Preparation for Childbirth & Parenting



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Preparation for Childbirth & Parenting




Preparation for Childbirth

  • Expectant families are faced with many choices about a childbirth experience and preparation for parenting.

  • Birth attendant

  • Setting

  • Expectant parents need to be prepared for childbirth or cesarean birth.

  • Physical

  • Emotional

Childbirth Education

  • Prepare expectant mother and support person for the childbirth experience.

  • Create knowledgeable consumers of OB care.

  • Help clients reduce and manage pain.

  • Help increase couples’ overall enjoyment with the childbirth experience.

  • Childbirth Educators and Teaching:

  • Group format with interaction with peers

  • Videotapes, slides, lecture, demonstrations

  • Efficacy of Childbirth Education Courses:

  • Increase satisfaction, reduce amount of pain, and increase feelings of control.

  • Cultural and Socioeconomic Factors:

  • Sometimes the advice of family or friends carry more weight than a professionals.

  • Avoid stereotyping

  • Consider financial needs

  • Perineal and Abdominal Exercises:

  • Encourage woman to maintain an active exercise program during pregnancy.

  • Classes teach exercises to strengthen their pelvic and abdominal muscles and make them more supple.

  • This allows for stretching during birth, reducing discomfort, strengthened muscles return to normal quickly.

  • Lamaze begins the last 8 to 10 weeks of pregnancy.




  • Tailor Sitting:

  • Stretches perineal muscles without occluding blood supply to the lower legs.

  • Do not put one ankle on top of the other.

  • 15 minutes per day.



  • Squatting:

  • Also stretches perineal muscles

  • Useful position for 2nd stage of labor

  • 15 minutes per day

  • Keep feet flat on floor to be effective.

  • Kegel Exercises (Pelvic Floor Contractions):

  • Tighten muscles of perineum

  • Helpful in postpartum period, perineal healing, increased sexual responsiveness, and stress incontinence in later life.




  • Abdominal Muscle Contractions:

  • Strengthen abdominal muscles.

  • Prevents constipation and restores abdominal tone after pregnancy.

  • Contracts abdominal muscles while standing or lying or hold fingers 6 inches in front of herself as if blowing out a candle.




  • Pelvic Rocking:

  • Helps relieve backache by making lumbar spine more flexible.

  • Arch back, trying to lengthen or stretch the spine for 1 minute, then hollows her back.

  • 5 times




Methods for Pain Management

  • 1. Discomfort can be minimized if woman is informed about what is happening and prepared with breathing exercises.

  • 2. If abdomen is relaxed and uterus is allowed to rise freely against abdominal wall with contractions.

  • 3. Pain perception can be altered by distraction techniques or gate control theory of pain perception.




  • Bradley (Partner-Coached) Method:

  • Muscle-toning exercises

  • Limits foods with preservatives, animal fat, or high salt content.

  • Abdominal breathing to relieve pain.

  • Walk during labor and use an internal focus point as a disassociation technique.

  • Psychosexual Method:

  • A program of conscientious relaxation and levels of progressive breathing that encourages the woman to “flow with” the contraction.




  • Dick-Read Method:

  • Based on fear leads to tension

  • Abdominal breathing during contractions.




Lamaze Method

  • Most often taught in the US today.

  • Developed in Russia.

  • Based on theory that thought stimulus-response conditioning, women can learn to use controlled breathing and reduce pain during labor.

  • Gate control method of pain relief:

  • Teaches A&P,labor and birth process.

  • Sensation(contractions) can be inhibited from reaching the brain cortex and registering pain.

  • Concentrate on breathing patterns

  • Use imagery or focusing (concentrating) on a specific object to block incoming pain sensations.

  • Conditioned reflexes-reflexes that automatically occur in response to stimulus. Displace pain during labor.

  • Woman is conditioned to relax automatically on hearing a command.

  • Pavlov

  • Conscious Relaxation:

  • Learn to relax body portions deliberately, relaxing one set of muscles then another.

  • Support person notices symptoms of tension, wrinkled brow, clenched fists …

  • Cleansing Breath:

  • To begin and end all breathing exercises: woman breaths in deeply and exhales deeply.

