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PREPARATION FOR CHILDBIRTH AND PLANNED PARENTHOOD.

Goals of childbirth preparation:


To provide parents with the knowledge and skill they need to cope with stress of pregnancy, labor and birth. To prepare parents to be intelligent consumers of maternity care. To assist parents in achieving a safe, positive and rewarding labor and birth experience.

Birth Plan : is set of instructions prepared in advance for the medical professionals who will help you through the delivery process.

Choosing

the birth settings

Sibling

preparation for birth Classes for Family Members during Pregnancy

Giving Birth in a Hospital Out-of-Hospital Births

Antepartal education

Class content

Early gestational changes. o Self-care during pregnancy. o Fetal development, environmental dangers for the fetus. o Sexuality in pregnancy. o Birth settings and type of care providers. o Nutrition, rest and exercise suggestions. o Relief measures for common discomfort of pregnancy. o Psychological changes in pregnancy. o Information for getting pregnancy to a good start.
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Early classes ( 1st trimester)

Later classes ( 2nd and 3rd trimesters)


Preparation for birth process. postpartum self care birth choices( analgesia, fetal monitoring etc) relaxation techniques infant stimulation, care and feeding Newborn safety issues.

Adolescent parenting classes

How to be a good parent. o Newborn care o Health dangers for the baby o Healthy diet during pregnancy o How to recognize when baby is ill, protecting from accidents o Baby care: physical and emotional, make the baby feel happy and loved

Breast feeding programs

Methods of breast preparation o Techniques of breast feeding o Advantages of breast feeding o Involvement of fathers in feeding process

Sibling preparation: Adjustment to newborn Classes for grand parents

Education of the family having cesarean birth Preparation for cesarean birth
Participating in the choice of anesthetic Father (significant other) being present during birth Planning initial contact with their newborn

Preparation for repeat cesarean birth Preparation for couples desiring vaginal birth after cesarean birth (VBAC)

PSYCHOPROPHYLACTIC (LAMAZE) METHOD: Topics covered in Lamaze classes Normal labor, birth and early postpartum Positioning to facilitate the normal progress of labor and birth Massage techniques to ease the pain of labor and to enhance relaxation Comfort measures, such as hydrotherapy, the use of heat, cold and pressure Relaxation skills to use during labor and after pregnancy to relieve stress Labor support advice for the partner and the professional (doula)

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Communication skills between the pregnant woman and her partner, and with members of the healthcare team Problems that could occur during labor and birth Guidance for the pregnant woman to make informed decisions about anesthesia and medical procedures Breastfeeding and the early postpartum period Healthy lifestyles for pregnancy and postpartum period Background about epidurals and other anesthesia choices to enable you to make the best choice for yourself Breastfeeding and the early postpartum period

Body conditioning exercises Relaxation exercises Breathing techniques: it uses 3 patterns of chest breathing which vary. The woman is taught to use one pattern until it is no longer effective, then move on to another. First pattern: it is called slow paced breathing. During the breathing movements only the chest moves. The woman inhales slowly through her nose. She lifts her chest up and out during the inhalation. She exhales through pursed lips. The breathing rate is 6-9 breaths a minute( 2 breaths every 15 seconds)

o Second

pattern: also called shallow breathing or modified-paced breathing. The woman begins with a cleansing breath and at the end of this she pushes out a short breath. She then inhales and exhales through the mouth at a rate of about 4 breaths every 5 seconds. She keeps her jaw relaxed and her mouth slightly open. The air should move in and out smoothly and silently and the breathing should be mouth centered.

Third pattern: it is also called pant-blow or pattern-paced breathing. The breathing is punctuated every few breaths by a forceful exhalation through pursed lips. A variation of this pattern consists of drawing the lips back to the teeth and making a hee sound with the exhalations. The forceful exhalation is through more pursed lips making a hoo sound.A pattern of 4 breaths may be used to begin. All breaths are kept equal and rhythmical. As the contractions become more intense, the pattern may be changed to 3:1, 2:1and finally 1:1.

o Second

stage breathing: in the second stage of labor the woman may assume any comfortable physiologic position, take several deep breaths, then hold her breath, bulge abdominal muscles, relax the perineum and push out through the vagina. This pushing effort is repeated throughout the contraction, timed and coached by the partner.

BRADLEY METHOD

It places an emphasis of natural approach to birth and on active participation of the babys father as the birth coach. Major goal is avoidance of medications unless absolutely necessary and working in harmony with the body using abdominal breathing and general body relaxation. Bradley Method natural childbirth classes offer 12 weeks of comprehensive education: information designed for couples planning to give birth in the hospital or at home. They total 24 hours of quality instruction, labor rehearsal, medical information, communication suggestions and more.

