Wednesday, June 8, 2011

Bradley Class #5--- Labor Practice

This class was my favorite one so far. It was nice to be able to put into practice the things we have been learning. The name of this lesson was “Introduction to First Stage of Labor” The first stage is considered beginning with the first contraction to the point of pushing. 

The reason for why labor starts isn’t a for sure fact but there is a theory which Sean and I think sounds the best. I thought this was interesting and kind of a “duh”.  It is said that when the baby’s lungs are finished developing and ready to work in the outside that a hormone is produced and that starts labor. So the baby in all actuality starts labor. Makes you think twice about doing a scheduled birth when you know that the labor starts when the baby is ready and that starting before then could be before the baby is ready to survive outside the womb. 

To begin class we started out with a question as usual. We each gave baby and news updates and then the coaches (Husbands) were asked to tell where the mom tensed up first and then the moms were to say if he was correct and if not tell him where it was. All the husbands did great and knew exactly where the moms tensed first. Knowing that information is very important so that the husbands can be ready to relieve the pain as best as they can with massage or other touch techniques. 

We then dove right into the lesson of how a mother’s body works in labor. We talked about Braxton Hicks, contractions, dilation, effacement, and the position of the baby. We also talked about what the Bradley Method calls “The Natural Alignment Plateau” This refers to a period of time during labor when the cervix stops dilating although contractions continue. It often ends with a quick dilation of the cervix. This natural phenomenon occurs in a large number of births, but is rarely talked about in the modern world of obstetrics. Dr. Emmanuel Friedman was the first doctor to create a graph of how a woman “should” dilate.  The name of this graph, which is still used today is called Friedmans Graph.  He determined that it was best for a woman to dilate 1 cm / hour until reaching 10cm. The problem with his chart is that most women do not dilate according to a chart or graph.  Even though many will coincidentally dilate in a similar pattern of 1 cm/ hour, there is a large group of women that will not. 

The Natural Alignment Plateau is one example of what many women commonly do.  A woman will be in labor and seems to be “progressing” (meaning dilating at a speed nurses or doctors want) just fine, and then “stop progressing” (break of no dilation). This is usually when a doctor or nursing staff will tell the mother that she is experiencing “failure to progress” and want to start her on Pitocin, or they may not even state that its Pitocin that they want to put her one, but instead just tell the mother that they are going to give her “a little something to speed things up”.  Once Pitocin is introduced a string of many other drugs may be administered, including an epidural or C-section. The period of time in which there is no progression can last anywhere from 20 minutes to 1-5 hours. However, what usually happens afterward is a rapid dilation at the end.  Reasons for the N.A.P (stall in progression) could be: Softening of cartilages, balancing of hormones, production of immunities for the baby, certain muscles groups needing a break, the baby may be in need of more contractions which massage the baby and stimulate its nervous and prepare it's lungs for breathing on the outside and physical alignment, meaning the baby is moving in position to come down the cervix.
Here is a picture of the Nautral Alignment Plateau graph: 

 The black solid line labeled average represents the expected rate of dilation. The dotted blue line represents the N.A.P. See how the "average" just goes up steadily, then the "N.A.P" has a straight line of "stalling" and then jets up to progression. 

We then talked about how to time contractions. Contractions are times from the start of one to the start of another. Sean and I decided to just download an app on his ipod to time them for us so we don’t have to have him sitting there staring at a clock or watching counting. It will be much easier to just push a button at the start of one and the start of another and have the app calculate the time in between contractions. This way he will have more focus on me rather than figuring out contractions.

Then we had on overview of what happens in the first stage and transition of labor. Transition is the term used to describe the period of time between the first stage and second stage of labor. It is often a short but stressful time. This is typically when mothers might ask for pain medication but not really want them just trying to express how difficult she feels the process is. Soon after this time the baby comes. We have a chart in our workbook that has the emotional signs, behavior of the mother, physical signs, what the contractions are like, sensations, needs and reminders to the coaches for the early first stage, first stage, and transition of labor.

The best part of the class was the end where we did a practice first stage of labor. It sounds odd but think about it. With anything else big in your life do you just jump in a wing it or do you prepare yourself to do your best? That’s what we are being taught in these classes so it makes sense to put them into practice so that on the actual day of birth mother and father are prepared and know what to do. At first it felt weird to be practicing a contraction but then we got in to it and benefited from it. We are going to practice contractions every night before bed so that we can discuss what my needs are and what Sean can do to be ready to support me. Now you may be confused how anyone can practice a contraction when they have never been in labor and can have no clue what it would really be like. Well here is your answer. Sean pinched me really really hard and I had to figure out how to work through it. . . . Now if you believed that then you will believe that my baby is actually coming out of my belly button! Haha Jk!! Here is what really took place.

Rachel sat in the front of the room and all the couples spread out throughout the area. The mothers laid down on their sides with the husbands at their heads. Rachel then would say “contraction begins” and we would go about what we expect to do when the mother is actually having a contraction. Then after a minute and a half (the length of an average contraction) she would say “contraction ends”.  Then the husband would help the mother move into whatever position is comfortable if needed or give her water, give her a pep talk whatever he felt she needed at that moment and then prepare her for the coming contraction.

Sean had a hard time this practice. He is shy with people he doesn’t know and he got nervous to talk. No one was listening because we were all involved in our own thing doing the practice with our partners but he still felt like someone was going to hear him. During the “contractions” he didn’t know what to say so he would say things like “good job honey”, “it’s almost over” and “keep going”. Hahaha! The last one was just the silliest. I know he was trying to be supportive and helpful but I told him that if he said that during labor it would probably just annoy me. Because what else am I going to do other than keep going? Stop in the middle of a contraction because it’s just too hard? We both had a good laugh at that. After doing 7 practice contractions Rachel talked with us a bit more about doing the practice at home and then we were dismissed.

On the way home from the class Sean and I discussed the “keep going” incident (again with much laughter) and talked about what other things he might say to encourage me. I know that when I am in labor he will know what needs to be said to calm me. He has this great gift of insight into my mind. I don’t even have to say anything and he knows what I’m feeling and thinking. It’s truly amazing how well he knows me. He always knows exactly what to say to calm me or make me laugh. It’s like the words are just placed in his head straight from my own of what I need. I can do anything as long as I have him there with me. I remember when I was in high school thinking about the idea of giving birth and how scary it seemed. This labor stuff doesn’t sound so scary now that I know more about what is going to happen and I have such a great support from my most amazing, loving husband.

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