complementary therapies in labour ..different types of therapies at the time of pregnancy , water birth and their advantages and disadvantages , different types of messages while pregnancy
LAW: THE SUM TOTAL OF RULES AND REGULATIONS BY WHICH THE SOCIETY IS GOVERNED
ETHICS: Ethics is the systematic study of What a persons conduct ought to be with regard to him or herself, other human beings and the environment, it is the justification of what is right or good and the study of what a person’s life and relationship ought to be, not necessarily what they are.
This document discusses legal and ethical issues in midwifery practice. It defines ethics and codes of ethics, outlining their purpose to guide ethical decision making. Key issues in midwifery like informed consent, failure to monitor, and medication errors are described. Standards of midwifery practice emphasize woman-centered care and professional accountability. Standing orders allow nurses to treat patients according to predefined protocols signed by licensed practitioners. Overall the document provides an overview of ethical and legal responsibilities in midwifery.
This document discusses induction of labour, which is defined as artificially stimulating uterine contractions before the onset of natural labour. It outlines the goals, indications, methods, and nursing responsibilities for labour induction. The main methods discussed are medical induction using prostaglandins or oxytocin, and surgical induction through membrane stripping or artificial rupture of membranes. The nursing responsibilities involve properly administering induction medications and procedures, monitoring the woman and fetus during labour induction, and providing general care and support to the woman and newborn.
A registered midwife is someone who has completed an approved midwifery education program, is registered to practice midwifery, and maintains competency. The scope of midwifery practice includes providing care during pregnancy, labor, birth and postpartum, as well as family planning advice and newborn care. Midwifery practice is underpinned by values of empowering women and respecting their decisions, and sees birth as a normal process where midwives are the primary caregivers. An individual midwife's scope may change based on their experience and training, practice guidelines, and the needs of the woman and baby.
The document outlines international standards and codes of ethics for midwifery practice. It discusses establishing a midwifery-specific regulatory authority to effectively regulate midwives and support autonomous midwifery practice. It also covers protecting the title of midwife, governance structures for regulatory authorities, and the importance of national regulation and collaboration between regulatory bodies.
Newborn infants undergo several physiological adaptations after birth. The foramen ovale and ductus arteriosus close as pulmonary vascular resistance decreases and oxygen levels in the lungs increase. Temperature regulation is important as newborns have a narrow temperature range and lack body fat. They rely on caregivers to prevent heat loss through proper drying, skin-to-skin contact, and room temperature. Liver function also adapts as the immature liver transitions to breaking down bilirubin from red blood cells.
The document discusses how technology has advanced obstetric and neonatal care. It notes that while technology has improved outcomes by reducing mortality and morbidity, it has also increased costs and the risk of care becoming too commercialized. It also discusses various risks faced by older and younger mothers as well as low birth weight infants. The use of technologies like fetal monitoring has led to higher caesarean rates. Care is now more family-centered and alternative therapies are increasingly used.
The document outlines 16 hallmarks that characterize the art and science of midwifery. Key hallmarks include recognizing important female life stages as normal physiological processes, advocating for non-intervention during normal processes absent complications, and promoting woman-centered care, empowerment, and continuity of care. Midwifery also focuses on health promotion, education, advocacy for informed choice, and collaboration with other healthcare professionals.
Obsterics and Gynaecology-
introduction-Preventive obstetrics is the concept of prevention or early detection of particular health deviations through routine periodic examinations and screening .
The concept of preventive obstetrics concerns with the concepts of the health & wellbeing of the mother her baby during the antenatal,intranatal & postnatal period.
The goal of the preventive obstetrics is the delivery of a healthy infant by a healthy mother at the end of a healthy pregnancy.
Pregnancy & child birth normal physiological
process that change from conception to
delivery.
Objectives
To promote , protect and maintain the health of the mother during pregnancy.
To detect “high risk” cases and give them special attention
To foresee complications and prevent them.