The

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Bradley Method of Natural Childbirth promotes: Natural childbirth Active participation by the husband as coach Excellent nutrition Avoidance of drugs during pregnancy, birth and breastfeeding Training and preparation Relaxation and natural breathing Understanding your body and working with it Breastfeeding your baby Parents preparing for unexpected situation

DICK -READ METHOD Conscious relaxation: progressive relaxation of muscle groups in entire body. Breathing technique: primarily abdominal. Woman concentrates on forcing the abdominal muscles to rise. Works on slowing number of respiration/ minute so that she can take 1 breath /minute. Slow abdominal breathing during 1st stage. Rapid chest breathing used towards end of labor if abdominal breathing not sufficient; panting is used to prevent pushing until needed. Physical exercise: to prepare body for labor.

KITZINGER METHOD: It uses sensory memory to help the woman understand and work with her body in preparation for birth. Uses chest breathing in conjunction with abdominal relaxation.
GAMPER METHOD: self determination and confidence instilled by instructor in the ability of the women to work and cooperate with the natural forces of childbirth. The emphasis is on the contraction rather than away from the contraction. Classes begin early in pregnancy so that the feartension-pain cycle can be broken and new self confidence instilled early on

SIMKINS METHOD: this approach works with the strength of the couple giving birth. They are encouraged to use whatever means of breathing and style which helps them as individuals. An electic mix of techniques is taught.
NOBLE METHOD: it involves relaxation of pelvic floor muscles and learning ways to relax them. Her gentle pushing or breathing the baby out technique is now incorporated in many classes. Her approach emphasizes woman listening to their body.

LE BOYER METHOD: introduced by French obstetrician in the 70s allow the baby to be born amid dim lights and soft voices. The baby is given a warm water bath, and then placed on mothers abdomen for bonding. They are handled gently and without certain movement that may jar or startle the baby. Babies are massaged at birth to start breathing.
ODENT METHOD: Michael Odent another French physician introduced this. He put mother and baby both in warm water and allowed his laboring mothers to submerse in a pool of water. It appears to help some women ease labor pain.

Supporting

the support person Providing comfort and reassurance Maintaining relaxation and concentration Giving information Supporting the unprepared women

In 1916 Margaret Sanger founded the Planned Parenthood Federation of America. National Birth Control League in1917. International Planned Parenthood Federation, in 1952 with goal every child a wanted child

Friedmans

4 stages of Planned Parenthood (1957) o Anticipatory o Honeymoon o Plateau o Disengagement

The

(1981), psychologist Ellen Galinsky

Six Stages of Parenthood

Parental Image Stage o Nurturing Stage o Authority Stage o Independent Teenage Stage o Departure Stage
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Allocation of power and decision making Value placed on education Locus of control Time orientation Perception of roles Socio economic status Parent education program

Providing

trusted community health care Informing and Educating the Community Leading the Reproductive Health and Rights Movement Advancing Global Health

Since 1972, (PPFA) has been working in India to improve the sexual and reproductive health of women, men, and youth. Four partners, The Child in Need Institute, Tata Steel Family Initiative Foundation, Prerana, and Action Research and Training for Health, oversee similar projects countrywide and follow the same innovative program models. The current phase of our youth program in India focuses on adolescents aged 15-19.

It is a vital step in economic and social planning. It maintains peace and harmony within the family and also assists the government to provide better living condition to all people. It improves socio cultural changes which are accompanying the developmental processes. It provides an opportunity for the couple to decide the family size, budgeting the family expenses. Provides congenial and conflict free environment. Promotes safe motherhood techniques and procedures.

Promote the health and welfare of mother and children specific and the family and total community in general. Reduces the morbidity and mortality of mother and child. Makes the woman, couple and other family members within the family to accept and adopt the changes in a holistic manner. Receiving proper guidance and counseling techniques with appropriate health care professionals. Parents will be able to will be able to give proper attention and concern for childs developmental activities.

Ladewig PW, London ML, Olds SB. Maternal newborn nursing. California: Addison Wesley nursing; 1994. Orshan SA. Maternity, Newborn and Womens health nursing. Philadelphia: Lippincott Williams and Wilkins ; 2008 Pilliteri A. Maternal and child health nursing. Philadelphia: Lippincott Williams and Wilkins; 1999 Fraser DM, Cooper MA. Myles textbook for midwives. 14th edition. London: Churchill Livingstone; 2003 Varney H, Kriebs JM , Gregor CL. Varneys textbook of midwifery . 4th edition. New Delhi: Elsevier; 2005 Novak C.J ,Broom B.L . Maternal and Child Health Nursing. 9th edition. Missouri: Mosby Inc; 1999. May AK, Mahlmeister LR. Comprehensive Maternity Nursing. 2nd edition. Philadelphia: Lippincott; 1990.

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