Physiologic Birth Care

“A normal physiologic labor and birth is one that is powered by the innate human capacity of the woman and fetus. This birth is more likely to be safe and healthy because there is no unnecessary intervention that disrupts normal physiologic processes” (2013). The RN is in a unique position to support physiologic birth because they attend almost all births.
• Two potential health benefits for the maternal/fetal dyad resulting from physiologic birth care -practices are:
• By positioning the mother in a way that is conducive for delivery, RN’s can reduce the length of time required for pushing. “In the past, a lithotomy position was preferred position for birth because it offers a clear view of perineum, but it is no longer a position of choice as a woman lying flat on her back may slow, not help fetal descent, and lying longer than 1 hour in a lithotomy position can lead to intense pelvic congestion and possible thrombophlebitis” (2014, pg 388). Upright positions such as semi sitting or
squatting, standing as well as lateral recumbent position or Sim’s position during the second stage of labor reduce the length of time required for pushing. “Implementation of upright positions for the second stage of labor can be categorized as one of many nonpharmacologic nursing interventions that are part of labor support” (2016). This one intervention by the RN helps decrease the length of labor and can be attributed to an increased effectiveness of pushing allowing mother to feel empowered and satisfied with the birth process. It can also be attributed to decreased use of analgesia and anesthesia as well as decreased newborn complications associated with elective inductions of labor and operative births.

• Once born, the RN can facilitate optimal newborn transition through skin-to-skin contact.
She should also keep the mother and infant together during the postpartum period as well as educate the mother of the benefits of breastfeeding as well as facilitate the early encouragement of breastfeeding. Health benefits of breastfeeding for the newborn include lower risks of asthma, ear infections, diarrhea and vomiting and SIDS. Health benefits of breastfeeding for mom include “the release of oxytocin from the posterior pituitary gland aids in uterine involution; a woman may return to her prepregnant weight sooner, and if menstruation is delayed, this may serve as a temporary family planning method and breast feeding may serve a protective function in preventing breast cancer and possibly ovarian cancer” (2014, pg 493). This intervention will also allow the mother to feel empowered and satisfied with the birth process as well as enhancing the bonding of both mother and
infant.

• The registered nurse would promote physiologic birth by decreasing the amount of interference with the birth process, encourage mother/baby bonding and promoting breastfeeding. This will ultimately improve the health of mothers and infants, while avoiding unnecessary and costly interventions.
• For the reasons listed above, multidisciplinary collaboration is important when promoting/supporting physiologic birth. RN’s, obstetricians and anesthesiologists or anesthetists are just a few of the members of the multidisciplinary team working with a laboring mother. The multidisciplinary team must have “education, knowledge, competence, skill, and confidence in supporting physiologic labor and birth, including helping women cope with pain” and having a “commitment to working with women through education to enhance their confidence in birth and diminish their fear of the process” (2013).