Labor Pain Test Flashcards
What is effleurage?
Any light massage that glides over the skin but does not use pressure or movement of deep muscle masses. It is performed by the woman or her partner or labor support. Rhythmic slow circles are “drawn” with finger tips on the abdomen, thighs or arms.
What is the Gate control theory?
The balance of painful and non-painful stimuli reaching your consciousness determines the perception of pain and its severity.
Pain fibers taking the pain stimulus to the brain are smaller and the sensation travels slower than the touch fibers, which are loch. When touch and pain are stimulated simultaneously, the touch sensation travels to the brain and “closes the Gate” in the brain, limiting the amount of pain perceived by the brain.
EMPOWER BIRTH from Labor tools
Encouragement Massage Position Open Mind Walking Empty Bladder Refreshments
Breathing Imagery Relaxation Trust Honor the Process Surroundings
How can you establish your relaxation routine?
- Select a time to relax when you are not disturbed.
- Set aside time each day and dedicate yourself to that time.
3, Choose a comfortable practice spot that has a soft, dim light. - Be sure your bladder is empty
- Wear clothes that are not binding and use a soft throw over your body to ensure that you are warm.
- Use any relaxation music that you plan to listen to during labor.
What are the benefits to using a birth ball during labor?
- Mothers may find it easier to sit on in the last months of pregnancy.
- Encourages pelvic mobility
- Allows the mother freedom to rock her pelvis, change her position, and shift her weight for comfort.
- Encourages fetal descent as the mother remains sitting in an upright posture taking advantage of gravity
- Helps keeps the fetus well aligned in the pelvis.
- Provides perineal support without undue pressure.
- Sitting on warm compresses on the ball will maximize perineal relaxation.
- Encourages rhythmic movement.
- Puts less strain on the hands and arms when mother is in the hands and knees position
- May speed up labor.
- Helps widen pelvic outlet to its maximum.
- Beneficial for techniques with “failure to progress.”
What are positions for pushing?
Sitting: ideal for caregiver to see and assist; most likely if you are medicated
Squatting: allows for greatest diameter of the pelvis; can hasten expulsion stage
Side-Lying: good choice when baby is large or coming too quickly
Hand and Knees: good position if you have intense back labor; can help rotate a posterior baby
Tug of War pull: beneficial for women who have had epidurals; should only be used after baby’s head has descended into the pelvis
What are position for labor?
Walking: ease of pain and back pressure; gravity
Sitting on Birth Ball: eases perineal pressure, aids in descent
Side-lying: relaxation, reduces elevated BP
Hands and Knees: relief of painful back labor
Leaning forward: takes pressure off back, helps rotate the baby
Squatting: encourages proper fetal alignment, opens the pelvis 1-2cm wider than other positions
Swaying/slow dancing: provides mobility to pelvis, uses gravity to speed up labor
Touch relaxation
Still touch: partner holds his or her hands firmly in place until he or she feels you release your tension
Firm pressure: partner applies pressure with fingertips or whole hand on tense area. Partner gradually releases pressure
Stroking: partner lightly or firmly strokes the tense area; strokes away from the center of mom’s body
Massage: partner firmly rubs or kneads tense muscles
Positions and Movements for Labor and Birth Handout
Standing: takes advantage of gravity during and between contractions
Walking: causes changes in pelvic joints, encouraging rotation and descent
Standing and leaning forward on partner, bed, or birth ball: relieves backache and encourages rotation of OP fetus
Slow dances: causes changes in pelvis joints, encouraging rotate and descent
Lunge: widens one side of the pelvis and encourages rotation of OP baby
Sitting upright: good resting position
Sitting on toilet: helps with pushing and may relax perineum
Semi-sitting: easy position to get into, may increase back pain
Rocking chair: may speed labor because of rocking movement
Sitting, leaning forward: relieves backache
Hands and knees: helps relieve back; assists rotation of baby in OP position
Open knee-chest position: encourages baby’s head out of the pelvis during contractions, reduces pressure on swollen cervix
Side-lying: good resting position, useful to slow a very rapid second stage
Squatting: takes advantage of gravity and widens pelvic outlet
Lap Squatting: reduces strain on knees and ankles and allows for ore support of mother
Supported Squat: takes advantage of gravity and lengthens mother’s trunk allowing more room for fetus to get into position
Dangle: same as supported squat but easier on the partner
What are some common sayings about pain in childbirth?
Women should have pain in childbirth.
Women don’t have to feel pain in childbirth
Pain serves a purpose in childbirth.
Pain is counterproductive in childbirth.
What is a Biblical perspective on childbirth?
Our work in labor was a directive from God, not a corrective God was assigning us a labor of love to help us maintain his intended order for creation. It connects us with God as the one who labored to birth creation. It attaches women to their children and gives women appropriate gender roles.
What is our role as childbirth educators?
To do our best to PROTECT through education, empowerment, and advocacy, this loving directive by God for women.
To protect this labor of love required of them that they might live in such a way that they bring order and health to their family and world, starting with birth!
