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Sweet Pea ​Births
Sweet Pea ​Births
...celebrating every swee​t pea their birth
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Failing to Progress or Naturally Aligning
Posted on June 1, 2012 at 4:52 PM |
One of the cornerstones of The Bradley Method® is a Healthy
Mom, Healthy Baby outcome. All of the
discussion below only applies if Mom and Baby are not showing any signs of
distress through labor. Mom is
maintaining a healthy temperature, heart rate and blood pressure, and Baby is
also showing that it is doing well as per the monitoring that is being
done. If Mom or Baby are starting to
demonstrate that their health is compromised, then parents are encouraged to
make the best choices for their particular situation. The words “Failure To Progress” are the sound of doom to
some of us (I say "us" because I heard this three times!). They very often mean that interventions are going to start being
suggested. How a couple acts upon those
suggestions is very individual. Marjie
Hathaway coined the phrase “Natural Alignment Plateau”, or “NAP” as an answer
to the dreaded “diagnosis”: “FTP”, or “Failure To Progress”. Failure To Progress is based on the Friedman’s Curve*. It looks like this: As human beings, it is in our nature to see this neat,
explainable graph and say, “It’s a rule!” This can have dire implications
whilst in labor if you really want a natural birth. There are no averages in the midst of a labor
– each labor on is unique and individual. Mathematically, it’s unfair for all labors to be expected to fit the average. That brings in another concept we teach in
The Bradley Method® classes: consumerism and informed consent. If there is time: ask questions, ask for
time, and then communicate and evaluate what you have heard with your partner
before you decide on a course of action.
When a mom does not progress in dilation from one vaginal
exam to the next, or between several vaginal exams, she may be diagnosed with
“Failure To Progress”, and along come the string of possible
interventions. They can include any or all of the following, along with other interventions: an Amniotomy (intentional rupture of the bag of waters),
augmentation of labor with Pitocin, an Epidural to take of the edge of
Pitocin-induced contractions, a Cesarean. A cesarean may also be suggested if the care team suspects that the baby may not fit through mom's pelvis. Diagnosed as "CPD", this is the subject for another post altogether. For now, check the link I listed below* for more information. Instead of accepting the words, “Failure To Progress”,
Marjie decided to suggest a new phrase to her students: “Natural Alignment
Plateau”. NAP instead of FTP. Natural Alignment Plateau is a different way
of approaching that point in labor when dilation does not change. What we teach in class and hope that our
students will remember when they face this crossroads is, "Labor is much
more than dilation." Labor can be slow to start, dilation can stop and/or
contractions can slow down for many reasons.
Here are some to consider:
If your labor has been slow to start after a spontaneous
rupture of membranes, or if you are seemingly “stuck” at a measurement of
dilation, it might be time to evaluate what could be going on and change
tactics:
If Mom and Baby are doing well, you can ask for
time. There is not a medical reason for
an intervention if Mom and Baby are doing well in labor and your care team
confirms that Mom and Baby are okay. Here
are two examples for you to consider and think about if you face a point in
labor when there is no measurable progress. We had a mom from our Winter class go from 6 cm dilated
(usually considered Active First Stage – not yet in Late First Stage) to
holding her baby in 21 minutes. Yes –
you read that correctly. She went from
what most care professionals would consider mid-range in labor to holding her
baby in 21 minutes…that meant she pushed within that time, too, folks. Hers was an emotional component. She was waiting for her mom to arrive. Once her mom arrived at the hospital and
stepped into the room where she and her husband were laboring, her baby and her
body got busy. They dilated a total of 4
cm from 6 cm to “complete” at 10 cm, then pushed, and they were holding their
baby in 21 minutes. Our other story is from our Spring Class. Mom had a slow start to labor. She had started seeing some clear fluid on
Sunday, noticed some more on Monday, and went to the hospital on Tuesday. They tested her fluid and it was amniotic
fluid. Although they were in triage and
barely 1 cm dilated, the couple was strongly encouraged to be admitted. Now they are into the hospital and the expectations
of “Friedman’s Curve.” This couple did a
great job of asking, “Is Mom okay? Is Baby Okay?” After getting their “Yes”
answers, then they followed up with, “That’s great! Then let’s wait a couple more hours and see
where we are.” And sure enough, the next
time the staff and their care provider checked in, they were a little further
along in labor. Once things got going,
this mom went from being 4 cm dilated to 8 cm dilated in one hour! Within two hours of that point, they were
holding their baby. The great news about hitting the NAP is that once the Mom’s
body and Baby “get organized”, labor seems to progress very quickly. Again, remember what I said at the beginning
– things go well when a Healthy Mom and a Healthy Baby are given the time they
need. If Mom or Baby start to indicate
that “healthy” is losing out, then a family needs to make the best choice for
their situation.
What has been your experience – have you had a NAP in your
labor? What choices did you make? For a full explanation of Friedman’s Curve click here or enter this URL into your browser: http://allaboutbirth.net/pdfs/Failure-to-progress.pdf Disclaimer: The material included on this site is for informational
purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult her or his healthcare provider to determine the appropriateness of the information for their own situation. Krystyna and Bruss Bowman and Bowman House, LLC accept no liability for the content of this site, or for the consequences of any actions taken on the basis of the information provided. This blog contains information about our classes available in Chandler, AZ and Payson, AZ and is not the official website of The Bradley Method®. The views contained on this blog do not necessarily reflect those of The Bradley Method® or the American Academy of Husband-Coached Childbirth®. |
Categories: Back Labor, Bradley Method® outcome, Bradley® Coaches, Cephalo-Pelvic Disproportion, CPD, Epidural, Failure to Progress, Fetal Distress, First stage labor, FTP, Going to your birthplace, Information Center, Informed Consent, Labor Marathon, Labor Sprint, Managing or coping with natural labor, NAP, Natural Alignment Plateau, Natural birth, natural labor coping mechanisms, Natural labor coping techniques, Pain, Pain management, Pain management natural labor, Prolonged Labor, Second Stage Labor, The Bradley Method®, The Bradley Method® classes
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