Ld

Labor Coaching

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Labor Coaching, Labor Coaches

  • Management
  • Use Gravity and Position Change
  1. One leg up
  2. Sit on the toilet and push
  3. Drape self over an oversized ball
  • Management
  • Standard Positioning
  1. Start
    1. Hips hyperflexed and abducted
    2. Hands on thighs and knees
    3. Patient pulls knees towards her
      1. Maximize abdominal muscle use with forward curl
  2. Encourage "Push as if having BM"
  3. Perineal massage
    1. No benefit in maintaining intact perineum
    2. May decrease labor discomfort
    3. Stamp (2001) BMJ 322:1277-80 [PubMed]
  4. Patient to hold presenting part down between pushes
  5. Complete rest "Time Out" between contractions
  6. Visualization between contractions
  • Management
  • Encourage pelvic floor relaxation
  1. Reassure that Bowel Movement and Urine are normal
  2. Hydrotherapy
    1. Warm shower or tub assists in Pelvic Relaxation
  • Management
  • Towel Trick (Tug-of-war)
  1. Patient sits in bed with knees adducted
    1. Patient pulls as hard as can on one end knotted towel
    2. Clinician pulls
      1. On other end of towel or
      2. With sheet tied around her waist
  2. Helps to relax the perineum
  3. Create a pelvic curve easier for fetal head to maneuver