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The Birth Process

The Birth Process. Mamie Guidera, CNM, MSN Carol O’Donoghue, CNM, MSN, MPH. Normal Labor and birth: Objectives. Introductions Physiologic labor and birth: the basics Phases of labor Birth video The P’s: Power, passageway, passenger, etc. Briefs: American birth & (some of the) influences:

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The Birth Process

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  1. The Birth Process Mamie Guidera, CNM, MSN Carol O’Donoghue, CNM, MSN, MPH

  2. Normal Labor and birth: Objectives • Introductions • Physiologic labor and birth: the basics • Phases of labor • Birth video • The P’s: Power, passageway, passenger, etc. • Briefs: • American birth & (some of the) influences: • Where births take place • Cultural expectations of pain management • A word on Fetal Monitoring

  3. Here’s the truth: Childbirth is not only a physiologic phenomenon, but a cultural/sociological experience. So before you walk onto the Labor Floor, ask yourself: • Where/how did you first learn about how a baby is born? What do you know about your own birth? • Who (family member, friends, healthcare provider) or what (your medical training, book, television show, movie) has influenced your perception of labor? What birth stories come to your mind first? • Is there such a thing as “good” pain? If you are an athlete, have you ever sought out physical discomfort? Why? • Have you ever been in pain? How did you deal with it? • What do you think is the role of the healthcare provider in birth?

  4. Birth in the United States • Site of birth • Hospital • Birth Center • Home • Model of birth • Medical Model • Midwifery Model

  5. Stages of Labor • First stage: early, active, transition • Dilatation • Second stage • Pushing and birth • Third stage • Delivery of placenta • Fourth stage • Postpartum

  6. True vs False Labor: Williams Obstetrics (22nd edition) True Labor: • Contractions occur at regular intervals • Intensity gradually increases • Discomfort is in the back and abdomen. • Cervix dilates. • Discomfort is not stopped by sedation • Contractions are irregular • Intensity remains the same • No cervical dilatation • Discomfort relieved by sedation

  7. Woman/Fetus Power Passageway Passenger Position Psyche Providers/Support Persons: Patience Persistence Practice/ Pain Relief Psyche The Ps of Labor

  8. The PassagePelvic Bones and Pelvimetry

  9. The PassagePelvic Bones and Pelvimetry

  10. Passenger: Attitude

  11. Passenger: Presentation

  12. Passenger: Presentation

  13. Perineal management (keep your hands off Mirror Ask mother to feel the baby’s head Stay focused on woman, not tasks Birth

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