Centering Pregnancy Group Checklist

CP Group: ex CP1A Facilitators: First Session: ex Nov 12,13 EDD’s: ex Jan 2013

Session #1: Setting the State for a Healthy Pregnancy : Teaching tools: Nutritionist will bring…  Canada’s Food Guide  Drink containers for sugar comparisons (pop, slurpee, choco milk, juice) Warm up exercise: Ice breaker Small groups of 3: One thing in common, one thing about you that is unique. Introduce each other. DURING BELLY CHECKS: □ ICE BREAKER □ SAS: Personal goals for a healthy pregnancy □ Pre-registrations ( for most of them) □ Email addresses (check) Content: □ Welcome group participants, remind them to get started on self care □ Make Name Tags □ Instruct women to be sure to hand co facilitator paper of self care numbers before seeing provider □ Start with Belly checks ASAP, □ Nutritionist (30-min) OR Nutrition Quiz  Group Introductions or ICE BREAKER Intro, 30mins ideal (see above)  Remind re expectation to attend CP groups now and PP ( attendance is NOT optional, if they are a no show for the first few groups the spot will be given away, they must attend sessions right until the end of session 9 or 10 with babies)  Reminder of start time and finish time, encourage a few to arrive earlier  Review Binder Content: o Confidentiality Agreement (sign but not to hand in) o Websites & Tel #’s o Self-assessments ( as precursor to group discussions)  Review all session dates ,email list and how to page  Mention registered DIETICIAN at BCWH 875-2330 (phone or appoint)  Discuss weight gain, lifestyle in pregnancy  Info re mother risk  IF pertinent for GA, Gestational Diabetes Screening and ICD Session #2: Dealing With Discomforts of Pregnancy Date: Teaching tools:  Pelvis (for PT)  Mat, pillow, sheet (for PT)  Slips of paper, 1 ‘common discomfort’ each slip (Common Discomforts Charades) Warm up exercise: Round to review names or new participants, due dates, and “One thing you do to relax that you plan to do in early labour to stay mellow” (refer to SAS: Relaxation Measures) Self-Assessments:  Relaxation Measures  Common Discomforts Content:  Introduce new people/introduce (as above)  Email list and session dates  Review & collect SAS sheets (Most important Goal) – OPTIONAL  Discuss gestational diabetes (handout)exercise, weight gain, lifestyle in general  GGT for those eligible  Physiotherapy: o Posture o Exercise in pregnancy o Skeletal and muscular discomforts o Pelvic floor muscles & Kegels o Refer to handouts o Ensure back class & BCWH resources announced  Common Discomforts Common Discomforts Charades: Pass the slips of paper to group members – can cut down the number of slips depending on time (i.e. use them all if you have a lot of time, few if short for time). Explain that we will be acting out (without words!!) the discomfort on the slip. Have one of the facilitators begin to demonstrate. Discuss what women are doing to alleviate the discomfort before moving to the next.  Perineal massage if time (handout) Session #3: Social Support, Mental Health and Planning for Parenting Group should now be complete Date:

Self-Assessments:  Thinking About Breastfeeding  Keeping Myself Safe and Healthy  Parenting Issues Warm up exercise: Final round of names (may be new members) and “What do you think is the biggest issue new mom’s face? Why?”

Content:  If not already done, start email list and distribute (encourage a member to create a distribution list)  Rhogam (If relevant to group )  PP Depression, Edinburgh Scale (EPDS)(included in binder)  Sexuality in Pregnancy: BBC p. 49-50, questions re: libido, communication  Perineal Massage – review process (if time)  Small Groups on Parenting Issues: (30 mins) Break group into groups of 4 - couples should be in groups together Ask them to review SAS on Parenting Issues together and discuss the questions. They do not HAVE to share on certain topics if they are not comfortable. After 25 mins, come back as a big group and ask if any particular questions arose during their discussion, or if there are any revelations their group would like to share.  Consider showing Video “Birthday” Session #4: Stages of Labour & Coping in Labour Date: Teaching tools:  Doula preference forms – collect at end of session  Pelvis, uterus, placenta, baby  Video: Stages of Labour  Posters: Stages of Labour, Dilation and Descent, Mechanisms of Birth Warm up exercise: optional (see Facilitator Resource Package for ideas) Self-Assessments: Content:  Doula Preference Form  Preterm labor  Pre-labor Vs True-Labor  Show ‘Stages of Labour’ video  Review of Stages of Labour: o Early versus active first stage o Cervical changes o Position and descent o Transition o Second stage – mechanisms of birth o Third stage Session #5: Complications of Pregnancy and Birth

