CMCA: PREPARING A FAMILY FOR CHILDBIRTH AND PARENTING
WHAT DO YOU THINK ARE THE THREE
IMPORTANT DECISIONS FAMILIES NEED TO
MAKE?
A. How much and what type of analgesic
they want to use in labor
B. Choice of food intake
C. Choice of setting
D. Choice of birth attendant
CHILDBIRTH EDUCATION
 Assessing whether couples need a preparation
for childbirth or parenting class: help family
bond with its new member, and become
effective parents
 Vaginal birth after cesarean (VBAC): women
who are having scheduled cesarean birth can
attend classes specially designed for them
 Goal of childbirth education: prepare expectant
parents emotionally and physically for
childbirth while promoting wellness behaviors
that can be used by parents and families for life
CHILDBIRTH EDUCATORS AND METHODS
OF TEACHING
 Are health care providers who usually have a
professional degree in the helping professions as
well as a certificate from a course specifically
about childbirth education.
 Most classes are taught in a group format; most
incorporate a variety of teaching techniques
such as videotapes and slides, lecture, and
demonstration (especially for content on
relaxation and breathing techniques)
CHILD BIRTH PLAN
 Include information such as their choice of
setting, birth attendant, special needs such as the
extent of family participation they wish during
labor, birthing positions, medication options,
plans for the immediate postpartum period and
baby care, and family visitation
 Be certain it includes flexibility as well as is
centered on the ultimate goal of childbirth
PRECONCEPTION VISITS
Are specific visits for couple who plan to get
pregnant within a short time and want to know more
about what they can expect pregnancy to be like and
what birth setting and procedure choices exist
EXPECTANT PARENTING CLASS
 Are designed for couples who are already
pregnant.
 They focus on family health during a pregnancy,
covering such topics as the psychological and
physical changes of pregnancy, pregnancy
nutrition, routine health care such as dental
checkups, and newborn care.
BREASTFEEDING CLASSES
Designed to help women learn more about
breastfeeding over bottle feeding and continue it at
least for 6 months following their child’s birth
NEW RESEARCH: Educating fathers on
breastfeeding and breast milk increases the rate and
continuity of exclusive breastfeeding.
EXERCISE DURING PREGNANCY
 Will both increase blood circulation to the fetus
and help prevent excessive weight gain in the
mother
 Do not enroll or participate without obstetric
provider approval
PRENATAL YOGA
 Aimed at helping a woman relax and manage
stress better for all times in her life, not just
pregnancy.
 Help a woman stay overall fit by their focus
on gentle stretching and deep breathing
 Help a woman experience high self-esteem as
she matters difficult levels at positions
 Yoga breathing techniques: useful in labor
to help both relaxation and pain management
 Caution women, as pregnancy progresses,
that it will become difficult to maintain
difficult yoga positions that involve balancing
 Use chair or wall for stabilization
 Avoid twisting exercises late in pregnancy
PERINEAL ABDOMINAL EXERCISE
 Reduces discomfort, and helps perineal
muscles
 Function more efficiently after childbirth,
which helps reduce the possibility of urinary
incontinence
 Best, however, for woman to set aside a
specific time each day for practicing
exercises, otherwise, her participation may be
sporadic.
PELVIC FLOOR CONTRACTIONS (KEGEL
EXERCISES)
 Can be done easily during daily activities
 While sitting at her desk or working around
the house, the woman can tighten the muscles
of her perineum by doing Kegel exercises
 Reduce pain and promote perineal healing
 Long term effects of increasing sexual
responsiveness
CMCA: PREPARING A FAMILY FOR CHILDBIRTH AND PARENTING
 Prevent stress incontinence
TAILOR SITTING
 Done in a way that stretches perineal muscles
without occluding blood supply to the lower
legs
 Good position to use to watch tv, read, talk to
friends on the phone, or file papers in a lower
cabinet at work.
SQUATTING
Also stretches the perineal muscles and can be
useful position for second-stage labor as well and,
like tailor sitting, should be practiced for about 15
minutes a day.
ABDOMINAL MUSCLE CONTRACTIONS
 Help strengthen abdominal muscles during
pregnancy
 Prevent constipation
 Help restore abdominal tone after pregnancy
 Can be done in standing or lying positions
PELVIC ROCKING
 Helps relieve backache during pregnancy and
early labor by making lumber spine more
flexible
 Can be done in variety of positions: on hands
and knees, lying down, sitting or standing
BIRTHING AIDS
 Discover what activities that could use as
distraction
 Use an exercise ball, jacuzzi tub or change of
position such as squatting, swaying with a
partner or rocking in a chai
METHODS TO MANAGE PAIN IN
CHILDBIRTH
1. The Bradley (Partner-Coached) Method
 originated by Robert Bradley, is based on the
premises that pregnancy and childbirth are
joyful natural processes and that a woman’s
partner should play an important role during
pregnancy, labor, and the early newborn
period
 a woman performs muscle-toning exercises
and limits or omits foods that contain
preservatives, animal fat, or a high salt
content.
