breat
4. effleurage
5. focusing
6. second stage breathing

Lamaze

-learning to relax body parts
-practice by relaxing 1 set of muscles then another
-support person watches for sx of tension (wrinkled brow, clenched fist)
-provide a comforting hand on the tense body

-begin & end all breathing exercises: breathes in deeply and then exhales deeply
-limits the possibilty of hypoventilation & hyperventilation assoc. w/ respiratory alkalosis: breath in a paper bag)

-set breathing patterns at specific rates, provides distraction as well as prevents the diaphragm from descending fully and putting pressure on the expanding uterus
-To practice, a woman inhales comfortably but fully, then exhales, with her exhalation a little stronger than her inhalation

Slow chest breathing of comfortable but full R at a rate of 6 to 2 bpm. The level is used for early contractions

-rib cage should expand but be so light the diaphragm barely moves.
The rate of R is up to 40 bpm. This is a good level of breathing for contractions when cervical dilation is between 4 and 6 cm.

-shallow/ rapid breathing.
-50 to 70 breaths/min
-practice saying “out” w/ each exhalation
-level for Transition contraction
-tongue against the roof mouth helps prevent dry mouth

-breathing sounds like a train (breath-breath-breath-huff
-“choo-choo” or “hee-hee-hee-hoo” breathing

Quiet, continuous, very shallow panting at 60 bpm
-used during strong contractions or during the 2nd stage of labor to prevent a woman from pushing before full dilatation

-tell the woman when to shift breathing levels depending on the coach's estim
-“contraction beginning, getting stronger, now getting weaker, gone.”

Effleurage:-a distraction tech.
-can be used on the thighs
-During uterine contractions, a woman traces a pattern on her bare abdomen with her fingers.

Focusing or Imagery
-pictures
-calm place (beach)
-don't ask quest or talk to woman (will break concentration)

second stage of labor

Second stage of Labor:
-Women should not practice pushing.

Leboyer:
ie. dim lights, soft voices,
-very dangerous b/c you can not see if the baby is cyanotic or not

water birth
-very dangerous b/c urine/feces can contaminate the water
-can cause Hypothermia in the mother
-based on the Leboyer method

Freebirthing: learns pregnancy care from the Internet and
-has child at home

the woman may not recognize that the complication is occurring until damage to her child or herself results

1. control the discomfort of labor through nonmedication measures, (controlled breathing) although epidural is readily available.
2. A woman is encouraged to be knowledgeable about the labor process and make decisions about procedures performed.
3. encouraged to breastfeed to aid uterine contraction and infant bonding after birth.
4. Labor, birth, and immediate postpartal care can all be scheduled in a single room.
5. attended by skilled md & nurses during labor, birth the postpartal period.
6. Emer care and high-risk care are immediately available

1. Separation of the family
2. Don't feel as much in control of the childbirth experience as she may wish.
3. Care may be fragmented, particularly if a woman's MD is not present during the entire labor and birth, or if labor nurses change shifts in the middle of labor.

1. woman is encouraged to be prepared to control the discomfort of labor through nonmedication measures such as controlled breathing.
2. A woman is encouraged to be knowledgeable about the labor process and to help care providers with decision making.
3.A woman is encouraged to breastfeed to aid uterine contraction and infant bonding
4. family may go to the birthing center.
5.attended by skilled professionals
6. Emergency care is immediately available. Extended high-risk care is easily arranged

1. Extended high-risk care is not immediately available.
2. may be fatigued after birth b/c of brief hc setting stay.
3. She must independently monitor her postpartal status b/c of brief hc setting stay.

4 to 24 hours

it encourages family integrity: a woman and her family are not separated so the baby can be immediately integrated into the family.

1. must be in good health,
2. must be able to adjust to changing circumstances, and 3. must have adequate support people who will sustain her during labor and assist her at home after birth

1. woman is encouraged to become knowledgeable about the birth process and be an active participant in independently reducing the discomfort of labor.
2. A woman has the greatest freedom for expressing her individuality.
3. There is no separation of the family at birth.
4. A skilled professional can attend the birth.

1. only emergency equipment is unavailable.
2. An abrupt change of goals is necessary if hospitalization is required.
3. may become exhausted b/c of the responsibility to prepare home for birth
4. Interference with the “taking-in phase” may occur postpartally b/c a woman must “take hold.”
5. A woman must independently monitor her postpartal status.

a person specially prepared to assist w/ birth
-frees the father so he can enjoy the birth rather than feeling occupied w/ coaching

Preconception Classes

Expectant parenting classes

Expectant parenting classes