Sunday, February 19, 2012

Unassisted birth: My "Birth Guide"

Remember that these descriptions of the stages of labor are generalizations and that you may experience some variation of 'normal'. No two labors are the same.

I. The First Stage of Labour refers to the onset of contractions until full dilation of the cervix.
Typically this stage is divided into three phases.
   Phase one - early labor, cervix dilates from 1-3cm, mild contractions with fairly long rests in        between
   Phase two - active / established labor, cervix dilates from 4-8cm, contractions longer and stronger    (45 seconds to 1 minute)
   Phase three - transition, cervix dilates from 8cm to 10cm, contractions close together and strong 1    min to 1 1/2 minutes)
It is during this stage that you will need encouragement and support from your partner and/or doula. Use a variety of natural comfort and pain relief methods, as well as various positions for labor to facilitate the dilation of the cervix.

Giving Birth Quote
"Just as a woman's heart knows how and when to pump, her lungs to inhale, and her hand to pull back from fire, so she knows when and how to give birth."
Virginia Di Orio

II. The Second Stage of Labor refers to the pushing and birth of the baby.
At this stage it is important to relax and rest whenever breaks in your contractions allow. There is no need to try to push or to push when you are told. Your body will have an uncontrollable urge to push and will automatically expel your baby.
Unnecessary pushing may tire you out or cause you to tear. Try to relax and 'breathe' your baby out!

III. The Third Stage of Labor
refers to the birth of the placenta.
Once again, ideally, nature should be allowed time to do her work. If your baby is placed skin-to-skin on your bare chest immediately after birth, this will trigger an automatic release of oxytocin, a hormone which among other things, will cause the placenta to detach from the uterus.
The length of time this may take could be between 5 to 45 minutes, depending on the type of labor and birth experience you have had up till this point. The less interventions, the better. You will experience another contraction which will expel the placenta - painlessly.

IV. The Fourth Stage of Labor refers to the first hours after birth.
The first hour is often called the 'Golden Hour', as in this hour you and your baby will enjoy your first encounter with each other. Physiologically, this first meeting will be stimulating many significant changes in both your baby and your own body, which will promote bonding, breast-feeding and other desired responses.
It is crucial that you and your baby are not separated during this hour.

Early Labor -
   -  Sleep as much as possible.
   -  If restless, One or Two drops Lavender Essential Oil on washcloth to put on pillow.
   -  If continually restless, take Chamomilla 30C tablets - Dissolve 5 tablets under tongue.

Active Labor -
   -  Light Candles, Darken house
   -  Relaxation Music
   -  If water has NOT broken, a hot bath with 1 Cup Epsom Salts and Lavender or Patchouli Essential Oil in bath or on washcloth
   -   If water HAS broken, replace 1 Cup Epsom Salts with 1 Cup Sea Salts in bath.
   -   1 pc. Rescue Gum or 40 drops Chamomile Tincture in cup of water for Birth attendants!
   -   Distilled water to sterilize Suction Bulb, Scissors, Cord ties. Bring to a rolling boil for 20-30 minutes. Spread Everything out on small Towel. Remaining boiling water can be added to bath if needed. 
   -   Prepare large Bowl or Strainer for Placenta
   -   Prepare a plate of fruit, cheese and crackers and a glass of ice water for mom.

Transition -
Transition is the most difficult phase of labor for most women; however, it is also the shortest phase generally lasting ½ hour to 1½ hours in length.

Physically, mom is experiencing contractions 2-3 minutes apart, lasting 60-90 seconds, and are very strong in intensity. Contractions may even "piggy-back" which means one contraction may start to fade away and another one comes along immediately. During this phase she may notice increased bloody show; nausea, vomiting, burping, or hiccups; shaking; hot/cold feelings; fatigue; and sensitivity to touch. Additionally, she may indicate increased pressure on the perineum and/or rectum.

Emotionally, mom can become restless, irritable, discouraged, and confused. She may find that she focuses inward as she works with her labor. She may have a hard time communicating her wishes. This is the point in labor when she usually needs the most support.

