One Day Childbirth Preparation Seminar

 

List of supplies and when and where I need them / get them. [ ] = bring from home, all else in office.

(For a one-day seminar, there’s so many materials to deal with, it’s very important to have them all in order before class!)

 

·   Handouts on table: Outline, Labor Comfort Kit, Cord Blood Donation, Books.

·   Handout at Lunch Time: Labor Review. Birth Plan. Food vouchers.

·   Handouts during Lunch: Coping with Common Variations in Labor, Breathing Techs

·   Handout at end of class: Evaluations For Labor Support people, Coping with Confidence

·   Posters Needed: 1) Pre-pregnant anatomy, full term body. Dilation and effacement? Rotation and descent.  2) Cervical Exam? Monitor, IV? Positions for Active Labor. Positions for Back Labor. Positions for Pushing. 3) Epidural, where inserted. Forceps, VE, Episiotomy.

·   Other Materials: 1) Cervical dilation chart, Baby, Pelvis, [Post-its for Onset]  [Index Cards for Early Labor Ideas]  2) [Flip Chart of hospital procedures], Hello Baby Video – set-up to Carl and Donna. 3) [Flip chart on Induction], Amnio-hook. [Flip on epidural]. Epidural role-play supplies. [Flip 2nd stage interventions]. [Flip cesarean]. [Video of procedure]. 4) Video of comfort techniques. Everything for labor rehearsal stations. Tape.

·   Nametags, attendance sheet.  Juice, snacks.

·   BOOKS!!  TV/VCR!

·   Materials I bring from home: Index card outline. Post-it notes written up for Onset of Labor activity. Index cards for early labor ideas. Flip chart! Videos for Stages of Labor, Comfort, C-section, Lunchtime handout, Epidural Role-play kit. Roll-up posters for epidural side effects. Video of comfort techniques. Print-outs for labor stations. Equipment for labor stations. Birth bag and birth bag cards.

·   Write on board: labor curve and info. (make sure to talk about varied numbers depending on source)

 

Outline I give out to the class:

 

One-Day Childbirth Preparation Class

 

Janelle Durham, MSW, CD, CCE. Mom. Email address…

 

9:00 – 10:50

Late Pregnancy, Onset of Labor, Early Labor

  • Introductions, Housekeeping, Goals for the Day
  • Anatomy and Physiology: 6 Ways to Progress in Labor
  • Onset of Labor: How will I know labor has started??
  • Warning Signs / Premature Labor
  • Stages of Labor – A Video
  • What to Expect, What to Do in Early Labor
  • Body Mechanics / Exercise
  • Pain in Labor and the Purpose of Comfort Techniques

 

10:50 – 11:00

Break

 

11:00 – 1:00

Active Labor and Delivery

  • How to Recognize Active Labor
  • Going to the Hospital / Arriving at the Hospital
  • Hospital Procedures and Birth Plans
  • Comfort Techniques: Coping with Active Labor / Back Labor
  • Second Stage Labor: Pushing and Delivery
  • Third Stage Labor and Newborn Procedures

 

1:00 – 1:45

Lunch

 

1:45 – 3: 45

Breathing Techniques for Labor

 

Variations of Labor, Interventions, and Pain Medication

  • Induction and Augmentation
  • Pain Medications
  • Second Stage Interventions: Forceps, Vacuum, Episiotomy
  • Cesarean Birth. Video

 

3:45 – 3:55

Break

 

4:00 – 5:30

Comfort Techniques, Postpartum Period, and Resources

  • Video: Understanding Comfort Techniques
  • Labor Rehearsal: Rotate through the Stations
  • Postpartum Recovery, Adjustment to Life with a Newborn
  • Resources: Where to Find More Information
  • Questions and Answers. Evaluations.

 

 

My notes for the class, to remind me what all I want to cover

 

·   Introductions. (Interactive)  20 minutes. 9:00 – 9:15

o       Housekeeping: Bathrooms, Class Structure, Breaks, Snacks, Page #’s, etc.

o       Introduce myself

o       Intro Selves: Names, Due Dates, Where Delivering, 1 question you hope to have answered today

o       Goals: Provide information about the labor and birth process: help you understand the range of normal, learn to trust your own process. Alleviate fears. Help you envision a positive birth. Different learning styles: help you retain information. (Answer all questions on labor review.)