To remove anxiety and dread associated with delivery
Menopause is the permanent cessation of menstruation that occurs naturally as part of aging when the ovaries stop producing estrogen and progesterone, and a woman can no longer get pregnant. Counseling women about menopause aims to address questions/concerns, provide education, facilitate informed decision making, and enhance confidence. The counseling process involves building rapport, exploring issues, and committing to actions. A survey found that over 75% of postmenopausal women received counseling on hormone replacement therapy, with no differences found between managed care and other insurance types. More efforts are needed to educate underserved women.
Nurses play several important roles in family welfare programs, including as counselors, administrators, educators, researchers, and supervisors. As counselors, nurses provide families with information on family planning methods, address concerns, and ensure clients are satisfied with their decisions. Administratively, nurses ensure staff and patients have adequate knowledge and resources about family planning services. In their educational role, nurses teach family planning topics and coordinate training. Nurses also conduct research and provide clinical care related to family planning.
Antenatal exercises aim at improving the physical and psychological well-being of an expected mother for labor and preventing pregnancy-induced pathologies by various physical means. It generally includes low impact aerobic exercises and stretching exercises.
This document provides instructions for breast care and cleaning to prevent breast engorgement. It involves cleaning the breasts with lukewarm water, soap, and massage in a circular motion for 5 minutes. The milk is then expressed and the process is repeated on the other breast. Cabbage leaf compresses are also described as a home remedy to relieve breast engorgement. Cabbage leaves with crushed veins are placed on the breasts for 20 minutes, 3 times per day for 3 days to help reduce swelling. Proper breast care and cleaning helps maintain hygiene and prevents infections while feeding.
This document describes the procedure for manual removal of the placenta (MRP). MRP is performed when the placenta fails to deliver within 30 minutes of childbirth. It involves inserting fingers into the uterus to locate and detach the placenta from the uterine wall while supporting the fundus. Once detached, the placenta is withdrawn from the uterus while continuing to provide counter-traction. Oxytocin is administered to encourage uterine contraction and prevent hemorrhage. The placenta is examined for completeness and the uterus is checked for contraction to ensure the procedure was successful. Potential complications include shock, postpartum hemorrhage, puerperal sepsis, and inversion or hysterectomy.
This topic includes Introduction for analgesia and anesthesia used in obstetrics, maternal risk factors for anesthesia, anatomical and physiological considerations, analgesia during labour and delivery, sedatives and analgesia, opioid analgesics, combination of narcotics and antiemetics, inhalation methods, commonly used local anesthesia in obstetrics, spinal anesthesia, infiltration anesthesia, patient controlled anesthesia, psychoprophylaxis, general anesthesia for cesarean section, complication of general anesthesia and its management.
This document provides a report on a charity drive event organized by a group of students. The group decided to sell roses and soft-serve ice cream, with all profits being donated to the Paws Animal Welfare Society. They secured sponsorship from a soft-serve ice cream company for ingredients and equipment rental. Roses were sourced from a local florist. The group aimed to raise over RM3500 through selling roses at RM10 each and ice cream for RM8 on average. They analyzed competition from other student groups and established a target of selling 200 roses and 500 ice cream cups. Packaging and promotions were developed. Profits of RM3579 were ultimately raised and donated to the charity.
1) The document discusses sustainable wastewater treatment, including categories of wastewater sources and types.
2) It describes the various stages of wastewater treatment - screening and primary treatment to remove solids, secondary treatment using biological processes, and tertiary treatment to remove additional contaminants.
3) Challenges in wastewater treatment are addressed, such as aging infrastructure and the need for funding, as well as solutions like upgrading pumps and optimizing aeration.
This is a basic marketing strategy I created when I first started working fo rthis advertising firm. They did not have a loft of direction with regards to how to determine their goals for the marketing department mainly because they had not established their marketing strategy. So my first job as Marketing Coordinator was to map out exactly who their target market was and how we were going to grab their attention and based on those ideas we would be able to create realistic goals to rate the department.
The document analyzes the indie folk music genre. It discusses that indie folk originated in the 1990s from indie rock musicians influenced by folk and country music. Some key artists in the genre include Mumford and Sons, Noah and the Whale, and Amy McDonald. Indie folk music entries are eligible for both small independent music awards and larger awards shows like the Grammys. The genre is characterized as modern folk music with country and rock influences that is often acoustic and lyrically focused.
