3 Rs: Relaxation, Rhythm, and Ritual Penny Simkin, P.T. Penny - - PowerPoint PPT Presentation

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

Fernand Lamaze Lamaze

• Elisabeth

Elisabeth Bing Bing

• Pavlov’s conditioned response

Pavlov’s conditioned response

• Intricate mental activity

Intricate mental activity

• Patterned breathing

Patterned breathing

• “Purple pushing”

“Purple pushing”

• Monitrice

Monitrice

• 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

Painless Childbirth, cont. Painless Childbirth, cont.

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 Sheila Kitzinger Kitzinger

• 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

• f supportive care during
• f 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

Essence of Coping Essence of Coping

• Marie

Marie Mongan Mongan

• Hypnobirthing

Hypnobirthing

• Replace fear with deep

Replace fear with deep relaxation, affirmations, and relaxation, affirmations, and partner support partner support

Essence of Coping, cont Essence of Coping, cont.

• Pam England

Pam England

• Woman as warrior

Woman as warrior

• Exploring and enhancing

Exploring and enhancing inner strengths inner strengths

• Birth Art

Birth Art

• Zen approach

Zen approach

• Unfocused awareness

Unfocused awareness

Essence of Coping, cont. Essence of Coping, cont.

• Penny Simkin

Penny Simkin – – The 3 The 3 Rs Rs

• R

Relaxation elaxation

• R

Rhythm hythm

• R

Ritual itual

• Women who cope well exhibit

Women who cope well exhibit these qualities these qualities

Videotape Videotape “Relaxation, Rhythm, & “Relaxation, Rhythm, & Ritual: Ritual:

The 3 Rs of Childbirth

Birth Rap Birth Rap

by Karen by Karen Miltner Miltner with Penny Simkin with Penny Simkin

My body knows just what to do My body knows just what to do My My-

• body

body ٠ ٠ ٠ ٠ knows knows-

• just

just-

• what to do

what to do My body knows just what to do My body knows just what to do-

• My

My-

• body

body-

• knows

knows ٠ ٠ ٠ ٠ just what to do just what to do

Birth Rap Birth Rap,

, cont

cont

My baby grows and knows My baby grows and knows-

• how to be

how to be My My-

• baby

baby ٠ ٠ ٠ ٠ grows grows-

• and

and-

• knows

knows-

• how to be

how to be My baby grows and knows My baby grows and knows-

• how to be

how to be-

• My

My-

• baby

baby-

• grows

grows ٠ ٠ ٠ ٠ and knows and knows-

• how to be

how to be

Birth “As Nature Intended”*

• The future direction of childbirth

preparation?

• Emphasizes the normal physiological

process of birth

• Emphasizes the mind-body-spirit

connection

• Emphasizes care that enhances the

normal process

*--Judy Lothian, of Lamaze International

Conclusions

• Childbirth preparation has undergone an

evolution over the past 50 years

• It reflects changing times, changing

knowledge, and a changing society

• It has always placed women and

partners (and more recently, babies) at the center of childbirth

• It has emphasized other influences

(support, environment) as new knowledge became available.