·   Anatomy and Physiology (Visual Aids)  5-10 minutes. 9:15 – 9:30

o       Just to make sure we all have the same vocabulary.  Book, pp 213-216

o       Pre-pregnant and term anatomy.  Touch on common discomforts.

o       Uterus, cervix, birth canal, etc.

o       Oxytocin and prostaglandins. Endorphins.

o       Cover 6 ways to progress: cervical changes, baby position

o       Due Dates!

·   Onset of Labor: Game. Describe possible, preliminary, positive. Book 217-221. 9:30-9:45

·   Warning Signs / Premature Labor. (Lecture / Flip Chart) Book 57.  9:45 – 9:50

·   Stages of Labor. (Video) 10 minutes. 9:50 – 10:00

·   Early Labor: What to Expect, What to Do  pp 222-25

o       Brief review of what to expect: 2-24+ hours. 30 minutes to 5 minutes apart, lasting 30-45 seconds. Can walk and talk, chat in between. Write on board.

o       Labor Record: How to Time contractions. Book 221.  ~10:05

o       Eating and Drinking ~10:10

o       Rabbits in Field

o       Rest/Relax, Distraction, Labor-Enhancing Activities  ~10:15

o       Hand out cards describing activities; why helpful? Why not? 10:15 – 10:25

·   Body Mechanics and Exercise: Exercises (Active) 10-15 minutes. 10:25 – 10:35!

o       Getting Up, Lifting things, Kegels, Squatting, Pelvic Tilt

·   Pain in Labor / Purpose of Comfort Techniques. 10 minutes.  10:35 – 10:45

o       Pain-Tension-Fear. Gate Control Theory.

o       If there’s time: Massage  (Demo/Return).

 

Active Labor and Delivery

·   Handouts: Birth Plan, Labor Comfort Kit, Breathing Techniques

·   Posters: Cervical Exam? Monitor, IV? Positions for Active Labor, Back Labor, Pushing.

·   Materials: Flip Chart of Hospital Procedures. Video: Carl and Donna

 

·   Do ice simulation. 11:00-11:10

·   Active L. overview: 100% effaced, dilate 4-8 cm. Ctx 3-5 mins apart, 40-70 seconds long, painful. Last 30 mins - 10 hours. Avg. 7 hrs. Mom’s mood, no walk/talk. 11:10 – 11:15

·   Deciding to Go to Hospital. ~11:20

o       When to call dr: Ask! When to go to hospital: Ask dr. 5-1-1 + Mood Change.

o       (Call (206)386-6000. Driving. Parking. 5 East elevator.

o       After 11 pm, Minor and James, ER. Validate parking for 8 ins/outs

o       What to Pack. See book, page 212

·   Hospital Procedures / Birth Plan. (Flip chart and handout) 20 minutes. 11:20 – 11:35

o       Unwritten Rules. What are hospitals like?

o       Triage: Decision to admit? 50% sent home.

o       Group B Strep stat test, comes back in a few minutes. 37% are positive. Treat

o       Vital Signs. Vaginal exams.

o       Fetal Monitoring: Routine.           20 minutes, then depends

o       IV or Heplock standard procedure. Care provider can change order. Food?

o       Birth plans: Refer them to handout, and book, pp 145 - 168

·   Active Labor. 20 minutes total.  Book 217-235.  

o       Think on each contraction: What are you feeling (Phys / emo) What is your job? What is your partner’s job?  Relaxation, Rhythm, Ritual

o       Coping with Active Labor (They brainstorm and I reinforce). 11:35 – 42

o       Positions. Demonstrate, have them practice. 5-10 minutes. 11:42 – 11:55

·   Birth Video: Carl and Donna on Hello Baby. 11:55-12:05

o       If time, ask them: what did you see? (nurses, late dr. comfort)

·   Transition: Book 232-234.  12:05 – 12:12

o       Overview: Dilates to 10 cm. Ctx 2-3 mins apart, 60-90 secs long. Intense. 10 minutes to 2.5 hours; 1.5 hrs avg.. Discouraged, scared, angry. May be trembling, hot/cold, nauseous.

o       Partner: stay close! Variable Breathe (Says #), Encouragement. Take Charge.