The document is a comic about a young girl living in a war-torn country. She is left to fend for herself and takes extraordinary measures to survive the hungry, bitter existence caused by enemy troops. The choices she makes during the war have dire consequences and are influenced by personal sentiment.
This video explores the impact of racism and prejudice on a friendship between an Indian boy and Chinese boy. As they start college, they are exposed to new people and social dynamics. Some students reject the Indian boy due to racial prejudices. Influenced by others' views, the Chinese boy stops associating with his longtime Indian friend, putting their friendship in jeopardy and demonstrating how racism can negatively affect relationships.
This document provides a 4-step process for critiquing photographs: 1) Description, 2) Reflection, 3) Formal Analysis, and 4) Judgment. It then analyzes the photograph "Lincoln on Battlefield of Antietam, Maryland" using these steps. The description notes the three men and setting depicted. The reflection discusses the somber tones and Lincoln's isolation. The formal analysis examines compositional elements like lines that draw attention to Lincoln. The document asks questions to understand the photographer's decisions.
The document summarizes the results of a questionnaire about preferences for horror movie trailers. It shows that 51% found a scary clown to be the scariest antagonist. For the antagonist's appearance, black, white, and red colors and red hair were popular choices. 45% preferred opera music. 40% thought bold typography would look best. White and black were the preferred trailer colors. Colors, typography, music, and actors were seen as the most appealing elements. 75% expected both males and females could be victims.
Transparency and governance in South KoreaK.s. Park
This document discusses three elements of transparency and governance: freedom of speech, freedom of information laws, and government 2.0. It notes issues with criminal defamation laws in Korea and censorship of online content. Regarding freedom of information laws, it highlights that 27% of information requests are denied by claiming disclosure is blocked by other laws, but without substantive judicial review. The document also discusses issues with Korea's voluntary disclosure of government data and court records, noting micro-segmentation of data and lack of standardization that limits its usefulness. Organizations working on these issues in Korea are also listed.
The document discusses various methods for managing pain during labor, including both non-pharmacological and pharmacological approaches. It defines true labor pain as being caused by uterine contractions and cervical dilation. Non-pharmacological methods discussed include psychological support, physical comfort measures, relaxation techniques like massage and TENS, and alternative therapies such as water birth, acupuncture, herbalism, and aromatherapy. Pharmacological approaches outlined are sedative/analgesics, narcotic drugs like pethidine, and inhalation analgesia. The document provides details on the physiology of labor pain and recommendations for nurses on supporting women throughout the different stages of labor.
What you and your loved ones need to know in order to restore your health even without medication nor doctor's consultation which may or may not benefit.
1. The document discusses various yoga breathing exercises and poses that can aid in weight loss. It provides instructions for exercises like Kapalbhati, Anulom Vilom Pranayama, and Bhastrika Pranayama.
2. Additional tips mentioned for aiding weight loss include drinking 8-10 liters of water per day, using smaller plates, getting enough sleep, reducing stress, incorporating more protein and fiber into one's diet, and increasing physical activity levels.
3. A morning drink of warm water with lemon, ginger, honey, and black pepper is also recommended for its health benefits like aiding fat burning and blood purification.
Stages of labour and alternative therapiesSaima Habeeb
Birth is a normal, healthy part of a woman’s life. This unexplainable happiness is usually accompanied by severe pain due to contractions.
Labour is a health state that most women aspire to, at some point in their lives. The first thought that comes to the mind of an expecting woman regarding her delivery is the pain of labour.
Labour is a normal physiological process, which while should be an occasion for rejoicing
Alternative medicine exists in all cultures to some degree and terms such as traditional medicine, indigenous medicine or folk medicine etc. are used to describe such practices. These medicines date back hundred or even thousands of years depending on the country and culture concerned. There are more than 100 systems of alternative medicines still in practice all over the world. Every country, region or area has its own traditional system of health and medical cares such as for the Chinese it is acupuncture, for the French, magnetic healing; for the Germans, Heilpraxis; for the English, Herbalism; for India, Ayurveda with Siddha being widely practice in the southern part of the country; for Japan, Shiatsu etc. The most popular forms of alternative medicine are ayurveda, homeopathy, naturopathy, yoga, acupuncture, acupressure, magneto therapy, shiatsu, herbalism, meditation, aromatherapy, Bach Flower Remedies, chromo therapy, diet therapy, hydropathy and reiki. Alternative medicine can help during pregnancy and labour where western medicine might pose a risk to the unborn child (such as certain medications in conditions such as headache). It’s also much more gentle and non-invasive, and addresses many of the emotional issues western medicine generally ignores.
health and fitness ,
What are the 4 types of health?
