Los Olivos Classes Part 1 Flashcards
What is the role of Oxytocin (OT) in labor?
Causes labor progression
What hinders OT during labor?
Fear and stress
How can you re-frame pain in childbirth?
Childbirth pain is from physical effort; different from pain being indication of something wrong (a warning).
Pain signifies labor is progressing
9 Factors that Decrease Pain
Well-fed
Well-rested
Well-hydrated
Relaxed, not stressed
Have knowledge - no fear of unknown
Feeling empowered and supported (good team!)
In the present moment: not dwelling on thoughts of pain to come, anticipating
Staying active and trying different positions
Stimulate pleasurable senses instead: acupressure, massage, music, aromatherapy, heat, cool, environment temperature
How do you re-think pain? PAIN Acronym
P - purposeful, helping labor progress
A - anticipated
I - intermittent. contractions aren’t constant. relax the body during this time
N - normal. not indicating injury
How do you evaluate an intervention? BRAIN acronym
Benefits Risks Alternatives, if any Intuition Need time: what happens if we wait?
What are the “stations” of the baby?
The position of the head relative to the ischial spines.
0 station is at the spines
Up above is negative. -4, -3, -2, -1
You don’t push when it’s up high
Past spines is +1, +2, +3, +4 (crowning, right at perineum)
How to relieve feeling of heaviness? (position)
Lie on left side, knee up, feet elevated
What are the cervical dilations and stages of labor?
0cm to fully dilated at 10cm
1-3 cm early labor
3-7cm active labor
You need to be 10cm before you start pushing
What things might happen before labor late in pregnancy?
Bloody show, loss of mucus plug, dilation, and cervical effacement
What 911 emergency is associated with the placenta? What symptoms?
Placenta abruption. Around 1% of pregnancies where the placenta partially or completely separates from the uterine wall.
Symptoms: Continuous severe abdominal pain: intense tightness Lower back pain more than normal Tender abdomen Constant tightening of uterus Bleeding
In what percent of pregnancies does the water break before labor starts?
10-15%
How soon after water breaking need you deliver?
24 hours (to avoid infection)
What do you tell the Dr. when your water breaks? Acronym COAT
Color (clear or milky is normal)
Odor (amonia-y or odorless is normal. foul indicates infection)
Amount - trickle or gush tells low or high break
Time - when did this happen?
What 911 emergency is associated with the water breaking? What do you do?
Gushing low break can sometimes take the umbilical cord out with it - this is a prolapse cord. Get on all fours with your butt higher in the air than the rest of you. Takes the pressure of the cord so blood keeps flowing.
What hormones soften the cervix?
Prostaglandins
What hormones induce contractions?
Oxytocin
When does the baby “drop”?
Usually 3-4 weeks before delivery
What “call the doctor” urgency is associated with swelling? What else can indicate this urgency?
Sudden increase in swelling (or sudden increase in weight gain or pitting edema under the eyes) can indicate pre-eclampsia. BP is too high.
Other symptoms: persistent headache, spots in eyesight, pain in shoulder or upper abdomen
How to practice kegles? (just a practice note)
Tighten all the way back to the rectum to help avoid hemorrhoids.
What massage tip helps with back pain?
Press on lower back, fingers reaching around sides of soft abdomen, just above hip bones
What is the 25-35-lb weight gain of pregnancy made of?
6-7lb baby 2lb placenta 1-2lb fluid 2-3lb blood Breasts 2-3 lb Uterus 2-3 lb Fat 4-8 lb
What is the single most important thing to remember from these classes? (about relaxation)
Relaxation = Dilation. So practice relaxation ahead of time with breathing exercises and meditation.
What are the four stages of labor and delivery? (big picture)
- Labor
- Pushing and Delivery of baby
- Delivery of Placenta
- Postpartum period
What are the three stages of labor (small picture)? What are the typical time-scales, dilations, and markers?
- 1 Early / Prodromal Labor
- 12hrs +
- Contractions starting, not so intense
- -30-60s in duration
- -5-20mins apart
- 0-6cm dilation - 2 Active Labor
- 6hrs+
- Contractions frequent and stronger
- -45-60s in duration
- -2-5mins apart
- 6+cm dilation
- Water might break
- THIS is when you go to the hospital
- Epidurals can start from here on out at any point - 3 Transition to delivery
- 0.5-2hrs
- Contractions different and much stronger
- -1-1.5min in duration
- -2-3min apart
- 10cm fully dilated
Then pushing and delivery (separate flashcard)
What marks pushing and delivery? What do you do?
Lasts 30-45mins 10cm fully dilated Contractions -45-90s in duration -3-5min apart
Now it’s okay to push, especially when you feel the urge.
Pushing can be hard
Push WITH the contractions and rest between contractions. Keep pushing THROUGHOUT the contraction with just little tiny breaths in. Mostly about pushing.
What are you going to have on hand for when Autumn goes into labor?
Cushy floor mat and green cushion as knee pads Her water bottle with straw Ice water Tea Udon Heating pad Bath
What are the signs of pre-labor 3-4 weeks before labor begins?
Lightening: baby lower, breathing a little easier Bloody show or loss of mucus plug Flu-like symptoms or diarrhea Nesting Weight loss of a couple pounds Braxton-hicks “practice” contractions. Feel real but not progressing the cervix dilation Cramping and pain in groin area Loosening of joints
What is false labor?
Some effacement and dialation but not progressing
Water doesn’t break (though doesn’t always break in true labor either)
Contractions not getting longer, stronger, closer together
Walking can make contractions go away
What to do if Braxton-Hicks contractions are becoming a little too real?
More than 5 contractions/hr can cause cervix to start dialating
If that happens:
Lay down on left side
Rest for hour or so
Do kick counts
Drink 1-2 glasses of water to avoid dehydration-caused contractions
What should you do to avoid early labor leading up to the 37 week mark?
No nipple play Sit somewhat more often Don’t carry heavy things Limit stairs and stooping and bending Keep exercise moderate Regular exercise will help prevent preterm labor Minimize stress as much as you can Have a good weight, get your nutrients Avoid raw meat, raw fish Limit caffeine, 2 cups coffe/day max or less if you can Keep up with dental work
What are the definitions of duration and frequency of contractions?
Duration: from beginning of contraction to end. Might take 30s at the beginning.
Frequency: from the BEGINNING of one contraction to the BEGINNING of the the next.
When do you go to the hospital? (mnemonic)
5-1-1
5 minutes – Contractions are about 5 minutes apart or less
1 minute – They last 45-60 seconds
1 hour – This pattern is holding for 1.5-2 hours. A nice consistent active labor pattern
What is “back labor”? What can you do to avoid it?
When the baby’s occiput is on the back side. This happens in 25% of labors and brings some serious bone-on-bone action and pain.
Ideally you want the baby’s nose facing mom’s butt (big part of he head is on mom’s anterior).
To reduce risk, MOVE A LOT DURING LABOR and the baby will more likely turn into the good position. So swaying, going to the bathroom every hour, slow dancing position, etc.
As a labor coach, what things should you think about doing/providing? (Acronym PURE)
Position
Urination
Relaxation
Environment
Change position every 30 minutes
Go pee once per hour. Toilet-sitting is also a fine laboring position.
Relaxation = dilation
Environment
-Music. Body goes with the tempo. Maybe find some stuff around 120 beats per minute
-Lighting
-Temperature
-Having the right people around
-Location: couch, tub, bed, rocker, floor, etc.
-Aromatherapy options
-Heat pads, cold pads