Teaching tools:  Swab (demonstrate how to do their own GBS swab)  Monitoring supplies: belts, EFM strips  Forceps  Vacuum  Pelvis, uterus, doll  U tube; DEMATRONAS  Warm up exercise: optional Self-Assessments:  Decisions of Pregnancy Content:  Group B Strep if relevant to GA  PIH  When, who, and how to call  Assessment room process Review complications of labor: DVD outline as follows  1)IOL & augment( ARM, cervidil, Oxy)REVIEW DYSTOCIA OF LABOR  2) IV fluids  3)fetal monitoring( Doppler,EFM, FECG) ADD scalp gas & IUPC  4) interventions to relieve back labor/pain: comfort measures, sterile H2O,narcotics, EA (light, position, timing, side effects ( shivering,H/A/spinal headache)  5) Episiotomy  6) Forceps & Vacuum(EPISIOTOMY)

 If Time: review 2nd stage of labor,positions for pushing.  CS ROLE PLAY  PRECIPITOUS DELIVERY  VBAC  Show Utube DEMATRONAS  Post-dates (can hold on this and discuss later session) o Definition o Fetal Surveillance (movement countings, NST/AFI) o Expectant (S&S, labour cocktail, acupuncture) vs Induction (cervidil, oxytocin) Session #6: Comfort Measures in Labour; Doulas Date: Teaching tools:  Video: 3 R’s  TENS  Pelvis for demonstrating sterile water, counter pressure, etc.  Comfort tools: massage tools, labour links, ball (to try out), etc. Warm up exercise: optional Self-Assessments:  Comfort measures for labour Content:  GBS screen  Introduction of doulas (if relevant to your setting)  Relaxation and affirmations  Comfort Measures (non-pharmacologic – gateway control) o TENS (reviewed in DVD last session) o Sterile water injection (reviewed in DVD last session) o Water immersion  Medical pain management (most already reviewed) o Narcotics o N2O2 (discuss if available in your setting) o Epidural  doula coordinator presentation if relevant to your setting)  Video: 3R’s  Recommended food and drink and SUPPLIES  If not already done and there is time: CS role play, PIH, AR process  Review 2nd stage: o Demonstrate positions for pushing o Use of balloon o Labor link Session #7: Breastfeeding is Best-feeding! Date: Teaching tools:  Breast  Baby  Mat, sheet and pillow for demonstrating feeding in bed  Video: Follow Me Mum  Optional video: Self-Attachment Warm up exercise: Self-Assessments:  Self-Inventory: Readiness for Labour and Delivery Content:  Share birth stories  Breastfeeding (LC , nurse to lead) o Advantages o Challenges o Breastfeeding plan (may include equipment) o Watch ‘Follow Me Mom’ video  Co-sleeping using PSBC guidelines  Introduce SCBP PP/BRFDG Clinic, Discuss PP follow up Session #8: Newborn Care Date: Teaching tools:  Pelvis and soft baby (to demonstrate birth onto abdomen, how dads can catch, etc)  Plastic baby (to demonstrate newborn care)  Breast (to answer questions, reinforce latch, etc.)  Optional video: Self-Attachment Warm up exercise: optional Self-Assessments:  Personal Assessment Delivery Content:  Share birth stories  Remind group members to come to CP sessions after delivery  What happens to baby immediately after delivery? o Dad catching baby o Cord cutting o Babe up onto maternal abdomen o Skin to Skin (4th Stage) o Newborn exam o Eye ointment o Vitamin K o Metabolic screen – early discharge  Self-attachment video  Equipment to have at home (Penny Simkin “Preparation for PP” checklist)  Safe sleeping – co-sleeping (review from session 7)  Remind re SCBP PP/BRFDG Clinic  Plant seed re future reunion just for group, pick date and place Session # 9: Early Postpartum Date: Teaching tools:  Baby  Breast Warm up exercise: optional Self-Assessments:  Contraception Content:  Sharing birth stories  Early postpartum: o Postpartum Blues & Postpartum Depression (PPPSS)( handout mood changes vs PPD o Sleep pattern changes (for parents) o Adjustment to parenthood o Coping strategies o Sibling preparation o Partner/Self returning to work o Support (family, neighbors, friends) o Exercises for after birth (handout)  Newborn immunization schedule, Vitamin D and breastfeeding  Sexuality and Contraception Options Can play the contraception game if you think suitable  Community Resources: o La Leche League o Drop-in groups (different around the city) o Neighbourhood Houses o Family Places (East Side, Mount Pleasant, West Side) o Community Centers (ie. Marpole, YMCA, Killarney, Sunset, Trout Lake) o Libraries (storytime programs)

Session #10 (PP Reunion)

 Birth Stories  Amazing newborn video  Group photos  Open Session  Discuss future reunion just for group, pick date and place