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PROGRESSION
Getting from Here to There in Labor1
The Journey
 Birth is a journey. If you look toward the end, it can
seem too far away.
 Progression is how you get to and through that end
and keep your sanity in the meantime. You must
focus on what is immediate.
 That’s how the athlete, dancer, or artist with skills
behaves, and your job is the same as theirs.
 The goal is reached by the small, discrete steps
you take now.
http://www.birthingbetter.com
Three Timeframes
1st Stage
 During this Stage, your baby moves down through the
hole in your pelvis, and your cervix opens.
 At the end of 1st Stage is a period of labor called “transition,”
which can be the toughest, yet shortest, part of 1st Stage.
This is the period when the cervix opens entirely and your
baby’s head moves all the way through your pelvis and into
the top of your vagina (its birth canal).
http://www.birthingbetter.com
2nd Stage
 This Stage is what people call the “delivery” or
“birth”. Your baby moves through and out of your
vagina and into your arms.
3rd Stage
 This Stage is when you deliver the
afterbirth/placenta.
http://www.birthingbetter.com
What is Labor?
 Labor is composed of contractions and a space
between.
 Your baby stimulates its home. Stimulation causes
the uterus to tug open its closure.
 Tugging open is the contraction, and then the
uterine muscle rests, which is the space in
between.
 Contraction has five phases, and you will work
through each phase.
http://www.birthingbetter.com
An important factor of labor
 You will inhale and exhale through one breath cycle
after another, so use effective, sustainable breathing
skills that give you the ability to work and cope with
the sensations of each contraction.
 Your body will always be in some position or posture
throughout the labor, so learn how to find positions
that truly relax you inside, help you stay open, and
create space for your baby to move through and out
of your body.
 Your husband/partner will be there to help you cope
with the hard work. This is not the same role as for
your birth provider.
http://www.birthingbetter.com
What can you expect during
progressive labor?
 Most people think that the three stages of childbirth
each have a very clear beginning and ending. That’s
not always accurate. The beginning part of 1st stage
can be terribly unclear, manifesting as “false labor,”
“pre labor”, “niggling labor”, or non progressive labor”.
 The other end of the 1st stage is “active labor”
 Active labor is NOT the same as progressing labor.
Women can be in active non-progressing labor.
http://www.birthingbetter.com
During progressive labor(which
happens in the 1st stage)
 Contractions get longer (timeable),
 The space between contractions gets shorter
(timeable), and
 Contractions get more intense (not timeable, but felt
by the woman).
Short form for this: longer, stronger, closer together.
http://www.birthingbetter.com
An important factor about progressive
labor
 When labor is progressing, each contraction has a
bell-shaped curve that can be drawn on a graph, as it
starts, gets more intense, reaches a peak, subsides,
and ends.
 The operative word is “bell”, rather than a “plateau”,
which has no defined peak. Flat contraction indicate a
stalled labor.
http://www.birthingbetter.com
What stalls labor?
 There are a finite number of reasons. We’ll start with some of
the more uncommon ones:
• A short umbilical cord
• Cord wrapped around the baby’s body
• Placenta in the way
• The baby in an unusual position
• The baby is just too big to come through the pelvic tube
 More common things women do without realizing that these
things are hindering the process.
• Being tense
• Bending over, leaning forward
• Being closed or not being in open positions
http://www.birthingbetter.com
Your birthing body basically uses three parts:
 The cervix – in your Pink Kit resources, you’ll learn skills such as the following to help your cervix
open:
• Pelvic Clock
• Cervical Relaxation
• Deep Touch Relaxation
• Directed Breathing
 The pelvis
• Mapping Your Pelvis
• Body Positions
• Hip Lift
• Kate’s Cat
• Sacral Maneuver
• Deep Touch Relaxation
 The birth Canal or Vagina- you will learn how to do Internal Work on your birth canal.
• Sit Bone Spread
• Kate’s Cat
• Sacral Maneuver
• Body Positions
http://www.birthingbetter.com
When to use what pink kit skills?
 Practice During Pregnancy
• Labor is no different. You learn your Pink Kit skills, practice them
more and more as you get closer to the birth experience, and use
them throughout the birth.
 These are the important reasons why you want to ready yourselves
with skills.
