Class 1 – Introductions; Labor Overview, Warning Signs, Exercise, and Relaxation.
·
Handouts
on table: Outline, Labor from Start to Finish, Questionnaires. Cards with my
contact information on them.
·
AV
Materials Needed: Anatomy: pre-pregnant anatomy, full term body. Cervical
dilation, effacement. Baby rotation and descent.
·
BOOKS
·
Materials
I bring from home: Post-it notes written up for Onset of Labor activity. Stages
of Labor video. Business cards.
·
Introductions.
(Interactive) 20 minutes.
o
Housekeeping:
Bathrooms, Class Structure, etc.
o
Introduce
myself
o
Goals:
Info, Alleviate Fear, Confidence, Diff Learning Styles
o
Intro
selves: Names, due dates, where delivering
·
Anatomy
and Physiology (Visual Aids)
10 minutes.
o
Pre-preg/preg. Uterus, placenta, amniotic sac, cervix, vagina.
o
Cover
6 ways to progress. Pp 213 – 216 Oxytocin
and prostaglandins.
·
Birth
Story /
o
Onset
of Labor: Possible, Preliminary, Positive Signs of Labor (“Game” – Interactive.
10-15 minutes.) pp. 217-22
o
Labor
Video on Stages of Labor. 10 minutes.
o
Further
Discussion of Normal Progress of Labor. 10-20 minutes
§
Labor
Record: How to Time contractions.
§
Labor
Curve. Average Time.
·
Break
around 7:00: 5 minutes.
·
Warning
Signs. (Lecture.) 5-10 minutes. Pp. 57
·
Body
Mechanics and Exercise: Exercises (demonstration/return) 10-15 minutes.
o
Kegels, Squatting, Pelvic Tilt, Tailors. Chapter 6.
·
Pain
in Labor / Purpose of Comfort Techniques. 10 minutes.
o
Relaxation
and Slow-Pace Breathing. (Guided Relaxation) 10 minutes.
o
If
there’s time: Massage / Touch Relaxation (Demo/Return. 10 minutes
·
Homework
assignment: Practice exercises, massage, slow pace breathing. Chapter 9, 12.
Class 2 – First Stage Labor, Hospital Procedures, Birth Plans, and Medication.
·
Handouts
on table: Birth Plan, Informed Consent.
·
Handouts
given out during class: Breathing Techniques, For Labor Support People
·
A-V
Materials Needed: Positions for First Stage Labor. Picture of monitor, IV.
Epidural illustration: where does the catheter go.
·
Supplies
to bring from home: Index cards for early labor techniques. Epidural role-play
kit. Birth bag. Epidural side effect poster.
·
Teach
two-breath relaxation technique.
·
Intros.
10 minutes. Birth Bag Exercise, or each couple tells about one comfort item
they’re bringing to hospital
·
Early
Labor (Writing on Board, Index card participatory lecture). 15 minutes.
o
Write
Overview on Board. P 222-25
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. 20 minutes total.
o
Write
overview on board. Pp. 225 - 232
o
Breathing
for Active Labor: Hee-Hee, Hee-Blow,
Slide. 5 minutes.
o
Coping
with Active Labor (They brainstorm and I reinforce). 5-10 minutes.
o
Positions.
Demonstrate, have them practice. 5-10 minutes.
·
Short
Break around
·
Hospital
Procedures / Birth Plan. 20 minutes total.
o
Arriving
at the hospital. Parking.
o
Triage.
Admitted or sent home.
o
Monitoring:
Your Vital Signs.
o
Fetal
Monitoring: Routine.
o
Vaginal
exams.
o
IV
·
Pharmacologic
Methods. 35 minutes total.
o
Communicating
with your labor support partner(s) about pain meds.
·
IV
Pain Meds / Narcotics (Lecture). 5 minutes.
§
Usually
i.v. Sometimes i.m.
§
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. Book 343
§
Environmental
factors.