What are the different coerces of labor pain?
Functional
Physiological
Emotional
What are functional sources of pain in childbirth?
Stretching of the cervix
Pressure of the baby on nerves in and near the cervix and vagina
Tension and stretching of the supporting ligaments of the uterus and pelvic joints during contractions and descent of the baby
Pressure on the urethra, bladder, and rectum
Stretching of the pelvic floor muscles and vaginal tissues
Vaginal examination
Contractions
What are physiological sources of labor pain?
The result of abnormal events, or events that are deviations from normal
Extreme back pain that can occur with a posterior labor
Pain from a uterine rupture
Exhaustion and fatigue increase the intensity of pain
Varicose veins, high BP, fever, headache, CPD, placental abruption
What are emotional sources of labor pain?
fear
anxiety
trauma
Fear tension pain fear tension pain (Dick Reed)
Our brain responds to fear by releasing adrenalin which results in dilation of the pupils, increased heart rate, and dry mouth. Our body begins pumping blood away from our internal organs to give us speed and strength
What does pain felt in normal labor serve to do?
Pain in a normal labor serves as an important messenger, ensuring labor progress. It informs those involved about the appropriate management of labor.
What does labor pain trigger the release of?
Endorphins, a woman’s natural pain relieving hormones
Explain the positive feedback loop
The neocortex needs to be turned off and the primal brain turned on. This involves the hormones oxytocin, endorphins, adrenaline, and prolactin. The uterus contracting stronger tells the brain to increase the release of hormones. If you take away the pain of contractions, everything comes to a screeching halt.
What benefit does labor provide for the baby?
It prepares baby from the changes that are coming as it enters the world.
What are the rates of respiratory complication for baby’s that go through labor and those that don’t?
Vaginal birth–.6%
Some labor than a c-section - 5.6%
No labor and a c-section - 12.4%
What factors determine a woman’s attitudes to pain?
Her beliefs and expectations about pain and childbirth.
the personal goals she has set for motherhood
Her earlier life experiences
Her previous experiences giving birth
What factors can increase or decrease the degree of labor pain a woman perceives?
Previous experiences with pain, medical care, and childbirth
Knowledge about birth from people, books, and other media
Cultural background
General health
Perception of herself as one who can or cannot deal with pain
Frequency of contractions
Size and position of the baby
Freedom to move around in labor
Degree of fatigue, anxiety and fear
Sense of aloneness verses support
Degree of confidence and preparedness
Describe the mind-body connection
The association of pain with childbirth is an example of a universally help conditioning and has become the source of needless suffering because of the myths that surround it.
If you listen to affirmations of positive, normal birth it will contribute to positive conditioning.
words/suggestion/thoughts –> feelings –> beliefs –>behavior –>positive or negative experience
The birth process is a ? process
brain
What part of the woman’s brain orchestrates childbirth?
Her autonomic nervous system, not under her conscious control
What part of the brain is active in labor and delivery?
the primitive part of the brain, or brain stem
What gland is also considered to be a gland that releases birthing hormones?
The primitive brain; it must secrete the hormones necessary for effective uterine contractions
Where do inhibitions come from?
The neocortex, or new brain, which enables us to be scientific, rational, and to communicate through language
What accompanies the release of the hormones necessary for the birth process?
reduction in the activity of the new brain; thus at a certain stage of normal birth, women have to divorce themselves from their surroundings and drift into another planet
What are main components to keeping the neo-cortex turned off?
light and silence, not asking the mother a lot of questions.
What becomes a key element during a woman’s labor?
darkness
What can sometimes relax pelvic muscles by discharging emotions that block further progress in labor?
true words spoken
What is another way in which the mind-body connection is made obvious in birth?
the separation of the placenta from the uterine wall
According to Michel odent, the length of labor is…
proportional to the number of people around
What is counterproductive during labor?
Eye to eye contact
What is the fetal ejection reflex?
the reflex right before the baby comes out. The woman expresses that she cannot do it anymore (help me, get this baby out, etc.).
It is immediately followed by a series of irresistible contractions. The maternal body has the sudden tendency to be upright.
The risk of dangerous tears is eliminated and the placenta typically separations.
What are the 3 R’s?
Relaxation
Rhythm
Ritual
What are the three coping mechanisms that are universal to women in labor?
Relaxation
Rhythm
Ritual
Women who cope well in labor always use what?
relaxation, either during or between contractions or constantly.
What is relaxation?
The art of releasing muscle tension, the cornerstone of comfort during labor.
What is key to coping better in labor?
identifying where in your body that you hold tension and releasing it.
How can mom set a good pattern for herself in labor?
By consciously working to remain relaxed during contractions in early labor.
What are the benefits to relaxation?
Conserving energy and reducing fatigue
Calms the mind and reduces stresses
Reduces pain
The mental concentration involved focuses your attention away form the pain of contractions
What forms can rhythm take in labor?
Rhythmically breathe, moan, or chant
Curl or uncurl their toes
wanting someone else to talk, stroke, or moan with them
Calms the mind and has a lulling effect