What is health and its importance?
What is the meaning of UN in health?
What are the 3 biggest health problems?
What is your definition of health?
What are the 5 issues on health?
What is the most health issue?
What are the 5 issues on health?
What is the most health issue?
What was the first definition of health?
What is global health issues?
Why does global health matter?
WHO main objective?
What are the objectives of health?
The document discusses medical changes and natural approaches to health and wellness through NO Gym Be Slim, LLC. It discusses using naturopathy, meditation, music therapy and other ancient practices to avoid health issues and promote holistic wellness. It emphasizes focusing on inner energy and enlightenment of the soul. The company provides spirulina, supplements and other products aimed at weight loss, increased circulation and nitric oxide levels, and overall wellness and health.
This document provides information about psychoprophylactic methods for labor and childbirth, specifically the Grantly Dick-Read method and the Lamaze method. It describes the history and development of each method, the underlying theories, and techniques taught to help alleviate pain and fear during childbirth. The Grantly Dick-Read method focuses on eliminating fear through education and the use of breathing exercises at different stages of labor. The Lamaze method originated in Russia and France and teaches breathing and relaxation techniques, as well as the importance of movement, positions, and partner support during labor and delivery.
The document discusses NO GYM BE SLIM, LLC and its mission to help people achieve a healthy lifestyle and stress-free mind without investing much time or effort. It aims to follow teachings from Hindu scriptures about enhancing one's internal energy to achieve goals and enlighten the soul. The company uses ancient practices like naturopathy, meditation, and music therapy involving classical ragas to heal the body and mind by establishing harmony.
Sleep is important for brain and body health. Simple lifestyle changes like waking and sleeping at consistent times, avoiding screens before bed, and practicing relaxation techniques can improve sleep. Certain foods, herbs, yoga poses, and breathing exercises have also been used in traditional Indian medicine to promote better sleep quality and reduce sleep needs. The bedroom environment should be clean, quiet and relaxing to support quality rest.
Liberty science llc52 weeks of ImprovementVera Shury
This document provides information and exercises for different parts of the body. It discusses how the brain remains plastic into old age and can form new pathways after injury. It recommends imagining movements to prepare like athletes do. Various supplements are mentioned for men's and women's energy, heart health, digestion and skin. Breathing, posture, range of motion and strength exercises are provided for every body part from head to toe. Nutritional supplements and stress support options are also listed.
Physiologic birth is powered by the innate human capacity of the woman and fetus and is more likely to be safe and healthy with little medical intervention. Key hormones like oxytocin, endorphins, and catecholamines drive the physiologic process of birth through activity in the limbic brain and optimal neuroendocrine function. Caregivers can support this process by creating a calm and private environment, encouraging relaxation techniques, optimizing hormone levels through positioning and skin-to-skin contact, and avoiding anything that may stimulate the mother's thinking brain or stress response.
How to sleep better during your period 2019 - NuvannaAlvaro Vaselli
The document discusses how to sleep better during your period. It notes that 30% of women have disrupted sleep during menstruation due to factors like mood swings, increased body temperature, and cramps. It recommends sleeping in a fetal position or on your side to minimize cramps, using heat therapy, trying herbal remedies like chamomile tea, exercising, and keeping your bedroom cool for better sleep during your period.
NON PHARMACOLOGICAL MANAGEMENT OF DISCOMFORT.pptxAURELIATEMBA
Define labor pain, non- pharmacological management, pain tolerance and endorphins
Describe different non pharmacological strategies/methods used to manage discomfort during labor and delivery
Identify advantages of non pharmacological management of discomfort during labor and delivery
Pain relief in labor is complex and often challenging.
