Biofeedback-Assisted Relaxation to Reduce Stress in Labor

OBJECTIVE: To test the feasibility and effectiveness of incorporating biofeedback-assisted relaxation techniques into routine instruction in Lamaze classes. DESIGN: A quasi-experimental design (static groups comparison) was used. SETTING: Lamaze classes. PARTICIPANTS: A convenience sample of 33 subjects recruited from 12 Lamaze classes. MEASURES: Duration of first-stage labor, amount of sedation and analgesia during first-stage labor, number of complications, and 1- and 5-minute Apgar scores of the neonates. RESULTS: The experimental subjects reported greater stress during labor than did the control subjects. CONCLUSIONS: Although the supplementary instruction in reducing stress seemed to promote relaxation during the prenatal classes, it did not reduce distress during labor and delivery because no mothers attempted to use the technique at that time.     

Second Stage Labor: What Is Normal?

Traditional management of second stage labor has come under scrutiny because of improved understanding of what normally occurs when second stage labor is allowed to proceed of its own accord without direction from birth attendants. When women bear down spontaneously as they feel the urge to push, either holding their breath briefly or with short exhalation of air, normal maternal and fetal physiological status is maintained and second stage labor does not appear to be lengthened. Using a variety of maternal positions during second stage labor can optimize physiologic functioning and increase maternal comfort.     

Nursing and the New Deal: We Met the Challenge

Abstract The years of the great depression were marked with unemployment and economic ruin for many people. Americans were left feeling helpless and hopeless. After the 1932 presidental election of Franklin Roosevelt, his administration embarked on a course of government known as the New Deal. Many new and innovative programs were established to create jobs and a sense of hope for the public. This article will examine four programs that were of particular interest to nursing: the Federal Emergency Relief Act, the Civil Works Act, the Works Progress Act, and the Social Security Act. Nurses of the time embraced these programs. They participated in their development and implementation and made a difference in the lives of many desperate Americans.     

Anticipatory Guidance Adding Solids to the Infant's Diet

Infant feeding practices have not always conformed to professional recommendations. Anticipatory guidance based on a careful assessment of the baby's mother, use of Gestalt principles, and innovative teaching techniques is more likely to lead to appropriate infant feeding practices than fragmented and inconsistent attempts.     

Women’s Use of Nonprescribed Methods to Induce Labor: A Brief Report

Abstract: Background: Sometimes pregnant women take it on themselves to hasten labor to alleviate the discomforts of pregnancy. This study sought to identify how frequently women attempt to induce labor through nonprescribed methods, and what factors are associated with the use of such methods. Methods: Surveys were distributed to postpartum women who had delivered at a Midwestern academic hospital. Women were asked what methods they had used to induce labor on their own, where they heard about these methods, and whether they had discussed it with their physician. Information about demographics and mode and timing of delivery was also collected. Results: Of the 201 women who responded, 99 (49.3%) did not try to induce labor themselves, whereas 102 (50.7%) used some type of nonprescribed method to induce labor. The most common method was walking (43.3%), followed by intercourse (22.9%), ingesting of spicy food (10.9%), and nipple stimulation (7.5%). Very few respondents used laxatives, heavy exercise, masturbation, acupuncture, or herbal preparations to induce labor. Women who used any nonprescribed method to induce labor were younger, had a lower parity, greater gestational age, and were more likely to have had a vaginal birth. Conclusions: A substantial portion of women used nonprescribed methods to induce labor, often without discussing them with a physician. Maternity caregivers may want to inquire about such issues, especially where interventions may do more harm than good. (BIRTH 38:2 June 2011)     

Postpartum Teaching Priorities: The Viewpoints of Nurses and Mothers

Objective: To compare mothers' and nurses' perceptions of postpartum learning needs and effective teaching modalities.
Design: Cross-sectional research design. Mothers were given a questionnaire during their postpartum stay to rate how important it was for them to learn about 44 maternal-infant topics before discharge. Nurses rated similar items on the basis of their perception of what is most important for mothers to learn during their postpartum stay.
Setting: Postpartum units in six hospitals that are part of a large midwestern health care system.
Participants: English-speaking women who delivered either vaginally or by cesarean section without complications and the nurses on their postpartum units.
Main outcome Measures: Identification of preferred topics and methods for postpartum teaching.
Results: Mothers and nurses agreed that topics related to immediate physical health needs were most important. Unmarried mothers considered topics related to personal care and mobility as particularly important. First-time mothers rated more topics as important than did experienced mothers. Individual teaching was rated most effective by both groups. Classroom teaching and the use of audiovisual media were considered less effective.
Conclusions: This study supports postpartum education that focuses on the physical needs of mothers and infants, as well as individual teaching models. The special learning needs of new mothers, including those who are not married, must be considered.     

Pregnancy and Lactation following Anorexia and Bulimia

Ten years after her battle with anorexia nervosa and bulimia began, a 26-year-old woman restored her normal body weight to 102 pounds from a low of 47 pounds (21.3 kilograms), became pregnant, delivered a healthy infant at term, and was successfully breastfeeding at five months. Her dietary intake, which was computer analyzed and compared with the recommended dietary allowances for pregnancy and lactation, revealed few nutrient deficiencies. Ample pregnancy weight gain provided an energy reserve for lactation.