17 terms

2145 Non-Pharmacologic Management of Labor Pain

What is Lamaze?
-Believe birth is natural, normal and
-Experience of birth profoundly affects women and their families
-Women's inner wisdom guides them through birth
-*Woman's confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth
-women have a right to give birth free from routine medical intervention
-birth can take place in homes, birth centers and hospitals
-childbirth education empowers women to make informed choices in health care, to assume responsibility for their health and to trust their inner wisdom
What is relaxation (7)?
1. no harmful s/e for mom or baby
2. can be done anywhere
3. mother can use by self for additional life stressors
4. may improve uterine blood flow, improve fetal O2
5. self-directed
6. practice before labor is critical for this technique to be useful tool in coping w/ labor experience
7. lowers pain perception
How do you perform relaxation (5)?
1. Appropriate enviornment for practice
2. Comfortable chair, bed, etc.
3. No distracting sounds, rather music or calming sounds
4. head to toe exercise, tense & hold muscle 5-10 secs then relax
5. progressive relaxation
What is head to toe exercise?
Tense 5-10 seconds then relax, take a slow deep breath btwn every muscle group, again head to toe just further relax
What is progressive relaxation?
Obtain end quicker
-'mother will go thru labor w/o fighting, ride the wave of contraction rather then 'crashing in surf'
What are some breathing techniques & what are the 3 goals (3)?
1. No magic breathing formulas for painless birth
2. GOAL: pt. not holding breath, not hyperventilating, is focused & have self control- this is working
3. Begin w/relaxation or cleansing breath-slow deep breath in through the nose and out through the mouth
Relaxation breath at beginning and end of every contraction
How can relaxation breathing work (4)?
1. Provides uterus muscle w/ adequate 02 -> therefore more efficient contractions and quicker progress
2. focuses mother on something other than the contractions therefore decreases release of stress hormones, increase release of endogenous endorphins
3. provides the mother w/ something 'to do' during the contraction rather than being passive
4. Distracting
What is slow chest breathing (8)?
"candle breathing"
1. IN on count of 1, OUT on 2,3,4
2. used for 1st stage (dilation) of labor
3. Use for mild-mod discomfort or whenever the mom wants to
4. begin & end w/cleansing breath
5. in thru nose, out thru mouth
6. Coach can speak the directions or demo to and do w/mother
7. coach watches fetal monitoring & warns mom when UC is beginning
8. Use calm voice
What is pant or pant-blow breathing (9)?
1. Use in transition or slow the delivery (of head). can't push yet b/c not dilated to 10
2. Tongue on upper palate near teeth
3. RR-60; very small amt of air that is moving, respirations should be quiet
4. He-ha technique, He-He
5. 1-2-3 blow out, 1-2-3 blow out (pant, pant, pant, blow)
6. Coach picks a number between 2-6 for blow out REQUIRES practice
7. mouth may become dry, offer ice chips
8. continued blowing at peak of UC to prevent pushing
9. finish w/cleansing breath
What is massage (6)?
1. Lower back- especially in 'back labor' w/ fetus in posterior position- try counter pressure
2. Arms, legs- light touch only
3. Feet, hands,
4. effleurage = massage abdomen during contractions. use both hands in a circular motion, soft, slow & gentle
5. Use lotion or cornstarch
6. If pt. does not like it- stop
What is effleurage?
massage abdomen during contractions. use both hands in a circular motion, soft, slow & gentle
How can positioning the mother affect her birth & what are types of positions?
1. Use gravity as a help to the birth process- the baby travels down and out of their mother
2. try to change position every 30-60 minutes
3. Types of position: Walk, stand, rocking chair, sit, side-lying, hands and knees, Birth balls (good if baby is posterior, gravity will help turn the baby), hula dance
What is hydrotherapy & what is a good to utilize it (5)?
1. Tub, shower, jacuzzi
2. Know policy at hospital
3. May need medical order
4. Would be helpful in early stages of labor before water breaks
5. possibility of infection
When is hydrotherapy contraindicated (2)?
1. non-reassuring FHR
2. Fever with increased WBC
How does the enviornment affect the birth (8)?
1. Who does mom want with her?
2. Who is in the room?
3. Why are they present?
4. How are they helping or hindering?
5. Lighting of the room
6. Noise/sounds in room, why are other patients screaming
7. Aroma therapy
8. Goal: comfort, relaxation
What is hypnosis (4)?
1. Ideal candidate- desires no pain meds or epidural
2. Self-directed, she will need to invest time in training and practice
3. Learned technique of conscious focus of thoughts away from labor or discomfort and towards pleasant thoughts
4. may be triggered by word. don't use negative words like "pain"
What is thermal stimulation (5)?
1. application of hot or cold
2. stimulates thermoreceptors & may ↓ pain sensation
3. cool cloths for woman's face, ice glove applied to lower back
4. heat pad to lower back, ↑ blood flow, relaxes muscles & raises pain threshold
5. never apply heat to anesthetized area b/c patient can't feel and may be burned