Prenatal II Slideshow

Prenatal II Presentation:
Positions, Rebozo, Newborn and Postpartum
Procedures, & Baby Care

2
Labor Positions

Hands and Knees

Crawl – mom is on hands and
knees as if she is about to crawl.
Great for utilizing pelvic rocking.

3
Labor Positions

Full Moon - Elbows & Knees, head
resting upon the arms that are folded
on the floor.

4
Labor Positions

Sitting
Positions

Toilet – mom can
sit facing the tank,
so that her partner
can rub her back.
Useful if SROM or
AROM has
occurred.

Backwards
sitting on a
chair

5
Labor Positions

Reclining –
great to help
mom rest/relax.

6
Labor Positions

Rocking
Chair – can
help mom
establish a
rhythm and also
uses gravity to
open the cervix

7
Labor Positions
 Birthing Ball –
Mom can
bounce, rock,
sway, or just sit
upright.

8
Coping Techniques - Positions

Squatting
Positions

Vertical
Supported Squat
– partner is sitting
well above the
mother as she
rests her arms on
the partner's legs
and hangs in a
supported squat.

9

Squatting
bar – a bar
that attaches
to the bed may
be utilized to
support mom
in a squat.

10

Assisted Squat – using a sturdy
object, mom squats next to it safely.

11

Side lying-
− Beneficial when mom
needs to rest. Use
this during early labor
when mom can be
completely relaxed.
Very useful during
long labors.
− Support mom with
pillows, between
knees & feet, under
head, hugging a
pillow

12

Standing &
Walking
positions

Slow Dancing
– mom dances
with her
partner,
creating a
rhythm

13

Walking –
Accelerates
labor. Can
help shorten
the early
stages of
labor.

Stairs are
even more
effective.

14
Pushing Positions

Squatting -

This opens up
the pelvis to its
biggest
possible size.
You are also
using gravity to
help push.

15
Pushing Positions

Hands and
Knees –

This is helpful
for a large
baby, back
labor or OP
baby

16
Pushing Positions

Side Lying -

This is great if for a mom that has to be
lying down, also to rest while pushing. This
allows for no pressure on the sacrum to
narrow the pelvis.

17
Pushing Positions

Lithotomy

Classic position
traditionally used
in hospitals for
patients that have
had epidurals.

How can we use a rebozo?

As we go through these techniques, keep in mind that
they can all be used on ANYONE – even if that person is
not pregnant. Why not use a technique to relieve low
back pain on someone who is suffering from PMS? Or a
friend who has chronic back pain?
Pain relief and relaxation during pregnancy
Comfort measures during Labor
PMS and menstrual cramps
Infertility Treatments
Massage
Baby Wearing

Optimal Fetal Positioning

Hands and Knees
Belly Sifting

Mom is on hands and
knees.

Wrap the rebozo
around the mother's
belly. Create even
tension around the
entire belly. Lift and
jiggle the belly side to
side.
Can help with...
OFP prior to labor
Asynclitic baby
OP presentation
Ligament Pain
Lower back pain

Rebozo in labor

Vibration with
Rebozo

Mother is in hands and
knees position

Wrap the rebozo around
her bottom. Gather it at
each hip.

Vibrate the rebozo over
her bottom firmly and
quickly. Do not let the
fabric shift over her.
Try this technique with the
mom on a birthing ball for
ultimate relaxation.
Can help with...
Tension in the hips
Hip Pain
Contraction discomfort

Rebozo in labor

Lying Down
Rocking Massage

Mother lies down flat on her
back

her entire abdomen and
hips.

Lift the mother gently and
rock her from side to side.
Can help with...
OP Presentation
Asynclitic Baby
Ligament Pain
Rib Pain
Compound
Presentation

Rebozo in labor

Inversion with
Rebozo

Mother gets into Child's
pose (on knees, laying
head down onto arms)

her hips and lift upwards.

Perform this for 5 minutes
at a time.
Can help with...
Persistent asynclitism
Breech presentation

Rebozo in labor

Double Hip
Squeeze

Mother is in a standing
position

Wrap the rebozo under the
mother's belly and around
her hips. Cross the rebozo
across her back and
squeeze.

Best done with two people.
Can help with...
Back Labor
Ligament Pain
Lower Back Pain
Hip Pain

Rebozo in labor

Hanging with the
Rebozo

Tie a knot in the rebozo
and close the door over the
knot.

