Published on March 14, 2014
Prenatal II Presentation: Positions, Rebozo, Newborn and Postpartum Procedures, & Baby Care
2 Labor Positions Hands and Knees Crawl – mom is on hands and knees as if she is about to crawl. Great for utilizing pelvic rocking.
3 Labor Positions Full Moon - Elbows & Knees, head resting upon the arms that are folded on the floor.
4 Labor Positions Sitting Positions Toilet – mom can sit facing the tank, so that her partner can rub her back. Useful if SROM or AROM has occurred. Backwards sitting on a chair
5 Labor Positions Reclining – great to help mom rest/relax.
6 Labor Positions Rocking Chair – can help mom establish a rhythm and also uses gravity to open the cervix
7 Labor Positions Birthing Ball – Mom can bounce, rock, sway, or just sit upright.
8 Coping Techniques - Positions Squatting Positions Vertical Supported Squat – partner is sitting well above the mother as she rests her arms on the partner's legs and hangs in a supported squat.
9 Coping Techniques - Positions Squatting bar – a bar that attaches to the bed may be utilized to support mom in a squat.
10 Coping Techniques - Positions Assisted Squat – using a sturdy object, mom squats next to it safely.
11 Coping Techniques - Positions Side lying- − Beneficial when mom needs to rest. Use this during early labor when mom can be completely relaxed. Very useful during long labors. − Support mom with pillows, between knees & feet, under head, hugging a pillow
12 Coping Techniques - Positions Standing & Walking positions Slow Dancing – mom dances with her partner, creating a rhythm
13 Coping Techniques - Positions Walking – Accelerates labor. Can help shorten the early stages of labor. Stairs are even more effective.
14 Pushing Positions Squatting - This opens up the pelvis to its biggest possible size. You are also using gravity to help push.
15 Pushing Positions Hands and Knees – This is helpful for a large baby, back labor or OP baby
16 Pushing Positions Side Lying - This is great if for a mom that has to be lying down, also to rest while pushing. This allows for no pressure on the sacrum to narrow the pelvis.
17 Pushing Positions Lithotomy Classic position traditionally used in hospitals for patients that have had epidurals.
How can we use a rebozo? As we go through these techniques, keep in mind that they can all be used on ANYONE – even if that person is not pregnant. Why not use a technique to relieve low back pain on someone who is suffering from PMS? Or a friend who has chronic back pain? Pain relief and relaxation during pregnancy Comfort measures during Labor PMS and menstrual cramps Infertility Treatments Massage Baby Wearing
Optimal Fetal Positioning Hands and Knees Belly Sifting Mom is on hands and knees. Wrap the rebozo around the mother's belly. Create even tension around the entire belly. Lift and jiggle the belly side to side. Can help with... OFP prior to labor Asynclitic baby OP presentation Ligament Pain Lower back pain
Optimal Fetal Positioning
Rebozo in labor Vibration with Rebozo Mother is in hands and knees position Wrap the rebozo around her bottom. Gather it at each hip. Vibrate the rebozo over her bottom firmly and quickly. Do not let the fabric shift over her. Try this technique with the mom on a birthing ball for ultimate relaxation. Can help with... Tension in the hips Hip Pain Contraction discomfort
Rebozo in labor
Rebozo in labor Lying Down Rocking Massage Mother lies down flat on her back Wrap the rebozo around her entire abdomen and hips. Lift the mother gently and rock her from side to side. Can help with... OP Presentation Asynclitic Baby Ligament Pain Rib Pain Compound Presentation
Rebozo in labor
Rebozo in labor Inversion with Rebozo Mother gets into Child's pose (on knees, laying head down onto arms) Wrap the rebozo around her hips and lift upwards. Perform this for 5 minutes at a time. Can help with... Persistent asynclitism Breech presentation
Rebozo in labor
Rebozo in labor Double Hip Squeeze Mother is in a standing position Wrap the rebozo under the mother's belly and around her hips. Cross the rebozo across her back and squeeze. Best done with two people. Can help with... Back Labor Ligament Pain Lower Back Pain Hip Pain
Rebozo in labor
Rebozo in labor Hanging with the Rebozo Tie a knot in the rebozo and close the door over the knot. Allow the mother to hang from the rebozo. She can even get into a squatting position if she feels comfortable Can help with... Rib Pain Upper/middle back pain Proper pushing
Rebozo in labor
Rebozo in labor Pull to Push Mother is in a pushing position, any pushing position. Tie a knot on each end of the rebozo Hold the rebozo taught between the mother and the support person, who is positioned on the other side of the mom's belly. Can help with... Proper and efficient pushing, even with mother has been exhausted.