During transition, labor support is crucial for the mom's physical and emotional well-being. Partners should remain with the mom; give firm, clear, positive, and simple directions; remind her to change her positions; assist with breathing patterns; offer a cool washcloth for her brow and lip balm; and keep her hydrated with water and/or ice chips. Remind her to take one contraction at a time and not to give in to the panicky feelings. If Mom Panics: call her by name, take her face in your hands, develop and maintain eye contact, breathe with mom or talk her through the contraction, try variations in breathing patterns, and give lots of reassurance that she is near the end! Remember, any questions for mom should be asked BETWEEN contractions and not during.

    -   Have bowl on hand in case of vomiting
   -   Dissolve 5 tablets Arnica Montana 30C under tongue to help prevent bruising/soreness after birth
   -   Additional Rescue Gum or Chamomile Tincture for birth attendants
   -   Encourage mom to try different positions and low back massage for pain relief
   -   Warm or Cool Washcloth compress for forehead
   -   Encourage and remind mom to loosen muscles and not to tense up

Pushing/Birth -
   -   Encourage to “breathe baby out” rather than actively pushing to reduce risk of tearing. WARNING- She may not appreciate any “suggestions” at this point.
   -   Pushing during contractions is important to help with pain and reduce risk of tearing.
   -   Visually check for baby’s position if possible. If the baby is not head down, the baby should NOT be handled or turned in any way before the head is delivered to prevent injury to baby. In this situation, it is important that baby should be born without interference. This is not an emergency or complication; just a variation of normal.
   -   If umbilical cord is wrapped around baby’s neck, cord can be gently slipped over baby’s head.
   -   Baby should be placed face down on mother’s chest after birth.
   -   It is normal for baby not to cry or breathe immediately after birth. It is also normal for baby to be Pink, Blue, or Purple at birth. The umbilical cord will continue to transfer oxygen to baby until baby can breathe on his or her own. If baby is not pink at birth, the bottoms of the feet and back can be massaged to stimulate breathing. If baby is Grey or White, baby’s mouth and nose can be aspirated with bulb suction along with massage. If baby is limp and does not respond to massage and suction, breathe gently into baby’s mouth to stimulate breathing reflex.
   -    Umbilical cord should not be cut until placenta has been delivered and cord stops pulsing.
   -   Placenta should be checked to make sure it is whole and no pieces were retained in the uterus.
   -   Breastfeeding baby at this point will stimulate the release of the hormone oxytocin which will help the placenta detach from the uterus. It’s normal for baby not to want to nurse right away if baby has swallowed amniotic fluid, etc.
   -   Shepherd’s Purse Tincture can be given after birth to help with bleeding. Dosage is 40 drops into a small cup of cold water.
   -   If part of placenta is retained in the uterus, 5 Sabina 30c tablets or piece of placenta may be dissolved under tongue for treatment of hemorrhage.

After Birth/Baby -
   -   After cord has stopped pulsing and placenta has been delivered, umbilical cord should be tied with a square knot about 4 inches away from baby and tied again about 2 inches higher (towards placenta). Cord can be cut between the two ties.
   -   A Square knot is made by bringing the left end of the tie over the right end for the first loop and the right end over the left end to form the second loop; both loops tightened. The resulting knot is square-shaped.
   -   Bed should be prepared for mom with waterproof pad and warm blanket.
   -   Baby should be gently rinsed with clean warm water. Vernix (white waxy substance) should be massaged into the skin (protects and heals the skin).
   -   Baby can be dressed in warm clothes, and weighed and measured at leisure.

Placenta -
   -   Placenta should be placed in strainer to be rinsed in the kitchen sink after birth.   
   -   Placenta can be stored safely in an airtight container for up to 24 hours in the refrigerator or may be frozen before use if necessary.
   -   After rinsing and removing membranes and remaining umbilical cord, placenta should be cut into small, thin(ish) pieces to aid in the drying process. Rubber or Latex Gloves are probably a good idea.
   -    Spread placenta pieces onto baking sheet and put in oven on the lowest setting overnight.
   -   Placenta will look like charred blobs when finished drying. Pieces should crack apart easily and not “bend” if totally dry.
   -   Once Placenta is dry, it can be stored in a cool, dark place until ready to use.
   -   Placenta should be ground into a powder and can then be encapsulated or stored as a powder to be added to smoothies or juices later. 

Disclaimer: The information on this site is not intended or implied to be a substitute for professional medical advice.

Sources and additional information:
Stages of Labour
Information about Placenta Benefits
A Simple Guide to Emergency Childbirth

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