Relaxation Techniques

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Often during pregnancy women learn the skill of relaxation to cope in labour but it may also help to cope with morning sickness. The reading list on p. 188 includes some relaxation tapes, which can be purchased. Simply follow the instructions on the tape. You may be able to borrow tapes from your local library. You may also find that using your own selection of music is more relaxing. People dealing with a whole range of unpleasant symptoms, such as chronic pain, find that learning the skill of relaxation can significantly reduce their experience of pain. Partly this can work by learning to focus on positive images and thoughts rather than the distressing symptom, which can reduce their experience of pain. Learning to relax certainly won't make the sickness and fatigue go away but at the very least it may just encourage you to take ten minutes out every day to put your feet up after all, the weeks when sickness occurs are crucial in the development of the baby.

Freestanding Birth Centers

A doctor is seldom present, and medical interventions are rarely or never done. Pain control is based on massage, whirlpool baths, relaxation exercises, and other techniques. Drugs are usually not available. If complications develop during labor or if a woman wants anesthesia for pain, she is taken to a hospital. This happens in 10 to 25 percent of labors and is especially common in first births.

2114 Migraini Ddications

Migraine suffering is frequently positively influenced by pregnancy. Non-drug processes such as muscle relaxation therapy, biofeedback, acupuncture and acupressure, as well as changes in lifestyle and nutrition, are preferable in the prodromal stage and in the intervals that are free from pain. The analgesic of choice is paracetamol, perhaps combined with caffeine or codeine (see Chapter 2.1.7). Ibuprofen or aspirin can also be considered, but these should not be used from the early third trimester onwards. If necessary, antiemetics like medozine or metoclo-pramide should be given prior to analgesics. To prevent dehydration, intravenous (i.v.) fluids should be given. To control nausea and pain, phenothiazines (prochlorperazine) can be administered intravenously, supplemented if necessary by i.v. narcotics (like codeine) or i.v. corticosteroids. Severe attacks can be treated with sumatriptan (preferably intranasal, s.c. or rectal) other triptanes should be used only...

Delivery Without Drugs

Without drugs include relaxation and breathing exercises, as taught in many childbirth classes hypnosis or self-hypnosis massage counterpressure changes of position and immersion in warm water. In many cases, a woman needs to start learning and practicing these techniques months or weeks before she gives birth.

Care of the Mother of a Baby on the Neonatal Unit

Mothers experience tiredness with frequent visits to a neonatal unit, and might be called throughout the night. A quiet, calm environment on the ward might assist relaxation and sleeping. As there is a chance of meals and drug rounds being missed, alternative arrangements should be made. Assistance should be given with breast pump use, and arrangements made for the storage of expressed milk.

Hypertrophic Cardiomyopathy HCM

There is enlargement and abnormal fibre orientation of the cardiac myocytes. Impaired diastolic relaxation results, the heart does not fill properly and there may be left ventricular outflow obstruction. It can present in childhood but may manifest at any age. There may be no symptoms, or there may be

Stress on the Parents

Once nursing is going well, breast-feeding can be more relaxing than bottle-feeding. If your baby sleeps in your room, you won't have to get up for a bottle. Travel with your baby is simpler. And many women report that nursing triggers deep feelings of relaxation and well-being (perhaps linked to hormonal changes).

Comparing forms of exercise

Yoga, which is a great choice for pregnant women, is not only an excellent form of exercise, but may also be helpful in mastering breathing and relaxation techniques. Yoga is particularly useful in strengthening lower back and abdominal muscles and increasing stamina and physical endurance all of which make you better equipped to handle the rigors of pregnancy.

Urinary stress incontinence

Leaking a little urine when you cough, laugh, or sneeze isn't unusual when you're pregnant. This kind of urinary stress incontinence occurs because your growing uterus is putting pressure on your bladder. Relaxation of the pelvic floor muscles increases the problem during the late second and third trimesters. And sometimes the baby may give the bladder a swift kick and cause it to leak urine. Kegel exercises in which you repeatedly contract the pelvic floor muscles as if you're trying very hard not to urinate can prevent or markedly reduce the problem. (See Chapter 13.) Some women continue to experience a little stress incontinence even after delivery, but it usually goes away after about 6 to 12 months.

