Liz Langthorn

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A Mother Makes Herself
Liz Langthorn Doula 405.517.2267 Liz_at_LizTheDoula.c
om
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• We have a secret in our culture, and it's not
  that birth is painful.It's that women are
  strong.
• Laura Stavoe Harm

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Tools To Take Home

• Comfort Measures
• Tricks of the Trade
• Labor Positions

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Comfort Measures

• Massage
• Shower/bath
• Hot/Cold packs
• Position Change
• Relaxation Rhythm Ritual

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Relaxation Rhythm Ritual

• Contractions are intense enough cannot walk or
  talk through them
• Begin ritual when contraction begins
• Breath slowly and Rhythmically (like sighing),
  Relaxing muscles with each outward breath
• Ritual can be anything. Touch, words, breathing,
  song, mantra.
• Internal or External
• Wont work with continual interruptions
• Simpkin, Penny. (2001). The Birth Partner.

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Tricks of the Trade

• Counter Pressure
• Passive pelvic tilt
• Double hip squeeze

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Positions

• Chair
• Squat
• Standing
• Hands and Knees

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First Stage of LaborDilation of Cervix Three
Phases
Early Labor Active Labor Transition Labor
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Early Labor(softening the cervix)

• Cervix dilates from 0 to 4 cm
• Cervix partially to completely effaces (0-100)
• Contractions 5-20 minutes apart
• Contractions 30-45 seconds long
• Average time 8-9 hours

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Early Labor Signs

• Restlessness
• Nagging back ache/cramps
• Several soft bowel movements
• Show-bloody mucus
• Mild to Moderate Contractions

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Early Labor Comforts

• Sex
• Walking
• Massage
• Nipple Stimulation
• Raspberry Leaf Tea
• Call Doula and/or Midwife

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• Just as a woman's heart knows how and when to
  pump, her lungs to inhale, and her hand to pull
  back from fire, so she knows when and how to give
  birth.
• Virginia Di Orio

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Active Labor(moving baby down)

• Cervix dilates to 4-8 cm
• Cervix completes effacement (100)
• Contractions 5-2 minutes apart
• Contractions 60 seconds long
• Average time 3-4 hours

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Active Labor Signs

• Contractions progressively longer, stronger and
  closer together.
• 511
• Mom not easily distracted

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Active Labor Comforts

• Doula
• Massage
• Bath/Shower
• Walking/Dancing
• Frequent Position change
• Relaxation, Rhythm, Ritual

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Medical Active Labor

• Pitocin
• AROM
• Epidural
• IV Fluids
• Pain Medication
• Fetal Monitoring
• Uterine Monitoring

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Belly dancing evolved from women moving and
dancing in labor. Fact or Fiction?
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Fact

• One theory of the evolution of belly dancing is
  that the gyrations helped pregnant women in labor
  by both lessening the discomfort of contractions
  and speeding labor along by moving baby down.

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Transition Labor(transitioning to birth)

• Cervix dilates to 8-10 cm
• Contractions less then 1 minute apart
• Contractions 70-90 seconds long
• Average time 10-60 minutes

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Transition Labor Signs

• It hurts
• Intense Contractions
• Cannot be distracted
• Long contractions, very close together, multiple
  peaks

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Fear is the number one cause of pain during
labor. Fact or Fiction?

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Fact

• Fear of pain, fear of future pain,
  embarrassment, doing the wrong thing, of
  letting someone down, all of these make women
  tense, which makes the pain more intense. It also
  raises stress hormones and adrenaline which
  suppress natural contraction and feel-good
  hormones, slowing labor down. This stress can
  also stop labor entirely.

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Transition Labor Comforts
Focal Object Hot/Cold packs Encouragement Counter
pressure Comfort Measures Guided
Visualization Relaxation, Rhythm, Ritual
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Medical Transition Labor
AROMCatheterEpiduralPain MedicationAnti-Nausea
drugs
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Second StageBirth

• Two Phases
• Latent Phase
• Active Phase

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Latent Phase(resting)

• Irregular or no contractions
• Average time 20 minutes
• Not universal

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• 300,000 women will be giving birth with you
  today.
• Relax and breathe and do nothing else.
• Labor is hard work, it hurts and you can do it.
• Unknown

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Active Phase(pushing and birth)

• Contractions 2-5 minutes apart
• Contractions 50-90 seconds long
• Average time 20 min-2 hours

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Active Pushing Signs

• Irresistible urge to push
• Feel need for bowl movement

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Active Pushing Comforts

• Position Change
• Counter Pressure
• Perineal Massage
• Perineal Hotpacks
• Spontaneous Bearing Down

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Medical Active Pushing

• Episiotomy
• Forceps/Vacuum
• Directed Pushing

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Third StagePlacenta Delivery

• Mild contractions
• Average time 5-20 minutes

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Placenta Delivery Comforts

• Nursing
• Fundal Massage

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Medical Placenta Delivery

• Pain medication
• Fundal Massage
• Cutting Umbilical Cord
• Remove retained placenta

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Fourth StageRecovery

• Begins after placenta is delivered
• Lasts until moms condition is stable

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Happy, Healthy, Whole!

• Food
• Stitches
• Nursing
• Perineal cold packs
• Cutting Umbilical Cord

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Post-Partum Care

• Pitocin
• Oxygen
• Stitches
• Vaccine
• Antibiotics
• Pain medication
• Blood coagulants

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Cesarean Delivery

• Emergency
• General anesthesia
• Midline incision
• (classical incision)
• No partner allowed

• Non Emergency
• Epidural anesthesia
• Transverse Incision
• (bikini cut)
• Partner allowed

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Suggested Reading List

• Mothers Intention How Belief Shapes Birth
• Kim Wilder
• The Thinking Womans Guide to a Better Birth
  Henci Goer, Rhonda Wheeler
• Obstetric Myths versus Research Realities
• Henci Goer