 she reduces pain in labor by abdominal
breathing
 she is encouraged to walk during labor and to
use an internal focus point as a disassociation
technique
2. The Psychosexual Method
 developed by Sheila Kitzinger in England
during the 1950s.
 the method stresses that pregnancy, labor and
birth, and the early newborn period
 it includes a program of conscious relaxation
and levels of progressive breathing that
encourage a woman to “flow with” rather
than struggle against contractions
3. The Dick-Read Method
 is based on an approach proposed by Grantly
Dick-Read, an English Physician
 the premise is that fear leads to tension,
which leads to pain
LAMAZE PHILOSOPHY
six major concepts are stressed:
1) Labor should begin on its own, nit be induced
2) Women should walk, move around, and change
positions throughout labor
3) Women should bring a loved one, friend, or doula
for continuous support
4) Interventions are not medically necessary should
be avoided
5) Women should be allowed to give birth in other
positions than on their back and should follow their
body’s urges to push
6) Mother and baby should be kept together after
birth, best for mother, baby and breastfeeding
A. CONSCIOUS RELAXATION
 learning to relax body parts by deliberately
relaxing one set of muscles, then another and
another until her body is completely relaxed
 her support person concentrates on noticing
symptoms of tension such as a wrinkled brow,
clenched fists, or a stiffly held arm
 place comforting hand on tense body area or tell
to relax
B. THE CLEANSING BREATH
 woman breathes in deeply and then exhales
deeply
 limits the possibility of either hyperventilation
(blowing off too much carbon dioxide) or
hypoventilation (not exhaling enough carbon
dioxide)
 helps ensure an adequate fetal oxygen supply
CMCA: PREPARING A FAMILY FOR CHILDBIRTH AND PARENTING
 if woman become light-headed from late; and the infant is placed immediately
hyperventilation, breathe into paper bag after birth into a warm-water bath.
C. CONSCIOUSLY CONTROLLED  reduce spontaneous respirations and allow a
BREATHING high level of acidosis to occur.
 set breathing patterns at specific rates, provides  Late cutting of a cord can lead to excess
distraction as well as prevents the diaphragm blood viscosity in a newborn
from descending fully and putting pressure on 2. Hydrotherapy and Water Birth
the expanding uterus.  Reclining or sitting in warm water during
D. EFFLEURAGE labor can be soothing; the feeling of
 French for “light abdominal massage,” done weightlessness that occurs under water as
with just enough pressure to avoid tickling well as the relaxation from the warm water
 Serves as a distraction technique and decrease a both can contribute to reducing discomfort in
sensory stimuli transmission from abdominal labor
wall, helping limit local comfort 3. Unassisted Birthing
E. FOCUSING OR IMAGERY  Refers to women giving birth without
 Focusing intently on an object (sometimes healthcare provider supervision
called “sensate focus”) is another method of  A woman learns pregnancy care from reading
keeping sensory input from reaching the cortex books or articles found on the Internet and
of the brain. then arranges to have her childbirth at home,
 Other women use imagery by imagining they perhaps accompanied by her family or friends
are in a calm place such as on a beach watching but without healthcare supervision
waves rolling in to them or relaxing on a porch  Believe birth is such a natural process that no
swing medical supervision is necessary
F. SECOND-STAGE BREATHING  No health insurance and so can’t afford
 Now it is believed that holding the breath for a  Potentially dangerous
prolonged time impairs blood return from the
vena cava (a Valsalva maneuver), so this is now
discouraged. Based on this, most classes suggest
that women breathe any way that is natural for
them, except holding their breath during this
stage of labor.
PREPARATION FOR CESAREAN BIRTH
 to ensure a safe birth and what a couple can
expect if this happens is covered in most
childbirth classes, although as vaginal birth is
encouraged, this may be done to varying
degrees
THE BIRTH SETTING
1. Choosing a Birth Attendant and Support Person
2. Choosing the Birth Setting
a. Hospital Birth
b. Postpartum care
c. Alternative Birthing centers (ABSs)
d. Home Birth
LYING INN IN THE PHILIPPINES
ALTERNATIVE METHODS OF BIRTH

1. Leboyer Method
 Frederick Leboyer was a French obstetrician
who postulated that moving from a warm,
fluid-filled intrauterine environment to a
noisy, air-filled, brightly lit birth room creates
a major shock for a newborn
 Leboyer method, the birthing room is
darkened so there is no sudden contrast in
light; it is kept pleasantly warm, not chilled.
Soft music is played, or at least harsh noises
are kept to a minimum.
 The infant is handled gently; the cord is cut