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 Pozicije tokom poroda - na engleskom (prevescu poslije)

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KomentarNaslov komentara: Pozicije tokom poroda - na engleskom (prevescu poslije)   Sat Mar 08, 2008 2:51 am

Advantages and disadvantages of various positions you might try during childbirth.

Fortunately we've left behind the days of the laboring-on-her-back, heavily sedated mother-to-be, totally dissociated from the natural workings of her own body and missing out on the joy of giving birth.

Today women can learn how to use their bodies to minimize discomfort and speed the progress of labor. Trying a variety of positions during labor and birth can help you to find what works best for you. Here is what you need to know about the various labor and birth positions.

Standing
Walking
Sitting
Sitting on Toilet
Semi-Sitting
Lithotomy
Side-Lying
Leaning
Kneeling, Leaning Forward with Support
Squatting
Hands and Knees

Standing

Advantages

Excellent for oxygenation of fetus
Uses gravity
Contractions are more effective and less painful
Helps speed up labor
Helps create pushing urge

Disadvantages

Poor control of delivery
Visualization very hard for birth attendant

Walking

Advantages

Uses gravity
Contractions often less painful
Encourages uterine contractility
Baby well-aligned in pelvis
May speed up labor
Reduces backache
Encourages descent

Disadvantages

Often mother can't use if she has high blood pressure
Can't be used with continuous electronic fetal monitoring

Sitting

Advantages

Good for resting
Uses gravity
Can be used with continuous electronic monitoring
Can be used with birth ball to encourage descent

Disadvantages

Possibly can't be used if mother has high blood pressure

Sitting on Toilet

Advantages

Helps relax perineum
Mother accustomed to open-leg position and pelvic pressure in this environment
Uses gravity

Disadvantages

Pressure from toilet seat can cause pain

Semi-Sitting

Advantages

Comfortable for mother
Good use of gravity
Good resting position
Works well in hospital beds
Good visibility at delivery for mom, dad and others present
Good access to FHTs (Fetal Heart Tones)

Disadvantages

Access to perineum can be poor
Mobility of coccyx is impaired
Some stress on perineum, but less than lithotomy

Lithotomy
(on back, legs raised -- avoid this position!)

Disadvantages

Compression of all major vessels
Laceration or need for episiotomy is more likely
No use of gravity to aid delivery

Side-Lying

Advantages
Good fetal oxygenation
Good resting position for mother
Helpful if mother has elevated blood pressure
Useful if mother has epidural anesthesia

Often makes contractions more effective
May promote progress of labor
Easier for mom to relax between contractions during second stage
Allows posterior sacral movement in second stage
Can slow precipitous delivery
Partner may need to support leg
Partner can assist in delivery
Lowers chance of laceration or need for episiotomy
Access to perineum is excellent

Disadvantages

Access to FHTs poor if mother is lying on same side as baby’s back
No help from gravity
Mother must support her leg under knee if no one is there to hold leg
Mother may feel too passive

Leaning

Advantages

Great for rotation of posterior presentation
Uses gravity
Contractions often less painful
Contractions often more productive
Baby is well-aligned in pelvis
Relieves backache
Facilitates use of back pressure
May be more restful than standing

Disadvantages

Hard for attendant if used at delivery

Kneeling, Leaning Forward with Support

Advantages

Helpful with persistent posterior presentation
Assists rotation of baby
Good for pelvic rocking
Good for use with birth ball
Less strain on wrists and arms

Squatting

Advantages

Encourages rapid descent
Uses gravity
May increase rotation of baby
Allows freedom to shift weight for comfort
Excellent for access to the perineum
Excellent for fetal circulation
May increase pelvis diameter by as much as two centimeters
Requires less bearing-down effort
Upper trunk presses on fundus to encourage descent
Thighs keep baby well-aligned

Disadvantages

Often tiring to mother
Sometimes hard to hear FHTs
May be hard for mother to assist

Hands and Knees

Advantages

Good for bradycardia (low heart tones)
Good for back labor
Useful with birth ball
Assists with rotation of posterior presentation
Takes pressure off hemorrhoids
Best position to avoid laceration or need for episiotomy
Good delivery position for large baby

Excellent for shoulder dystocia

Disadvantages

Hard to maintain eye contact with mother
Hard for mother to see
Baby must be passed through mother’s legs
Can be disorienting to inexperienced attendant.
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