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Birth and Family Education The Expectant and New Family Workbook Birth and Family Education 188177 3/08 The Expectant and New Family Workbook Birth and Family Education Copyright © 2006 Fairview Health Services. All rights reserved. Published by Fairview Press, 2450 Riverside Avenue, Minneapolis, MN 55454. The information in this book should not replace the advice of your care provider. Always follow your care provider’s instructions. Before having any test or treatment, talk to your care provider to be sure you fully understand the risks and benefits involved. Please tell us if you need a language interpreter. If you are deaf or hard of hearing, please let us know. We provide many free services including sign language interpreters, oral interpreters, TTYs, telephone amplifiers, note takers and written materials. Acknowledgments and permissions: “Birth Preferences” worksheet (page 18) and “Baby Care Preferences” worksheet (page 31) by Carla Reinke, adapted with permission. “Comfort Measures in Labor” checklist (page 10) and pain medications scale (page 13) by Penny Simkin, adapted with permission. SMARTworks 188177 – REV 03/08. Contents Introduction iv Learning about Decision Making 1 Learning about Pregnancy 2 Learning about Labor and Birth 3 Learning about Comfort in Labor 5 Learning about Medical Care during Labor and Birth 14 Learning about Feeding Your Baby 20 Learning about Your Newborn 28 Learning about Postpartum and Early Parenting 32 Appendices 37 Glossary 41 Resources 42 iii Welcome! This workbook will help you prepare In case of bad weather for labor, birth and early parenthood. You will receive most of the information you need in class. Please call one hour before class to ask if it’s The workbook will be your guide. been cancelled. On Monday through Friday, call 612-672-7272. On weekends, call the hospital To get the most out of this class, please feel free where you are taking your class: to share with us any concerns, questions or information you have. • Fairview Ridges Hospital: 952-892-2000 • Fairview Southdale Hospital: 952-924-5000 General Information • University of Minnesota Medical Center, Fairview: 612-672-6000 Telephone numbers If class is cancelled, we will try to reschedule. Educator’s name and telephone number: Please call 612-672-7272 three working days later _______________________________________ to ask about a new date and time. _______________________________________ Infant car seats Fairview On Call (to register for tours and classes): 612-672-7272 Minnesota State law requires that all infants be in a federally approved car seat when in a car. Birth and Family Education Program Office: 612-672-4118 For information on car seats, call the National Highway Traffic Safety Administration Auto The Birthplace at: Safety Hotline at 1-800-424-9393. Or contact Buckle Up Kids at www.buckleupkids.state.mn.us. • Fairview Ridges Hospital: 952-892-2480 • Fairview Southdale Hospital: 952-924-5000 • University of Minnesota Medical Center, Fairview: 612-273-4040 iv The Expectant and New Family Workbook Learning about Decision Making You will make the decisions you feel you need to make. You will make informed choices. You need clear, accurate informawtion. This class will add to what you already know " about labor, birth and parenting. It will help you For you to try decide what you want during labor and birth As you learn about each option, use these and how you want to parent your baby. Many questions to make an informed choice. families also make choices about housing, work and financial changes at this time. • What is this (procedure, suggestion, problem)? We will give you the facts in clear, simple terms. This allows you to make the best choices for you • How will it affect me? and your family. • How will it affect my baby? • How will it affect my care, labor or ___________________? • What are my other options? The Expectant and New Family Workbook 1 Learning about Pregnancy Pregnancy involves the mind, body and spirit. Pregnancy is different for each woman. For both men and women, the role of the parent begins in pregnancy. Physical Changes: " What’s Happening to Your Body For you to try To check how well you understand what In class, you will learn how your body changes you’ve learned in class, try to describe these as the baby grows. We will define the parts of body parts in your own words. Assume that the body and the changes that take place during you are trying to explain them to someone pregnancy. We discuss: else. If you have any questions, you may ask them in class. • Breasts • Lungs and diaphragm Emotional Changes: Becoming a Parent • Blood volume Pregnancy is also a time of emotional change. • Stomach and intestines You will start to explore what becoming a parent means to you personally and as a family. You will • Ligaments also begin to examine relationships within the family—and with your unborn baby. • Bladder and urethra Dr. T. Berry Brazelton describes this as the first • Uterus, cervix and vagina of many “touchpoints” between parents and their baby. These touchpoints center around times • Rectum and anus of change. They often lead parents to reflect on their past experiences and knowledge. • Perineum • Placenta, umbilical cord, membranes and " amniotic fluid For you to try Begin to explore the changes that preg- You will use this knowledge later as you explore nancy, labor and parenthood will bring. the labor process. List the joys and challenges in this preg- nancy so far. It can be helpful for family members to do this separately and then come together to discuss their responses. 