  • Limits hyperventilation.

  • Consciously Controlled Breathing:

  • Set breathing patterns at specific rates.

  • Prevents diaphragm from descending fully which prevents pressure on uterus.

  • Exhalation little stronger then inhalation.

  • Level 1- slow chest breathing, full respirations, 6 to 12 /min. (early contractions).

  • Level 2 – breathing lighter, rib cage expands but diaphragm barely moves. Rate 40/min. Use when cervix is 4 to 6 cm.

  • Level 3- breathing more shallow at sternum. Rate 50 to 70/min. exhalation little stronger than inhalation saying “out” keeping tip of tongue against the roof of the mouth. Transition contractions.

  • Level 4- “pant-blow”pattern. Take 3to 4 quick deep breaths in and out then forced exhalation. Breath-breath-breath-huff or hee-hee-hee-hoo.

  • Level 5- Chest panting is continuous very shallow 60/min. used in 2nd stage to prevent pushing before full dilatation.

  • Identify contraction by hand on abdomen or observe monitor.

  • Cleansing breath

  • Level 1- 3 breaths

  • Level 2 - 4 to 6 breaths

  • Level 3 - 10 breaths

  • Level 2 - 4 to 6 breaths

  • Level 1 - 3 or 4 breaths

  • Cleansing breath

  • Effleurage:

  • Light abdominal massage with fingertips at constant pressure and rate.

  • Distraction technique and decreases sensory stimuli transmission from abdominal wall.

  • Can be done on thighs. Support person may do.

  • Focusing or Imagery:

  • Focusing intently on an object (sensate focus). Keeps sensory input from reaching the cortex of the brain.

  • Do not break their concentration.




  • Second Stage Breathing:

  • Breath out while pushing.

  • Avoid holding their breath.

  • Do not practice pushing because they could rupture membranes.

Expectant Parenting Classes

  • Cover 4 to 8 hours of content spaced over a 4 to 8 week period.

  • Tour of maternity unit, nutrition, birth, supplies, childcare and other plans.




  • Sibling Education Classes:

  • Acquaint siblings with what happens during birth at age appropriate levels.




  • Childbirth Plan:

  • Choice of setting and birth attendant.

  • Meds, family, complications, visitation.




Birth Setting

  • Setting:

  • Depends on woman’s health and fetus.

  • Preferences, economics, hospital, birthing settings, or home.

  • Physician, Nurse-midwife.

  • Birth Attendant and Support Person:

  • Obstetrician, physician, midwife.

  • Father, doula or person to assist.




  • Hospital Birth:

  • Come to hospital when contractions are 5 min. apart and regular.

  • Birthing room:

  • LDR-labor-delivery-recovery rooms

  • LDRP-labor-delivery-recovery-postpartum rooms.

  • Bed converts to birthing bed.

  • Home like setting, family present.




  • Birthing chairs:

  • Reclining chair with a slide away seat to allow perineal exposure.

  • Gravity.




  • Alternative Birthing Centers: (ABCs)

  • Wellness oriented childbirth facilities.

  • Within or near a hospital.

  • Screened for complications.

  • Minimal analgesics or anesthesia.

  • Remain 4 to 24 hours after birth.

  • Home Birth:

  • 1% in US

  • Nurse midwife.

  • No complications.

  • Allows for family integrity: not separated.

  • Children Attending the Birth:

  • Need supervision.

  • A pets birth may help prepare.

Alternative Methods of Birth

  • Leboyer Method:

  • Based on decreasing the shock to the newborn. Moving from a warm, fluid filled intrauterine environment.

  • Birthing room is darkened, warm, soft music playing or no harsh noises, handle the infant gently, cord is cut late, infant is placed immediately into a warm-water bath.

  • Late cutting of cord may lead to excess blood viscosity in the newborn.

  • Hydrotherapy and Water Birth:

  • Soothing and relaxing.

  • Baby is born under water and immediately brought to the surface for a first breath.

  • Difficulties- feces, aspiration by fetus, and maternal chilling when she leaves the water.




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