3 R’s: Relaxation, Rhythm, and Ritual Penny Simkin, P.T. Penny Simkin, P.T.
Evolution of Childbirth Empowerment • History of changes in History of changes in • women’s role in childbirth women’s role in childbirth • Childbirth preparation Childbirth preparation • methods/philosophies methods/philosophies
Painless Childbirth Painless Childbirth • Labor is not painful in itself Labor is not painful in itself • • If a woman feels pain, it is because she If a woman feels pain, it is because she • is afraid and tense is afraid and tense • A woman can master techniques to A woman can master techniques to • prevent labor pain prevent labor pain • Women who have pain Women who have pain- -free labor are to free labor are to • be admired be admired • “Blame the woman” who suffers pain “Blame the woman” who suffers pain •
Painless Childbirth Painless Childbirth • Grantly Grantly Dick Read Dick Read • • Fear tension, pain cycle Fear tension, pain cycle • • Passive relaxation Passive relaxation • • Abdominal breathing Abdominal breathing • • Knowledge Knowledge • • “Purple pushing” “Purple pushing” • • Labor support Labor support •
Painless Childbirth, cont. Painless Childbirth, cont. Fernand Lamaze Lamaze • Fernand • • Elisabeth Bing Bing • Elisabeth • Pavlov’s conditioned response • Pavlov’s conditioned response • Intricate mental activity • Intricate mental activity • Patterned breathing • Patterned breathing • “Purple pushing” • “Purple pushing” • Monitrice • Monitrice
Painless Childbirth, cont. Painless Childbirth, cont. • Robert Bradley • Robert Bradley • Read method, modified Read method, modified • • Husband as coach Husband as coach • • First North American First North American • contribution to childbirth contribution to childbirth preparation preparation
Pain as a Side Effect Pain as a Side Effect Pain with a Purpose Pain with a Purpose • Labor pain is a side effect of a normal Labor pain is a side effect of a normal • process process • Labor pain is not to be feared or Labor pain is not to be feared or • avoided avoided • Labor pain guides the mother to seek Labor pain guides the mother to seek • movements and behaviors for comfort movements and behaviors for comfort
Pain as a Side Effect Pain as a Side Effect Pain with a Purpose Pain with a Purpose Sheila Kitzinger Kitzinger Sheila • Body awareness Body awareness • • Psychosexual approach Psychosexual approach • • Guided imagery Guided imagery • • “Breathe the baby out” “Breathe the baby out” • • Husband/father’s presence as Husband/father’s presence as • support support
Pain as a Side Effect Pain as a Side Effect Pain with a Purpose, cont. Pain with a Purpose, cont. • Elizabeth Noble Elizabeth Noble • • Birth “with insight” Birth “with insight” • • Critical of “the breathing” Critical of “the breathing” • • Breath awareness Breath awareness • • Exhalation pushing Exhalation pushing • • Alternative birth settings Alternative birth settings •
Pain as a Side Effect Pain as a Side Effect Pain with a Purpose, cont. Pain with a Purpose, cont. • Gayle Peterson • Gayle Peterson • “As a woman lives, so will “As a woman lives, so will • she give birth” she give birth” • Birth visualizations Birth visualizations • • Psychotherapeutic approach Psychotherapeutic approach • • De De- -emphasis on a “method” emphasis on a “method” • • Alternative birth settings. Alternative birth settings. •
Emphasis on Baby’s Emphasis on Baby’s Experience of Birth Experience of Birth • Recognition that baby is conscious and Recognition that baby is conscious and • has memory has memory • Mother’s emotions impact the baby Mother’s emotions impact the baby • • Medications, interventions impact baby Medications, interventions impact baby • • The baby has ability to “help” the birth The baby has ability to “help” the birth •
Emphasis on Baby’s Emphasis on Baby’s Experience of Birth Experience of Birth • Frederick Frederick Leboyer Leboyer • • Gentle birth Gentle birth • • Quiet room, dim light Quiet room, dim light • • Womb to water to air Womb to water to air • • “Mother as Monster” “Mother as Monster” •
