Labor Needs

Peggy Korman CNM

Assignment

• Upon successful completion of this unit, the student will be prepared to use standards of professional nursing practice in developing interventions to meet the needs of the laboring woman and her partner

How to meet the needs of the laboring woman and her partner

Reflection

• How do you view birth?

• What beliefs will guide your interventions?

Normalcy: treat birth as a natural, healthy process

Empowerment: provide the birthing woman and her family with supportive, sensative and respectful care

Autonomy: enable women to make decisions based on accurate information and provide access to the full range of

options for care

Do no harm: provide safe care, avoid routine use of tests, procedures, drugs and restrictions,

respect the birth plan

Responsibility: give evidence-based care solely for the needs and in the interest of mothers and

infants

Options

• Pharmacological pain management

• Anesthesia: Epidural• Non-pharmacological

Needs

• Basic comfort needs: nourishment, rest, hygiene, elimination

• Information/Education needs: to make informed choices

• Love and support for family & caregivers:

“mother the mother”

How to Help

• Nurse needs to respond to the progess in labor by suggesting position changes, body massage, emesis basin handy, towels, ice, moist hot/cold, hydration

• Informing the woman about expected physical sensations so as not to be caught unaware.

• Ongoing verbal support and reassurance. Give direction and encouragement.

The Olympics of Birthing

• Asking your body to perform under stress for a number of hours

• Needs energy, massage to match the phase and stage

Perception

• How much pain is expected or tolerable is strongly influenced by culture

• Women in the Netherlands and in Japan do not view labor pain as negative or unacceptable, and there is no epidemic of epidurals for normal labor in either country.

The U.S.

• The way women perceive labor pain is strongly influenced by the way her care giver perceives pain

Physiological basis for pain

• Purpose of pain=alerts us that something is not in harmony with our body.

• Typically evokes a response• Labor pain is different, it is purposeful, not

pathologic, alerts us a baby is to be born Joyful• Pain is an essential component of normal labor,

it is necessary for the release of hormones that control the progress of labor, requires no treatment

Disadvantages of invasive methods of pain control

• When an epidural block removes all feeling in a woman’s lower body, the necessary hormones are not released and labor does not progress normally, leading to more intervention.

Alternatives

• Many far safer, less invasive methods of pain control that have been scientifically proven to be effective

• Presence of family is one

• The level interest and commitment of fathers to the birth of their children is high-professional sports star

Childbirth Education

• Knowledge replaces fear

• Fear…anxiety….tension…heightens perception of painful stimuli

• Muscular tension…decreases oxygen…increases pain. Try massage & relaxation techniques

• Behavioral modification. Breathe in purposeful fashion, focal point, massage

Other alternatives

• Water tubs and showers

• Freedom of movement-sitting up and walking around, changing positions

• Continuous one-on-on attendance by the nurse, midwife, doula

• Acupuncture

• Hypnosis

• Aromatherapy

Water tubs

Assessment of Needs

• “take a listening breath” before you enter the client’s room

• Nurses do so much multi-tasking that we may be thinking about the next 3 things we need to do and not necessarily about the immediate task

• “Taking a breath means remembering why we’re there”

Body language

• Increasing your peripheral awareness when you enter the client’s room will help you understand how your own body language is perceived by the client

• “Read your patient” gauge the emotional climate of the room and audience

Emotional Climate?