Lamaze Magazine 2008 - (Page 13) By Judith A. Lothian, RN, PHD, LCCE, FACCE and Kathryn McGrath, MSW, LSW, CD(DONA), LCCE, FACCE | | | | Do something active during contractions, such as breathing in a pattern or moving around, and rest in between. As the strength of your contractions increases, so does your need for support. All present should focus their attention solely on you. Changing positions helps you stay more comfortable and enhances progress. The environment can influence your labor. Make it peaceful and personalize it with music and dim lights. | | Just before the baby is born, you may feel a burning, stinging, stretching sensation at the vaginal opening. As the baby’s head emerges, it turns to one side to allow the shoulders to align, then the rest of the baby’s body slips outs. Second Stage Transition WHAT’S HAPPENING | The cervix finishes dilating and begins the transition from opening to pushing. | Contractions are now powerful and efficient, so this phase is usually quite short (less than an hour). | Some women feel nauseous, shaky, restless or irritable. WHAT HELPS | To keep from feeling overwhelmed, focus on one contraction at a time. | Continue with breathing, vocalization (if it helps) and rhythmic movement. | Even though rest periods are short, they allow you to relax and restore yourself. | Those providing labor support should offer undivided attention, unwavering encouragement and praise. If you’re using a breathing pattern, your team should try “conducting” to help you focus or moving with you in rhythm to your breathing. Birth WHAT’S HAPPENING | The baby makes its way down through the pelvis and birth canal. | This phase can last from 15 minutes to several hours. | Although it may take several contractions after full dilation to be noticeable, most women get an urge to bear down. The urge to push usually gets stronger as the baby descends. | Many women feel more clearheaded and have a renewed sense of optimism when pushing begins. WHAT HELPS | The urge to push is usually strongest at the peak of contractions, then fades. Just follow along and do what feels right. For most women, this means taking normal breaths as the contractions build and then pushing when it becomes irresistible. | It may help to make sounds (like athletes do) in response to what you’re feeling. | Labor supporters should provide quiet, reassuring encouragement. | If progress is slow, change positions. Squatting, all fours and side-lying are all good options. | Let go of any tension in your perineum. Applying warm compresses there may help you push. | Rest deeply between contractions. SECOND STAGE: The baby’s head emerges. With the next few contractions, he turns to one side and the rest of his body slips out. Third Stage Recovery WHAT’S HAPPENING | Your baby is placed on your abdomen and quickly dried, and the cord is cut. | What a mix of feelings: excitement, joy, awe and relief! | The placenta is delivered, usually within the first 10 minutes. | Cold compresses are often applied to the perineum to ease discomfort and reduce swelling. | Many women get afterpains or “the shakes” after birth. WHAT HELPS | Touch, caress and cuddle your baby without time constraints. Keep him skin-to-skin with you from birth. | Do your first breastfeed, which tightens the uterus and decreases bleeding. | All routine infant procedures can be done without removing the baby from your side. Request that measuring, weighing and applying eye medication be delayed for a few hours. | LAMAZE MAGAZINE 2008 13 LAMAZE.ORG http://LAMAZE.ORG
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