PREPARATION FOR CHILDBIRTH AND

PLANNED PARENTHOOD.

Goals of childbirth preparation: To provide parents with the knowledge and skill they need to cope with stress of pregnancy, labor and birth.

To prepare parents to be intelligent consumers of maternity care.

To assist parents in achieving a safe, positive and rewarding labor and birth experience.

PREPARATION FOR CHILDBIRTH

Birth Plan : is set of instructions prepared in advance for the medical professionals who will help you through the delivery process.

Childbearing decision

Choosing the birth settings• Giving Birth in a Hospital• Out-of-Hospital BirthsSibling preparation for birth Classes for Family Members during

Pregnancy Antepartal education Class content

Early classes ( 1st trimester)o Early gestational changes.o Self-care during pregnancy.o Fetal development, environmental dangers

for the fetus.o Sexuality in pregnancy.o Birth settings and type of care providers.o Nutrition, rest and exercise suggestions.o Relief measures for common discomfort of

pregnancy.o Psychological changes in pregnancy.o Information for getting pregnancy to a good

start.

Later classes ( 2nd and 3rd trimesters) ◦Preparation for birth process.◦postpartum self care◦birth choices( analgesia, fetal monitoring etc)

◦relaxation techniques◦infant stimulation, care and feeding

◦Newborn safety issues.

Adolescent parenting classes o How to be a good parent.o Newborn careo Health dangers for the babyo Healthy diet during pregnancyo How to recognize when baby is ill,

protecting from accidentso Baby care: physical and emotional,

make the baby feel happy and loved

Breast feeding programso Methods of breast preparationo Techniques of breast feedingo Advantages of breast feedingo Involvement of fathers in feeding process Sibling preparation: Adjustment to newborn

Classes for grand parents

Education of the family having cesarean birth

Preparation for cesarean birtho Participating in the choice of anesthetico Father (significant other) being present during birtho Planning initial contact with their

newborn Preparation for repeat cesarean birth

Preparation for couples desiring vaginal birth after cesarean birth (VBAC)

Child birth preparation methods

PSYCHOPROPHYLACTIC (LAMAZE) METHOD:

Topics covered in Lamaze classeso Normal labor, birth and early postpartum o Positioning to facilitate the normal progress of

labor and birth o Massage techniques to ease the pain of labor

and to enhance relaxation o Comfort measures, such as hydrotherapy, the

use of heat, cold and pressure o Relaxation skills to use during labor and after

pregnancy to relieve stress o Labor support advice for the partner and the

professional (doula)

o Communication skills between the pregnant woman and her partner, and with members of the healthcare team

o Problems that could occur during labor and birth

o Guidance for the pregnant woman to make informed decisions about anesthesia and medical procedures

o Breastfeeding and the early postpartum period o Healthy lifestyles for pregnancy and

postpartum period o Background about epidurals and other

anesthesia choices to enable you to make the best choice for yourself

o Breastfeeding and the early postpartum period

Body conditioning exercises Relaxation exercises Breathing techniques: it uses 3 patterns of

chest breathing which vary. The woman is taught to use one pattern until it is no longer effective, then move on to another.

o First pattern: it is called slow paced breathing. During the breathing movements only the chest moves. The woman inhales slowly through her nose. She lifts her chest up and out during the inhalation. She exhales through pursed lips. The breathing rate is 6-9 breaths a minute( 2 breaths every 15 seconds)

oSecond pattern: also called shallow breathing or modified-paced breathing. The woman begins with a cleansing breath and at the end of this she pushes out a short breath. She then inhales and exhales through the mouth at a rate of about 4 breaths every 5 seconds. She keeps her jaw relaxed and her mouth slightly open. The air should move in and out smoothly and silently and the breathing should be mouth centered.

o Third pattern: it is also called pant-blow or pattern-paced breathing. The breathing is punctuated every few breaths by a forceful exhalation through pursed lips. A variation of this pattern consists of drawing the lips back to the teeth and making a hee sound with the exhalations. The forceful exhalation is through more pursed lips making a hoo sound.A pattern of 4 breaths may be used to begin. All breaths are kept equal and rhythmical. As the contractions become more intense, the pattern may be changed to 3:1, 2:1and finally 1:1.

oSecond stage breathing: in the second stage of labor the woman may assume any comfortable physiologic position, take several deep breaths, then hold her breath, bulge abdominal muscles, relax the perineum and push out through the vagina. This pushing effort is repeated throughout the contraction, timed and coached by the partner.

BRADLEY METHOD

It places an emphasis of natural approach to birth and on active participation of the baby’s father as the birth coach. Major goal is avoidance of medications unless absolutely necessary and working in harmony with the body using abdominal breathing and general body relaxation.

Bradley Method natural childbirth classes offer 12 weeks of comprehensive education:  information designed for couples planning to give birth in the hospital or at home. They total 24 hours of quality instruction, labor rehearsal, medical information, communication suggestions and more.

