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Using Water During Labor and Birth

          Humans have an integral relationship with the element of water.  It runs through our veins, we are born of it, and it is necessary for our survival. We are drawn to it for escape, adventure, release, and cleansing. As a woman is preparing to give birth, water is a means of release from the weight of her growing belly, and the means to ease her aching muscles. Water is a great coping tool in labor, whether through a shower or tub. (For the sake of this paper we will only be mentioning the use of a tub.) The use of water in labor can aide in pain management by increasing relaxation, decreasing strain on muscles, and creating freedom of movement.

 

         The mother’s ability to relax her muscles during labor can affect the length of labor and the intensity of contractions. The more a mother fights and tenses her muscles the worse contractions may feel. Especially in active labor, the mother may need as many coping strategies as possible. The birthing tub offers a great respite, and a simple way to relax. The birthing tub is often called, "The midwife’s epidural”, for its effectiveness (Drichta, Owen p. 257). The warmth of the water helps to ease the pain felt from contractions, relaxing muscles of the pelvic floor and back, and creates a mental space that creates privacy (Drichta p. 258). It is recommended to maintain water temperature at 96-98 degrees. Using higher temperatures could cause increased blood pressure, dehydration and lethargy (Drichta p. 258). The bath is also deeply engrained as a place of mental release in daily routines. Our bathtubs are typically places of retreat to relax, and the mental association during labor holds true.

 

          Labor is a physically demanding process. From hours of walking, lunging, squatting, intense contractions, and the possibility of little sleep can make for a grueling marathon on the mother’s muscles. The warmth of the tub eases both the pain of the contractions and the work of her remaining muscles (Drichta p. 257). Being in a large tub that covers her belly, the mother is buoyant and freed from the gravity of dry land. Her pelvic muscles are relaxed and her cervix will continue to dilate, often with more ease as she relaxes. A mother that is able to relax and mentally release her tension, will have an easier time laboring than a mother that is fighting each contraction.

 

        Being weightless allows the mom to assume positions that could be too taxing on land, such as deep squats using the side of the pool, that will help baby to descend and turn. She's able to easily move from one position to the next in response to her labor, while remaining warm and relaxed. The ease of movement allows the mother to find her own rhythm and coping responses that she would not have had if she was limited to a bed. Her ability to move through labor gives the mother more control and autonomy during the birth. She's able to push in the position that suits her, catch her own baby, and bring baby to chest without outside help or others manipulating her body. She has full confidence and control.

 

          Relaxation, decreased strain on muscles and freedom of movement are gained for the birthing mother with the use of water during labor. The three work together as a pain management strategy, addressing both mental and physical tension that could hinder a birth. The birthing tub is used at its greatest advantage during late stage active labor throughtransition. It is recommended that for every hour spent in the tub, the mother spends at least thirty minutes out of the tub. This is to ensure that contractions do not slow down, as can sometimes happen. Often contractions may just feel less intense, but are still actively working. According to Water BirthInternational, “Getting back in the water after thirty minutes will reactivate the chemical and hormonal process, including a sudden and often marked increase in oxytocin.” (Harper p. 2) As with other labors, hydration is of the utmost importance. Keep a drink with a straw nearby so the mother can drink at will. The birth can be completed in the water as well, depending on location (some hospitals only allow laboring in the tub) and as long as the labor is not having any complications (ex:meconium, shoulder dystocia).

           

 

                                                     Works Cited

Drichta, Jane E., CPM and Owen, Jodilyn, CPM. The Essential Homebirth Guide for Families Planning or Considering Birthing at Home. 2003. Simon and Schuster.

 

Harper, Barbara. "Guidelines for Safe Waterbirth.”Waterbirth International. p. 2

https://www.youtube.com/watch?v=aQVM36r1rvw#action=share

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Birth Balls, Best thing ever

Birth balls, commonly recognized as exercise balls, have been used for many purposes over the last ten years, including physical therapy, abdominal exercise, and most recently to aid pregnancy and labor. Its shape and durability allow it to be used by a variety of weights and heights, and in multiple positions. Birth balls can aide in pregnancy and labor to improve fetal positioning, fetal descent and maternal comfort.

Fetal positioning can make a huge difference in how labor develops. A baby facing in the posterior position in the womb may have a slow descent, and can also cause painful back labor (Spinning Babies). Poor fetal position can also cause very slow dilation, often resulting in unnecessary interventions. In some cases, the baby may have a difficult time turning and become stuck, requiring surgery or forceps delivery (Spinning Babies). Fetal positioning can be improved by having good posture. Often pregnant women are sitting on cushy couches or less than ergonomic driver seats, causing poor posture (Spinning Babies). By sitting and resting on the ball, the posture is upright and forward leaning, engaging abdominal muscles while relaxing the pelvis area. The back is comforted and strengthened by ball use, supporting the pelvis. With proper alignment and a relaxed pelvic area, the baby will have room to position properly, and begin to drop into the pelvis (Spinning Babies). It also encourages the baby to settle into an anterior position that is optimal for labor (Spinning Babies). Often a posterior baby can be encouraged to turn during labor by sitting on the ball.

Fetal descent is defined as entrance of the presenting portion (usually the head) into the birth canal. Descending takes time and hard work from both mom and baby.The use of gravity and squatting positions are helpful in this process, but can be taxing on the mother’s muscles over a long labor. The birth ball is a great tool in this scenario, as it allows mom to sit in a squatting position, allowing the use of gravity and an open pelvis to bring the baby down, but also allows for rest. The mother can also lean forward while sitting, and receive a massage or counter pressure. The ball can also be hugged while deeply squatting on the floor. It allows mom a greater balance and ease in the position, one that can be utilized in the pushing stage.

The birth ball is a great comfort tool for mothers in labor. It allows the mother to rest while still engaging an open pelvis. The birth ball can be a great break from walking, while still remaining active (Birth Arts Handbook p.187). It allows the mother to do pelvic circles and rhythmic movements that help her ease the pain of contractions. These movements often help the baby to navigate the turns in the pelvis before crowning (Birth Arts International p.187).  The birth ball also creates a counter pressure against the perineum and buttocks that can ease the sensations of early transition, which can be a difficult time for the mother. Having the birth ball as a comfort tool the mother can find a coping mechanism and rhythm through her contractions. By having support and a rhythm to help her cope, the mother can navigate her labor and have a mental place to return to when labor gets hard.

By utilizing the versatility of the birth ball, a mother can improve fetal position, while encouraging fetal descent and increasing comfort during labor. By improving these aspects of birth, unnecessary intervention can be avoided, as well as the use for drugs. This can greatly improve outcomes for mothers and babies, especially in a hospital setting where the mother is out of her comfort zone.

Works Cited

Birth Arts International, Certified Doula Education Program. Demetria Clark. 2000-2015. P.187

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