Emphasis on Baby’s Emphasis on Baby’s Experience of Birth (cont.) Experience of Birth (cont.) • John Kennell & Marshall Klaus John Kennell & Marshall Klaus • • “Bonding” “Bonding” • • The sensitive period (1 The sensitive period (1- -2 hrs. 2 hrs. • after birth) after birth) • Immediate skin Immediate skin- -to to- -skin skin mother mother- - • infant contact infant contact
Emphasis on Environment Emphasis on Environment • Comfort, feelings of “safety,” familiarity Comfort, feelings of “safety,” familiarity • • Home or “homelike” place Home or “homelike” place • • Encourages spontaneity, Encourages spontaneity, • individualization in coping styles individualization in coping styles • Provides for a variety of positions, Provides for a variety of positions, • movements, and coping aids movements, and coping aids
Emphasis on Environment, Emphasis on Environment, cont. cont. • Ina May Gaskin Ina May Gaskin • • Midwife Midwife- -attended home birth attended home birth • • Birth as a spiritual Birth as a spiritual • experience experience • Women teaching and Women teaching and • learning from other women learning from other women
Emphasis on Environment, Emphasis on Environment, cont. cont. • Michel Odent Michel Odent • • “Salle “Salle sauvage sauvage” ” • • Spontaneous behavior Spontaneous behavior • • Bath available for pain Bath available for pain • • No disturbance No disturbance • • Presence of a “mother figure” Presence of a “mother figure” • • Supported squat position Supported squat position •
Emphasis on Environment, Emphasis on Environment, cont. cont. • Water Birth Water Birth • • Michel Odent, Barbara Michel Odent, Barbara • Harper Harper • Controversies over effects on Controversies over effects on • labor and safety for baby now labor and safety for baby now largely resolved with largely resolved with appropriate protocols appropriate protocols
Emphasis on Emotional Emphasis on Emotional Support Support • The woman’s emotional experience The woman’s emotional experience • during birth influences outcome during birth influences outcome • When women are cared for, respected, When women are cared for, respected, • and nurtured… and nurtured… – Labor progresses more normally Labor progresses more normally – – Satisfaction is greater Satisfaction is greater – – Mother Mother- -infant relationship is improved infant relationship is improved – – Memories of birth are more positive Memories of birth are more positive –
Emphasis on Support for the Emphasis on Support for the Woman and Partner Woman and Partner • Marshall & Phyllis Klaus, Marshall & Phyllis Klaus, • John Kennell John Kennell • Continuous presence of Continuous presence of • doula doula • Reassurance, guidance, Reassurance, guidance, • physical comfort, physical comfort, information information • Improved obstetrical and Improved obstetrical and • psychological outcomes psychological outcomes
Emphasis on Support for the Emphasis on Support for the Woman and Partner, cont. Woman and Partner, cont. • Penny Simkin Penny Simkin • • Birth as a lifelong memory Birth as a lifelong memory • • Guide to support during labor Guide to support during labor • • Understanding by partner or Understanding by partner or • doula of woman’s experience doula of woman’s experience • Doulas of North America Doulas of North America •
Emphasis on Support for the Emphasis on Support for the Woman and Partner, cont. Woman and Partner, cont. • Polly Perez Polly Perez • • Monitrice as labor support Monitrice as labor support • • A caring heart A caring heart -- -- the essence the essence • of supportive care during of supportive care during labor labor • Professional labor assistant Professional labor assistant – – • change agent change agent
Essence of Coping Essence of Coping • Strengthen women’s internal resources Strengthen women’s internal resources • • Look to other disciplines for innovations Look to other disciplines for innovations • in women’s coping techniques in women’s coping techniques • Recognize the many ways that women Recognize the many ways that women • cope well with labor pain and stress cope well with labor pain and stress • Identify and teach qualities shared by Identify and teach qualities shared by • laboring women who are coping well laboring women who are coping well
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