Allow the mother to hang
from the rebozo. She can
even get into a squatting
position if she feels
comfortable
Can help with...
Rib Pain
Upper/middle back pain
Proper pushing

Rebozo in labor

Pull to Push

Mother is in a pushing
position, any pushing
position.

Tie a knot on each end of
the rebozo

Hold the rebozo taught
between the mother and
the support person, who is
positioned on the other side
of the mom's belly.
Can help with...
Proper and efficient
pushing, even with
mother has been
exhausted.

33
Stages and Phases of Labor

Stage I – Labor
− Phase I – Early Labor

Emotions: Happiness, excitement,
anticipation

Contractions are 5-20 minutes apart

Contractions are 30-60 seconds long

Contractions are mild

Mom is dealing with contractions without
much difficulty

Cervix is dilating to 4 cm

This is usually the longest phase of labor
− “Pushing the dirt around”

34
− Phase II – Active Labor

Emotions: serious, calm

Contractions are 3-5 minutes apart


Contractions are moderate

Mom is working harder to get through each
contraction


This phase is typically shorter than early
labor.

35
− Phase III – Transition

Hormones: Lowering of Oxytocin and rising
of Adrenaline

Emotions: stressful, mom might want to
throw in the towel

Contractions are about 30-90 seconds apart


Contractions are very strong, sometimes
with multiple peaks


This is the hardest and the shortest part of
Labor.

36

Stage II – Delivery of Baby

1st
time moms may push for multiple hours

Emotion: excited, inspired, second wind

Contractions are only a couple of minutes
apart and are not as strong as transition
contractions

Ring of Fire – as baby crowns

Mom is working with the contractions to
help push baby out
− Baby is using reflexes to kick the top of
the uterus
− Mom cannot fight the urge to push

37

Stage III – Delivery of
Placenta

Emotions: happiness, relief,
excitement, love

5-30 minutes after delivery of
the Baby

Contractions are mild and
intermittent

Care providers might massage
abdomen to help uterus
contract and shed the placenta

38
The Wonderful Placenta

The only human organ that creates itself and
does not exist throughout a lifetime.

9” Dinner plate

Sustains baby by transferring nutrients
through blood

Traditionally ingested in many cultures around
the world
− Placenta Encapsulation
− Placenta Prints
− Plant in your garden
− Plant with a tree
− Soup, smoothie, baked... find recipes online.

39
Aromatherapy
Test each scent and note how it
makes you feel!

40
Aromatherapy

Stimulating scents
Stress Relief: Bergamot, Chamomile, Lavender, Lemon, Orange,
Patchouli, Vanilla
Anxiety/Fear: Bergamot, Chamomile (Roman), Cedarwood,
Frankincense, Jasmine, Lavender, Neroli, Patchouli, Rose,
Sandalwood
Self Esteem: Bergamot, Cypress, Grapefruit, Jasmine, Orange,
Rosemary
Sadness/Grief: Bergamot, Chamomile (Roman), Clary Sage,
Frankincense, Grapefruit, Jasmine, Lavender, Lemon, Orange,
Rose, Sandalwood, Ylang Ylang
Fatigue: Basil, Bergamot, Clary Sage, Frankincense, Ginger,
Grapefruit, Jasmine, Lemon, Patchouli, Peppermint, Rosemary,
Sandalwood
Agitation: Chamomile (Roman), Lavendar, Mandarin, Sandalwood
Isolation: Chamomile (Roman), Bergamot, Clary Sage, Frankincense,
Rose
Memory Boosters: Basil, Cypress, Lemon, Peppermint, Rosemary

41
Postpartum
Commonly procedures performed
on mom:
− Suturing of tears or episiotomy
− Hospital stay of 24 hours or longer
− Abdominal massage
− Uterus checks

42
The Newborn
The Apgar score is named after Virginia Apgar
who designed it as a simple method to quickly
asses the health of a newborn.

A - Appearance

P - Pulse

G - Grimace

A - Activity

R - Resolve

44
Newborn Appearance

Vernix – the whitish coating on a baby. This
coating was built up while your baby was living in
your uterus. As a baby nears its birthday, the
vernix begins to absorb into the skin. Little to no
vernix is seen on babies that are very ready to be
born!

45
Newborn Appearance

Purple Baby –
During delivery,
sometimes babies
become deprived of
oxygen. This causes
them to appear more
purple until they take
their first breaths and
allow the oxygen to
circulate.

