Class 1 – Preparing for Labor

·    Handouts on table: Outline, Labor from Start to Finish, 41 Ways a Labor Partner can Help or Checklist of Comfort Measures, Cards with my contact information on them.

·    AV Materials Needed: Anatomy: pre-pregnant anatomy, full term body. Cervical dilation, effacement (like Simkin, page 224). Baby rotation and descent. (like Simkin, page 215)

·    Materials I bring from home: Post-it notes written up for Onset of Labor activity.  Feedback folders. Items for break display: A&P, Nutrition.

·    Introductions. (Interactive)  15 minutes.

o        Housekeeping: Bathrooms, Class Structure, etc.

o        Introduce myself. Have them introduce themselves.

o        Class objectives.

·    Icebreaker: Small group discussion of common discomforts. 10 minutes

·    Anatomy and Physiology (Visual Aids)  10 minutes.

o        Brief, just to make sure we all have the same vocabulary.

o        Cover 6 ways to progress, including position and station.

·    Optimal Fetal Positioning. 5 minutes.

·    Onset of Labor: Possible, Preliminary, Positive Signs (“Game” – Interactive. 15 minutes.)

·    Warning Signs. (Lecture with poster/outline.) 5 minutes.

o        Premature Labor.

·    Relaxed Abdominal Breathing. 5 minutes.

·    Nutrition and Avoidance of Harmful Substances. 10 minutes.

·    Break around 7:30: 10 minutes.

o        Have display of fetal development books, A&P, and nutrition resources.

·    Conditioning Exercises and Body Mechanics (demonstration/return) 15 minutes.

o        Kegels, Squatting, Pelvic Tilt, Optimal fetal positioning

·    Pain in Labor / Purpose of Coping Techniques and Comfort Techniques. 15 minutes.

o        Relaxation and Slow-Pace Breathing. (Guided Relaxation) 10 minutes.

·    Homework assignment: Practice exercises, slow pace breathing. Chapter 7, chapter 9 discussion of First Stage Labor (pp. 209-234)

Class 2 – Understanding Labor, Birth Plan, Video

·    Handouts on table: Birth Plan, Informed Consent,

·    Handouts given out during class: Breathing Techniques, For Labor Support People

·    A-V Materials Needed: Positions for Labor.

·    Supplies to bring from home: Positions poster. Index cards for early labor techniques. Birth plans for display? Some exercise from BFW?

·    Teach two-breath relaxation technique.

·    Intros. 10 minutes. Have you ever attended a labor or birth? What’s your experience with labor and birth?

·    Early Labor (Writing on Board, Index card participatory lecture). 25 minutes.

o        Write Overview on Board.

o        Labor Record: How to Time contractions. “Lab”

o        Vacation Day: Alternate rest, relaxation, labor stim. 5 minutes.

o        Coping with Early Labor. 15 minutes. I give each couple an index card with a comfort technique for early labor. They tell why it’s helpful; I reinforce.

·    Active Labor. 25 minutes total.

o        Write overview on board.

o        Breathing for Active Labor. 5 minutes. (Hee-Hee, Hee-Blow)

o        Coping with Active Labor (They brainstorm and I reinforce). 5-10 minutes.

o        Positions. Demonstrate, have them practice, with breathing. 10 minutes.

·    Transition (Lecture and Practice) 5 – 10 minutes.

o        Write overview on board:

o        What is transition like: physical and emotional.

o        Support

o        Take Charge Routine

o        Variable Breathing: Teach counted hee-hee-blow. Have them practice.

·    Short Break around 7:40 (70 minutes).

o        Sample birth plans? Better to have a pictorial thing… collage?

·    Video: Stages of Labor. 18 minutes.

·    Birth Plan, and Informed Consent. 10 minutes.

·    Labor Game: What might my labor be like? A diceing game. ~20 min

o        Touch on precipitous labor. Discuss prolonged labor in depth.

·    Homework: Breathing Techniques and “For Labor Support People” handouts. Continue doing exercises. Read remainder of chapter 9: pp 235-256.

Class 3 – Labor Process Stage 2, Labor Support.

·    Handouts on table: PALS Brochure, 41 Things a labor partner can do

·    Handouts given out during class:

·    A-V Materials Needed: Positions for Labor. Picture of monitor, IV.

·    Supplies to bring from home: Positions poster. Comfort tools.

·    Introductions. When you’re sick / tired / out of control, what helps? 10 minutes.

·    Pushing and Birth (2nd stage of labor) (Lecture, Pictures, Practice). 20 minutes.

o        Write overview on board

o        Breathing during Pushing. Spontaneous versus directed pushing. Resisting urge to push.

o        Positions for Pushing: Goal of these positions / criteria. Show them poster of different second stage positions, and have them evaluate.

o        Practice Positions and breathing. 10 minutes.

