CHILDBIRTH EDUCATION

Grantly Dick-Read Childbirth Method Childbirth education classes allow expectant mothers to spend time with other pregnant women who are experiencing the same fears and discomforts for the upcoming labor and delivery. Nowadays, couples are attending specific types of childbirth education classes for several reasons. One of these is to prepare themselves for labor and delivery. Others are just tagged by friends and there are some who are just joining the sessions because they know they have to. To sum it up, people are joining childbirth education classes because they want become oriented about the upcoming event in their lives (labor and delivery) and they want to make the moment as a much as possible comfortable and valuable both for the newborn and the mother herself. There are different theories governing the childbirth methods. All of these techniques help expectant couples to anticipate and prepare for what to expect during labor and delivery. Though the theories are different all the childbirth methods are promoting comfort and relaxation to the mothers and newborns making the event a less stressful and fulfilling experience. Definition Grantly Dick-read Method is a psychophysiological preparation for childbirth. This technique alleviates pain during childbirth by blocking feelings of fear and tension. Theory Women who had been prepared for childbirth still experience pain because of fears associated with the event. Dr. Dick-Read postulated that this fear felt by women during delivery causes the blood to be carried away from the uterus to be used by the muscles needing it due to perceived pain. This results to an unoxygenated uterus which would be unable to perform its function well leading to pain, a phenomenon called the fear-tension-pain syndrome. Dick-Read believed that presence of fear and tension result to labor pains. Thus, eliminating fear would increase blood supply to the uterus and alleviating labor pains. He also identified that laboring women needed constant emotional support to help them cope. Technique To prevent the fear-tension-pain cycle Dick-Read developed a method of slow abdominal breathing in the early stage of labor and rapid chest breathing in the latter stage. A woman should break the chain of events occurring (between fear and tension or tension and pain) to reduce the pain during contractions. Relaxation, comfort and minimal pain are achieved only if the woman focuses on abdominal breathing during contractions. LeBoyer Childbirth Method Childbirth education is an essential part of a successful, safe and comfortable delivery. Although all methods of childbirth education utilize different techniques they all contribute to promoting comfort during childbirth. Definition Leboyer childbirth method sometimes termed as birth without violence, views birth as a stressful experience for the newborn. The focus of this method is to primarily improve the quality of the birth experience for the baby. Leboyer Method or Technique Leboyer childhood method or birth without violence, creates an environment of serenity and peacefulness. To decrease the trauma at birth this technique is an advocate of the following:

The birthing room is darkened or dimmed. Doing so prevents

sudden contrast of light that might distress the newborn. Leboyer thought that this is less shocking for the neonates eyes that have been in semi-darkness for several months.

A soft music is played or at least harsh noises are kept to a

minimum. All the talking inside the delivery room is done by whispering.

The room is kept pleasantly warm, not chilled, to help the

newborn be comfortable with the new environment and adapt to extrauterine life more easily.

Newborns are handled gently and carefully. Leboyer

recommends not pulling the babys head to completely allow a natural childbirth.

The umbilical cord is cut late (It is cut after it has stopped
pulsating). According to Leboyer, this allows the newborn to continue receiving the maternal hormones and oxygen carrying red blood cells. This is also done to allow the baby to breathe when he is ready and not have to be rushed.

The infant receives a warm bath immediately after birth for

relaxation.

Before maternal and newborn bonding is done, the infant is

massage to ease crying. Nowadays, mothers do this massaging to encourage immediate bonding.

Placing the infant in the mothers abdomen is done

for maternal-neonate bonding. Since fewer drugs are given to the mother during delivery with this method babies are typically more alert and need less invasive measures to help them breathe. Bradley Childbirth Method Bradley childbirth method was the first technique to include the father as a support person during delivery. This method embraces the belief that childbirth is a natural event and with the right preparation most women can have spontaneous and unmedicated vaginal births. Theory Dr. Robert Bradley believed that birth is a joyful natural process and women can handle it without drugs or medical interventions. He is also an advocate to the idea that husbands are vital factors in the birthing process and early newborn period. Aside from avoiding all medications and other interventions, relaxation techniques such as abdominal breathing and breath control is taught usually for 12 weeks.