Rebozo in labor
33 Stages and Phases of Labor Stage I – Labor − Phase I – Early Labor Emotions: Happiness, excitement, anticipation Contractions are 5-20 minutes apart Contractions are 30-60 seconds long Contractions are mild Mom is dealing with contractions without much difficulty Cervix is dilating to 4 cm This is usually the longest phase of labor − “Pushing the dirt around”
34 Stages and Phases of Labor − Phase II – Active Labor Emotions: serious, calm Contractions are 3-5 minutes apart Contractions are 45-90 seconds long Contractions are moderate Mom is working harder to get through each contraction Cervix is dilating to 7 cm This phase is typically shorter than early labor.
35 Stages and Phases of Labor − Phase III – Transition Hormones: Lowering of Oxytocin and rising of Adrenaline Emotions: stressful, mom might want to throw in the towel Contractions are about 30-90 seconds apart Contractions are 45-90 seconds long Contractions are very strong, sometimes with multiple peaks Cervix is dilating to 10 cm This is the hardest and the shortest part of Labor.
36 Stages and Phases of Labor Stage II – Delivery of Baby 1st time moms may push for multiple hours Emotion: excited, inspired, second wind Contractions are only a couple of minutes apart and are not as strong as transition contractions Ring of Fire – as baby crowns Mom is working with the contractions to help push baby out − Baby is using reflexes to kick the top of the uterus − Mom cannot fight the urge to push
37 Stages and Phases of Labor Stage III – Delivery of Placenta Emotions: happiness, relief, excitement, love 5-30 minutes after delivery of the Baby Contractions are mild and intermittent Care providers might massage abdomen to help uterus contract and shed the placenta
38 The Wonderful Placenta The only human organ that creates itself and does not exist throughout a lifetime. 9” Dinner plate Sustains baby by transferring nutrients through blood Traditionally ingested in many cultures around the world − Placenta Encapsulation − Placenta Prints − Plant in your garden − Plant with a tree − Soup, smoothie, baked... find recipes online.
39 Aromatherapy Test each scent and note how it makes you feel!
40 Aromatherapy Stimulating scents Stress Relief: Bergamot, Chamomile, Lavender, Lemon, Orange, Patchouli, Vanilla Anxiety/Fear: Bergamot, Chamomile (Roman), Cedarwood, Frankincense, Jasmine, Lavender, Neroli, Patchouli, Rose, Sandalwood Self Esteem: Bergamot, Cypress, Grapefruit, Jasmine, Orange, Rosemary Sadness/Grief: Bergamot, Chamomile (Roman), Clary Sage, Frankincense, Grapefruit, Jasmine, Lavender, Lemon, Orange, Rose, Sandalwood, Ylang Ylang Fatigue: Basil, Bergamot, Clary Sage, Frankincense, Ginger, Grapefruit, Jasmine, Lemon, Patchouli, Peppermint, Rosemary, Sandalwood Agitation: Chamomile (Roman), Lavendar, Mandarin, Sandalwood Isolation: Chamomile (Roman), Bergamot, Clary Sage, Frankincense, Rose Memory Boosters: Basil, Cypress, Lemon, Peppermint, Rosemary
41 Postpartum Commonly procedures performed on mom: − Suturing of tears or episiotomy − Hospital stay of 24 hours or longer − Abdominal massage − Uterus checks
42 The Newborn The Apgar score is named after Virginia Apgar who designed it as a simple method to quickly asses the health of a newborn. A - Appearance P - Pulse G - Grimace A - Activity R - Resolve
44 Newborn Appearance Vernix – the whitish coating on a baby. This coating was built up while your baby was living in your uterus. As a baby nears its birthday, the vernix begins to absorb into the skin. Little to no vernix is seen on babies that are very ready to be born!
45 Newborn Appearance Purple Baby – During delivery, sometimes babies become deprived of oxygen. This causes them to appear more purple until they take their first breaths and allow the oxygen to circulate.