46
Common Newborn Procedures

Eye Drops – erythromycin
− Thick gel that is applied to the eyes of a
newborn to prevent infection of the eye.
This is necessary for babies born to
mothers who have gonorrhea or
chlamydia.
− You may need to sign a form that states
that you are opting out of this treatment
if you choose to do so.

48
Advantages -

Erythromycin can reduce the risk of
chlamydia and gonorrheal infection of the
eye

Erythromycin ointment is inexpensive
Disadvantages -

Adverse effects include eye irritation and
blurred vision, which may interfere with
bonding

Erythromycin is not 100% effective at
preventing infection (it has a 20% failure
rate)

49

Vitamin K Shot
− Vitamin K is crucial in the process of
clotting blood. Babies are born with low
levels of Vitamin K and are injected with
a dose of the vitamin to prevent Vitamin
K deficiency bleeding.
− This is a routine injection that will
require a signature on a refusal form.

50
Advantages -
− May prevent excessive bleeding in the
newborn
Disadvantages -
− Potential emotional trauma to the
newborn
− 20-80% increase in childhood leukemia
in children who have received the
Vitamin K shot. 1.5 additional cases to
every 100,000 children.

51

Hepatitis B Shot
− This shot is administered to vaccinate
newborns against the Hep B virus. This
is important in women who are currently
carrying the virus.
− Given as a three shot series that
commences at birth. May also be
administered later in life, such as in the
teenage years.
− This is a routine injection that may
require the signing of a refusal form.

52
Advantages -
− Can prevent the transmission of the
Hep B virus from a mother who carries
it to her newborn baby.
Disadvantages -
− Suspected cause of some SIDS cases
− Reported but not confirmed associated
diseases include:

Multiple Sclerosis, Guillain-Barre Syndrome, Bell's Palsy, Diabetes,
Rheumatoid Arthritis, Lupus, Convulsions and Brain disorders such as
Encephalitis, Immune dysfunction, Visual and Hearing impairments,
Pancreatitis

53

Hearing Screening
− Your newborn will be hooked up to a
hearing test to record his hearing ability.
This test may take 5-40 minutes.
− Does not hurt the baby.

55

PKU Test
− This test is a heel stick. Blood is applied
to a test paper at the first and 14th
day
of life.
− This test can tell you if your baby may
have metabolic disorders that could
have devastating effects on his or her
life.
− Early detection is key in preventing
these disorders from affecting your
child.

56

Newborn Bath
− Your newborn
will be given a
sponge bath
during their
hospital stay.
This bath will
probably be
given in the
nursery.

57

Circumcision
− The surgical removal of the foreskin which
is the skin that covers the tip of the penis.
− This procedure is most often done before
the male newborn leaves the hospital.
− Reasons why parents choose to do it vary
from religious beliefs, the belief that it
makes the penis easier to clean, to cultural
pressures, or family tradition.

58
Advantages -
− Circumcision makes it easier to clean
the penis.
Disadvantages -
− Foreskin may be cut too long or short
− Foreskin may not heal properly, or may
reattach itself to the head of the penis,
causing additional surgery
− May traumatize the newborn

59
Circumcision Statistics

The rate of circumcision in the US is steadily
declining – 65% in 2002, 56% in 2006, 54% in
2008 and in 2010 it was 32%

Circ removes 75% of the sensitive tissue on
the penis

Anesthesia is only used in 45% of circs

Adults who were circd in their infancy are 5x
more likely to develop ED

60
Unexpected Outcomes
An expected outcome can be
anything that the parents do not
expect or prepare for.
− Different gender than expected
− Traumatic Birth
− Cesarean Section
− Abnormalities in baby
− Stillbirth or Death

61
Unexpected Outcomes
In the event of an unexpected
outcome:
− Take time to rest and recover
− Ask someone else to prepare your
meals for you for a while
− Make sleep a priority
− Be patient with your spouse
− Talk and share as often as you feel you
should
− Write about your feelings

62
Unexpected Outcomes
− Remember that your feelings will evolve
over time
− In the event of loss: spend all of the
time that you need to with your baby.
− Allow other children or family members
to express their feelings
− Talk with your birth attendants about
your feelings
− Avoid making big decisions
− Seek grief counseling

