University Mission University Vision

The premier University in historic Cavite recognized for excellence in the development of globally competitive and morally upright individuals. CaviteStateUniversity shall provide equitable and relevant educational opportunities in the art, sciences and technology through quality instruction and responsive research and development endeavors. It shall produce professional, skilled and morally upright individuals for global competitiveness.

Republic of the Philippines CAVITE STATE UNIVERSITY DON SEVERINO DE LAS ALAS CAMPUS Indang, Cavite College of Nursing S.Y. 2011-2012

LATEST TRENDS IN LABOR AND DELIVERY

PRESENTED BY: VILLAFRANCA, JAVELENE P. BSN4-2

SUBMITTED TO: MARY ANTOINIETTE VIRAY, RN CLINICAL INSTRUCTOR LEVEL

In partial fulfillment of RELATED LEARNING EXPERIENCE in the Bachelor of Science in Nursing

7 Alternative Ways to Prepare for Childbirth and Cope with the Intensity of Labor Carlsbad, CA (PRWEB) As the shift toward self-education continues to grow, large numbers of American women are choosing alternative ways to prepare for childbirth and cope with the intensity of labor. Instead of waiting for the doctor to tell them what they need to know, women are doing more research on their options and exploring ways to make pregnancy and birth less painful. Here is what they are choosing: 1. Birth Networks These organized, regional groups of pregnant women and birthing professionals meet regularly to educate, empower and support each other and advocate for the improvement of maternity care in their communities. What started as a grassroots movement has exploded across the county. Evidence of a growing trend: Amy Romano of Lamaze International estimates that the number of birth networks has doubled in the past year. Since 2004, the Lamaze Institute for Normal Birth has awarded grants to form and expand birth networks. It also offers organizational resources for birth networks. 2. Birth Stories Expectant women are hungry for information on labor and birth, and the mainstream media is responding with birth stories. These stories offer much more than entertainment; they provide information on birth options, tools, classes and techniques. The impact of birth stories on expectant parents is quickly coming to the attention of the birth professionals, and many are actively discouraging patients from watching the highly-dramatized birth programs on cable television. Because the level of fear in a laboring woman directly impacts the progression of her labor, birthing professionals are directing patients to read only empowering, inspiring birth stories, such as those found in Journey into Motherhood: Inspirational Stories of Natural Birth (White Heart Publishing, 2005). Evidence of a growing trend: There are now 7 programs on cable television that highlight the experience of labor and delivery. Most pregnancy magazines now feature birth stories on a regular basis, and many birth networks and childbirth educators now sponsor birth-story nights. 3. Hypnosis for Childbirth Since a 1999 segment on NBCs Dateline featured hypnosis for childbirth, interest has steadily grown. The HypnoBirthing Method and Hypnobabies are two of the oldest and most popular programs, but with the growing interest in this method, there are now several different programs available, as well as supplemental products such as Journey into Childbirth: Hypnosis for Empowered Birthing by Sheri Menelli. While no program promises a pain-free birth, this is a frequent result. Evidence of a growing trend: In the late 19990s there were only a few hundred educators, and as of this year, there are over 3000. 4. Prenatal yoga Prenatal yoga strengthens and stretches the muscles that are used in childbirth, and teaches breathing and focusing techniques that help women through labor. Evidence of a growing trend: In San Diego, California, prenatal yoga instructors are reporting an increase in class attendance of approximately 50% over the last three years. Much of the increase is attributed to growing support from doctors, midwives and childbirth educators who send their

