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The 37-Week Teaching

21 Clips by Joanne Yarrish, CNM, FNP

Empowering Mothers Through Knowledge

Joanne Yarrish, a certified nurse midwife with 30 years of experience and over 1,000 deliveries, is presenting teaching videos aimed at empowering women through knowledge about pregnancy and childbirth. She emphasizes that with proper information, women can feel more confident and empowered in their birthing experiences. Joanne highlights the natural process of pregnancy and motherhood, aiming to provide reliable and useful information amidst the vast amount of unreliable content available.

Latent Labor: Overview

The video discusses the three phases of true labor, focusing on the first phase known as the latent phase. This phase involves cervical dilation from zero to about five centimeters or more. It is noted as the longest part of labor, and the speaker advises that once labor begins, most babies are born within 24 hours.

Planning for Latent Labor

The video provides guidance on managing the latent stage of labor by having a plan that involves watching movies with friends or family for distraction. It suggests choosing familiar movies and engaging in light activities like walking or resting. The video emphasizes that companions should offer soft gestures rather than active labor support. It also highlights the importance of having at least one knowledgeable person present, while allowing younger family members to participate under clear guidelines. They should leave before the active labor phase begins.

Reporting Bleeding in Labor

The video discusses warning signs during labor, emphasizing that any bleeding should be reported. Pinkish discharge is usually a positive sign indicating cervical dilation, whereas bright red bleeding, akin to menstrual bleeding, is alarming and requires immediate medical attention.

Reporting Water Breaks & More

The video discusses the importance of reporting certain symptoms during pregnancy, particularly if the water breaks. It emphasizes that breaking water, whether during labor or not, should be reported immediately unless it happens at night and the fluid is clear. Other warning signs that require immediate attention include reduced baby movement, bleeding, fluid loss, fever, severe vomiting, and unusual feelings of illness. The transcript highlights that any symptom out of the ordinary should be communicated to a healthcare provider.

Reporting Water Breaks in Labor

The video emphasizes the importance of informing your healthcare provider or labor and delivery team if your water breaks, regardless of whether you are in labor. If your water breaks and you're not in labor, you can wait until the morning to report it, as long as the fluid is clear, but this should be done around 7:00 AM.

Water Breaks: Color & Smell

The video provides guidance on what to do if a pregnant woman's water breaks while she is at home. It highlights the importance of observing the color and consistency of the amniotic fluid. Clear fluid without a distinct smell indicates normality, whereas any discoloration, especially meconium-stained fluid (dark green, mustard yellow, or dark gray), requires immediate medical attention. It also mentions the difference between amniotic fluid and urine and offers advice on how to determine if the water has truly broken by observing if the leaking continues.

Managing False Labor: Four Steps

The video provides guidance on distinguishing true labor from false labor and offers strategies to manage false labor effectively. The speaker outlines a four-step process: changing positions and hydrating, taking a hot shower, immersing in a hot bath, and using either a small amount of red wine or a sweet drink to help calm false labor contractions. These steps help parents, especially first-timers, determine whether labor is false and find relief from it.

False vs. True Labor Conractions

The video discusses the differences between false labor and true labor contractions. False labor is characterized by unpredictable and erratic contractions that vary greatly in timing, described as having an energy called "Tinkerbell." In contrast, true labor contractions are consistent and progressively closer together, indicating a more orderly progression. A reliable sign of true labor is when contractions occur every 3 to 5 minutes, each lasting around 60 seconds.

Measuring Conractions

The video explains how to measure contractions during labor, distinguishing between two types of measurements: the interval from the start of one contraction to the start of the next (contraction pattern) and the duration from the start to the end of a single contraction. It highlights the role of dads in timing contractions, often using stopwatches to help manage the process.

The Beginning of Active Labor

The video discusses the second phase of labor, focusing on the active labor part, which is further divided into phases. The speaker highlights the middle phase of active labor, where contractions become more intense and extend to the top of the uterus. This phase marks a significant shift in the labor experience, where the pain is profound and demands full attention, signifying the hard work the body undergoes during this process.

Active Labor: Getting to your Birthplace

The video provides guidance for when to head to a birth center during labor. It advises those close to their birth center to prepare to leave when reaching the active phase of labor and suggests utilizing a shower to clean up and prepare. It highlights the need for preparation time, with experienced mothers needing about an hour and first-time mothers about two hours. Laboring in a tub is mentioned as an option, though it may accelerate the labor process, potentially leading to the transition phase too soon.

Anticipating Pain in Active Labor

The video discusses the stages of labor, focusing on managing pain through different phases. It emphasizes the importance of mental strength and body awareness to handle latent and active labor phases. The speaker notes that many women opt for an epidural during active labor, whether in a hospital or birth center. The importance of personal choice in the decision to pursue natural or medicated birth is highlighted.

The Importance of your Birthplace

The transcript advises individuals to consider going to their chosen birthplace, such as a hospital or birth center, during the second phase of labor to receive necessary support and assistance. It emphasizes the importance of being in a comfortable environment and suggests utilizing facilities like a birthing tub at the hospital or birth center rather than at home, as labor can progress unpredictably.

Cervical Dilations in Labor

The video explains the process of labor, specifically focusing on cervical dilation during true labor. It describes how the cervix opens and progresses from zero to ten centimeters, illustrating the gradual changes in dilation using finger measurements. The video also explains that uterine contractions are responsible for pulling the cervix open, allowing for childbirth.

Transitional Labor Process

The video discusses managing transitional labor through movement, particularly side-to-side motions, to aid in the baby's descent and speed up labor. The focus is on having intense contractions to fully dilate the cervix. The speaker emphasizes not attempting this alone at home and highlights the importance of having labor support present during this intense phase. The speaker usually arrives when transitional labor begins and reassures viewers that the intensity is at its peak during this phase, but support will be available.

Getting Through Transitional Labor

The video discusses the final phase of active labor, known as transitional labor. This phase is described as extremely challenging and often difficult to remember in detail. During this phase, women may feel overwhelmed and express doubts about their ability to continue, despite having made significant progress. Encouragement plays a crucial role, as women have reached 8 centimeters of dilation with only two centimeters remaining. Although it is the most intense part of labor, it is also the shortest phase.

24+ Hour Labor Debunked

The video discusses the usual duration of labor and the reasons why some labors may extend beyond the typical 24-hour period. It suggests that prolonged labor could either be due to initial false labor or mismanagement. The speaker emphasizes the importance of recognizing true labor and the need for intervention if labor lasts longer than 24 hours, particularly for those delivering outside of a hospital.

Involving Fathers in Labor

The video discusses the involvement of fathers during childbirth, emphasizing that their participation can be beneficial, particularly in applying pressure to alleviate the mother's discomfort. It encourages fathers to engage as much as they feel comfortable and advises women to manage their expectations of their partners during labor, as men may cope with the experience differently.

Challenges for Fathers during Labor

The video discusses the challenges and expectations for fathers in the labor and delivery room, which is often a female-dominated environment. The main expectation for fathers is to manage their own physical well-being, particularly to avoid fainting due to the overwhelming sights, sounds, and smells. Fathers are advised to sit or lie down to maintain proper blood flow to the brain if they feel dizzy. They should also step out of the room if necessary to prevent distracting the medical team from focusing on the woman giving birth.

The Feminine Power of Childbirth

The video discusses the concept of "female power" as it relates to childbirth and motherhood. It highlights how women have a unique strength and rhythm in life, particularly during labor and birth, which men often recognize as something they couldn't endure themselves. The speaker emphasizes the hard work and dedication involved in motherhood, including the process of giving birth, nursing, and raising a child, as a demonstration of this power.