46 Common Newborn Procedures Eye Drops – erythromycin − Thick gel that is applied to the eyes of a newborn to prevent infection of the eye. This is necessary for babies born to mothers who have gonorrhea or chlamydia. − You may need to sign a form that states that you are opting out of this treatment if you choose to do so.
47 Common Newborn Procedures
48 Common Newborn Procedures Advantages - Erythromycin can reduce the risk of chlamydia and gonorrheal infection of the eye Erythromycin ointment is inexpensive Disadvantages - Adverse effects include eye irritation and blurred vision, which may interfere with bonding Erythromycin is not 100% effective at preventing infection (it has a 20% failure rate)
49 Common Newborn Procedures Vitamin K Shot − Vitamin K is crucial in the process of clotting blood. Babies are born with low levels of Vitamin K and are injected with a dose of the vitamin to prevent Vitamin K deficiency bleeding. − This is a routine injection that will require a signature on a refusal form.
50 Common Newborn Procedures Advantages - − May prevent excessive bleeding in the newborn Disadvantages - − Potential emotional trauma to the newborn − 20-80% increase in childhood leukemia in children who have received the Vitamin K shot. 1.5 additional cases to every 100,000 children.
51 Common Newborn Procedures Hepatitis B Shot − This shot is administered to vaccinate newborns against the Hep B virus. This is important in women who are currently carrying the virus. − Given as a three shot series that commences at birth. May also be administered later in life, such as in the teenage years. − This is a routine injection that may require the signing of a refusal form.
52 Common Newborn Procedures Advantages - − Can prevent the transmission of the Hep B virus from a mother who carries it to her newborn baby. Disadvantages - − Suspected cause of some SIDS cases − Reported but not confirmed associated diseases include: Multiple Sclerosis, Guillain-Barre Syndrome, Bell's Palsy, Diabetes, Rheumatoid Arthritis, Lupus, Convulsions and Brain disorders such as Encephalitis, Immune dysfunction, Visual and Hearing impairments, Pancreatitis
53 Common Newborn Procedures Hearing Screening − Your newborn will be hooked up to a hearing test to record his hearing ability. This test may take 5-40 minutes. − Does not hurt the baby.
55 Common Newborn Procedures PKU Test − This test is a heel stick. Blood is applied to a test paper at the first and 14th day of life. − This test can tell you if your baby may have metabolic disorders that could have devastating effects on his or her life. − Early detection is key in preventing these disorders from affecting your child.
56 Common Newborn Procedures Newborn Bath − Your newborn will be given a sponge bath during their hospital stay. This bath will probably be given in the nursery.
57 Common Newborn Procedures Circumcision − The surgical removal of the foreskin which is the skin that covers the tip of the penis. − This procedure is most often done before the male newborn leaves the hospital. − Reasons why parents choose to do it vary from religious beliefs, the belief that it makes the penis easier to clean, to cultural pressures, or family tradition.
58 Common Newborn Procedures Advantages - − Circumcision makes it easier to clean the penis. Disadvantages - − Foreskin may be cut too long or short − Foreskin may not heal properly, or may reattach itself to the head of the penis, causing additional surgery − May traumatize the newborn
59 Common Newborn Procedures Circumcision Statistics The rate of circumcision in the US is steadily declining – 65% in 2002, 56% in 2006, 54% in 2008 and in 2010 it was 32% Circ removes 75% of the sensitive tissue on the penis Anesthesia is only used in 45% of circs Adults who were circd in their infancy are 5x more likely to develop ED
60 Unexpected Outcomes An expected outcome can be anything that the parents do not expect or prepare for. − Different gender than expected − Traumatic Birth − Cesarean Section − Abnormalities in baby − Stillbirth or Death
61 Unexpected Outcomes In the event of an unexpected outcome: − Take time to rest and recover − Ask someone else to prepare your meals for you for a while − Make sleep a priority − Be patient with your spouse − Talk and share as often as you feel you should − Write about your feelings
62 Unexpected Outcomes − Remember that your feelings will evolve over time − In the event of loss: spend all of the time that you need to with your baby. − Allow other children or family members to express their feelings − Talk with your birth attendants about your feelings − Avoid making big decisions − Seek grief counseling
