Bumps to babies. Childbirth education course

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Rodney Harmon
5 years ago
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1 Bumps to babies Childbirth education course

2 Contents Childbirth 3 Stages of labour 5 Positions for laboring out of bed 6 A-Z What can help in labour 7 Relaxation exercise 8 Breathing exercise 9 Labour bag (Freephone) bumpstobabies@barnardos.org.nz barnardos.org.nz/bumpstobabies

Comfort techniques: If it s night, try to rest! A warm bath might help you feel sleepy.

3 STAGES OF LABOUR 1 st stage - Early labour Am I in labour? What s happening? Cervix effaces (thins) from 50% to 100%, and dilates (opens) to 4cm. Contractions are 5 to 30 minutes apart, lasting 15 to 45 seconds. It may last from 2 to 24 hours, sometimes longer. Mum may want to focus during contractions but can easily walk and talk. Comfort techniques: If it s night, try to rest! A warm bath might help you feel sleepy. If it s day, be active for some of the time (walking, dancing, shopping, hobbies you never have time for), but remember to rest too so you don t exhaust yourself. What can support people do? Encourage mum to alternate rest, distracting activities, and labour-enhancing activities. Encourage mum to eat, drink and go to the toilet at least once an hour. Focus on easily digested carbohydrates like bananas, non-fat yoghurt, cooked cereal, eggs, crackers, toast, noodles or rice. Avoid fatty or acidic foods. Drink as much as possible mostly water and unsweetened tea (sweet drinks can cause nausea). Every few hours, or when labour seems to have changed: Time 5 contractions in a row. Record when each began, how long it lasted, and how long since the start of the last one. 1st stage - Active labour I m in labour What s happening? Cervix is fully effaced, it now dilates (opens) from about 4 to 8cm. Contractions are about 3 to 5 minutes apart, lasting about 40 to 70 seconds, becoming stronger. Active labour may last from 30 minutes to 10 hours, sometimes longer. As contractions become stronger mum will become more focused on dealing with them, and less likely to walk and talk as normal. Comfort techniques: Breathing breathe deeply into your abdomen for as much of the contraction as is comfortable. Relaxation warm bath, touch relaxation, visualisation, breathe in energy and strength & breathe out tension. Touch massage, double hip squeeze counter-pressure. Hot/cold - heating packs on back or belly, cool cloths on forehead and back of neck. Sensory distraction sing, moan, listen to music, aromatherapy, picture to focus on. What can support people do? Encouragement! Help with comfort techniques and remember to look after yourself as well. Remind her to keep hydrated, and to use positions to open the pelvis (upright and leaning forward) Let her rest sometimes, but gently reminder her that being active can help labour to progress. 3

1 st stage - Transition Can I do this? What s happening? Cervix dilates fully to about 10cm. Contractions are about 2 to 3 minutes apart, lasting about 60 to 90 seconds, and are intense.

Comfort techniques: Any of the techniques and positions from active labour. What can support people do? Stay very close to mum. Watch mum for cues about which support techniques to use.

2 nd Stage - Pushing baby is born This is hard work! What s happening? Cervix is fully dilated baby has descended and is ready to be birthed.

4 1 st stage - Transition Can I do this? What s happening? Cervix dilates fully to about 10cm. Contractions are about 2 to 3 minutes apart, lasting about 60 to 90 seconds, and are intense. Transition may last from 10 minutes to 2.5 hours. Mum may feel discouraged, scared, or overwhelmed. She may be trembling and hot/cold, nauseous. Comfort techniques: Any of the techniques and positions from active labour. What can support people do? Stay very close to mum. Watch mum for cues about which support techniques to use. Give short and simple directions don t ask lots of questions. Speak calmly. This is the most intense time in labour for many mums. She needs lots of support and reassurance! 2 nd Stage - Pushing baby is born This is hard work! What s happening? Cervix is fully dilated baby has descended and is ready to be birthed. Contractions are about 2 to 5 minutes apart, lasting about 45 to 90 seconds. Pushing may last anywhere from a few minutes to two hours or more. Typically one to two hours. Mum may feel a strong urge to push during contractions (like you need to have a bowel movement), and sounds may change to groaning or deep grunts. Mums often become more alert and focused on pushing. Tips for the pushing stage: Your LMC will guide you Generally start pushing when you feel ready to. If you are guided to hold off from pushing, try tilting your head back to look at the ceiling. Pant, or pretend to blow out a candle over and over again. With each contraction, take a deep breath, tuck your chin down, bear down for 4 to 7 seconds while exhaling. Take in another quick breath and bear down again. Bear down a few times during each contraction. Rest and take nice deep breaths between contractions. Remember positions to open your pelvis: upright or leaning forward, legs open. What can support people do? Help support mum in her chosen position(s). Help guide and encourage her pushing efforts and breathing. Lots of encouragement and reassurance. 3rd Stage - Baby is here placenta is birthed. Phew! Immediately after the birth, baby is placed on mum s abdomen. Mum will birth the placenta. Your LMC will guide you may need a few light pushes to help this process. Your LMC will examine your perineum and will repair any tears or episiotomy if applicable. An adaption from 4