• The process your baby is going through deserves your full
attention.
• You and your partner will truly become a team with the goal of
working with your baby’s efforts.
http://www.birthingbetter.com
Practiced? Now Use the Skills During
Pre-Labor!
 After months of practising your skills while pregnant,
you are now actually beginning to work with the
efforts your baby will make shortly to come down,
through, and out your body.
 As you start to experience these pre-labor changes, it
is a good time to begin the “touch relaxation” to help
calm down the hormone rushes. Also, begin using
some of your other skills.
• Kate’s Cat
• Body Positions
• Start your teamwork, as well
http://www.birthingbetter.com
Use the Skills During 1st Stage
 This is what you need to focus on during the 1st stage: use
your skills to work with each contraction and each space in
between.
 During the driving journey, you stopped to rest. You can’t do
that in labor. There is no stop (except the times between
contractions) until your baby is born. This means two things:
• No matter what is happening on this birth journey, you
cannot choose one convenient, long rest stop. Instead,
you will have many, many short ones that happen when
your baby feels like it.
• Even during your brief rests, you cannot put your skills
aside as you do when you break an auto journey. You must
use energy-conserving skills in between contractions.
http://www.birthingbetter.com
Cont. Use the Skills During 1st Stage
 As for working phases themselves (contractions), you have another whose
set of skills.
• Directed Breathing- helps you cope with the natural pain during contractions
and helps you achieve deep relaxation.
• Pelvic Clock- helps you relax the soft tissue of the pelvic floor, both during
contractions and rest periods.
• Cervical Relaxation – helps you relax the soft tissue of the cervix.
• Letting Down Reflex Relaxation- helps with a pinched cervix.
• Uterine Lift—Improves the effectiveness of contractions.
• Thai Massage—Helps the baby move down into the pelvic inlet.
• “Bony Structure” skills (e.g. Hip Lift, Rocking the Sacrum, Kate’s Cat)—Create
structural and internal relaxation.
• Choosing Body Positions that help create internal relaxation and eliminate
internal tension no matter what posture or position you are in.
http://www.birthingbetter.com
Use the Skills During 2nd Stage
 To reduce or prevent a delayed 2nd Stage, your job is first to prepare this
area during pregnancy to become stretchable tissue, and second to use your
skills to keep your active labor progressing.
 This final part of your baby’s journey is still an exercise in plumbing an object
has to come down, through, and out this last part of your body: your vagina,
your baby’s birth canal.
 These are the skills you’ll use to keep this phase of labor progressive:
• Breathing into the Perineum
• Letting Down Reflex Relaxation, to counteract your instinctive reaction to feeling
the baby coming down
• Internal Work
• Sit Bone Spread
• Hip Lift
• Kate’s Cat
• External Massage
http://www.birthingbetter.com
Cont. Use the Skills During 2nd Stage
 Anterior Lip -An anterior lip is caused by your baby pinching
the front of the cervix against the pubic bone, thus preventing
the final full dilation.
 These are the skills:
• Letting Down Reflex Relaxation
• Sit Bone Spread
• Kate’s Cat
• Hip Lift
• Sacral Maneuver
http://www.birthingbetter.com
Use the Skills During 3rd Stage
 The most dangerous period of labor is after the baby is born
and before the placenta is delivered, because this is the time
when a woman might bleed excessively.
 If excessive bleeding occurs, the woman will be given an
injection that will contract her uterus.
http://www.birthingbetter.com
Basic take-away
 Birth is unknown until it unfolds. You just have to work with
what you have, but there are two very important things that
you have huge control over:
1. Don’t go into labor tired.
2. Don’t overreact to contractions when they are lasting 15–
30 seconds and are 5–20 minutes apart. Instead, quietly
learn about your contractions and teach yourself how to
relax in this early phase, so you develop good labor
management skills for the later stages.
http://www.birthingbetter.com
End of the Road: Making Memories
 Giving birth is seen from several time perspectives. The first
perspective is when you’re pregnant and you look forward to
the birth experience, knowing it’s unknown until it happens.
 Then you view the experience as it unfolds and as you
experience it. Then you look back immediately afterwards with
opinions and emotions.
 Finally, you periodically look back throughout your life. The
birth of your baby is always something you look back on.
