1 / 26

Alternative Birthing Methods

Alternative Birthing Methods Erin Cook January 19, 2006 THRS Presentation Alternative Methods Lamaze Waterbirth Acupuncture, Acupressure, & Moxibustion Hypnobirthing Yoga Ginger for N/V Massage Reflexology for edema Perineal massage Red raspberry leaf & Chanlibao to shorten labor

jana
Télécharger la présentation

Alternative Birthing Methods

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Alternative Birthing Methods Erin Cook January 19, 2006 THRS Presentation

  2. Alternative Methods • Lamaze • Waterbirth • Acupuncture, Acupressure, & Moxibustion • Hypnobirthing • Yoga • Ginger for N/V • Massage • Reflexology for edema • Perineal massage • Red raspberry leaf & Chanlibao to shorten labor • Cabbage, tea, jasmine flowers for breast engorgement • Home birth / Midwives / Doulas

  3. Lamaze • Techniques developed by Dr. Fernand Lamaze (Paris, 1950’s) • American Society for Psychoprophylaxis in Obstetrics founded as a nonprofit in 1960 by Elisabeth Bing and Marjorie Karmel • Emphasis on activity during labor, breathing techniques to assist contractions, and relaxation methods to separate muscle groups

  4. Lamaze™ Philosophy of Birth • Birth is normal, natural, and healthy. • The experience of birth profoundly affects women and their families. • Women's inner wisdom guides them through birth. • Women's confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth. • Women have the right to give birth free from routine medical interventions. • Birth can safely take place in homes, birth centers and hospitals. • Childbirth education empowers women to make informed choices in health care, to assume responsibility for their health and to trust their inner wisdom.

  5. Lamaze • No longer just a “breathing” technique • Classes taught by a Lamaze Certified Childbirth Educator (some hospitals provide them) • “affirms the normalcy of birth, acknowledges women’s inherent ability to birth their babies, and explores all the ways that women find strength and comfort during labor and birth”

  6. Lamaze • Encourages many techniques to respond to contractions and find comfort • Emphasizes emotional and physical support during labor but not “coaching” • Goal: “every woman gives birth confidently, free to find comfort in a wide variety of ways, and supported by family and health care professionals who trust that she has within her the ability to give birth”

  7. Waterbirth • Waterbirth International founded in 1988 by Barbara Harper • Currently avaliable in 250 US Hospitals and 70% of birthing centers • Birthing tub at 95-100°F • May be used for labor • and/or birthing

  8. Waterbirth Benefits • Water is relaxing, soothing, and calming • Buoyancy decreases body weight and promotes circulation and efficient contractions • Lowers BP by reducing anxiety • Allows for increased endorphin production • Promotes elasticity of perineum • Provides a sense of privacy • Eases transition for baby

  9. Risks of Waterbirth • Theoretical risk of water embolism • Water aspiration • Cord Avulsion Contraindications • Herpes • Breech • Bleeding disorder • Multiples • Preterm • Severe Meconium • Pre-Eclampsia ACOG: “insufficient data to render an opinion”

  10. Waterbirths compared with landbirths: an observational study of nine years; Verena Geissbuehler*, Sonja Stein and Jakob Eberhard: J. Perinat. Med. 32 (2004) 308–314 • Compared 3617 waterbirths and 5901 landbirths (all spontaneous singltetons with cephalic presentation) in one hospital to assess differences in maternal and neonatal morbidity and mortality • Limited use of episiotomies in waterbirths (8.3% in waterbirths versus 25.7% in landbirths) does not lead to more third and fourth degree perineal lacerations • Landbirths show higher rates of episiotomies as well as third and fourth degree perineal lacerations. • After a waterbirth, there is an average loss of 5.26 g/l blood; this is significantly less than landbirths where there is an 8.08 g/l blood loss on average. • Waterbirths are not associated with increased risk of infection

  11. Unanswered questions • Effect of water on contractions • Degree of analgesia provided by warm water

  12. Acupuncture • Chinese in origin • Used for 4 main purposes • Induce labor • Relief of Nausea/vomiting • Turn breech presentation • Pain control

  13. Acupuncture • Nausea and vomiting • Acupoint 6: 3 fingerbreadths proximal to distal wrist crease and 1cm deep • 3 Studies • No significant difference between experimental and control • Decrease nausea but no change in emesis frequency • Decreased vomiting episodes in hyperemesis gravidarum