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6 A TO Z - WHAT CAN HELP IN LABOUR? A B C D E F G H I J K L M N O P Q R S T U V W X Y Z Activity, acupressure, aromatherapy, attitude, affirmations Breathing, bath, birth plan, bed, balls for massage, yoga/swiss ball Counting, confidence, communication, cuddles, cool cloths, candles, combs for acupressure Distraction, drinking, dancing Eating, encouragement, empty bladder, eye contact, excitement, electricity, environment Food, family, focal point, fans, familiar objects, fresh air Guidance Heat, hydration, hot towels, headphones, hypnobirthing Information, ice Juice, jokes Kisses, knowledge Low lighting, LMC, lollies Massage, midwife, moaning, music, moving, meditation Nesting Organised, open spaces Positions, praise, pillows, positive thoughts, prayer Quiet, questions Rest, relaxation, reassurance, rocking, rebozzo Shower, singing, stretching, support person, sounds, swearing, screaming, Swiss ball, scents Touch, trust, TENS, towels, teamwork Upright, urination, understanding vocalisation, visualisation Walking, wheat-bags, water XO's (hugs and kisses) Yelling, yoga Zzzzz (sleep), zone 6

7 RELAXATION EXERCISE Relaxation can be a useful tool to use during labour. Find a position that is comfortable for you. Close your eyes and breathe deeply at the end of each breath, notice there is a slight pause and take note of how the next breath automatically follows on Continue your deep breathing beginning at your feet, curl up your toes and relax Moving up your legs, tighten your calf muscles...and relax Tighten up your knees and relax Moving up your legs to your thighs, tighten and relax Now draw up your pelvic floor muscles and buttocks and relax Moving up through your tummy muscles and chest and relax Now think about your hands, make a tight fist and relax Your wrist and lower arms and relax Shoulder and upper arms and relax Press your neck hard against the floor or back of the chair and relax Screw up your face as tight as you can and relax Imagine you are in a favourite place where you go to feel private, safe, secure and comfortable Identify the various attributes of this place. How does it look? Does it have a special colour? How does it feel against your body? What can you hear? What is the temperature? Is it light or dark? Who is with you? OK, now coming back to your breathing Share these thoughts with your partner or support person, so that you can work together and help make relaxation special for you. 7

BREATHING EXERCISE Begin in a comfortable position, such as lying on your back or side. Simply notice how you are feeling physically. Are there areas of your body that feel more relaxed than others?

8 BREATHING EXERCISE Begin in a comfortable position, such as lying on your back or side. Simply notice how you are feeling physically. Are there areas of your body that feel more relaxed than others? Take several breaths and with each breath out, allow your body to let go of any tension. Become more aware of your breath Breathe in and out of your nose. Notice how your belly rises and falls with each breath. Imagine that your breathing is like filling a jug of water. As you inhale, the water pours into the body. First filling the belly, then the lungs as the ribcage expands, and finally the chest. Hold the breath for a moment. Next, exhale your breath out, imagine that your are emptying the jog of water. The air first pours out of your chest, then out of your lungs, and finally your belly as you feel your navel drawn towards your spine. Repeat this exercise for five to ten more cycles of breath. Take a moment to notice how you feel physically, mentally and emotionally. 8

LABOUR BAG Towel to sit on in car For Mum Empty container in case you feel sick on the

feet warm Something loose and comfy to wear Hair-ties Birth positions sheet Stress ball

bottle (for cooling down) Rescue remedy Massage oil Music/ CD player / ipod

Toiletries Loose comfy clothes Roll of soft toilet paper Pillow / case Separate bag for

g. noodles, cereal bars, fruit Camera / batteries / memory card Cash may be needed for

baby Expressed colostrum (as discussed with your LMC) - named and dated Barrier cream -

9 LABOUR BAG Towel to sit on in car For Mum Empty container in case you feel sick on the way Quick easily digested snacks, eg yoghurt Lollies for quick energy fix e.g. jellybeans Water bottle Lip balm Socks to keep feet warm Something loose and comfy to wear Hair-ties Birth positions sheet Stress ball and/or tennis ball Wheat-packs or hot water bottles (one for tummy, one for back) Spray bottle (for cooling down) Rescue remedy Massage oil Music/ CD player / ipod Magazines/cards/laptop (for inductions as they can take a while) Cellphone and charger Toiletries Loose comfy clothes Roll of soft toilet paper Pillow / case Separate bag for hospital stay Plastic bag for dirty washing For Dad/Support person Quick easy snacks, e.g. noodles, cereal bars, fruit Camera / batteries / memory card Cash may be needed for café, vending machine and car parking Togs / shorts Spare tee shirt Pen and paper For baby Expressed colostrum (as discussed with your LMC) - named and dated Barrier cream - to put on with first nappy Hat Woolen or merino singlet Booties Wipes if you don t want to use the flannels provided Outfit to wear home Infant car-seat Maternity pads Some meals in the freezer Nappies, baby clothes etc. Things to have ready at home 9

Early Labor - Touch Relaxation

Early Labor - Touch Relaxation Breathe: Deep, abdominal breathing. Position: Sit in a way that opens up your pelvis. Partner s job: look for someplace mom is holding tension, touch her there, stroking