 Only the human mind has the ability to imagine the future, be
so self-reflective in the present, and recall experiences in the
past.
http://www.birthingbetter.com

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Progression of labour ... a new insight.

  • 1. PROGRESSION Getting from Here to There in Labor1
  • 2. The Journey  Birth is a journey. If you look toward the end, it can seem too far away.  Progression is how you get to and through that end and keep your sanity in the meantime. You must focus on what is immediate.  That’s how the athlete, dancer, or artist with skills behaves, and your job is the same as theirs.  The goal is reached by the small, discrete steps you take now. http://www.birthingbetter.com
  • 3. Three Timeframes 1st Stage  During this Stage, your baby moves down through the hole in your pelvis, and your cervix opens.  At the end of 1st Stage is a period of labor called “transition,” which can be the toughest, yet shortest, part of 1st Stage. This is the period when the cervix opens entirely and your baby’s head moves all the way through your pelvis and into the top of your vagina (its birth canal). http://www.birthingbetter.com
  • 4. 2nd Stage  This Stage is what people call the “delivery” or “birth”. Your baby moves through and out of your vagina and into your arms. 3rd Stage  This Stage is when you deliver the afterbirth/placenta. http://www.birthingbetter.com
  • 5. What is Labor?  Labor is composed of contractions and a space between.  Your baby stimulates its home. Stimulation causes the uterus to tug open its closure.  Tugging open is the contraction, and then the uterine muscle rests, which is the space in between.  Contraction has five phases, and you will work through each phase. http://www.birthingbetter.com
  • 6. An important factor of labor  You will inhale and exhale through one breath cycle after another, so use effective, sustainable breathing skills that give you the ability to work and cope with the sensations of each contraction.  Your body will always be in some position or posture throughout the labor, so learn how to find positions that truly relax you inside, help you stay open, and create space for your baby to move through and out of your body.  Your husband/partner will be there to help you cope with the hard work. This is not the same role as for your birth provider. http://www.birthingbetter.com
  • 7. What can you expect during progressive labor?  Most people think that the three stages of childbirth each have a very clear beginning and ending. That’s not always accurate. The beginning part of 1st stage can be terribly unclear, manifesting as “false labor,” “pre labor”, “niggling labor”, or non progressive labor”.  The other end of the 1st stage is “active labor”  Active labor is NOT the same as progressing labor. Women can be in active non-progressing labor. http://www.birthingbetter.com
  • 8. During progressive labor(which happens in the 1st stage)  Contractions get longer (timeable),  The space between contractions gets shorter (timeable), and  Contractions get more intense (not timeable, but felt by the woman). Short form for this: longer, stronger, closer together. http://www.birthingbetter.com
  • 9. An important factor about progressive labor  When labor is progressing, each contraction has a bell-shaped curve that can be drawn on a graph, as it starts, gets more intense, reaches a peak, subsides, and ends.  The operative word is “bell”, rather than a “plateau”, which has no defined peak. Flat contraction indicate a stalled labor. http://www.birthingbetter.com
  • 10. What stalls labor?  There are a finite number of reasons. We’ll start with some of the more uncommon ones: • A short umbilical cord • Cord wrapped around the baby’s body • Placenta in the way • The baby in an unusual position • The baby is just too big to come through the pelvic tube  More common things women do without realizing that these things are hindering the process. • Being tense • Bending over, leaning forward • Being closed or not being in open positions http://www.birthingbetter.com
  • 11. Your birthing body basically uses three parts:  The cervix – in your Pink Kit resources, you’ll learn skills such as the following to help your cervix open: • Pelvic Clock • Cervical Relaxation • Deep Touch Relaxation • Directed Breathing  The pelvis • Mapping Your Pelvis • Body Positions • Hip Lift • Kate’s Cat • Sacral Maneuver • Deep Touch Relaxation  The birth Canal or Vagina- you will learn how to do Internal Work on your birth canal. • Sit Bone Spread • Kate’s Cat • Sacral Maneuver • Body Positions http://www.birthingbetter.com
  • 12. When to use what pink kit skills?  Practice During Pregnancy • Labor is no different. You learn your Pink Kit skills, practice them more and more as you get closer to the birth experience, and use them throughout the birth.  These are the important reasons why you want to ready yourselves with skills. • The process your baby is going through deserves your full attention. • You and your partner will truly become a team with the goal of working with your baby’s efforts. http://www.birthingbetter.com