Techniques and Methods During pregnancy, a woman performs exercises to tone the muscles and omit if not minimize foods that contains preservatives, fats and salt. She should also takes early birth classes followed by weekly sessions on the sixth month until birth. The husband should actively participate during these sessions and in delivery. Throughout labor, the woman is advised to walk and use an internal focus point as a dissociation technique. Relaxation and natural breathing techniques are also employed at this point. However, there is no patterned breathing with this method. The women are just taught to breathe deeply within their abdomen. After delivery, immediate maternal-newborn bonding is promoted and breastfeeding is encouraged. Still the husband is actively participating up to this time. Bradley Method Class The Bradley program lasts for about 12 weeks. The philosophy of this method believes that it takes months to prepare the couple not only for childbirth but also for parenting. It takes pride in addressing all aspects of natural childbirth (mentally, physically and emotionally). The course is an advocate on educating the husbands to be an effective coach to their wives. The following concepts are taught in Bradley Classes: Natural birth process

The gating theory of pain refers to gate control mechanisms in the substantia gelatinosa that has the ability to stop an impulse at the level of the spinal cord so the never would not reach the brain as pain. This process is similar to that of closing a gate. The following techniques are used to assist gating mechanism:

Cutaneous stimulation
This technique involves: 1. Effleurage slow massage of the abdomen during contractions. The massage is done with just enough pressure to avoid tickling. The woman can perform effleurage using her fingertips and tracing a pattern on her abdomen. Massage and pressure on the palms and fingertips stimulate the large diameter nerves to decrease the ability of the small nerve fibers at the site of pain to transmit impulses. 2. Sacral Pressure firm pressure against the sacral area may help relieve strain on thesacroiliac joint. The partner (husband) can increase the pressure on the sacrum as soon as the contraction begins. 3. Thermal stimulation application of heat and cold stimulates the thermoreceptors thereby decreasing pain felt by the woman. This is done by wiping the womans face with cool cloths and ice chips offered to the woman for eating. In early labor a warm shower directed against the back may be soothing. 4. Positioning position changes during labor also provides cutaneous stimulation. Ambulation and fowlers position makes contractions less painful. Changing position can be done every 30-60 minutes to increase comfort. Distraction An impulse cannot register in the brain if it is distracted. Techniques of distraction are as follows: 1. Breathing techniques 2. Focal point a focal point is an object in which the woman focuses during contractions to help her direct her thoughts away from the contractions. 3. Imagery 4. Music

Active involvement of the husband as a coach Proper nutrition during pregnancy Avoidance of drugs throughout the pregnancy Natural breathing methods (without patterns) Coaching techniques Natural pain coping methods Maternal-newborn bonding Breastfeeding Education on emergent situations throughout pregnancy and delivery (CS)

Postpartum and newborn care Responsible parenthood

The physiology of labor and delivery is discussed in one of the sessions with emphasis on making the expectant mothers to believe that birth can be a joyful and natural process without drug administration and medical interventions Lamaze Childbirth Method Lamaze method is a prepared labor and delivery technique. It is often called psychoprophylactic method as it uses the mind (psyche) to prevent labor pains (prophylaxis). Theory The Lamaze method of prepared childbirth is based on the gating control theory of pain relief. It involves concentration and conditioning to help the woman respond to contractions with relaxation from techniques thereby alleviating pain. This is based on the theory that through stimulus-response conditioning, women can learn to use controlled breathing to reduce the pain in the labor. Lamaze method is the most popular approach used to today. Techniques and Methods Gating Control Theory of Pain

Reduction of anxiety
1. Giving the woman idea of what to expect during labor 2. Presence of a support person (husband) Concepts stressed in Lamaze method 1. Labor should not be induced 2. 3. 4. 5. 6. Women should move freely during labor A continuous support should be available for the woman No routine interventions should be done (IV fluids) Woman should change position during labor The newborn and mother should stay in the same room after birth and breastfeedingopportunity should be unlimited