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4/15/2018 What Factors Influence the Progression of Childbirth?

| Taking Charge of Your Health & Wellbeing

University of Minnesota

What Factors In uence the

Progression of Childbirth?
Your body is perfectly designed to
promote a healthy pregnancy and Holistic Pregnancy
childbirth. For the majority of healthy
women, childbirth progresses & Childbirth Home
spontaneously without complications. (h ps://www.takingchar
However, there are steps you can take to
promote this normal progression, and ge.csh.umn.edu/explore
there are factors that can interfere with it. -healing-

What are the practices/holistic-

physical factors? pregnancy-childbirth)

Many physical factors can promote the
A holistic approach
progression of labor.
Why go holistic?
Position of the baby
Birthing positions
The position of your baby might play a
role. Most babies navigate best through What about pain?
the pelvis if they are head down, with their
face toward your spine. This is called an History of childbirth
anterior position. During the last weeks of How childbirth works
pregnancy, try to promote this positioning
of your baby. Factors that in uence

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Avoid lying on your back. Preparing for pregnancy

When relaxing, choose forward and birth
leaning positions such as sitting on a
Get birth support
physical therapy ball with your legs
apart. Classes and birth plans
When resting or sleeping, lay on your Research
side as far to your stomach as you
comfortably can.

Your position
As contractions begin, choose positions of comfort.
Freedom of movement and frequent position
changes can help the baby choose optimal positions
for birth. Upright positions allow you to use gravity to
promote the downward movement of the baby.

You might find it very difficult to move during a

contraction. That's okay - just relax as much as
possible during the contraction, breathe slowly and
deeply, and move when it is over. You might also
find that changing to a new position makes the
contraction more intense or painful. However, try to
avoid switching again too soon - try several
contractions in the new position, readjusting and
regrouping - before deciding to abandon it. Alternate
upright positions with positions of rest, such as
sitting in a rocking chair or side-lying in bed.

How can emotions impact labor?

Your emotional wellbeing is very important during labor. Do what you can during pregnancy
to address fears and concerns so you can enter labor with confidence in yourself, your
partner, your other birth attendants, and your midwife or doctor.

You can also use guided relaxation or meditation at any time during labor to help you build
images of safety and strength, or to identify fears that might need to be addressed.

Women in labor are often advised to let go and release control of labor to their bodies' own
innate ability. In order to do this, you will need to feel safe with the environment and with
your chosen care providers and support people. Because labor is a time when many
women feel vulnerable, you should ask for understanding, support, and respect from those
around you to help enhance your feelings of safety and strength.

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What helps the natural progression of

Support Touch Water
The active Human touch
participation of can also help Many
your partner, labor progress. childbirth
doula, labor This touch can professionals
nurse, take many promote the
midwife, or forms: back use of water
doctor is one and hip therapy-
way to counter- immersion in a
promote the pressure to warm tub or
natural help alleviate warm shower-
progression of pain, massage to cope with
labor. to promote and shorten
Research relaxation, active labor. In
shows that the acupressure to general, it is
presence of a alleviate pain best to wait
doula or other or promote until labor is
supportive effective well
person is contractions, established
associated or energy work before
with many such as entering the
positive Therapeutic water or
bene ts during Touch or Reiki your contractions
childbirth, to promote might become
including relaxation and less strong or
shorter labors, pain relief. less frequent.
less use of (However this
pain might not
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medication or It can even be necessarily be

epidurals, as simple as a
fewer cesarean holding disadvantage,
sections, and someone's if you need a
successful hand for break from a
breastfeeding. support. long labor to
Your midwife, rest and
doctor, or regroup.)
labor nurse
may spend
you, but they
might also
for other
women as
well. A doula,
on the other
hand, is likely
to spend much
of your labor
with you.

Lighting Sound and

One of the
pioneers in the You might
natural want to
childbirth bring music
movement, that you enjoy,
obstetrician nd
Robert Bradley, meaningful to
compared the you, or feel
medicated and simply
dif cult promotes
childbirths of feelings of
women in relaxation.
brightly lit,
tiled delivery You can also
rooms with the consider
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relatively easy which can

births of contribute to
animals that feelings of
chose dark, wellbeing and
comfortable thus in uence
places of your course of
safety. Thus, labor. Many
his initial birth
recommendation professionals
to promote the recommend
natural the use of
progress of lavender
labor was to during labor.
choose a dark, You can try an
quiet infuser or
environment. make a small
  sachet.  Check
ahead of time
for any
policies on

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What factors may interfere with the natural

progression of labor?
It should come as no surprise that the opposites of
some of the promoting factors we discussed above can
interfere with labor progress.

1 of 7

What effects can pain medication and

epidurals have on the progression of
Pain medication and regional anesthetics (such as epidural, intrathecal, or spinal
anesthesia) bear special mention. Most midwives and physicians agree that the use of
pain medication or regional anesthesia during early labor can slow labor progress. A
common midwifery text by Varney describes this very well, cautioning midwives about
using IV pain medication too early in labor: "although you have made the woman extremely
comfortable, you have lengthened the total labor by several hours (for which she would
probably not thank you if she knew)."

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Risks of epidurals
Most researchers have concluded that epidurals or
other regional anesthesia may be associated with
longer labors, longer pushing, increased risk of
vacuum, forceps, and cesarean sections, as well
as increased risk of other complications, such as
low blood pressure (which might adversely affect
the baby), fever, headache, and nerve damage. (It
should be noted however that a newer research
study challenges the association with longer labor
lengths and increased cesarean sections.)

Situations where they may be

bene cial
However, in some instances, pain medication or
epidural anesthesia might help to promote labor

Medication might help women who are very fearful and who have not been able to
alleviate this anxiety with emotional support.
Anesthesia might help the pelvic muscles relax when a woman cannot relax using
breathing, relaxation, and supportive techniques.
Epidurals might help women with an uncontrollable urge to push against an only
partially dilated or swollen cervix to stop pushing, allowing the swelling of the cervix to
subside and dilation to continue.

What you should ask about medications

You should make a decision to use medications or

interventions during labor carefully and take plenty of time to
ask questions about this during your prenatal exams. Ask your
midwife or physician for input if you are considering these
choices. Informed consent for medications, or for other
proposed labor interventions, means that you know the

The name of the drug, procedure, or other intervention.

The reason the drug, procedure, or intervention is being
proposed (the bene ts).
The potential risks of the proposed therapy.
What would happen if you did not use the proposed
therapy, or if you waited.
What alternatives exist to the proposed therapy.

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Unless there is an emergency, it is always appropriate to ask

questions, and to ask to be given time to talk privately with
your partner as you make a decision. We've mentioned this
before, but it is worth saying again: try not to make a decision
about pain medication in the middle of a contraction!

A very brief description of some medical forms of pain relief

for labor and their risks and bene ts can be found at

Birthing Questions Review

Positions to ask your these
birthplace questions
with your
There are
midwife or
several Bring these
birthing questions with
position you as you
options to consider Review these
consider. View potential questions with
these photos birthing your midwife
and read their centers or or doctor.
descriptions to hospitals.
help prepare
for childbirth.

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Expert Contributor: Kathryn Leggitt, RNC, MS, CNM

Reviewed by: Deborah Ringdahl, DNP, RN, CNM


Aromatherap Reiki How thoughts

and emotions
affect health

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