Instructions:
When using visual aids, consider the emotional or “gut” response to any visual aid you use when evaluating its effectiveness. When using a doll, model behavior you would use with a baby. Treat it gently, putting it down on a blanket or pillow, rather than tossing it on a table after the “birth!”
An abundance of visual aids are available to show the difference between one and ten centimeters: using foods from Cheerios to bagels, circles on a page, plastic dilation charts, a series of rings, or even glass bottles and jars. If you think it increases understanding to show these dimensions, be careful of the images you choose. The cervix is a soft, supple organ designed to stretch and open. It is not really like a ketchup bottle becoming a pickle jar!
A knitted uterus or turtle neck sweater creates a realistic image of how the uterus pulls back and opens the cervix for the baby to come through. By showing how the thick soft “cervix” of the knitted uterus thins out and pulls back over the head of a doll, or your own head pushes through and opens a turtle neck sweater, a positive image of birth is portrayed.
A series of rubber bands in various diameters and thicknesses make a good visual. Check the rubber bands you find around stalks of broccoli and asparagus at the grocery store. Put the rubber band around the ends of all your fingers. Now, try to open your fingers. The thinner/larger rubber bands will be easier. The thicker/smaller rubber bands will be harder.
Using a model of a pelvis and a baby doll, show how the baby negotiates the “canal” as it descends, flexes, rotates internally, extends, and finally rotates externally. It is fine if it is a tight fit — just practice before class so you know it will work.
You can use the “baby blockhead” to show students why the baby must rotate for the birth to occur. The wider diameter of the pelvic inlet, then outlet, matches the wider diameter of the baby’s head, then shoulders, as the baby rotates through the pelvis. It becomes evident that this process will require time, even after the cervix has fully dilated.
Visual Aids:
Talking Points:
Based on new research that normal labor may take much longer than previously thought, researchers and health care providers are now saying that “6 is the new 4.” It is now recommended that active labor be defined as beginning at 6 cm. when labor begins to progress more quickly for most women.
In order to help bring down the skyrocketing cesarean rate, it is strongly recommended that cesareans for dystocia NOT be suggested before 6 cm. When teaching about the stages of labor, remind students that although signs and symptoms are often shown as distinct phases, most often one phase of labor melds into the next in a flowing process. The physical and emotional experiences a birthing person feels may not necessarily follow dilation to the exact centimeter on a chart. For instance, a person five to six centimeters dilated is probably experiencing the sensations of active labor, but could be feeling or coping as though she were in either early labor or transition.
Every labor is unique, and the range of “normal” is wide. Instead of talking about the stages and phases of labor in isolation, teach how labor might progress by weaving in information about the ways in which the labor support team can provide support and encouragement.
Whether you use charts or PowerPoint slides to illustrate the progress of labor, point out the following to your students:
- Begin by showing them the various presentations and positions.
- Show a depiction of the cervix. Follow the effacement and dilation as it progresses through second stage.
- Notice the rotation of the baby from transverse to anterior.
- Notice how the position of the baby moves from flexion to extension.
Discussion: Draw on a white board or use a chart or PowerPoint slide to illustrate the waves of contractions in early, active, and transition labor. Point out how the peaks become higher and closer together as the contractions intensify.