2 The Expectant and New Family Workbook Learning about Labor and Birth Families prepare for labor with their own expectations and personal histories. Every woman preparing for labor is able and strong. The Labor Process Signs of Labor The steps below provide a framework for The normal signs of labor are listed below. These exploring the labor process. We will help you signs will tell you how your body is preparing for find a way to identify with this process, which labor. They will also help you recognize the signs will help you prepare for labor. of premature labor. 1. The uterus contracts. Possible signs of labor: 2. The baby is pushed against the cervix. • A vague, nagging backache that’s different from the normal backache in pregnancy 3. The cervix thins (effaces 0 to 100%) and opens (dilates 0 to 10 cm). • Soft bowel movements, sometimes with flu- like symptoms 4. The pelvic bones move apart a tiny bit. • Cramps (like menstrual cramps) that happen 5. The baby is pushed down into the vagina. sometimes or all the time 6. The pelvic floor muscles stretch and the • A burst of energy, sometimes called the vagina opens. “nesting” instinct 7. The baby is pushed out. Preliminary signs of labor: 8. The placenta is delivered. • You discharge blood-tinged mucus from your vagina (called “bloody show”). " • Your bag of waters (amniotic fluid sac) leaks For you to try without contractions. As you learn more about the labor process, ask yourself how it changes from begin- • You have contractions, but they do ning to middle to end. Try to keep these not progress. changes in mind. This will help you to better identify the signs of labor as well as your options for comfort. The Expectant and New Family Workbook 3 Positive signs of labor: Even if you have only a nagging feeling that “something is wrong,” your doctor or midwife • Your contractions get longer, stronger and will want to hear from you right away. closer together. • Your bag of waters breaks. Call your doctor or midwife if you have any of " these signs before 37 weeks of pregnancy. For you to try Other warning signs: Birth stories are powerful tools to help you prepare for the labor experience. They can • Unusual health problems help you understand what a contraction is really like, or how you might feel if you – swollen hands, face, feet or ankles must move from a vaginal birth to a cesar- – severe headache ean birth. – vomiting (throwing up) or nausea (feeling sick to your stomach) that won’t go away Seek out stories from family and friends as well as birth videos and written stories. – blurred vision or spots before your eyes We will provide written stories and birth • A change in vaginal discharge videos in class. – spotting or bleeding from the vagina – increase in discharge before week 37 – the bag of waters leaks or breaks – discharge that smells bad, itches or is a different color or thickness • Abdominal or back pain that is sharp or that won’t go away • A change in the pattern or amount of the baby’s movements • Urinary tract problems – pain or burning when urinating (using the toilet) – fever or chills – a sudden decrease in urine amounts or urinating often in small amounts 4 The Expectant and New Family Workbook Learning about Comfort in Labor Labor support is essential. You will decide what works best for you. The wordcomfort means different things to different people. As you learn more about the labor process, you Other possible sources of pain: will begin thinking about what you need for Full bladder comfort in labor. We will show you a wide range of comfort measures. You will choose which ones Tension in the body to add to the self-comfort skills you already use every day. Fatigue Hunger, thirst, nausea Physical Sources of Pain Effects of a medical procedure or medicine First stage: The comfort level for dads and labor partners, may also be affected by hunger, thirst and fatigue Cervical stretching during labor. Lack of oxygen to the uterus Pressure on the bones and joints of the pelvis Psychological Sources of Pain Pain in areas that share spine and pelvic nerves Feeling alone or abandoned Second stage: Feeling trapped Pressure on the bones and joints of the pelvis Fear (of labor, pain, staff, support people) Pressure on and stretching of tissues as the Past experiences with pain, hospitals or labor baby passes through the pelvis, vagina and vaginal opening Feeling a loss of control or no control Tearing of tissues Frustration with the labor’s progress Feeling shame; feeling that the task ahead has Third stage: little or no value Contractions Dads and partners may have these feelings as Stretching of cervix and vagina as the well.
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