Ready class?

RELAX!!!

Objectives1. Discuss the evolution of relaxation as a

labor coping skill.2. Describe the physiologic response to

stress in labor and the impact of eliciting the relaxation response on labor coping abilities.

3. Experience a variety of relaxation exercises designed for use in a childbirth class.

4. Choose and use at least two ways to teach expectant parents about the use of relaxation in labor and birth.

Relaxation Break #1

STRESSAny perceived threat,

which results in the release of…

CATECHOLAMINES

ALARM!

Typical Human Stress Response

heart rate & blood pressure Pupils dilate Digestion slows Glucose released from liver Blood shunted to skeletal muscles

and vital organs Air passages widen, oxygen

uptake

Resistance

Exhaustion

Is labor stressful?

Yeah.

Relaxation Break # 2

Stressors in labor• Imposed restrictions• Strange

environment• Perceived threat

(interventions, staff)• Cold• Pain• Hunger

Simkin Study (1986) –16 events described as VERY

stressful• Labor induction or augmentation• EFM• Internal EFM• Vaginal exams• IVs• Administration of analgesia• Administration of anesthesia

• Restriction to bed• Restriction of drink• Unfamiliar doctor• Episiotomy & repair• Forceps• Vacuum• Limited time with baby after birth• Circumcision

Two ways to be relaxed in labor…

1. AVOID or REDUCE the existing stressors

2. Use relaxation and other techniques to deal with remaining stress.

AVOID or REDUCE Stressors

• Alter environment (lighting, sounds, privacy, people, temperature)

• Enhance physical comfort (positioning, pillows, temperature, touch, massage)

• Calm the psyche (visitors, music, soft voice, white noise)

• Distraction (talking, breathing patterns, focal point)

• Practice decision-making skills

FEAR - TENSION -PAIN

FEAR

PAIN TENSION

Relaxation Break # 3

Stress response in labor…

Part of the fetal ejection reflex newborn alertness & readiness

for the outside world maternal ferocity and

aggressiveness the release of vasopressin,

which interferes with oxytocin Cold and shaky feeling Forgetfulness

Female Stress Response• Catecholamines are

released…

• Because we have estrogen and access to oxytocin …women tend to react differently seeking to…

• Tend & befriend (calm & connection)

The release of oxytocin causes…

blood pressure stress hormones; causing the tend

and befriend effect Facilitates reproduction (facilitates mating

by making certain men more attractive to us, sperm ejection reflex, fetal ejection reflex & milk ejection reflex, bonding)

pain threshold sleepiness, feeling of laziness muscle tension, relaxing (less

circulation to muscles)

calming, less upset about life’s big problems, peaceful

curiosity and a sense of closeness to the people nearby,

trust, daring (more courage = less fear) desire to please people

Openness to touch Increases digestion and fat absorption and storage

Releases stored nutrients to make milk

appetite

skin and mucous membrane circulation

Fosters love of infant, creates emotional bond

Sensitive to other’s feelings, recognize non-verbals

Causes blood vessels on the front dilate (rosy cheeks & warm chests)

Facilitates learning wound healing (twice as fast)

Induces social memory and calmness in infant

Buffers Prolactin’s response to stress

Oxytocin is stimulated by...

StressWarmthStrokingSexual

stimulationDescent of

the fetusGood foodCompanionshi

p (doulas)Quiet & low

light

Meditation & visualization

Positive thoughts & memories

MovementSucklingPleasant

smells & sounds

Oxytocin

Relaxation Break # 4

Relaxation break # 5

Teaching Relaxation

Sample Spiral…• What is relaxation? (previous

knowledge)• Relaxation breath (new simple

skill)• Relax with breath (add new skill)• Breathing awareness (add touch)• Roving body check (reinforce

touch)

Continuing…• Moving into relaxation (new skill)• Relaxation, rhythm and ritual

(putting it all together)• Releasing to birth• Birth visualization• Parenting/breastfeeding

visualization

Relaxation break # 6