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Ready class? RELAX!!! . Objectives. Discuss the evolution of relaxation as a labor coping skill. Describe the physiologic response to stress in labor and the impact of eliciting the relaxation response on labor coping abilities.

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Ready class? RELAX!!!

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Ready class relax

Ready class?RELAX!!!


Objectives

Objectives

  • Discuss the evolution of relaxation as a labor coping skill.

  • Describe the physiologic response to stress in labor and the impact of eliciting the relaxation response on labor coping abilities.

  • Experience a variety of relaxation exercises designed for use in a childbirth class.

  • Choose and use at least two ways to teach expectant parents about the use of relaxation in labor and birth.


Relaxation break 1

Relaxation Break #1


Stress

STRESS

Any perceived threat, which results in the release of…

CATECHOLAMINES


Alarm

ALARM!


Typical human stress response

Typical Human Stress Response

 heart rate & blood pressure

Pupils dilate

Digestion slows

Glucose released from liver

Blood shunted to skeletal muscles and vital organs

Air passages widen,  oxygen uptake


Ready class relax

Resistance


Exhaustion

Exhaustion


Is labor stressful

Is labor stressful?

Yeah.


Relaxation break 2

Relaxation Break # 2


Stressors in labor

Stressors in labor

  • Imposed restrictions

  • Strange environment

  • Perceived threat (interventions, staff)

  • Cold

  • Pain

  • Hunger


Simkin study 1986 16 events described as very stressful

Labor induction or augmentation

EFM

Internal EFM

Vaginal exams

IVs

Administration of analgesia

Administration of anesthesia

Restriction to bed

Restriction of drink

Unfamiliar doctor

Episiotomy & repair

Forceps

Vacuum

Limited time with baby after birth

Circumcision

Simkin Study (1986) –16 events described as VERY stressful


Two ways to be relaxed in labor

Two ways to be relaxed in labor…

1. AVOID or REDUCE the existing stressors

2. Use relaxation and other techniques to deal with remaining stress.


Avoid or reduce stressors

AVOID or REDUCE Stressors

  • Alter environment (lighting, sounds, privacy, people, temperature)

  • Enhance physical comfort (positioning, pillows, temperature, touch, massage)

  • Calm the psyche (visitors, music, soft voice, white noise)

  • Distraction (talking, breathing patterns, focal point)

  • Practice decision-making skills


Fear tension pain

FEAR - TENSION -PAIN

FEAR

PAIN

TENSION


Relaxation break 3

Relaxation Break # 3


Stress response in labor

Stress response in labor…

  • Part of the fetal ejection reflex

  •  newborn alertness & readiness for the outside world

     maternal ferocity and aggressiveness

     the release of vasopressin, which interferes with oxytocin

     Cold and shaky feeling

  • Forgetfulness


Female stress response

Female Stress Response

  • Catecholamines are released…

  • Because we have estrogen and access to oxytocin …women tend to react differently seeking to…

  • Tend & befriend (calm & connection)


The release of oxytocin causes

The release of oxytocin causes…

 blood pressure

 stress hormones; causing the tend and befriend effect

Facilitates reproduction (facilitates mating by making certain men more attractive to us, sperm ejection reflex, fetal ejection reflex & milk ejection reflex, bonding)

 pain threshold

 sleepiness, feeling of laziness

 muscle tension, relaxing (less circulation to muscles)


Ready class relax

 calming, less upset about life’s big problems, peaceful

 curiosity and a sense of closeness to the people nearby,

 trust, daring (more courage = less fear)

 desire to please people

 Openness to touch

Increases digestion and fat absorption and storage

Releases stored nutrients to make milk

 appetite

 skin and mucous membrane circulation


Ready class relax

 Fosters love of infant, creates emotional bond

 Sensitive to other’s feelings, recognize non-verbals

Causes blood vessels on the front dilate (rosy cheeks & warm chests)

 Facilitates learning

 wound healing (twice as fast)

Induces social memory and calmness in infant

Buffers Prolactin’s response to stress


Oxytocin is stimulated by

Stress

Warmth

Stroking

Sexual stimulation

Descent of the fetus

Good food

Companionship (doulas)

Quiet & low light

Meditation & visualization

Positive thoughts & memories

Movement

Suckling

Pleasant smells & sounds

Oxytocin

Oxytocin is stimulated by...


Relaxation break 4

Relaxation Break # 4


Relaxation break 5

Relaxation break # 5


Teaching relaxation

Teaching Relaxation


Sample spiral

Sample Spiral…

  • What is relaxation? (previous knowledge)

  • Relaxation breath (new simple skill)

  • Relax with breath (add new skill)

  • Breathing awareness (add touch)

  • Roving body check (reinforce touch)


Continuing

Continuing…

  • Moving into relaxation (new skill)

  • Relaxation, rhythm and ritual (putting it all together)

  • Releasing to birth

  • Birth visualization

  • Parenting/breastfeeding visualization


Relaxation break 6

Relaxationbreak # 6


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