Going back to school Classes to take

In order to prepare yourself for labor, you may want to consider taking some birthing classes to find out about breathing, relaxation, and massage techniques that help alleviate the fear, anxiety, and pain associated with labor. Today, a great majority of first-time expectant parents attend childbirth classes. Childbirth education has dramatically changed the average woman's experience of labor and delivery. Today's birthing experience is a far cry from the middle part of the last century, when women were knocked out with anesthesia for the delivery and the expectant father's only job was to pace around the waiting room like Ricky Ricardo anticipating the arrival of Little Ricky.

Fetal Risk Summary

The competitive (nondepolarizing) neuromuscular blocking agent, atracurium besylate, provides muscle relaxation during surgery or mechanical ventilation. The drug undergoes rapid, nonenzymatic, spontaneous degradation in the plasma (Hofmann elimination) that is independent of hepatic or renal mechanisms (1,2). In five women, from a total group of 26 undergoing cesarean section, average venous concentrations of the drug, following a 0.3 mg kg IV dose, ranged from 3.34 pg mL at 3 minutes to 0.7 pg mL at 10 minutes (6). Venous cord blood concentrations of atracurium ranged from undetectable to 0.23 pg mL, suggesting that the cord maternal ratio varied from 5 to 20 (6). In the second report by these authors, 53 women, delivered by cesarean section, received atracurium 0.3 mg kg IV followed by increments of 0.1-0.2 mg kg IV as necessary to maintain surgical relaxation (7). Concentrations of the drug in 16 women at delivery ranged from 0.54 to 3.34 pg mL. Only 1 patient received a second IV...

Symphysis Pubis Dysfunction

Symphysis pubis dysfunction (SPD) encompasses symphysis pubis malfunction due to ligament relaxation giving rise to varying degrees of immobility or disability3, of which the definitions vary4. The condition is also known as pelvic girdle relaxation, pelvic relaxation syndrome, pelvic insufficiency or pubo-pelvic arthropathy5.

2153 Prolactin antagonists

Oxytocin produces contraction of the uterine muscle and the myoepithelial cells in the breast. During pregnancy, it is produced physiologically in increasing amounts at the same time, it is inactivated by a similarly increased synthesis of the so-called pregnancy oxytocinase. A role for oxytocin in the natural initiation of labor has been suspected but not proven, but oxytocin is used clinically to induce or augment labor. Undesirable effects of administered oxytocin, such as fetal hypoxia, are associated with excessively strong uterine contractions or inadequate uterine relaxation between contractions (see also Chapter 2.14).

The least invasive early in your labour

You might well find yourself uncertain at first whether labour has begun. You are perhaps just having period-type pains and feel a little 'unusual'. Midwives will usually advise you simply to carry on as normal at first or to try and sleep if it is still night-time. Despite this being very good advice, most women are probably emotionally 'charged'at such a time wondering what will happen next, feeling a mixture of fear and excitement.This is the time, before it becomes too painful, to perhaps try to do some relaxation exercises to try to focusyour thoughts. It is important where possible to try and stem panic thoughts, possibly by trying to replace them with more

Psychological Therapy

Psychosocial factors such as a history of abuse should be addressed by the physicians caring for these women in a sensitive manner. Some women may require additional psychiatric or psychological intervention. Some of these include relaxation therapy, hypnosis, cognitive behavioural therapy and biofeedback techniques.

Other Types of Pain Relief

Using a progressive relaxation technique, various muscle groups are relaxed one by one in order to help detect tension and then release it 5. Imagery. This technique uses the mind to form mental pictures that can aid in relaxation. 7. Warm showers or a bath. Warm water is an effective tool for relaxation.

Stage One Active Phase

The active phase of stage one labor can last up to 6 hours, or more, although it can be shorter, especially if you have previously had a vaginal delivery. Now the real work of labor begins, and you will no longer be able to talk during contractions. Breathing exercises, relaxation techniques, and a good labor coach can be helpful during this phase. Massage and gentle encouragement can also be helpful. By now, you have probably arrived at the hospital or birth center. If you have no medical or obstetric complications, you should be able to move around. You may find that it feels good to walk, but you will probably want to stop and lean against someone or something during contractions. If you feel exhausted, sit in a rocking chair or lie in bed on your left side. This might be a good time to take a warm shower or bath if you have access to these facilities. Warm water can help ease the pain of labor, and women sometimes progress quite rapidly with the relaxation that water provides.