clients to yoga classes to relieve back pain, reduce tension, and cope with high blood pressure. A number of prenatal yoga videos are now available to women who prefer to practice at home. 5. Water-assisted labor Widely known as natures epidural, warm water can ease the discomfort of labor by helping a woman relax. A birthing tub counters the effect of gravity on her contracting muscles, and even a warm shower can provide soothing comfort to tired and tense women. Evidence of a growing trend: In the last 10 years, water-assisted labor has grown exponentially. In 1995 there were only three hospitals in the country that offered it. Now it is offered in more than 260 hospitals 15% of all U.S. hospitals. In the last year alone there was a 4% increase, and this number is expected to grow in the coming year. 6. Doulas A doula is a professional who is trained to provide emotional and tactical support a family through pregnancy, labor, delivery, and newborn care. Studies show that the presence of a doula reduces the need for medication, as well as the possibility of a Cesarean-section birth. Evidence of a growing trend: Every doula organization reports phenomenal growth in membership, and in the number of students in doula training classes. Doulas of North America (DONA), just one of several doula organizations reported a 10-fold increase in the number of certified doulas in the last 7 years. 7. Pregnancy Massage A specialized form of bodywork, pregnancy massage addresses the specialized needs of a rapidly changing body. It enhances the function and alignment of muscles and joints, improves circulation and muscle tone, and relieves mental and physical fatigue. These benefits translate to lower levels of stress hormones, as reported in a study by Dr. Tiffany Field at the University of Miami School of Medicine. Evidence of a growing trend: Instructor Elien Alexander from The School of Healing Arts in San Diego, California, reported a 10-fold increase in the number of students becoming certified in pregnancy massage in the last 5 years. INDUCING LABOR TO REDUCE RISKS OF COMPLICATIONS Inducing labor for women after 37 weeks of pregnancy can help reduce the risk of perinatal mortality, i.e., death before, during or shortly after birth, without increasing caesarean section rates. However, induction is associated with a greater risk of admission to a special care baby unit. Induction of labor is frequently performed for pregnancies of more than 41 weeks gestation to reduce perinatal mortality. Induction at term (beyond 37 weeks) can also reduce complications, particularly when a mother has existing health problems like high blood pressure. Yet there has been no large study examining the risks and benefits of induction at term on newborn deaths. This information is needed to help guide decisions about pregnancy management. So a team of researchers in Scotland compared rates of perinatal mortality and maternal complications after elective induction (induction of labor with no recognized medical indication) and expectant management (continuation of pregnancy to either spontaneous labor or induction or caesarean section at a later date). Using Scottish birth and death records, they analyzed data for over 1.2 million women with single

pregnancies who gave birth after 37 weeks gestation between 1981 and 2007. Outcomes were adjusted for factors such as age at delivery, whether the mother had given birth before, birth weight and deprivation. At each gestation between 37 and 41 weeks, elective induction of labor was associated with lower death rates compared with expectant management, without increasing the need for a caesarean section. For example, at 40 weeks gestation, deaths occurred in 37 out of 44,764 (0.08%) in the induction group compared with 627 out of 350,643 (0.18%) in the expectant management group. However, elective induction of labor was associated with increased rates of admission to a special care baby unit (8%) compared with expectant management (7.3%). This means that for every 1,040 women having elective induction of labor at 40 weeks, one newborn death may be prevented, but this would result in seven more admissions to a special care baby unit, explain the authors. Although theres a possibility that some other unmeasured (confounding) factor may explain these results, the authors conclude that elective induction of labor at term has the potential to reduce perinatal mortality in developed countries without increasing the risk of operative delivery.

LATEST TRENDS FOR MOMS TOBE TO COMBAT BIRTH PAIN When a person is pregnant apart from the usual question of what the gender of the baby will be is the question how much pain will be there during labor? But there is no certain answer as to how much pain an individual can have, but one things for sure is that pain is always there during labor and delivery. Today, the NHS is investigating in an 18-month study on the effectiveness of hypnobirthing being launched just this week which is hoped to reduce the financial strain on the tightening budget of costly drug treatments such as epidurals. Epidurals are free on the NHS but on private clinics, it can cost hundreds of pounds. So how does a mum-to-be save on medical bills and help the NHS with their budget and still combat pain during labor? Here are some options. 1. Laughing gas For many women laughing gas will offer a certain amount of relief, said Judith Bishop a certified nurse midwife at the University of California San Francisco Medical Center and leader in the effort to reintroduce nitrous oxide for labor. Though the practice has fell out of favor in the recent years and only a few hospitals offer it in the US, recently some respected hospitals including Dartmouth-Hitchcock Medical Center are planning to offer it again and the federal government is reviewing it. Nitrous oxide equipment is going the hit the markets soon, expected on April. Hospitals are hoping to use nitrous oxide by summer but in the meantime its effectiveness and safety is being reviewed by the federal Agency for Healthcare Research and Quality in the US. 2. Hypnotherapy in Childbirth There had been testimonies from women saying that through hypnotherapy, the pain during labor is reduce and as stated above the NHS is investigating its effectiveness. More 800 mothers-to-be are recruited for the trial of hypnotherapy. These first time mothers will be taught deep relaxation techniques which are believed to induce an almost trance-like state making them calmer and more able to block out pain. An English physician Dr Grantly Dick-Read wrote that fear and tension are responsible for the 95% of pain during labors, and these two factors can be eliminated through hypnotherapy. If the NHS will have good results with this, then they will be able to survive the cut in their budget.