·    Third Stage Labor. (Brief lecture) 2 minutes.

·    Labor Support. 30 minutes.

o        Who does it? What is it? What is it not? 20 minutes

o        Massage and Touch Relaxation (Demonstration/Return. 10 minutes)

·    Break. 7:30. Have comfort tools display: lotion, tennis balls, etc.

·    Video: Look for a good one… Maybe the injoy segment on comfort techniques. 20 minutes?

·    Small Group Discussion: Labor Scenarios. Goal: Get them into the role of being in labor, and thinking how they would handle various situations: diagnosing labor, deciding when to go to hospital, advocating for themselves. 20 minutes.

·    Relaxation Technique: Progressive Relaxation. 10 minutes

·    Homework: Practice massage. Practice positions and breathing. Chapter 12.

Class 4 – Hospital Procedures, Pain Meds, Video

·    Handouts on table:

·    Handouts given out during class:

·    A-V Materials Needed: Picture of monitor, IV. Where does epidural catheter go?

·    Supplies to bring from home: Epidural role-play kit. Add EKG electrodes. Birth bag. Focal points and music.

·    Intros: Birth Bag Exercise. 15 minutes

·    Hospital Procedures. 20-25 minutes total.

o        Arriving at the hospital. What are hospitals like? Unwritten rules.

o        Triage.

o        Vital Signs.

o        Vaginal exams.

o        Fetal Monitoring: Routine.            

o        IV, No food policy.

·    Brief discussion: do you believe it is possible to give birth without pain medication?

·    Pharmacologic Methods. 35 minutes total.

§         3 main uses: sleep, high anxiety, pain relief.

o        Communicating with your labor support partner(s) about pain meds.

·    IV Pain Meds / Narcotics (Lecture). 10 minutes.

§         Usually i.v. Sometimes

§         Timing, additional doses.

§         Not anesthesia: analgesia. Alter your reaction to the pain.

§         “take the edge off the contraction.”

§         When are they useful?

§         Side effects on mom. Side effects on baby.

§         Environmental factors.

·    Break. Break. Focal points. Music. 10 minutes

·    Epidural Anesthesia. (Role Play). 20-25 minutes.

o        What is it?

o        Advantages:

o        How is an epidural administered, and what are the side effects? Role Play covers procedures and side effects, encourages students to ask questions.

·    Video. Carl and Donna from Hello Baby. 15 minutes?

·    Discussion of meaning of pain. (from Shogren’s subbing in Betsy’s class) 20-25 min

·    Homework: Discuss pain med preference scale. Read chapter 10 and 11.

Class 5 – Variations of Labor: Medical Interventions, Cesarean Birth, Recovery

·    Handouts on table: Variations Handout.

·    Handouts given out during class:

·    A-V Materials Needed:

·    Intros: 10 minutes.

·    Interventions prior to Labor. 10 minutes.

o        Premature Labor. 2 minutes.

o        Induction. 5-10 minutes?

·    First Stage Interventions. 5 minutes.

o        Augmentation: AROM and Pitocin.

o        Normal length of labor

o        I.V., Monitoring, etc.

·    Second Stage Interventions. (Lecture) 10 minutes.

o        Why?

o        Episiotomy: describe it, why it’s done, what you can do to prevent

o        Forceps. Vacuum extractor.

o        Alternatives

·    Cesarean Birth. 20 minutes. (Lecture with outline on flip chart.)

o        What is it? Summary

o        Rates

o        Indications

o        Risks

o        Procedure: Show video: 5 minutes.

o        After the birth. Recovery:

o        What you can do to help avoid a cesarean

·    Break. 7:25-7:35

·   Back Labor. 10 minutes.

·   Postpartum Care. 10 minutes.

·   Labor Rehearsal: Stations around the room. Have whole class progress through labor together, or do teams of three couples. 20 minutes.

·   Homework: Chapter 13, 14, 15. Write up birth plan, discuss with physician.

Class 6 – Postpartum Family Adjustments, Breastfeeding Intro, Labor Rehearsal

·   Handouts: Symptoms of Problems in Postpartum Adjustment, Evaluations, PEPS brochure

·   Materials Needed from Office: Handouts.

·   Supplies to Bring from home: Sling. Video of Comfort Techniques, Position Posters. Labor Scenarios Cards for Rehearsal.

·   Intros. 5-10 minutes. What part of parenting a newborn are you most/least looking forward to?

·   Newborn Care. 10 minutes.

·   Breastfeeding. 10 minutes.

·   Family Adjustment. 30 minutes??

·   Break. 5 minutes.

·   Video of Comfort Techniques. 15 minutes. 

·   Breathing, Relaxation, and Positions Practice (20 minutes) (Game)

·   Questions and Answers. 10 minutes.

·   Plan Reunion, Evaluations. 5 minutes.