The Labor Progress Handbook (eBook)

Early Interventions to Prevent and Treat Dystocia

Penny Simkin, Ruth Ancheta (Autoren)

eBook Download: PDF

2011 | 3. Auflage
John Wiley & Sons (Verlag)
9780470959367 (ISBN)

Infos

The third edition of The Labor Progress Handbook builds on the success of first two editions and remains an unparalleled resource on simple, non-invasive interventions to prevent or treat difficult labor.  Retaining the hallmark features of previous editions, the book is replete with illustrations showing position, movements, and techniques and is logically organized to facilitate ease of use.

This edition includes two new chapters on third and fourth stage labor management and low-technology interventions, a complete analysis of directed versus spontaneous pushing, and additional information on massage techniques. The authors have updated references throughout, expertly weaving the highest level of evidence with years of experience in clinical practice.

The Labor Progress Handbook continues to be a must-have resource for those involved in all aspects of birth by providing practical instruction on low-cost, low-risk interventions to manage and treat dystocia.

Penny Simkin is a physical therapist who has specialized in childbirth education since 1968. She serves on the editorial board for Birth: Issues in Perinatal Care and the consultant boards for the International Childbirth Education Association and the Seattle Midwifery School.

Ruth Ancheta is a certified DONA doula and approved trainer and has been a certified childbirth educator through ICEA for more than twenty years. She has authored numerous childbirth education materials including the Childbirth Skills Teaching Kit and the VBAC Source Book and Teaching Kit.