3. Acupressure A Chinese traditional medical technique based on the same principle as acupuncture, the difference is that instead of needles, fingers and thumbs are used to stimulate specific points. This technique is known to be beneficial for a great number of health related issues and is extremely helpful before and during childbirth. Stimulation on specific has been scientifically shown to be effective in labor pain as well as the total length of delivery time. The benefits of using acupressure before and during childbirth are plenty and includes effective birth pain relief, induces labor naturally and more. Many mothers have been very satisfied with this technique. 4. Reflexology It is found out that by applying gentle pressure on some points of the feet during labor can stimulate the bodys pituitary gland to release hormones that will accelerate the labor process and reduce pain. Reflexology is used as an alternative to drugs to stimulate labor and reduce pains. Study shows that reflexology reduces pain levels during labor and that it accelerates the release of placenta. TELEMETRY A WIRELESS FETAL MONITOR According to surveys such as Listening to Mothers from 2002 and 2006, the majority of births in the U.S. today occur with the assistance of electronic fetal monitoring. However, new technology, in the form of wireless telemetry monitoring, allows the staff to record the baby's heart rate while the mother is free to walk around her room or labor and delivery floor. HOW DOES FETAL MONITORING WORKS? Instead of having the pressure gauge that measures contractions and the Doppler detecting the baby's heart rate both attached by cables to the external monitor's display unit in your hospital room, the wireless telemetry monitor works to detect both heart rate and contractions without the use of cables tethered to the unit. The mother's contraction and fetal monitor are attached to a small radio control device about the size of a cell phone. The telemetry uses a UHF radio frequency that transmits the recordings of the contraction monitor and heart rate monitor to the digital display unit. ADVANTAGES OF TELEMETRY One obvious advantage with using telemetry for labor is the mother's increased mobility. Not being tethered to the display unit allows the mother complete freedom to move about her room or even venture out of her room to walk around the labor and delivery floor while still having her baby monitored. Research has even shown that there may be a difference in pain level with traditional external monitoring versus wireless fetal monitoring. One study showed that second-time mothers reported they experienced less pain when they used telemetry with their second labor as compared to their first with a standard external monitor significantly more often than the mothers who used the standard monitor in both labors.

DISADVANTAGES OF USING TELEMETRY In some cases, the readings on the wireless fetal monitoring may not be as reliable as those in external or internal monitoring. There tends to be more interference with the radio frequency used in telemetry monitoring that may, at times, interrupt the signal that reaches the graph on the display unit. For that reason, some care providers may not be comfortable seeing an inconsistent recording of the baby's heart rate on the printout of the fetal monitor and might not like to use telemetry with their patients. IS WIRELESS FETAL MONITORING SAFE? The Federal Drug Administration has now decided that wireless monitoring is safe for use during labor. Just recently, they approved the use of a wireless fetal monitor, known as Monica's Healthcare AN24 for use on all moms with a singleton pregnancy (one baby) for use during labor in the United States. The company Monica states that the new wireless fetal monitor even works well with expectant mothers who are overweight or obese, unlike some of the standard external fetal monitors available.