Teaching about NAP.

AltHealthMomma · 09-10-2009, 11:13 AM

Wondering how other approach NAP (Natural Alignment Plateu/Positioning). I currently go over it when discussing labor and birth (right before second stage). I have enough info to pass along to clients, but I want more for myself. Anyone have great resources or study references to share? The one reference I have is by Zang.
TIA!

TO Doula · 09-10-2009, 01:56 PM

I've never even heard of this. Must go read!

amylou · 09-10-2009, 02:38 PM

I remember going over it in my Bradley training, so I don't know if that would be a good place to look for more info.

Rain Forest Doula · 09-10-2009, 05:12 PM

I also go over this with my clients. I first heard of this in my bradley class also. Would you mind sharing what you have by ZANG?

AltHealthMomma · 09-13-2009, 05:48 PM

My clients find this such a great concept. Personally, it makes so much sense, esp. to me in terms of women who "don't experience the urge to push." I suspect many would given time for baby/mom's body to complete whatever adjustements they experience in NAP and then go on. The Zang citation does not use the term "NAP" but is clearly discussing the phenomenon. Also worth noting, it is discussed in the Childbirth Education text / Maternity Nursing text I use. Can't recall if it is both or just one right now. very, very tired.

Citation access via : http://www.ncbi.nlm.nih.gov/pubmed/12388957

Zhang J et al. Reassessing the labor curve in nulliparous women. Am J Obstet Gynecol 2002 Oct; 187:824-8.

Abstract:
"RESULTS: Our average labor curve differs markedly from the Friedman curve. The cervix dilated substantially slower in the active phase. It took approximately 5.5 hours from 4 cm to 10 cm, compared with 2.5 hours under the Friedman curve. We observed no deceleration phase. Before 7 cm, no perceivable change in cervical dilation for more than 2 hour was not uncommon. The 5th percentiles of rate of cervical dilation were all below 1 cm per hour. The 95th percentile of time interval for fetal descent from station +1/3 to +2/3 was 3 hours at the second stage. CONCLUSION: Our results suggest that the pattern of labor progression in contemporary practice differs significantly from the Friedman curve. The diagnostic criteria for protraction and arrest disorders of labor may be too stringent in nulliparous women."

HorizonBirth09 · 11-03-2009, 04:06 PM

Quote:

Originally Posted by Rean

I've never even heard of this. Must go read!

I hadn't either! This is what I found on facebook:

http://www.youtube.com/watch?v=6aEk-...layer_embedded

DoulaMorgan · 11-06-2009, 04:43 PM

I find that the friedman curve almost NEVER applies in real life. Of course that is purely ancedotal.

sunshine · 11-12-2009, 01:41 AM

Quote:

Originally Posted by HorizonBirth09

I hadn't either! This is what I found on facebook:

http://www.youtube.com/watch?v=6aEk-...layer_embedded

this is excellent! thank you for sharing.

i think "normal" labor is incredibly hard to define and to find. if we stopped checking on cervical dilation and just patiently waited for moms to tell us they are pushing, we would avoid many many c/s. vaginal exams are too intrusive and can cause a mama to stall. the stress of hearing she is "still" whatever number, can cause her to stall. heck, the darned position she has to get into to get a check is bad for labor. i think labor progress happens in fits and starts all the time, and we could just patiently accept this as normal. simply accept that each labor is unique.