Progression of labour ... a new insight.


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There's one blunt way to say this ... 'Don't waste one contraction'.

Too many women waste heaps of contractions and spend hours in labour longer then necessary. The most common cause of delayed labour is getting into positions that ease off contractions because you can't cope with the pain. Or because you can't read whether the contraction is effective. Or because you're tense.

Medically a progressive birth is determined by a narrow perception ... 'approximately 1 cm dilation per hour'. That's nuts really. 30% of women have a progressing labour but don't dilate until the very end. How do they know the labour is progressing? Because the contractions get longer, stronger and closer together.

This means ... and yes it does mean this ... when contractions stay the same for hours the labour is not progressing. Yet most women are permitted to have ineffective contractions for hours and hours because there is an honest belief there's nothing you can do about it. Skills are the solution. Honestly, skilled families are much less likely to let labour linger because they have the skills to work through each contraction, get into positions that are effective, stay open inside the pelvis and cope with the natural occurring pain of each contraction.

When labour is progressing, most women cope because they sense 'things are moving along'. When labour is not progressing women will say 'I just feel the contractions are the same'.

The bottom line of this resource? Become skilled and many of the Pink Kit skills are mentioned in the Powerpoint. Why are these skills so essential? They were developed by hundreds of ordinary families in the early 1970s so you can trust them to be effective.

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  • Progression of labour ... a new insight.