Effective management of labor pain plays a relatively major role in a woman's satisfaction with childbirth.
Labor contractions usually cause discomfort or a dull ache in the back and lower abdomen, along with pressure in the pelvis.
Contractions move in a wave-like motion from the top of the uterus to the bottom.
Some women describe contractions as strong menstrual cramps.
support measure during childbirth
Reduction of fear and anxiety by providing information and support.
Facilitation of appropriate rest, sleep and for ambulation.
Provision of a labor companion.
If you are an expectant mother,
you should talk with your obstetrician and your anesthesiologist to develop a plan on
Pain management during labor and delivery
that ensures the safest possible pregnancy, childbirth, and recovery.
Every woman experiences labor pain differently based on emotional, psychological, and cultural factors. Preparing for birth through education and developing a birth plan can help reduce anxiety and better cope with pain. There are many natural and medical options for pain relief during labor, including relaxation techniques, immersion in water, massage, nitrous oxide, and an epidural. The best methods vary for each woman and may change during labor.
The document discusses various types of complementary and alternative medicine (CAM) therapies. It describes several alternative medical systems including acupuncture, ayurveda, homeopathy, and naturopathic medicine. It also discusses mind-body interventions like meditation, relaxation, hypnosis, and biofeedback. The document provides details on what each therapy involves, its proposed mechanisms of action, conditions it can be used to treat, risks, and contraindications.
health and fitness ,
What are the 4 types of health?
What is health and its importance?
What is the meaning of UN in health?
What are the 3 biggest health problems?
What is your definition of health?
What are the 5 issues on health?
What is the most health issue?
What are the 5 issues on health?
What is the most health issue?
What was the first definition of health?
What is global health issues?
Why does global health matter?
WHO main objective?
What are the objectives of health?
Similar to Complementary therapies in labour gihs (20)
The document defines prolonged labour as when the first and second stages of labour last more than 18 hours total. It then discusses the phases of labour and outlines causes of prolonged labour including issues with uterine contractions, the cervix, pelvis, or baby. Diagnosis involves assessing cervical dilation and descent rates. Dangers to the mother and baby include hypoxia, infection, and trauma. Treatments include preventing issues with early monitoring, changing positions, hydration, and pain relief or interventions like amniotomy, oxytocin, or c-section depending on the stage and severity.
The document discusses fetal development from 6 weeks to 38 weeks of pregnancy. It describes the key physical changes that occur in the embryo and fetus each week. During the first trimester (6-12 weeks), major organs begin to form and external features develop. In the second trimester (13-28 weeks), the fetus grows rapidly and all systems continue to mature. By the third trimester (29-38 weeks), the fetus prepares for birth by gaining weight and fat and increasing lung and brain development.
clinical teaching methods
purposes
principles
models of clinical teaching methods
adult learning
types of learning
types of clinical teaching methods and their advantages and disadvantages
methods of teaching
The immune system protects the body from infection through a complex network of interacting cells and molecules. It includes both non-specific defenses that provide immediate protection, and specific adaptive defenses that develop over time through vaccination or exposure to pathogens. The adaptive immune system includes B cells that produce antibodies, T cells that coordinate immune responses, and phagocytes that engulf foreign substances. Vaccination exposes the immune system to an antigen in a controlled way to stimulate lifelong immunity against disease.
Patient positioning in operating theatre -gihsgangahealth
This document discusses proper patient positioning during surgery. It outlines common surgical positions like supine, prone, Trendelenburg, and lithotomy. For each position, it describes how to position the patient, nursing precautions to take, and potential complications to avoid. The goal of positioning is to provide optimal surgical access while maintaining patient safety, comfort, and dignity. Careful positioning can prevent injuries, but risks increase for patients with certain medical factors.