  • 13. Practiced? Now Use the Skills During Pre-Labor!  After months of practising your skills while pregnant, you are now actually beginning to work with the efforts your baby will make shortly to come down, through, and out your body.  As you start to experience these pre-labor changes, it is a good time to begin the “touch relaxation” to help calm down the hormone rushes. Also, begin using some of your other skills. • Kate’s Cat • Body Positions • Start your teamwork, as well http://www.birthingbetter.com
  • 14. Use the Skills During 1st Stage  This is what you need to focus on during the 1st stage: use your skills to work with each contraction and each space in between.  During the driving journey, you stopped to rest. You can’t do that in labor. There is no stop (except the times between contractions) until your baby is born. This means two things: • No matter what is happening on this birth journey, you cannot choose one convenient, long rest stop. Instead, you will have many, many short ones that happen when your baby feels like it. • Even during your brief rests, you cannot put your skills aside as you do when you break an auto journey. You must use energy-conserving skills in between contractions. http://www.birthingbetter.com
  • 15. Cont. Use the Skills During 1st Stage  As for working phases themselves (contractions), you have another whose set of skills. • Directed Breathing- helps you cope with the natural pain during contractions and helps you achieve deep relaxation. • Pelvic Clock- helps you relax the soft tissue of the pelvic floor, both during contractions and rest periods. • Cervical Relaxation – helps you relax the soft tissue of the cervix. • Letting Down Reflex Relaxation- helps with a pinched cervix. • Uterine Lift—Improves the effectiveness of contractions. • Thai Massage—Helps the baby move down into the pelvic inlet. • “Bony Structure” skills (e.g. Hip Lift, Rocking the Sacrum, Kate’s Cat)—Create structural and internal relaxation. • Choosing Body Positions that help create internal relaxation and eliminate internal tension no matter what posture or position you are in. http://www.birthingbetter.com
  • 16. Use the Skills During 2nd Stage  To reduce or prevent a delayed 2nd Stage, your job is first to prepare this area during pregnancy to become stretchable tissue, and second to use your skills to keep your active labor progressing.  This final part of your baby’s journey is still an exercise in plumbing an object has to come down, through, and out this last part of your body: your vagina, your baby’s birth canal.  These are the skills you’ll use to keep this phase of labor progressive: • Breathing into the Perineum • Letting Down Reflex Relaxation, to counteract your instinctive reaction to feeling the baby coming down • Internal Work • Sit Bone Spread • Hip Lift • Kate’s Cat • External Massage http://www.birthingbetter.com
  • 17. Cont. Use the Skills During 2nd Stage  Anterior Lip -An anterior lip is caused by your baby pinching the front of the cervix against the pubic bone, thus preventing the final full dilation.  These are the skills: • Letting Down Reflex Relaxation • Sit Bone Spread • Kate’s Cat • Hip Lift • Sacral Maneuver http://www.birthingbetter.com
  • 18. Use the Skills During 3rd Stage  The most dangerous period of labor is after the baby is born and before the placenta is delivered, because this is the time when a woman might bleed excessively.  If excessive bleeding occurs, the woman will be given an injection that will contract her uterus. http://www.birthingbetter.com
  • 19. Basic take-away  Birth is unknown until it unfolds. You just have to work with what you have, but there are two very important things that you have huge control over: 1. Don’t go into labor tired. 2. Don’t overreact to contractions when they are lasting 15– 30 seconds and are 5–20 minutes apart. Instead, quietly learn about your contractions and teach yourself how to relax in this early phase, so you develop good labor management skills for the later stages. http://www.birthingbetter.com
  • 20. End of the Road: Making Memories  Giving birth is seen from several time perspectives. The first perspective is when you’re pregnant and you look forward to the birth experience, knowing it’s unknown until it happens.  Then you view the experience as it unfolds and as you experience it. Then you look back immediately afterwards with opinions and emotions.  Finally, you periodically look back throughout your life. The birth of your baby is always something you look back on.  Only the human mind has the ability to imagine the future, be so self-reflective in the present, and recall experiences in the past. http://www.birthingbetter.com

Notas del editor

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