63 The First Few Weeks - Bath Time!
64 How to Diaper a baby
65 How do I hold my baby?
66 How do I burp my baby?
67 How to swaddle a baby... Remember – DUDU
68 How to calm a fussy baby... The 5 S's Shush Swaddle Side Lay Sway Suck
69 What is Colic? “Colic” is a catch-all term for babies that cry for more than 3 hours for more than 3 days a week. − Baby may turn red in the face − Cries are usually higher in pitch − Belly may be distended and solid − Arms and legs are extended and/or flailing
70 Co Sleeping
71 Benefits of Breastfeeding Protection against − Gastroenteritis − Constipation, colic and other stomach upsets − Childhood diabetes − Ear infections, pneumonia, bronchitis, kidney infections − Allergies, asthma, eczema − Meningitis − Childhood Lymphoma − Crohn's Disease and ulcerative colitis
72 Benefits of Breastfeeding Reduced rates of − SIDS (for every 87 deaths, only 3 are breastfed) − Tooth decay − Heart disease later in life − Iron deficiency − Appendicitis − Rheumatoid Arthritis − Childhood Obesity
73 Benefits of Breastfeeding Promotes − Facial structure development − Enhanced speech − Straight teeth − Good vision − Increased bone density − Antibody response to vaccines − IQ development − Emotional bonding − Healthy GI tract
74 Benefits of Breastfeeding Benefits to mom − Reduced rate of breast, ovarian and endometrial cancer later in life − Reduced rate of anemia − Protects against osteoporosis − Delays the return of fertility − Helps moms get back to pre-baby weight in a healthy way − Bonding with baby − Uterus contracts after birth − Mom misses less work over time due to reduced rate of child related illnesses
75 Benefits of Breastfeeding Human milk is FREE! When stored properly, human milk can be kept for many months.
76 Breastfeeding Holds Cradle Hold Football Hold Side-Laying
77 Laid Back Breastfeeding
78 The Proper Latch
79 The Postpartum Period The postpartum period can last anywhere from 2-8 weeks, depending on your delivery experience.
80 The Postpartum Period Lochia − Lochia is the vaginal discharge that is present anywhere from 2-6 weeks. It comes in three stages: − 1st : Red in color, very heavy period. 3-5 days postpartum − 2nd : Thinner than previously and also more brown or pink in color. 5-10 days postpartum − 3rd : Whitish or yellowish-white discharge. 2nd through 3rd to 6th week.
81 The Postpartum Period If at any time you pass a blood clot that's bigger than a golf ball, or a sudden and large gush of fluid is discharged, please call your care provider immediately.
82 The Postpartum Period Healing − Depends diapers may be a good investment! − Witch hazel pads and solarcaine help soothe the wound of a vaginal birth − Use a peri bottle to cleanse and soothe with warm water − When bearing down for a bowel movement, hold a pad against your vulva − After urinating, cleanse with warm water and pat the area dry.
83 The Postpartum Period Sitz Bath − Used during the early postpartum period to help cleanse, soothe and aid in the healing of the perineum. − Small herbal bath that you sit in. − Steep your bath for four hours. Strain the liquid and then use it for a bath. − Peri bottle − Toilet basin − Tub
84 The Postpartum Period Postpartum Depression − Affects up to 13% of women after birth − Usually occurs in the first three months postpartum, but can up to a year later − Anxiety, irritation, tearfulness and restlessness are common in the first couple of weeks postpartum. These feelings increase, or do not fade away.
85 The Postpartum Period Postpartum Depression Moms are more at risk for PPD when: Under the age of 20 Currently abuse alcohol, illegal substances or smoke Unplanned pregnancy Previous depression, bipolar or an anxiety disorder before pregnancy or with a previous pregnancy Stressful event during pregnancy, labor, delivery Close family member with depression Poor relationship with significant other, or is single Money/Housing problems Little support from family, friends, or spouse/partner
86 The Postpartum Period Call your care provider: − Baby blues don't go away after two weeks − Symptoms get more intense − Symptoms of depression begin at any time after delivery, even many months later − It's hard for you to perform tasks at work or home − You cannot care for yourself or your baby − You have thoughts of hurting yourself or your baby − You develop thoughts that are not based in reality or you start hearing or seeing things that people cannot
87 The Postpartum Period Support for New Parents What support do you have for your postpartum period? Mealbaby.com Postpartum Doula Lactation Consultant OB/Midwife http://www.sbpep.org/ Have you taken a Newborn Care class yet?
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