The Bradley Method of Natural Childbirth promotes:

o Natural childbirtho Active participation by the husband as coach o Excellent nutrition o Avoidance of drugs during pregnancy, birth

and breastfeeding o Training and preparation o Relaxation and natural breathing o Understanding your body and working with it o Breastfeeding your baby o Parents preparing for unexpected situation

DICK -READ METHOD o Conscious relaxation: progressive relaxation

of muscle groups in entire body.o Breathing technique: primarily abdominal.

Woman concentrates on forcing the abdominal muscles to rise. Works on slowing number of respiration/ minute so that she can take 1 breath /minute. Slow abdominal breathing during 1st stage. Rapid chest breathing used towards end of labor if abdominal breathing not sufficient; panting is used to prevent pushing until needed.

o Physical exercise: to prepare body for labor.

KITZINGER METHOD: It uses sensory memory to help the woman understand and work with her body in preparation for birth. Uses chest breathing in conjunction with abdominal relaxation.

GAMPER METHOD: self determination and confidence instilled by instructor in the ability of the women to work and cooperate with the natural forces of childbirth. The emphasis is on the contraction rather than away from the contraction. Classes begin early in pregnancy so that the fear-tension-pain cycle can be broken and new self confidence instilled early on

SIMKINS METHOD: this approach works with the strength of the couple giving birth. They are encouraged to use whatever means of breathing and style which helps them as individuals. An electic mix of techniques is taught.

NOBLE METHOD: it involves relaxation of pelvic floor muscles and learning ways to relax them. Her gentle pushing or breathing the baby out technique is now incorporated in many classes. Her approach emphasizes woman listening to their body.

LE BOYER METHOD: introduced by French obstetrician in the 70’s allow the baby to be born amid dim lights and soft voices. The baby is given a warm water bath, and then placed on mother’s abdomen for bonding. They are handled gently and without certain movement that may jar or startle the baby. Babies are massaged at birth to start breathing.

ODENT METHOD: Michael Odent another French physician introduced this. He put mother and baby both in warm water and allowed his laboring mothers to submerse in a pool of water. It appears to help some women ease labor pain.

Supporting the support person

Providing comfort and reassurance

Maintaining relaxation and concentration

Giving informationSupporting the unprepared women

Role of nurse in childbirth preparation

In 1916 Margaret Sanger founded the Planned Parenthood Federation of America.

National Birth Control League in1917. International Planned Parenthood

Federation, in 1952 with goal every child a wanted child

PLANNED PARENTHOOD

Friedman’s 4 stages of Planned Parenthood (1957)

oAnticipatoryoHoneymoonoPlateauoDisengagement

The Six Stages of Parenthood (1981), psychologist Ellen Galinsky

o Parental Image Stageo Nurturing Stageo Authority Stageo Independent Teenage Stageo Departure Stage

Allocation of power and decision making

Value placed on educationLocus of controlTime orientationPerception of rolesSocio economic statusParent education program

Factors influencing family roles

Providing trusted community health care

Informing and Educating the Community

Leading the Reproductive Health and Rights Movement

Advancing Global Health

Functions of Planned Parenthood federation of America

Since 1972, (PPFA) has been working in India to improve the sexual and reproductive health of women, men, and youth.

Four partners, The Child in Need Institute, Tata Steel Family Initiative Foundation, Prerana, and Action Research and Training for Health, oversee similar projects countrywide and follow the same innovative program models.  The current phase of our youth program in India focuses on adolescents aged 15-19. 

PPFA in India

It is a vital step in economic and social planning.

It maintains peace and harmony within the family and also assists the government to provide better living condition to all people.

It improves socio cultural changes which are accompanying the developmental processes.

It provides an opportunity for the couple to decide the family size, budgeting the family expenses.

Provides congenial and conflict free environment.

Promotes safe motherhood techniques and procedures.

Advantages of Planned Parenthood

Promote the health and welfare of mother and children specific and the family and total community in general.

Reduces the morbidity and mortality of mother and child.

Makes the woman, couple and other family members within the family to accept and adopt the changes in a holistic manner.

Receiving proper guidance and counseling techniques with appropriate health care professionals.

Parents will be able to will be able to give proper attention and concern for child’s developmental activities.

 

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nursing. California: Addison Wesley nursing; 1994. Orshan SA. Maternity, Newborn and Women’s health

nursing. Philadelphia: Lippincott Williams and Wilkins ; 2008

Pilliteri A. Maternal and child health nursing. Philadelphia: Lippincott Williams and Wilkins; 1999

Fraser DM, Cooper MA. Myles textbook for midwives. 14th edition. London: Churchill Livingstone; 2003

Varney H, Kriebs JM , Gregor CL. Varneys textbook of midwifery . 4th edition. New Delhi: Elsevier; 2005

Novak C.J ,Broom B.L . Maternal and Child Health Nursing. 9th edition. Missouri: Mosby Inc; 1999.

May AK, Mahlmeister LR. Comprehensive Maternity Nursing. 2nd edition. Philadelphia: Lippincott; 1990.

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