·   Second Stage Labor. Book 235-42

o       Overview: dilated, baby’s descended, ready to be delivered. Ctx 3-5 mins apart, 45-90 secs. UTP. Grunts, groans.  Lasts 1-3 hours. Average 1.5. ~12:20

o       Breathing Pushing. Spontaneous versus directed pushing. Resisting UTP.

o       Positions for Pushing: Goal of these positions / criteria. Show them poster of different second stage positions, and have them evaluate. Book 227-229

o       Practice Positions and breathing. ~12:37

·   Third Stage Labor, and Initial Newborn Procedures. ~12:45

o       Placenta, Baby on chest, oxygen, Cord Blood. Book 232-245

·   Give homework: Labor Review and Birth Plan Handout

Over lunch: Hand out variations. Set up c-section video. Set up Comfort Techniques video

Variations of Labor, Interventions, and Pain Medication

·   Handouts: Common Variations of Labor, Breathing Techniques

·   Posters: Epidural, where inserted. Forceps, vacuum, episiotomy.

·   Materials: Flip chart on Induction, Amnio-hook. Flip on epidural. Any epidural supplies. Flip 2nd stage interventions. Flip cesarean. Video of procedure.

·   Bring from Home: Epidural role-play kit, epidural side effects poster

 

·   When back from lunch: Q&A

·   Breathing Techniques: 1:45 – 2:00

o       Cleansing. Deep Abdominal. Hee-Hee. Hee-Hee-Blow. Variable. Slide.

·   The Fast Labor: Touch on precipitous. Book 275 – 279.  ~2:05

·   Induction Book 260-75.  2:05-15

o       Post-dates, Other Reasons

o       Natural: Nipple Stim, Intercourse / Orgasm, Herbal, Acupressure

o       (ask dr. first!)

o       Medical: Prostaglandins, Pitocin, AROM (pass amnio hook)

o       Risks

·   Slow first stage labor: 2:15 – 2:20

o       Patience, self-care. Augmentation.

·   Back Labor.  284-290  2:20 – 2:30

o       Why? How to recognize. Getting baby to turn. Comfort.

·   Pain Medication

o       Confidence / Commitment. Communicating with partner about 2:30 – 2:40

§         Pain Med Pref Scale. 337-38 What does med/unmed birth look like?

§         Why you need coping techniques even if planning on meds.

o       IV Pain Meds / Narcotics (Lecture). 2:40 – 2:47

§         Usually i.v. Sometimes i.m. Timing, additional doses.

§         Not anesthesia: analgesia. Alter reaction to pain. “take the edge off.”

§         When are they useful?

§         Side effects on mom. Side effects on baby. Book 343

§         Environmental factors.

o       Epidural Role Play. 2:47 – 3:15

§         What? Advantages.

§         How administered? Side effects?  Pp. 345-349

§         Minimizing the Risks.  PUT UP POSTERS

·   Slow Second Stage. Second Stage Interventions Book 314-15.  3:15 – 3:25

o       Reasons

o       Forceps, VE (stops from receding), Episiotomy (75% tear). Preventing.

·   Cesarean Birth.  Book 317-34 3:25 – 3:45

§         Reasons. Risks.

§         Video of Procedure.

§         To help avoid cesarean.

 

Over break, set up stations. Can overflow into beginning of video.

Comfort Techniques, Postpartum Period, and Resources

Materials: Video. Everything for Stations.

Bring from home: Video of Comfort Techniques, Print-outs for Labor Stations, Equipment for Labor Stations

 

·   Video: Understanding Comfort Techniques 4:00 – 4:20

·   Labor Rehearsal: 4:20 – 4:50

·   Postpartum Period 4:55 – 5:10

o       Physical Recovery: Lochia (9 months worth of period), 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 5:10 – 5:15

o       (206) 386-MOMS Infant Care and Breastfeeding Hotline, 215-3338 Class Reg, Books, Websites, Coping with Confidence Class, www.pepsgroup.org

·   Evaluations, Questions, and Answers  5:15 – 5:30