    1. 1. PROGRESSION Getting from Here to There in Labor1
    2. 2. The Journey  Birth is a journey. If you look toward the end, it can seem too far away.  Progression is how you get to and through that end and keep your sanity in the meantime. You must focus on what is immediate.  That’s how the athlete, dancer, or artist with skills behaves, and your job is the same as theirs.  The goal is reached by the small, discrete steps you take now.
    3. 3. Three Timeframes 1st Stage  During this Stage, your baby moves down through the hole in your pelvis, and your cervix opens.  At the end of 1st Stage is a period of labor called “transition,” which can be the toughest, yet shortest, part of 1st Stage. This is the period when the cervix opens entirely and your baby’s head moves all the way through your pelvis and into the top of your vagina (its birth canal).
    4. 4. 2nd Stage  This Stage is what people call the “delivery” or “birth”. Your baby moves through and out of your vagina and into your arms. 3rd Stage  This Stage is when you deliver the afterbirth/placenta.
    5. 5. What is Labor?  Labor is composed of contractions and a space between.  Your baby stimulates its home. Stimulation causes the uterus to tug open its closure.  Tugging open is the contraction, and then the uterine muscle rests, which is the space in between.  Contraction has five phases, and you will work through each phase.
    6. 6. An important factor of labor  You will inhale and exhale through one breath cycle after another, so use effective, sustainable breathing skills that give you the ability to work and cope with the sensations of each contraction.  Your body will always be in some position or posture throughout the labor, so learn how to find positions that truly relax you inside, help you stay open, and create space for your baby to move through and out of your body.  Your husband/partner will be there to help you cope with the hard work. This is not the same role as for your birth provider.
    7. 7. What can you expect during progressive labor?  Most people think that the three stages of childbirth each have a very clear beginning and ending. That’s not always accurate. The beginning part of 1st stage can be terribly unclear, manifesting as “false labor,” “pre labor”, “niggling labor”, or non progressive labor”.  The other end of the 1st stage is “active labor”  Active labor is NOT the same as progressing labor. Women can be in active non-progressing labor.
    8. 8. During progressive labor(which happens in the 1st stage)  Contractions get longer (timeable),  The space between contractions gets shorter (timeable), and  Contractions get more intense (not timeable, but felt by the woman). Short form for this: longer, stronger, closer together.
    9. 9. An important factor about progressive labor  When labor is progressing, each contraction has a bell-shaped curve that can be drawn on a graph, as it starts, gets more intense, reaches a peak, subsides, and ends.  The operative word is “bell”, rather than a “plateau”, which has no defined peak. Flat contraction indicate a stalled labor.
    10. 10. What stalls labor?  There are a finite number of reasons. We’ll start with some of the more uncommon ones: • A short umbilical cord • Cord wrapped around the baby’s body • Placenta in the way • The baby in an unusual position • The baby is just too big to come through the pelvic tube  More common things women do without realizing that these things are hindering the process. • Being tense • Bending over, leaning forward • Being closed or not being in open positions
    11. 11. Your birthing body basically uses three parts:  The cervix – in your Pink Kit resources, you’ll learn skills such as the following to help your cervix open: • Pelvic Clock • Cervical Relaxation • Deep Touch Relaxation • Directed Breathing  The pelvis • Mapping Your Pelvis • Body Positions • Hip Lift • Kate’s Cat • Sacral Maneuver • Deep Touch Relaxation  The birth Canal or Vagina- you will learn how to do Internal Work on your birth canal. • Sit Bone Spread • Kate’s Cat • Sacral Maneuver • Body Positions
    12. 12. When to use what pink kit skills?  Practice During Pregnancy • Labor is no different. You learn your Pink Kit skills, practice them more and more as you get closer to the birth experience, and use them throughout the birth.  These are the important reasons why you want to ready yourselves with skills. • The process your baby is going through deserves your full attention. • You and your partner will truly become a team with the goal of working with your baby’s efforts.
    13. 13. Practiced? Now Use the Skills During Pre-Labor!  After months of practising your skills while pregnant, you are now actually beginning to work with the efforts your baby will make shortly to come down, through, and out your body.  As you start to experience these pre-labor changes, it is a good time to begin the “touch relaxation” to help calm down the hormone rushes. Also, begin using some of your other skills. • Kate’s Cat • Body Positions • Start your teamwork, as well
    14. 14. Use the Skills During 1st Stage  This is what you need to focus on during the 1st stage: use your skills to work with each contraction and each space in between.  During the driving journey, you stopped to rest. You can’t do that in labor. There is no stop (except the times between contractions) until your baby is born. This means two things: • No matter what is happening on this birth journey, you cannot choose one convenient, long rest stop. Instead, you will have many, many short ones that happen when your baby feels like it. • Even during your brief rests, you cannot put your skills aside as you do when you break an auto journey. You must use energy-conserving skills in between contractions.
    15. 15. Cont. Use the Skills During 1st Stage  As for working phases themselves (contractions), you have another whose set of skills. • Directed Breathing- helps you cope with the natural pain during contractions and helps you achieve deep relaxation. • Pelvic Clock- helps you relax the soft tissue of the pelvic floor, both during contractions and rest periods. • Cervical Relaxation – helps you relax the soft tissue of the cervix. • Letting Down Reflex Relaxation- helps with a pinched cervix. • Uterine Lift—Improves the effectiveness of contractions. • Thai Massage—Helps the baby move down into the pelvic inlet. • “Bony Structure” skills (e.g. Hip Lift, Rocking the Sacrum, Kate’s Cat)—Create structural and internal relaxation. • Choosing Body Positions that help create internal relaxation and eliminate internal tension no matter what posture or position you are in.
    16. 16. Use the Skills During 2nd Stage  To reduce or prevent a delayed 2nd Stage, your job is first to prepare this area during pregnancy to become stretchable tissue, and second to use your skills to keep your active labor progressing.  This final part of your baby’s journey is still an exercise in plumbing an object has to come down, through, and out this last part of your body: your vagina, your baby’s birth canal.  These are the skills you’ll use to keep this phase of labor progressive: • Breathing into the Perineum • Letting Down Reflex Relaxation, to counteract your instinctive reaction to feeling the baby coming down • Internal Work • Sit Bone Spread • Hip Lift • Kate’s Cat • External Massage
    17. 17. Cont. Use the Skills During 2nd Stage  Anterior Lip -An anterior lip is caused by your baby pinching the front of the cervix against the pubic bone, thus preventing the final full dilation.  These are the skills: • Letting Down Reflex Relaxation • Sit Bone Spread • Kate’s Cat • Hip Lift • Sacral Maneuver
    18. 18. Use the Skills During 3rd Stage  The most dangerous period of labor is after the baby is born and before the placenta is delivered, because this is the time when a woman might bleed excessively.  If excessive bleeding occurs, the woman will be given an injection that will contract her uterus.
    19. 19. Basic take-away  Birth is unknown until it unfolds. You just have to work with what you have, but there are two very important things that you have huge control over: 1. Don’t go into labor tired. 2. Don’t overreact to contractions when they are lasting 15– 30 seconds and are 5–20 minutes apart. Instead, quietly learn about your contractions and teach yourself how to relax in this early phase, so you develop good labor management skills for the later stages.
    20. 20. End of the Road: Making Memories  Giving birth is seen from several time perspectives. The first perspective is when you’re pregnant and you look forward to the birth experience, knowing it’s unknown until it happens.  Then you view the experience as it unfolds and as you experience it. Then you look back immediately afterwards with opinions and emotions.  Finally, you periodically look back throughout your life. The birth of your baby is always something you look back on.  Only the human mind has the ability to imagine the future, be so self-reflective in the present, and recall experiences in the past.