45 minutes of CBE...Go!

[chitowndoula]

Hey ladies,
I am interning at a free/low cost clinic in a poor neighborhood in chicago. One of the things the clinic offers is Centering Pregnancy as an alternative to traditional prenatal care. The hospitals that these mothers give birth as are as conservative and not mother friendly as any I have seen or heard of. Excessivly high c-sec rates, nearly 100% epidural rate, routine episiotomys, you get the idea. Most women that we work with have grade school educations and live in extreme poverty. This is all just to set the stage for my real quesiton...

I have been asked to teach the comfort measures/stages of labor section of the Centering Pregnancy group. I have 45 minutes to explain the birth process, teach breathing/positions/comfort measures, talk about when to go to the hospital, and prep these mamas for what they are likely to expereince at the hospital without scaring the C**P out of them. If you were teaching this 'class' what would you include? Keeping in mind that the material needs to be presented at 2nd to 6th grade level.

I know it is far from ideal. There is so much that needs to change. But this is what I'm working with and I want to give these moms what I can with what I have. Also if you aren't familiar with Centering Pregnancy check out the website at
http://www.centeringhealthcare.org/p...y-overview.php

[VogueMum]

I would physically show them some comfort measures they and/or support person can do. Maybe mention about tuning into the breath and trusting their bodies. Maybe a quick explanation about why you shouldn't labor in bed and baby positioning. How about the importance of breastfeeding and doing it soon after the baby is born? Maybe bring up PPD? I would just touch on the stages of labor but focus more on coping skills. Hope that helped a little!

[AngelsMum]

Do you have many visual aids? I would think a baby & pelvis would be super-helpful to explaining why active birth works. I would use lots of analogies & visuals to explain concepts.

I would also use appropriate language to discuss how the body supports birth (ie. hormones etc).

[mamato6]

I had to give this some thought, because 45 minutes is tight to pack that much info in!
I'd probably spend 5 minutes on the benefits of going natural, explaining very quickly the benefits of the hormones to mom and baby.
I'd probably say something like "There are three stages of labor, the first stage where all the dilation and effacement takes place, the second stage is the pushing stage ending with the birth of the baby, and the third stage is the delivery of the placenta". Next I would go into detail with comfort measures combined. Early stage, dilation to 3/4cm.. can take hours or days (whatever), and these are things to do or not to do.. (like eat, stay hydrated, keep pelvis open, don't run any marathons, reserve energy) possibly say a sentence or two on how mom feels emotionally. Active stage, dilation from 4/5cm-8cm...on average takes anywhere from 2-16 hours (can take less, can take longer)..contractions get stronger, longer and closer together. Mom may feel X (just a couple of sentences). Here are some things to cope: Shower/tub, counter pressure, double hip squeeze, a swim noodle, a rice pack, staying up right, using a birth ball. (whatever) I'd probably spend 5 minutes talking about how giving birth actively helps reduce pain all on it's own. (This is probably going to be your longest talk session?).. Then talk briefly on transition.. usually the hardest and usually the shortest part of the labor. Ways to cope and how they might be doing physically and emotionally (vomiting, shaking, scared etc). More comfort measures if you have time, or focus on relaxation. Remind them to keep breathing through the contractions and not hold their breaths.. IF you have time talk about back labor, and things to do if that occurs.

I'd probably bring in my dilation model, doll and pelvis, a blown up birth ball, a swim noodle, some tennis or nerf balls.. give everybody something to try for about 30 seconds, and have them change stations to try another technique. (If possible do this in pairs so that others can help). Talk about how a doula can help, how to find a free or low cost doula..? I dunno!

I don't know what is more important if you still have time:: hospital or relaxation. I'm really leaning towards hospital. Is there anyway you can offer to teach a class privately to these girls? Maybe several would want to get together for a real class even if it's done privately? It's got to be frustrating to only get 45 minutes! I wish you lots of luck, and hope you can make a difference! Go get 'em!

[doularina]

Quote:

Originally Posted by mamato6 I'd probably bring in my dilation model, doll and pelvis, a blown up birth ball, a swim noodle...

How does one use a swim noodle in labor?

[chitowndoula]

Thank you so much ladies! The class is this afternoon! Wish me luck! Also, I too am wondering how to use a swim noodle in labor support??