Inhalt

The Labor Progress Handbook 5
Contents 9
Foreword to the third edition 17
Foreword to the second edition 19
Foreword to the first edition 23
Acknowledgments 25
Chapter 1: Introduction 29
SOME IMPORTANT DIFFERENCES IN MATERNITY CARE BETWEEN THE UNITED STATES, THE UNITED KINGDOM, AND CANADA 34
NOTES ON THIS BOOK 38
CONCLUSION 39
REFERENCES 40
Chapter 2: Dysfunctional Labor: General Considerations 41
WHAT IS NORMAL LABOR? 42
WHAT IS DYSFUNCTIONAL LABOR? 47
WHY DOES LABOR PROGRESS SLOW DOWN OR STOP? 49
A role for the fetus in regulating labor? 49
THE PSYCHOEMOTIONAL STATE OF THE WOMAN: MATERNAL WELL - BEING OR MATERNAL DISTRESS? 50
Pain versus Suffering 50
The “ fight - or - flight ” and “ tend - and - befriend ”responses to distress and fear in labor 55
The environment for birth 57
Psychoemotional measures 57
Physical comfort measures 59
Physiologic measures 60
WHY FOCUS ON MATERNAL POSITION? 61
MONITORING THE MOBILE WOMAN ’ S FETUS 63
Auscultation 63
When EFM is required: options to enhance maternal mobility 63
Continuous EFM 64
Intermittent EFM 67
Telemetry 68
TECHNIQUES TO ELICIT STRONGER CONTRACTIONS 71
CONCLUSION 72
REFERENCES 72
Chapter 3: Assessing Progress in Labor 77
BEFORE LABOR BEGINS 78
Malposition 78
Leopold ’ s maneuvers 83
Belly Mapping 86
Other assessments prior to labor 90
ASSESSMENTS DURING LABOR 92
Position, attitude, and station of the fetus 92
Vaginal examinations: indications and timing 92
Performing a vaginal examination during labor 93
Assessing the cervix 96
Unusual cervical findings 97
The presenting part 98
The vagina and bony pelvis 106
Quality of contractions 107
ASSESSING THE MOTHER ’ S CONDITION 110
Hydration and nourishment 110
Vital signs 111
Psychology 111
ASSESSING THE FETUS 112
Fetal heart rate 112
How to perform intermittent auscultation 113
When using continuous electronic fetal monitoring 115
The three - tiered fetal heart rate interpretation system 117
PUTTING IT ALL TOGETHER 120
Assessing progress in the first stage 120
Assessing progress in the second stage 122
CONCLUSION 122
REFERENCES 122
Chapter 4: Prolonged Prelabor and Latent First Stage 127
IS IT DYSTOCIA? 127
When is a woman in labor? 128
Can prenatal measures prevent the fetal occiput posterior position during labor? 129
The woman who has hours of contractions without dilation 132
THE SIX WAYS TO PROGRESS IN LABOR 134
SUPPORT MEASURES FOR WOMEN WHO ARE AT HOME IN PRELABOR AND THE LATENT PHASE 135
SOME REASONS FOR EXCESSIVE PAIN AND DURATION OF PRELABOR OR THE LATENT PHASE 137
Iatrogenic factors 137
Cervical factors 137
Fetal factors 138
Emotional factors 138
TROUBLESHOOTING MEASURES FOR PAINFUL PROLONGED PRELABOR OR LATENT PHASE 139
MEASURES TO ALLEVIATE PAINFUL, NONPROGRESSING, NONDILATING CONTRACTIONS IN PRELABOR OR THE LATENT PHASE 141
Synclitism and asynclitism 142
CONCLUSION 147
REFERENCES 147
Chapter 5: Prolonged Active Phase of Labor 150
WHEN IS ACTIVE LABOR PROLONGED? 151
CHARACTERISTICS OF PROLONGED ACTIVE LABOR 152
POSSIBLE CAUSES OF PROLONGED ACTIVE LABOR 153
Fetal and fetopelvic factors 155
How fetal malpositions delay labor progress 158
Problems in diagnosis of fetal position during labor 159
Artificial rupture of the membranes with a malpositioned fetus 160
Specific measures to address and correct problems associated with a “ poor fit ” — malposition, cephalopelvic disproportion, and macrosomia 161
MATERNAL POSITIONS AND MOVEMENTS FOR SUSPECTED MALPOSITION, CEPHALOPELVIC DISPROPORTION, OR MACROSOMIA 162
Forward - leaning positions 162
Side - lying positions 164
Asymmetric positions and movements 167
Abdominal lifting 170
An uncontrollable premature urge to push 170
IF CONTRACTIONS ARE INADEQUATE 172
Immobility 173
Medication 175
Dehydration 176
Exhaustion 177
Uterine lactic acidosis as a cause of inadequate contractions 177
When the cause of inadequate contractions is unknown 179
IF THERE IS A PERSISTENT ANTERIOR CERVICAL LIP OR A SWOLLEN CERVIX 182
Positions to reduce an anterior cervical lip or aswollen cervix 182
Other methods 184
Manual reduction of a persistent cervical lip 184
Assessing the woman ’ s coping 184
Indicators of emotional dystocia during active labor 186
Predisposing factors for emotional dystocia 187
Helping the woman state her fears 187
How to help a laboring woman in distress 188
Special needs of childhood abuse survivors 64 190
Incompatibility or poor relationship with staff 192
If the source of the woman ’ s anxiety cannot be identified 192
CONCLUSION 193
REFERENCES 193
Chapter 6: Prolonged Second Stage of Labor 199
DEFINITIONS OF THE SECOND STAGE OF LABOR 200
PHASES OF THE SECOND STAGE OF LABOR 200
The latent phase of the second stage 200
The active phase of the second stage 203
Physiologic effects of prolonged breath - holding and straining 204
If the woman has an epidural 208