8 Maternal Opioid

Heroin is processed from morphine, a naturally occurring opiate extracted from poppy plants. It is sold illegally, often tied in the ends of small balloons. Common street names for heroin include smack, dope, H, China white, black tar, and junk. Heroin can be smoked, sniffed, or injected intravenously or intramuscularly. After an injection, the user experiences euphoria, relaxation, warmth, and an absence of anxiety. Because the duration of action is 4-6 h (72), users tend to use it two to three times a day. The signs of heroin use include drowsiness, itching, pinpoint pupils, loss of appetite, slowed breathing, and constipation. Death in chronic intravenous heroin users is often the result of overdose. Heroin users are also at risk for developing collapsed veins, endocarditis, abscesses, cellulitis, HIV, AIDS, and hepatitis (73).

2167 Muscle relaxants

Muscle relaxants are usually used in surgical anesthesia because most anesthetics alone do not produce sufficient relaxation of the skeletal muscles. In contrast to general and local anesthetics, muscle relaxants cross the blood-brain barrier and the placenta only in limited amounts due to their high degree of ionization and limited lipid solubility. Thus, in fetal tissue these agents achieve only 5-10 of the concentration measured in the maternal blood (Demetriou 1982, Abouleish 1980). Hence, under regular anesthesia, it is presumed that the concentrations of these agents in fetal blood are well below the effective dose for production of fetal muscle relaxation. Indeed, no effects were observed in the fetuses of 25 women treated with tubocu-rarine in the second or third trimester of pregnancy (Moise 1987). On the other hand, there is one case report of an infant born with multiple congenital joint contractures whose mother was treated with multiple doses of tubocurarine (Jago 1970)....

Box 122 Frequency windows

0.5-3 Hz (delta) this band is associated with deep sleep, meditative and subconscious states analgesia produced using these frequencies appears to be blocked by naloxone, implicating beta-endorphin production. Virtually any frequency within this band is capable of producing fast relaxation, treating insomnia and providing good pain relief. This band is recommended for high-intensity electroacupuncture, neuroelectric acupuncture or acupuncture-like TENS. 7-12 Hz (alpha) this band is associated with the relaxed waking state, with conscious physical relaxation with the second stage of sleep. A frequency around 10 Hz is the safest frequency in the whole spectrum. It acts both as an analgesic and as a tonic and exerts a stabilising influence. Yoga and Zen meditation increase alpha activity. If in doubt, use 10 Hz.

83 Discomforts Related To The Musculoskeletal System a Backache

(1) Backache is caused by relaxation of the sacroiliac joint which is due to increased hormones (steroid sex hormone and relaxing) resulting in slight joint and muscle relaxation and increased mobility and exaggerated lumbar and cervico thoracic curves caused by changes in the center of gravity from the enlarging abdomen and breasts.

59 Changes Of The Skeletal System During Pregnancy

Uterine Size Weeks

There is a slight relaxation and increased mobility of the pelvic joints, which allows stretching at the time of delivery of the infant. b. Peristalsis is slowed because of the production of the hormone progesterone, which decreases tone and mobility of smooth muscles. This slowing enhances the absorption of nutrients and slows the rate of secretion of hydrochloric acid and pepsin. Flare-up of peptic ulcers is uncommon in pregnancy. Slow emptying may increase nausea and heartburn (pyrosis). Relaxation of the cardiac sphincter may increase regurgitation and chance for heartburn. Movement through the large intestines is also slowed due to an increase in water consumption from this area. This increases the chance for constipation.

Effect of HRT on vascular reactivity

Menopause and diabetes have independent and adverse impacts on microvascular reactivity, as measured by forearm cutaneous vasodilation in response to acetylcholine and nitroprusside. HRT was found to improve this relaxation response in both healthy and diabetic subjects.74 Another in vitro study conducted in patients with Type 2 diabetes given HRT for 6 months yielded similar results, demonstrating an effect of HRT on both endothelium-dependent and -independent mechanisms of vascular relaxation.75 Other studies on vascular function failed to confirm beneficial effect of HRT. In short term controlled study no significant effect of HRT was shown during performance of isometric exercises or intra-venous infusion of vasoactive substances. However, mental stress induced blood pressure elevation, was moderated by estrogen only treatment in the diabetic patients but not in the nondiabetics.76 HRT also failed to reduce elevated levels of endothelin-1, a natural vasoconstrictor, which is...

98 Preparation For Labor And Delivery

Relaxation and Psychological Control of Pain. Several methods of relaxation and psychological control of pain during labor are listed below (1) Lamaze method (Psychoprophylactic method-PPM). This method is the most widely taught. It deals with combating the fears associated with pregnancy by teaching relaxation and breathing techniques. (b) The patient is taught to respond to pain with respiratory activity and relaxation of uninvolved muscles. (2) Bradley method (husband-coached childbirth). This is similar to the Lamaze method. Emphasis is placed on slow, deep breathing along with complete relaxation. Women using this practice often appear to be asleep during labor. However, they are not asleep, but are simply in a state of deep mental relaxation.

