Supporting a Physiologic Approach to Pregnancy and Birth

342 Pages·2013·6.65 MB·English

Supporting a
Physiologic Approach
to Pregnancy and Birth
The optimal role of the attendant—whether physician or midwife—is to be vigilant
without being meddlesome.
R. A. Rosenblatt, MD
Supporting a
Physiologic Approach
to Pregnancy and Birth
A Practical Guide
Edited by
Melissa D. Avery, PhD, CNM,
FACNM, FAAN
Professor
Chair, Child and Family Health Co-operative
University of Minnesota, School of Nursing
Minneapolis, Minnesota
A John Wiley & Sons, Inc., Publication
This edition first published 2013 © 2013 by John Wiley & Sons, Inc
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1 2013
Dedication
To the women—for allowing us the privilege of being present with them during
their special time.
And to my husband—Randy Schnoes—who is always there for me.
Contents
Contributors ix
Foreword by Holly Powell Kennedy xi
Acknowledgments xiii
Section 1 Understanding a physiologic approach 1
1 The case for a physiologic approach to birth: An overview 3
Melissa D. Avery
2 The physiology of pregnancy, labor, and birth 13
Cindy M. Anderson
3 A supportive approach to prenatal care 29
Carrie E. Neerland
4 Supporting a physiologic approach to labor and birth 49
Lisa Kane Low and Rebeca Barroso
Section 2 Interventions and approaches 77
5 Promoting comfort: A conceptual approach 79
Kerri D. Schuiling
6 Continuous labor support 91
Carrie E. Neerland
7 Techniques to promote relaxation in labor 105
Kathryn Leggitt
8 Touch therapies in pregnancy and childbirth 119
Deborah Ringdahl
9 Water immersion for labor and birth 157
Michelle R. Collins and Dawn M. Dahlgren-Roemmich
10 Aromatherapy in pregnancy and childbirth 173
Linda L. Halcón
11 Acupressure and acupuncture in pregnancy and childbirth 197
Katie Moriarty and Kennedy Sharp
viii Contents
Section 3 organizational approaches to supporting physiologic
pregnancy and birth 227
12 Rethinking care on the hospital labor unit 229
Emily Higdon, Rachel Woodard, Kristin Rood and Heidi Jean Bernard
13 Out-of-hospital birth 251
Marsha E. Jackson and Alice Bailes
14 Educating health professionals for collaborative
practice in support of normal birth 275
Melissa D. Avery, John C. Jennings and Michelle L. O’Brien
15 Women’s health and maternity care policies: Current
status and recommendations for change 301
Heather M. Bradford
Resources for physiologic pregnancy and childbirth 331
Index 335
Contributors
Cindy M. Anderson, PhD, RN, Heather M. Bradford, MSN, CNM,
WHNP-BC, FAAN ARNP, FACNM
Associate Professor Certified Nurse-Midwife
Department of Nursing Evergreen Health Midwifery Care
College of Nursing and Professional Kirkland, Washington
Disciplines Affiliate Faculty
University of North Dakota Department of Family and Child Nursing
Grand Forks, North Dakota University of Washington
Seattle, Washington
Melissa D. Avery, PhD, CNM,
FACNM, FAAN
Michelle R. Collins, PhD, CNM
Professor
Associate Professor of Nursing
Chair, Child and Family Health
Director, Nurse-Midwifery Program
Co-operative Unit
Vanderbilt University School of Nursing
Director, Nurse-Midwifery Program
Nashville, Tennessee
School of Nursing
University of Minnesota
Dawn M. Dahlgren-Roemmich, MS,
Minneapolis, Minnesota
CNM
Alice Bailes, CNM, MSN, FACNM Certified Nurse-Midwife
Co-Founder Jordan, Minnesota
Birth Care and Women’s Health
Alexandria, Virginia Linda L. Halcón, PhD, MPH, RN
Associate Professor
Rebeca Barroso, DNP, CNM
School of Nursing
Faculty, Frontier Nursing University
University of Minnesota
Staff Nurse-Midwife
Minneapolis, Minnesota
HealthEast Nurse-Midwives
St. Paul, Minnesota
Emily Higdon, RN, MSN
Heidi Jean Bernard, RN, ADN PhD Student and Jonas Scholar
Staff Nurse Staff Nurse
Department of Labor and Delivery Department of Labor and Delivery
University of Iowa Hospitals and Clinics University of Iowa Hospitals and Clinics
Iowa City, Iowa Iowa City, Iowa
x Contributors
Marsha E. Jackson, CNM, MSN, Michelle L. o’Brien, MD, MPH,
FACNM IBCLC
Director and Co-Founder Adjunct Faculty
Birth Care and Women’s Health Assistant Professor
Alexandria, Virginia Department of Family Medicine and
Community Health
John C. Jennings, MD
University of Minnesota Medical School
Professor of Obstetrics and Gynecology
Minneapolis, Minnesota
Texas Tech University Health Sciences
Odessa, Texas Deborah Ringdahl, DNP, RN, CNM
Reiki Master
Kathryn Leggitt, MS, CNM
Clinical Assistant Professor