How long an active phase of second stage is too long 212
POSSIBLE ETIOLOGIES AND SOLUTIONS FOR SECOND - STAGE DYSTOCIA 214
Maternal positions and other strategies for suspected occiput posterior or persistent occiput transverse fetuses 214
Manual interventions to reposition the occiput posterior fetus 226
Early interventions for suspected persistent asynclitism 226
If cephalopelvic disproportion or macrosomia ( “ poorfit ” ) is uspected 231
Positions for “ possible cephalopelvic disproportion ” in second stage 232
Shoulder dystocia 240
If contractions are inadequate 241
IF EMOTIONAL DYSTOCIA IS SUSPECTED 241
The essence of coping during the second stage of labor 241
CONCLUSION 245
REFERENCES 245
Chapter 7: Optimal Newborn Transition and Third and Fourth Stage Labor Management 250
OVERVIEW OF THE NORMAL THIRD AND FOURTH STAGES OF LABOR FOR UNMEDICATED MOTHER AND BABY 251
THIRD STAGE MANAGEMENT: CARE OF THE BABY 253
Oral and nasopharynx suctioning 253
Delayed clamping and cutting of the umbilical cord 254
THIRD STAGE MANAGEMENT: THE PLACENTA 255
Expectant physiologic management of the third stage of labor 255
Active management of the third stage of labor 256
THE FOURTH STAGE OF LABOR 260
Keeping the mother and baby together 260
BABY - FRIENDLY (BREASTFEEDING) PRACTICES 262
ROUTINE NEWBORN ASSESSMENTS 263
CONCLUSION 264
Ten steps to successful breastfeeding 263
REFERENCES 264
Chapter 8: Low - Technology Clinical Interventions to Promote Labor Progress 268
INTERMEDIATE - LEVEL INTERVENTIONS FOR MANAGEMENT OF PROBLEM LABORS 269
WHEN PROGRESS IN PRELABOR OR LATENT PHASE REMAINS INADEQUATE 270
Therapeutic rest 270
Nipple stimulation 270
Management of cervical stenosis or the “ zipper ” cervix 271
WHEN PROGRESS IN ACTIVE PHASE REMAINS INADEQUATE 271
Artificial rupture of the membranes ( AROM ) 272
Digital or manual rotation of the fetal head 272
Manual reduction of a persistent cervical lip 276
Reducing swelling of the cervix or anterior lip 277
FOSTERING NORMALITY IN BIRTH 277
Perineal management 277
WHEN PROGRESS IN SECOND STAGE LABOR REMAINS INADEQUATE 283
Duration of second stage labor 283
Supportive directions for bearing - down efforts 284
HAND MANEUVERS AND ANTICIPATORY MANAGEMENT OF INTRAPARTUM PROBLEMS 284
Shoulder dystocia 284
Somersault maneuver 291
NONPHARMACOLOGIC AND MINIMALLY INVASIVE PHARMACOLOGIC TECHNIQUES FOR INTRAPARTUM PAIN RELIEF 293
Acupuncture 293
Sterile water injections 295
Nitrous oxide 297
Topical anesthetic applied to the perineum 297
CONCLUSION 297
REFERENCES 298
Chapter 9: The Labor Progress Toolkit: Part 1. Maternal Positions and Movements 303
MATERNAL POSITIONS 304
Side - lying positions 305
Standing, leaning forward 315
Kneeling positions 316
Squatting positions 323
Supine positions 332
MATERNAL MOVEMENTS IN FIRST AND SECOND STAGES 337
REFERENCES 350
Chapter 10: The Labor Progress Toolkit:Part 2. Comfort Measures 352
Other rhythmic movements 349
GENERAL GUIDELINES FOR COMFORT DURING A SLOW LABOR 353
NONPHARMACOLOGIC PHYSICAL COMFORT MEASURES 354
Heat 354
Cold 356
Hydrotherapy 358
Touch and massage 363
Acupressure 371
Acupuncture 373
Continuous labor support from a doula, nurse, or midwife 373
Psychosocial comfort measures 376
Assessing the woman ’ s emotional state 377
TECHNIQUES AND DEVICES TO REDUCE BACK PAIN 380
Counterpressure 380
The double hip squeeze 381
The knee press 383
Cook ’ s counterpressure technique No. 1: ischial tuberosities ( IT ) 385
Cook ’ s perilabial counterpressure technique No. 2 387
Cold and heat 389
Hydrotherapy 391
Movement 392
Birth ball 393
Transcutaneous electrical nerve stimulation ( TENS ) 394
Sterile water injections for back pain 397
BREATHING FOR RELAXATION AND A SENSE OF MASTERY 397
BEARING - DOWN TECHNIQUES FOR THE SECOND STAGE 400
CONCLUSION 402
REFERENCES 402
Epidural Index 405
Index 407

Rezensionen

"Each edition of The Labor Progress Handbook improves on the previous one, and this third edition is an even more indispensable resource for maternity care practitioners, especially within the context of today's overuse of birth technology, cesarean sections, and nonevidence-based management practices. Congratulations, Penny Simkin and Ruth Ancheta! You've given caregivers a powerful gift to pass on to childbearing women ... again!." (Birth, 1 March 2012)

Produkt-Details

• Erscheint lt. Verlag: 31.1.2011
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe ► Hebamme / Entbindungspfleger
• Themenwelt: Medizin / Pharmazie ► Pflege
• Schlagworte: Book • builds • Chapters • difficult • Edition • Editions • features • First • Geburtshilfe • hallmark • Handbook • Hebammenpraxis • Illustrations • Interventions • Krankenpflege • Labor • Midwifery • noninvasive • nursing • Position • previous • Progress • replete • showing • Success • Third • Treat • two • two new • use
• ISBN-13: 9780470959367 / 9780470959367