  14. Acupuncture • Breech Version • Utilizes acupuncture with moxibustion; heating of needles with burning Artemesia vulgaris • At 35 weeks, 75% of exposed fetuses were cephalic compared to 48% in controls, and at delivery 75% and 62%, respectively. This difference was significant despite 19 in the control group undergoing successful external cephalic version • Statistically significant results in 3 RCTs • In one RCT in a non-Chinese population in 1995 study interrupted due to compliance issues • No good data for success in Western countries

  15. Acupuncture • Labor induction • Acupuncture one time on due date (German study) • The time from estimated delivery date (EDD) to labor was 2 days shorter in the acupuncture group. No differences in clinically significant outcomes such as Bishop’s score or length of different labor stages • 4h session 8days after due date (American study) • The number of contractions in the experimental group significantly increased from 63 at baseline to 116 in the fourth hour of stimulation, compared with a decrease in the control group from 84 to 75

  16. Acupuncture • Labor analgesia (3 studies) • Acupuncture vs. sham-puncture • Recipients of the acupuncture had significantly lower reported levels of pain throughout labor, and lower oxytocin, epidural and narcotic use • Acupuncture vs. no acupuncture • no significant difference in pain intensity or delivery outcome, but observer-rated relaxation scores improved in the acupuncture group. Epidural use was 12% in the acupuncture group and 22% in the controls • Acupuncture vs. no-acupuncture • meperidine use was 11% in the acupuncture group compared to 37% in a no-acupuncture group

  17. Hypnobirthing • Founded in 1989 by Marie Morgan • “There is no pathological reason for pain in childbirth. There is nothing that actually malfunctions. It’s tension and fear and interventions that cause the malfunctioning.”

  18. Hypnobirthing • Trained therapists teach women to self-hypnotize and control breathing to match contractions • Allows women to remove themselves from the pain of childbirth • Techniques learned include self-hypnosis, deep relaxation, visualizations, positions and special breathing methods

  19. Hypnobirthing • Benefits • A more relaxed and enjoyable pregnancy • Shortens the first stage of labour by several hours • Eliminates or greatly reduces the need for medical intervention • Fewer breech presentations and other special circumstances • Easier and calmer resolution in the event of special circumstances • A more enjoyable, peaceful birth experience rather than a tense, stressful ordeal • A special, integral role for the birth companion • Reduces risk of hyperventilation from “shallow” breathing methods • Promotes bonding of mum, baby and birth companion • Babies are calm at birth and really alert • More rapid postnatal recovery • Returns childbirth to a positive and beautiful experience that nature intended www.hypno-birthing,org.uk

  20. Yoga

  21. Yoga • Many prenatal yoga classes and videos avaliable • Benefits in prenatal period • Relief of aches and pains, swelling, insomnia • Strengthen pelvic floor muscles • Teaches deep breathing techniques • Contributes to general health and well-being

  22. Yoga • RCT in India (2005) • birth-weight is significantly higher in the Yoga group, compared to the control (walking) group • Occurrence of complications of pregnancy (pregnancy-induced hypertension, intrauterine growth retardation, pre-term delivery) shows lower trends in yoga group • No significant adverse outcomes in yoga group

  23. Conclusions • Many methods available to women • Alternative methods focus on putting women in control of birth environment and process • Controversy exists regarding need for fetal monitoring and psychological effects of invasive instruments

  24. References • www.americanpregnancy.org • www.waterbirth.org • www.parenthood.com • www.hypnobirthing.org • www.lamaze.org • Anderson F, C Johnson: Complementary and alternative medicine in obstetrics. International Journal of Ob/Gyn (2005) 91, 116-124. • Cardini F, P Lombardo, A Regalia, G Regaldo, A Zanini, M Negri, L Panepuccia, T Todros: A randomized controlled trial of moxibustion for breech presentation. BJOG. June 2005, Vol. 112, 7453-747. • Geissbuehler V, S Stein, J Eberhard: Waterbirths compared with landbirths: an observational study of nine years. J. Perinat. Med. 32 (2004) 308-314 • Hyangsook L, E Edzart: Acupuncture for labor pain management: A systemic review. American Journal of Ob/Gyn (2004) 191. 1573-9. • Lamaze International (2001). Position paper- Lamaze for the 21st century. • Narendran S, Nagarathna R, Gunasheela S, Nagendra HR Efficacy of yoga in pregnant women with abnormal Doppler study of umbilical and uterine arteries.J Indian Med Assoc. 2005 Jan;103(1):12-4, 16-7

More Related