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Ready class? RELAX!!! . Objectives. Discuss the evolution of relaxation as a labor coping skill. Describe the physiologic response to stress in labor and the impact of eliciting the relaxation response on labor coping abilities.
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Objectives • Discuss the evolution of relaxation as a labor coping skill. • Describe the physiologic response to stress in labor and the impact of eliciting the relaxation response on labor coping abilities. • Experience a variety of relaxation exercises designed for use in a childbirth class. • Choose and use at least two ways to teach expectant parents about the use of relaxation in labor and birth.
STRESS Any perceived threat, which results in the release of… CATECHOLAMINES
Typical Human Stress Response heart rate & blood pressure Pupils dilate Digestion slows Glucose released from liver Blood shunted to skeletal muscles and vital organs Air passages widen, oxygen uptake
Is labor stressful? Yeah.
Stressors in labor • Imposed restrictions • Strange environment • Perceived threat (interventions, staff) • Cold • Pain • Hunger
Labor induction or augmentation EFM Internal EFM Vaginal exams IVs Administration of analgesia Administration of anesthesia Restriction to bed Restriction of drink Unfamiliar doctor Episiotomy & repair Forceps Vacuum Limited time with baby after birth Circumcision Simkin Study (1986) –16 events described as VERY stressful
Two ways to be relaxed in labor… 1. AVOID or REDUCE the existing stressors 2. Use relaxation and other techniques to deal with remaining stress.
AVOID or REDUCE Stressors • Alter environment (lighting, sounds, privacy, people, temperature) • Enhance physical comfort (positioning, pillows, temperature, touch, massage) • Calm the psyche (visitors, music, soft voice, white noise) • Distraction (talking, breathing patterns, focal point) • Practice decision-making skills
FEAR - TENSION -PAIN FEAR PAIN TENSION
Stress response in labor… • Part of the fetal ejection reflex • newborn alertness & readiness for the outside world maternal ferocity and aggressiveness the release of vasopressin, which interferes with oxytocin Cold and shaky feeling • Forgetfulness
Female Stress Response • Catecholamines are released… • Because we have estrogen and access to oxytocin …women tend to react differently seeking to… • Tend & befriend (calm & connection)
The release of oxytocin causes… blood pressure stress hormones; causing the tend and befriend effect Facilitates reproduction (facilitates mating by making certain men more attractive to us, sperm ejection reflex, fetal ejection reflex & milk ejection reflex, bonding) pain threshold sleepiness, feeling of laziness muscle tension, relaxing (less circulation to muscles)
calming, less upset about life’s big problems, peaceful curiosity and a sense of closeness to the people nearby, trust, daring (more courage = less fear) desire to please people Openness to touch Increases digestion and fat absorption and storage Releases stored nutrients to make milk appetite skin and mucous membrane circulation
Fosters love of infant, creates emotional bond Sensitive to other’s feelings, recognize non-verbals Causes blood vessels on the front dilate (rosy cheeks & warm chests) Facilitates learning wound healing (twice as fast) Induces social memory and calmness in infant Buffers Prolactin’s response to stress
Stress Warmth Stroking Sexual stimulation Descent of the fetus Good food Companionship (doulas) Quiet & low light Meditation & visualization Positive thoughts & memories Movement Suckling Pleasant smells & sounds Oxytocin Oxytocin is stimulated by...
Sample Spiral… • What is relaxation? (previous knowledge) • Relaxation breath (new simple skill) • Relax with breath (add new skill) • Breathing awareness (add touch) • Roving body check (reinforce touch)
Continuing… • Moving into relaxation (new skill) • Relaxation, rhythm and ritual (putting it all together) • Releasing to birth • Birth visualization • Parenting/breastfeeding visualization