II. Management: Use Gravity and Position Change

  1. One leg up
  2. Sit on the toilet and push
  3. Drape self over an oversized ball

III. 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

IV. 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

V. 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

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Ontology: Labor Coaches (C2936641)

Concepts Professional or Occupational Group (T097)
MSH D059037
English Coach, Labor, Coaches, Labor, Labor Coaches, Labor Coach
French Accompagnatrices en périnatalité, Accompagnatrices de la naissance, Monitrices d'accouchement, Accompagnantes de la naissance, Accompagnantes en périnatalité
German Geburtsbegleiter
Czech porodní instruktorky
Italian Preparatori al parto
Norwegian Fødselsveiledere