63
The First Few Weeks - Bath Time!

67
How to swaddle a baby...

Remember – DUDU

68
How to calm a fussy baby...
The 5 S's

Shush

Swaddle

Side Lay

Sway

Suck

69
What is Colic?

“Colic” is a catch-all term for
babies that cry for more than 3
hours for more than 3 days a
week.
− Baby may turn red in the face
− Cries are usually higher in pitch
− Belly may be distended and solid
− Arms and legs are extended and/or
flailing

71
Benefits of Breastfeeding

Protection against
− Gastroenteritis
− Constipation, colic and other stomach upsets
− Childhood diabetes
− Ear infections, pneumonia, bronchitis, kidney
infections
− Allergies, asthma, eczema
− Meningitis
− Childhood Lymphoma
− Crohn's Disease and ulcerative colitis

72

Reduced rates of
− SIDS (for every 87 deaths, only 3 are
breastfed)
− Tooth decay
− Heart disease later in life
− Iron deficiency
− Appendicitis
− Rheumatoid Arthritis
− Childhood Obesity

73

Promotes
− Facial structure development
− Enhanced speech
− Straight teeth
− Good vision
− Increased bone density
− Antibody response to vaccines
− IQ development
− Emotional bonding
− Healthy GI tract

74

Benefits to mom
− Reduced rate of breast, ovarian and
endometrial cancer later in life
− Reduced rate of anemia
− Protects against osteoporosis
− Delays the return of fertility
− Helps moms get back to pre-baby weight in a
healthy way
− Bonding with baby
− Uterus contracts after birth
− Mom misses less work over time due to
reduced rate of child related illnesses

75
Human milk is FREE!
When stored properly, human milk
can be kept for many months.

76
Breastfeeding Holds

Cradle Hold

Football Hold

Side-Laying

79
The Postpartum Period
The postpartum period can last
anywhere from 2-8 weeks,
depending on your delivery
experience.

80
Lochia
− Lochia is the vaginal discharge that is
present anywhere from 2-6 weeks. It
comes in three stages:
− 1st
: Red in color, very heavy period. 3-5
days postpartum
− 2nd
: Thinner than previously and also
more brown or pink in color. 5-10 days
postpartum
− 3rd
: Whitish or yellowish-white
discharge. 2nd
through 3rd
to 6th
week.

81
If at any time you pass a blood
clot that's bigger than a golf
ball, or a sudden and large
gush of fluid is discharged,
please call your care provider
immediately.

82
Healing
− Depends diapers may be a good investment!
− Witch hazel pads and solarcaine help soothe
the wound of a vaginal birth
− Use a peri bottle to cleanse and soothe with
warm water
− When bearing down for a bowel movement,
hold a pad against your vulva
− After urinating, cleanse with warm water and
pat the area dry.

83
Sitz Bath
− Used during the early postpartum
period to help cleanse, soothe and aid
in the healing of the perineum.
− Small herbal bath that you sit in.
− Steep your bath for four hours. Strain
the liquid and then use it for a bath.
− Peri bottle
− Toilet basin
− Tub

84
Postpartum Depression
− Affects up to 13% of women after birth
− Usually occurs in the first three months
postpartum, but can up to a year later
− Anxiety, irritation, tearfulness and
restlessness are common in the first
couple of weeks postpartum. These
feelings increase, or do not fade away.

85
Postpartum Depression
Moms are more at risk for PPD when:

Under the age of 20

Currently abuse alcohol, illegal substances or smoke

Unplanned pregnancy

Previous depression, bipolar or an anxiety disorder before
pregnancy or with a previous pregnancy

Stressful event during pregnancy, labor, delivery

Close family member with depression

Poor relationship with significant other, or is single

Money/Housing problems

Little support from family, friends, or spouse/partner

86
Call your care provider:
− Baby blues don't go away after two weeks
− Symptoms get more intense
− Symptoms of depression begin at any time after
delivery, even many months later
− It's hard for you to perform tasks at work or home
− You cannot care for yourself or your baby
− You have thoughts of hurting yourself or your baby
− You develop thoughts that are not based in reality or
you start hearing or seeing things that people cannot

87
Support for New Parents
What support do you have for
your postpartum period?

Mealbaby.com

Postpartum Doula

Lactation Consultant

OB/Midwife
 http://www.sbpep.org/
Have you taken a Newborn Care class
yet?

Prenatal II Slideshow

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