Thursday, January 12, 2012

Learning Lamaze: Back to Basics!

You have been practicing the basics of Lamaze probably your whole life. Surprised? Let me explain…

Lamaze is built on the basic principle that you have the power to raise your pain tolerance through various comforting techniques. Lamaze, learning from the research of two specialists who published extensively in the 1960s, created techniques that challenged the body’s gating system. This gating system works on the principle that our pain fibers are smaller and the pain stimulation travels slower than touch. Our touch fibers are larger and thus the touch stimulation travels faster to the brain. If given a painful stimulus (stubbing one’s toe) and then rubbing the toe, the touch sensation travels to the brain faster and in greater quantity than the pain, thus closing the gate to the pain stimuli – as the brain can only take so much stimulation at one time. In turn, this enables the laboring mother to raise her pain tolerance (the variable degree of pain a person can endure) while acknowledging her pain threshold (the rising degree of pain from a particular source).

Lamaze also drew some of his knowledge from two Russian researchers who encouraged expectant mothers to practice certain techniques prenatally so that the techniques would seem almost automatic when they went into labor. These techniques included structured breathing patterns, focusing on an external source, and a relaxing touch technique call effleurage.

Breathing
All breathing begins with a Deep Cleansing Breath
Inhale-through the nose (if possible), keeping shoulders relaxed
Exhale-through the mouth, letting go of all the tension in your body

SLOW-PACED BREATHING
Rate is approximately half the number of breaths you normally take per minute; not less than 3 or 4 breaths per minute;aids relaxation and provides optimum oxygenation.
When doing the more advanced breathing techniques, return to slow-paced breathing when able.
Procedure:
Deep Cleansing Breath
Inhale (through nose if possible) to a count of 4 - In two, three, four
Exhale through mouth to a count of 4 - out two, three, four
Repeat the inhale/exhale throughout the contraction
When contraction ends, Deep Cleansing Breath

MODIFIED-PACED BREATHING
Rate is slightly faster than your normal breathing rate; not exceeding twice your resting rate; allows you to be more focused and alert.
Procedure:
Deep Cleansing Breath
Inhale through nose to a count of 2 - In two
Exhale through mouth to a count of 2 - Out two
Repeat the inhale/exhale throughout the contraction
When contraction ends, Deep Cleansing Breath

PANT-BLOW BREATHING
Same rate as modified-paced breathing
Blowing softly at regular intervals creates a rhythmic pattern
The pant is an in breath and an out breath (touching the tip of your tongue to the roof of your mouth will help keep your mouth moist)
Patterns may vary: pant - 2 -3 - 4 - blow, or pant - 2 - 3 - blow
Procedure:
Deep Cleansing Breath
Take upper chest, shallow breaths follow by relaxed exhales
At regular intervals, add a slightly emphasized exhalation (a sigh)
The importance is to keep facial muscles relaxed
When contraction ends, Deep Cleansing Breath

Focusing
A focal point is an object, such as a photo, stuffed animal or even a cross stitch piece that will help you to focus on something other than the contractions and the time that labor is taking. The focal point also helps to stimulate certain positive feelings…for example if you plan on giving the stuffed animal to the baby after the birth, there may be feelings of nurturing and love and motherhood attached to the stuffed animal. If the focal point is a photo of a place you have been, there may be feelings of calmness and serenity evoked when looking at the photo. If you choose to use your husband/partner’s eyes during labor as a focal point, this can be particularly empowering as you work together and a powerful team to being this new family! Knowing and drawing strength from your partner can energize a woman even in the closing hours of a long birth!

Effleurage
Effleurage is a rhythmic stroking motion on the larger portions of the body (long bones of the legs, back, abdomen) in circular or back-and-forth movements.
In the classical sense of Lamaze, the emphasis has been on carefully designed, learned and practiced breathing techniques, abdominal massage (effleurage), choosing a "focal point" to look at during uterine contractions, counting during contractions and understanding standard hospital procedures. Dr. Lamaze believed that distractions from pain reduces the perception of pain. Therefore, most women could labor and give birth awake, aware and under their own power if they mastered his techniques in order to avoid being overwhelmed by the intensity of labor. As mentioned previously, the Gate Control Theory or Gating Theory uses touch and effleurage as a key piece for raising pain tolerance.

While these tools and techniques cannot make labor painless, it can make labor less painful by showing you just how much power you have over the pain of the contractions!

Reference:
The Lamaze Guide: Giving Birth With Confidence, 2nd Edition Judy Lothian/Charlotte Dvries, 2010 

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