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Prepared Childbirth
Hannilore Villamor, RN
• Historically, the term natural
   childbirth has evolved to mean:
1) delivery outside in nature
2) home birth
3) nonhospital birth (birthing center)
4) facility birth-no medical intervention
(ie, no IV, meds)
5) facility birth without analgesia or
anesthesia
PREPARED CHILDBIRTH
• Preparation through education and
  training prior to labor gives the
  pregnant woman a method of coping
  with the discomforts of labor and
  delivery
• This method incorporates analgesia
  and anesthesia into the process
• Dominates current culture in the
  United States
Psychoprophylactic or Lamaze
Method
• Psychoprophylactic childbirth has a
  rationale based on Pavlov's concept
  of pain perception and his theory of
  conditioned reflexes (the substitution
  of favorable conditioned reflexes for
  unfavorable ones)
• The Lamaze method is an example of
  this technique.
• The woman is taught to replace
  responses of restlessness, fear, and
  the loss of control with more
  controlled measures, which can
  excite the cerebral cortex efficiently
  to inhibit other stimuli such as pain
  in labor.

• The mother-to-be is taught exercises
  that strengthen the abdominal
  muscles and relax the perineum.
• Various breathing techniques to help
  the process of labor are practiced

• The woman is conditioned to
  respond with respiratory measures
  and disassociation or relaxation of
  the uninvolved muscles, while
  controlling her perception of the
  stimuli associated with labor
The Bradley Method of Delivery
• “husband-coached childbirth”
• A coach may be any significant other
  such as a friend, mother, sister,
  boyfriend, aunt, grandmother, or
  husband
• Involves the concepts of leading,
  guiding, supporting, caring, and
  fostering specific skills and
  confidence
• Coaches attend classes and learn to
  help the woman prior to initiation of
  labor

• The coach serves as a conditioned
  stimulus using the sound of his voice,
  use of particular words, and
  repetition of practice.
• Medications are not encouraged for
  pain relief
• Relaxation is the core component
• Increased tolerance to pain is
  accomplished by decreased mental
  anxiety and fear, which ultimately
  decreases the awareness of the pain
  stimulus
• This occurs through cognitive and
  physical rehearsal
HOME DELIVERY
Motivations for home delivery:
• Increases patient choices and
  flexibility during the birth process
  while decreasing patient separation
  and fear of intrusive intervention

• Rising costs of hospitalization
• Desire to avoid such practices as
  routine cesarean delivery for breech
  presentation, episiotomy, forceps
  delivery, oxytocin stimulation,
  routine monitoring of the fetal heart
  tones, and other practices associated
  with facilities

• Risk of in-hospital infections; belief
  that infant is immune to own-home
  bacteria.
Contraindications:
• High-risk pregnancy

• History of:
  • premature or postdate delivery in
    previous or current pregnancy or
    previous cesarean delivery
  • Preeclampsia
  • gestational diabetes
• Woman with medical, surgical, or
  emotional complications

• Fetal complications
   • cardiac anomalies
   • placental abnormalities
Alternatives to home delivery:
• Family-centered hospital setting

• Birthing centers with adequate
  facilities for emergency care for low-
  risk women
Home Delivery is highly
discouraged by the DOH in
   the Philippines due to
increased risk for maternal
    and neonatal deaths.
Prepared childbirth

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Prepared childbirth

  • 2. • Historically, the term natural childbirth has evolved to mean: 1) delivery outside in nature 2) home birth 3) nonhospital birth (birthing center) 4) facility birth-no medical intervention (ie, no IV, meds) 5) facility birth without analgesia or anesthesia
  • 3. PREPARED CHILDBIRTH • Preparation through education and training prior to labor gives the pregnant woman a method of coping with the discomforts of labor and delivery • This method incorporates analgesia and anesthesia into the process • Dominates current culture in the United States
  • 4. Psychoprophylactic or Lamaze Method • Psychoprophylactic childbirth has a rationale based on Pavlov's concept of pain perception and his theory of conditioned reflexes (the substitution of favorable conditioned reflexes for unfavorable ones) • The Lamaze method is an example of this technique.
  • 5. • The woman is taught to replace responses of restlessness, fear, and the loss of control with more controlled measures, which can excite the cerebral cortex efficiently to inhibit other stimuli such as pain in labor. • The mother-to-be is taught exercises that strengthen the abdominal muscles and relax the perineum.
  • 6. • Various breathing techniques to help the process of labor are practiced • The woman is conditioned to respond with respiratory measures and disassociation or relaxation of the uninvolved muscles, while controlling her perception of the stimuli associated with labor
  • 7. The Bradley Method of Delivery • “husband-coached childbirth” • A coach may be any significant other such as a friend, mother, sister, boyfriend, aunt, grandmother, or husband • Involves the concepts of leading, guiding, supporting, caring, and fostering specific skills and confidence
  • 8. • Coaches attend classes and learn to help the woman prior to initiation of labor • The coach serves as a conditioned stimulus using the sound of his voice, use of particular words, and repetition of practice.
  • 9. • Medications are not encouraged for pain relief • Relaxation is the core component • Increased tolerance to pain is accomplished by decreased mental anxiety and fear, which ultimately decreases the awareness of the pain stimulus • This occurs through cognitive and physical rehearsal
  • 11. Motivations for home delivery: • Increases patient choices and flexibility during the birth process while decreasing patient separation and fear of intrusive intervention • Rising costs of hospitalization
  • 12. • Desire to avoid such practices as routine cesarean delivery for breech presentation, episiotomy, forceps delivery, oxytocin stimulation, routine monitoring of the fetal heart tones, and other practices associated with facilities • Risk of in-hospital infections; belief that infant is immune to own-home bacteria.
  • 13. Contraindications: • High-risk pregnancy • History of: • premature or postdate delivery in previous or current pregnancy or previous cesarean delivery • Preeclampsia • gestational diabetes
  • 14. • Woman with medical, surgical, or emotional complications • Fetal complications • cardiac anomalies • placental abnormalities
  • 15. Alternatives to home delivery: • Family-centered hospital setting • Birthing centers with adequate facilities for emergency care for low- risk women
  • 16. Home Delivery is highly discouraged by the DOH in the Philippines due to increased risk for maternal and neonatal deaths.