5/15/2020 Welcome! Childbirth Preparation 4 Week Series Week 2 Class 2 Topics • Stages & Phases of Labor • 2nd Stage Labor/Pushing • Labor positions • Birth Video • Coping Skills Your Hospital Stay • Arrival at Hospital o Please wear a face covering when you arrive at the hospital o All patients and visitors entering the hospital are screened for any signs of illness • Triage o No support person allowed, support person will be called when patient is admitted to L&D • Labor and Delivery o One support person only (ok to leave and re-enter) o Support person will be screened once per day on entering hospital 1
5/15/2020 Covid-19 Testing • Covid-19 testing o Scheduled surgical patients will have COVID-19 test at their physician’s office prior to being admitted. o Laboring patient will be tested when admitted o Nasal Swab, patient can do the test, nurse will observe o Swab both nostrils, rotate swab 5 times in each nostril • Covid-19 positive o No support person allowed o We need healthy caregiver at home to care for the baby Stages of Labor 1 st Stage Cervix thins and opens 2 nd Stage Pushing and birth 3 rd Stage Delivery of the placenta 4 th Stage Recovery & breastfeeding First Stage Phases Early Labor 6-12+ hours Active Labor 3-5 hours Transition 30 minutes-2 hours Every labor is unique. The length of your labor may be different! 2
5/15/2020 1 st Stage: Early Labor Contractions Time (in minutes) Strength 30-45 sec 5-30 min apart Cervical Dilation: 0-6 cm Emotions : Happy, Excited, 6 cm Some anxiety Early Labor 1:47 Early Labor Activities • Rest or sleep • Diversions (music, TV, cards) • Eat lightly • Drink fluids • Take a walk • Shower or bath (call caregiver first if you think your bag of waters is broken!) 1 st Stage: Active Labor Contractions Time (in minutes) Strength 45-60 sec 3-5 min apart Cervical Dilation: 6-8 cm Emotions: 8 cm Serious, Focused Active Labor 2:33 3
5/15/2020 Active Labor Activities • Shower • Massage • Diversions (music, TV, cards) • Upright positions like the birthing ball • Breathing & relaxation techniques • Ice chips • Take a walk if not medicated 1 st Stage: Transition Contractions Time (in minutes) Strength 60-90 sec 1-3 min apart Cervical Dilation: 8-10 cm Emotions: Frustrated, 10 cm Dependent Transition 1:33 Transition Labor Activities • Diversions • Upright positions • Breathing techniques • Ice chips • Shower if not medicated • Eye contact • Firm, simple directions 4
5/15/2020 Fetal Descent 2 nd Stage Contractions ( there may be a resting period before contractions restart) Time (in minutes) Strength 60-90 sec 3-5 min apart Emotions: Happy, Relieved, Exhausted Pushing & Bony Plates 1:40 Pushing Positions Hands-and-knees Squatting Side-lying Birth Stool Pushing Positions 1:38 5
5/15/2020 Breathing During Pushing • Breathe in a way that feels good during pushing • Try a controlled exhale as you push, instead of holding your breath • You will push 3-4 times per contraction for about 6-8 seconds each time Birth Birth reactions vary Birth video begins with crowning 2:12 Brandy’s Birth Story Join the couple at home and in the hospital. Watch the story, then discuss: • Did you see anything in this birth story that you want to use in your own experience? • Did you see anything that surprised you? Brandy’s Birth Story 13 minutes 6
5/15/2020 Skin-to-Skin Contact Healthy infants should be placed and remain in direct skin-to-skin contact with their mothers immediately after delivery until the first feeding is accomplished. American Academy of Pediatrics Policy Statement on Breastfeeding (2005) 3 rd Stage • The placenta detaches from the uterine wall 5- 20 minutes after birth • You may feel a mild contraction as it detaches • Your healthcare provider will examine the placenta to make sure that it You’ll push out the placenta comes out in one complete piece Placenta 0:20 (no audio) 4 th Stage • The 4th stage of labor is the first few hours after birth • Your uterus continues to contract and shrinks to about the size of a cantaloupe • Holding your baby skin to skin and feeding him within the first This baby’s first feeding occurs during the 4 th stage hour after birth helps long- term breastfeeding and milk production, and helps your uterus contract to its usual size 4 th Stage 0:54 7
5/15/2020 Stages of Labor Review Any questions? Pushing Practice and Labor Positions are next! Tips for Labor Partners • Suggest a variety of comfort measures (try one at a time) • Rest when you can • Nourish yourself • Be the link between medical staff and Mom Find what works best for Mom • Don’t take things personally Birth Companions 0:49 Tips for Long Labor • Rest if you can • Change positions • Change the atmosphere or environment • Stay hydrated and nourished • Support people may need a break; consider a back-up • Try new techniques 8
5/15/2020 Tips for Back Labor Counterpressure Heat or Cold Packs Double Hip Squeeze Back Labor 0:38 Breathing Patterns Slow Breathing Click pattern to play 45 second exercise Paced Breathing Click pattern to play 45 second exercise Patterned Breathing Click pattern to play 45 second exercise Labor Positions • Help a baby descend and turn into a more optimal position for birth • Cause more efficient contractions • Reduce the pain of contractions This upright position allows • Help mom actively the baby to move participate in her labor • Provide a change of pace Labor Positions 2:07 9
5/15/2020 Labor Positions Side-lying Forward-leaning Sitting Hands-and-knees Labor Positions Squatting Lunging Slow Dancing Fitness Ball Sitting Forward-leaning Peanut ball between legs Fitness Ball 0:52 10
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