SEMINAR ON VARIOUS CHILD BIRTH PRACTICE , POSITION

CHANGE
Submitted By
Ankita Manna
M.Sc Nursing 1st Year
EBMCON
WATER BIRTH/HYDROTHERAPY
INTRODUCTION
Hydrotherapy is the use of water for physical or
psychological benefits. The value of hydrotherapy for
labour has been known and used around the world for
many years. There are two options for hydrotherapy
during labour - Showering or Immersion Hydrotherapy.
objectives
General objectives
At the end of the class students will be able to know
about water birth and position changing.
Specific objectives
 To know about definition of water birth
 To know about showering and immersion hydrotherapy
 To know about benefits of hydrotherapy
 To know about various position during labour
DEFINITION
Water birth is labour and sometimes delivery that occurs
in water, usually a birthing pool. birth proponents
believe childbirth in water result in a more relaxed, less
painful experience that promotes a midwife-led model
of care.
Showering

All labour rooms are equipped with a seated shower

and removable shower head.
Immersion Hydrotherapy
Soaking in warm water sufficient to cover the mother’s
belly is available upon request and by provider order.
Foetal heart monitoring may be done intermittently while
in the water or a mobile foetal heart monitoring
device may use.
Benefits of Using Immersion
Hydrotherapy
Physiological and psychological benefits include:
 Ease of movement with greater mobility due to

buoyancy
 Relaxation during and between contractions
 Safe and effective pain management
 Reduction of blood pressure
 A sense of control as mother occupies her warm,

private space
 Facilitation of cervical dilation
When the Tub Can Be Used

 After an assessment of labour is performed, your

obstetrician is notified and there is a provider order to
determine appropriateness of the tub
 Immersion hydrotherapy may be used any time during

labour. In some cases it is best to wait until labour is

well-established. For a first-time mom, this is usually
4-5 centimetres of cervical dilation with good, regular
contractions.
When the Tub Shouldn’t Be Used
 If there are any signs of
maternal or foetal distress during labour
 Epidural anaesthesia
 IV infusion of medicines
 Medications for pain or induction of labour
 Continuous foetal monitoring or if gestational age is

less than 37 weeks

Delivering in the Water
We do not allow delivery of the baby in the water.
When delivery is near, you will be assisted back to bed
for delivery.
Variety of positions offer choice and comfort

Women can choose from a variety of positions that

take advantage of gravity, enlarge the pelvis diameter,
relieve back pressure, or simply make them feel more
comfortable
Standing and walking

Standing and walking both provide a sense of control,

and can reduce backache. During difficult contractions,
the woman can lean against the wall or her partner.
Some women also like to sway in rhythm to their
breathing, or stand in a supported squat, which has
been shown to realign the pelvis and increase opening
by up to 15%.
Kneeling
Some women choose to kneel while leaning on a chair.
Kneeling on all fours may offer relief from back pain
and can help shift the baby’s position.
Leaning
Leaning takes advantage of gravity while also
supporting the woman’s body. She can lean against a
wall, a bed, a partner, or even place one foot on a chair
or footstool and lean into a lunge during contractions.
Squatting
Squatting encourages foetal descent, allows the woman
to shift her weight comfortably, and may increase pelvis
diameter by up to 2 centimetres, making it easier for the
baby to move through the pelvis.
In water
Many women find labouring in water to be relaxing. In
addition, it creates buoyancy that can make changing
positions easier.
Massage/soft touch during labour

Massage and touch can be a powerful and effective

tool for helping women during childbirth. Modern and
scientific evidence supports the use of massage during
labour. A 2016 study on the effect massage therapy on
the duration of labour found that those who received
massage therapy during the first and second stages of
labour had a significant decrease in labour duration as
compared to the control group.
Massage technique
The use of tennis balls on the lower back or hips or
using a rolling pin (hollow) filled with ice can provide
pain relief. Massaging in between contractions, using
long strokes down the mid back to the sacrum, stroking
up the back and massaging the shoulders and neck,
applying counter-pressure during contractions at sites
of pain, and hip squeezes to help with relief of back
pain are helpful Massage Techniques for Early labour
Effleurage is a massage technique that involves a light
pressure over the body. During labour, a doula can use
a flat hand to stroke the client’s back, arms, and legs.
Feathering, a sub-category of Effleurage is performed
solely with your fingertips. A labouring person might
find this helpful during contractions over their
abdomen (Birthing Naturally.).
Nursing Care during the first stages of
labour
• Latent
• Active
Nursing Care during Second Stage
Supporting the woman and her partner in making active
decisions about her care and labour management.
• Support her choice of pushing method
• Give feedback on her progress
• Perineal Lacerations
• Episiotomy
Nursing Care during Third and Fourth
stage
• Third- gradual decrease in the size of the uterus this
helps to shear the placenta away from its attachment
site. Immediate newborn care/assessment, assist with
the delivery of the placenta inspect for intactness.
• Fourth- Observation for hemorrhage, comfort measures,
promotion of family attachment.
Application of the Nursing Process
• Primary risks associated with EPIDURAL analgesia
 Maternal hypotension with secondary fetal hypoxia
 Injury related to reduced sensation and movement