Certified Nurse-Midwife
School of Nursing
Hennepin County Medical Center
University of Minnesota
Minneapolis, Minnesota
Minneapolis, Minnesota
Lisa Kane Low, PhD, CNM, FACNM
Kristin Rood, RN
Assistant Professor and Director
Maternal and Infant Staff Nurse
Nurse-Midwifery Education Program
Children and Women’s Services Division
School of Nursing and Women’s Studies
University of Iowa Hospitals and Clinics
Department
Iowa City, Iowa
University of Michigan
Ann Arbor, Michigan Kennedy Sharp
Licensed Acupuncturist
Katie Moriarty, PhD, CNM,
Masters in Oriental Medicine
CAFCI, RN
NCCAOM Certified
Clinical Assistant Professor
sharpacupuncture.com
Associate Director Nurse-Midwifery
Minneapolis, Minnesota
Education Program
School of Nursing Kerri D. Schuiling, PhD, CNM,
University of Michigan FACNM, FAAN
Ann Arbor, Michigan Dean
Certified Acupuncture Foundation of School of Nursing
Canada Institute Oakland University
Rochester, Michigan
Carrie E. Neerland, MS, CNM
Certified Nurse-Midwife Rachel Woodard, RN, BSN, RNC-oB
Women’s Health Specialists Obstetrical Nurse Specialist
University of Minnesota Physicians Staff Nurse Labor and Delivery
Adjunct Faculty Departments of Pediatrics and Nursing
University of Minnesota School of University of Iowa Hospitals and Clinics
Nursing Iowa City, Iowa
University of Minnesota Medical School
Minneapolis, Minnesota
Foreword
Birth is an event that carries our universe into the future. Each pregnancy and birth holds
the promise of fresh life, renewed faith in our survival, and awe at the magnificence of
human reproduction and the power of woman. Every birth is unique and every birth
changes the person fortunate enough to witness the emergence of a new life.
Melissa Avery has brought together midwives, nurses, physicians, and other health
practitioners in a collective, in-depth discussion of how to support a woman’s physiologic
capacity to carry and birth her child. This long overdue book is founded on the premise
that pregnancy and birth are normal physiologic processes. It takes a direction often
missing in traditional texts—that birth is more than simple mechanical, physical processes
that can be inherently controlled. Rather, it acknowledges that although there is much we
fully understand, there is still much to be learned. Thus, she and her colleagues have
expertly woven current scientific evidence and theory with practical clinical expertise for
helping women and their families during this life-producing and life-changing event.
The first section grounds the reader in a woman’s physiology during pregnancy and
birth. Avery starts the section off with a “real-life” scenario that clinicians who attend
birth are often faced with each day. This is followed by an exquisite description of the
physiologic intricacies of pregnancy and parturition that leaves us breathless in its detail
and design and sets the stage for understanding how it all works. Prenatal care is empha-
sized as the place to work with the woman to establish her confidence in her body and its
capabilities. The section closes with a stunning overview of how to keep the woman and
her needs central during childbirth. The authors review the evidence on routine maternity
care practices that can disrupt normal labor and birth and describe approaches to care that
provide step-by-step support of a woman’s physiology. Taken together, these four chap-
ters provide the essential elements of the book and lay the underpinning for the following
sections, which explore specific techniques and policy.
The second section provides an overview of specific strategies in caring for childbearing
women. Different theories and evidence for care strategies are presented, always return-
ing to why and how they support normal physiologic birth. The section begins with an
introduction to the theories of “comfort,” helping the reader understand how to meet each
woman at the intersection of her life and her perception of pain and discomfort. The com-
plexity of labor pain is disentangled through creative descriptions of pain modulation
through the release of naturally occurring neuropeptides. The theoretical basis of comfort
is extended by presence—the act by which the labor attendant creates a space in which
the woman feels safe and thus her body’s physiology is supported to do the work of labor.
Techniques of relaxation, healing touch, therapeutic use of water, aromatherapy, and