·
Video
of Carl and Donna. 10 minutes
·
Informed
Consent. 2 minutes.
·
Epidural
Anesthesia. (Role Play). 25 minutes.
o
What
is it? Pp 345-49
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.
- Effects on the
Birth
- Possible
Effects after the Birth.
- What can you do
to minimize the risks of epidurals?
·
If
I’m lucky, and there’s time left: Massage and touch relaxation.
·
Homework:
Breathing Techniques and “For Labor Support People” handouts. Mention Pain Med
Preference scale (p 337), encourage them to discuss. Read Chapter 10 and 11.
Class 3 – Transition and Second Stage Labor, Variations, C-Sections.
·
Handouts
on table: Coping with Common Variations in Labor, Action Assignments
·
A-V
Materials: Poster: Positions for Second Stage. Forceps and vacuum extractor.
·
Supplies
to bring: Flip-chart outline for 2nd stage interventions and c-section.
Paper slips describing labor scenarios.
·
Introductions
/ Check-In. 10 minutes max. 6:10. What part of labor
are you most/least looking forward to?
·
Review:
Early and Active Labor. 5 minutes. 6:15. Q&A.
·
Transition
(Lecture and Practice) 5 – 10 minutes.
o
Write
overview on board: pp. 232-34
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.
·
Pushing
and Birth (2nd stage of labor) (Lecture, Pictures, Practice). 15 minutes.
o
Write
overview on board. Pp 235-42
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.
·
Third
Stage Labor. (Brief lecture) pp
242-45 2 minutes.
·
·
Second
Stage Interventions. (Lecture) 5-10 minutes.
o
Why?
Pp. 291-2
o
Episiotomy:
describe it, why it’s done, what you can do to prevent
o
Forceps.
o
Vacuum
extractor.
o
Alternatives
·
Short
Break around
·
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
o
Recovery:
o
What
you can do to help avoid a cesarean
o
· Common Variations in
Labor. 25 minutes.
Precipitous
Labor: pp 275 - 280
Pre-term Labor. Pp. 60-61, 303-4
Post-Date
Pregnancy
Induction pp 261 - 275
Prolonged
Labor
Early pp 280 - 283
Active
Second Stage pp 290-2
Back
Labor pp 284 - 290
·
Small
Group Discussion. 20 minutes. Labor Scenarios 7:58
·
Wrap
up. 2 minutes.
·
Homework:
Chapter 13. Work on birth plan.
Class 4 – Breathing and Relaxation Review, Postpartum, Breastfeeding
·
Handouts:
Symptoms of Problems in Postpartum Adjustment, Evaluations, PEPS brochure, 41
Ways a Labor Partner can Help, Checklist of Comfort Measures,
·
Materials
Needed from Office: Handouts.
·
Supplies
to Bring from home: Sling. Video of Comfort Techniques, Position Posters. Labor
Scenarios Cards
·
Intros.
5 minutes. What part of parenting a newborn are you most/least looking forward
to?
·
Video
of Comfort Techniques. 15 minutes.
·
Breathing,
Relaxation, and Positions Practice (20 minutes) (Game)
·
Postpartum
Period chapter 13
o
Physical
Recovery: Lochia, Involution, Care of the Perineum (peri bottle), Elimination.
o
Emotional
Recovery: Changes. Lack of sleep. Changes in self-image, priorities. Pushes
normal coping abilities. Power of peer support.
o
Baby
Blues, PPD Book 377-380
o
Relationship:
Division of Labor. Quality Time. Sex after baby. Counseling now.
·
Where
to Find More Info
o
(206)
386-MOMS Infant Care and Breastfeeding Hotline, 215-3338 Class Reg, Books, Websites, Coping with Confidence Class, www.pepsgroup.org
·
Newborn
Care. 5-10 minutes.
·
Breastfeeding.
10 minutes.
·
Potty
Break. 5 minutes.
·
Tour
of Birthing Center. 30 minutes.
·
Questions
and Answers. 10 minutes.
·
Plan