Risks to the Woman

Pregnant women with epilepsy who want to have a home birth need to consider the complications that could arise if a seizure occurs during labor. Water births also need to be carefully considered, because consciousness may be impaired during seizures. A water birth can be performed at home or at a birthing center. The warm water relaxes the mother's back and pelvic muscles, and takes the weight of the baby off the mother's back and hips. Relaxation, combined with the buoyancy of water, helps the baby descend through the birth canal. A water birth can provide a relaxing transition for the baby from the womb into the world.

37 the elite athlete

The elite athlete experiences limitations and physiological changes in pregnancy similar to the recreational athlete, including ligament relaxation, change in posture, and weight gain. These changes may in turn impact a woman's competitive ability and increase her desire for strenuous training, making her more prone to injury 12 . The

Bedtime Rituals

A bedtime ritual consists of anything you'd like to do as you put your child to bed for the night. Parents often include things such as bathing or washing, putting on pajamas, brushing teeth, singing, rocking, feeding, reading, playing soft music, and telling a story. You might want to include prayer, massage, or relaxation techniques. You might talk about what your child did today and what is planned for tomorrow. Sometimes a consistent exit line from you some-thing as simple as Sweet dreams or I love you can be a comfort, along with a promise to check on your child in 10 minutes. (Be sure you keep the promise.)

Baby Showers

This is all fine and good, and since these things are traditionally held on Saturday or Sunday, that means you get some much needed free time to catch up on your sports watching. It also means not only do you get some cool, free stuff for your kid (and you) to play with, but your wife will also be much more relaxed. This relaxation is twofold, due to the sharing of ideas with others and her venting to her friends. Venting to her friends is much better than her venting to (on) you. Not only don't you have to listen, but she'll be pleased to learn that her friends' husbands were just as big of bozos as you are. This will make her happy. No woman wants her husband to be special when it comes to this sort of thing. So traditional showers are good things.

B Heartburn Pyrosis

(1) Heartburn is a burning sensation in the epigastric and sternal region. It results from relaxation of the cardiac sphincter and the decreased tone and mobility of smooth muscles which is due to increased progesterone thereby allowing for esophageal regurgitation, decreased emptying time of the stomach, and reverse peristalsis.

B Muscle Cramps

(2) It is caused by the relaxation of smooth muscle walls of veins, which is due to increased hormones (progesterone), which causes pelvic vasocongestion. This condition is aggravated during pregnancy due to the enlarging uterus in the pelvis causing pressure on the great abdominal veins, which interferes with return blood flow from the lower extremities. It is also aggravated by gravity and bearing down for bowel movements. This may also be a hereditary disposition.

Rozas story

Roza was referred to see me for help with managing a chronic pain problem. She had a pain in her ankle that at times stopped her from walking. The doctors could find no clear cause for this pain and felt that she needed to learn some relaxation techniques. Roza had four children, two of whom were at school but her eldest son had recently started 'staying home'and she was finding it difficult to get him out of bed in the mornings. Roza had come to live in England to marry her husband who was born in this country. He had worked in the family catering business for many years but had not worked for three years since he had fallen out with his father. He usually stayed in bed until after she had taken the children to school. Roza was responsible for the care of the children and the housework. She said it would be inappropriate for a man to help her with these tasks but she did wish she had more support particularly concerning managing their eldest son's behaviour.

The natural

Undermined rather than developed their self-confidence. Many also distrusted the medical profession's enthusiasm for technological developments for example, a woman who was X-rayed in order to diagnose a twin pregnancy in the 1950s later confessed, 'I was a bit worried about having an X-ray when I was pregnant, but at that time you didn't feel you could question things. They were the professionals and they knew - you just took their word for it.'48 The natural childbirth movement attempted to address the related issues of women's lack of self-confidence and the increased medicalisation of pregnancy and childbirth. It began with the work of Grantly Dick Read, who had become convinced that women experienced pain in childbirth because they anticipated pain. Fear caused their muscles to tense and the cervix to contract, making it difficult for the child to descend through the pelvis 'fear of itself produces pain, and pain, terror, and so the agony of childbirth.'49 The remedy was an...

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