This document discusses tracheoesophageal fistula (TEF), including its definition, development, epidemiology, anatomical variations, pathophysiology, clinical manifestations, diagnosis, management, and nursing care. TEF is a congenital abnormality where the trachea and esophagus are connected. It develops due to incomplete separation of the trachea and esophagus during embryonic development. Clinical signs include drooling, choking, respiratory distress, inability to feed, and aspiration pneumonia. Treatment involves surgical repair to separate the trachea and esophagus.
spinal injury
Goal of spine trauma care
Pre-hospital management
Clinical and neurologic assessment
Acute spinal cord injury
Term, type and clinical characteristic
Common cervical spine fracture and dislocation
The document discusses various types of materials, equipment, and linen used in hospitals and their care and maintenance. It covers the different categories of equipment including reusable and disposable items. It provides details on the proper cleaning, disinfection, and sterilization techniques for different materials like linen, rubber goods, steel instruments, glass, and plastic items. The document also discusses the care and maintenance of other items like furniture and machinery equipment. It emphasizes the importance of maintaining proper inventory and indent records for materials and ensuring their optimal availability.
This document provides an outline on Ebola virus disease (EVD). It discusses the history and epidemiology of EVD, noting its origins in 1976 outbreaks in Sudan and the Democratic Republic of Congo. It describes Ebola viruses, including their structure and five identified species. It covers EVD's life cycle, signs and symptoms, diagnostic evaluation, treatment, prevention and control methods. The document also discusses prognosis, complications, differential diagnosis, and current research on antiviral treatments and vaccine development for Ebola virus disease.
The Value of Time ~ A Story to Ponder On (Eng. & Chi.).pptxOH TEIK BIN
A PowerPoint presentation on the importance of time management based on a meaningful story to ponder on. The texts are in English and Chinese.
For the Video (texts in English and Chinese) with audio narration and explanation in English, please check out the Link:
https://www.youtube.com/watch?v=lUtjLnxEBKo
Credit limit improvement system in odoo 17Celine George
In Odoo 17, confirmed and uninvoiced sales orders are now factored into a partner's total receivables. As a result, the credit limit warning system now considers this updated calculation, leading to more accurate and effective credit management.
Join educators from the US and worldwide at this year’s conference, themed “Strategies for Proficiency & Acquisition,” to learn from top experts in world language teaching.
Webinar Innovative assessments for SOcial Emotional SkillsEduSkills OECD
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Understanding and Interpreting Teachers’ TPACK for Teaching Multimodalities i...Neny Isharyanti
Presented as a plenary session in iTELL 2024 in Salatiga on 4 July 2024.
The plenary focuses on understanding and intepreting relevant TPACK competence for teachers to be adept in teaching multimodality in the digital age. It juxtaposes the results of research on multimodality with its contextual implementation in the teaching of English subject in the Indonesian Emancipated Curriculum.
How to Configure Time Off Types in Odoo 17Celine George
Now we can take look into how to configure time off types in odoo 17 through this slide. Time-off types are used to grant or request different types of leave. Only then the authorities will have a clear view or a clear understanding of what kind of leave the employee is taking.
Delegation Inheritance in Odoo 17 and Its Use CasesCeline George
There are 3 types of inheritance in odoo Classical, Extension, and Delegation. Delegation inheritance is used to sink other models to our custom model. And there is no change in the views. This slide will discuss delegation inheritance and its use cases in odoo 17.
Satta Matka Dpboss Kalyan Matka Results Kalyan ChartMohit Tripathi
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Beyond the Advance Presentation for By the Book 9John Rodzvilla
In June 2020, L.L. McKinney, a Black author of young adult novels, began the #publishingpaidme hashtag to create a discussion on how the publishing industry treats Black authors: “what they’re paid. What the marketing is. How the books are treated. How one Black book not reaching its parameters casts a shadow on all Black books and all Black authors, and that’s not the same for our white counterparts.” (Grady 2020) McKinney’s call resulted in an online discussion across 65,000 tweets between authors of all races and the creation of a Google spreadsheet that collected information on over 2,000 titles.
While the conversation was originally meant to discuss the ethical value of book publishing, it became an economic assessment by authors of how publishers treated authors of color and women authors without a full analysis of the data collected. This paper would present the data collected from relevant tweets and the Google database to show not only the range of advances among participating authors split out by their race, gender, sexual orientation and the genre of their work, but also the publishers’ treatment of their titles in terms of deal announcements and pre-pub attention in industry publications. The paper is based on a multi-year project of cleaning and evaluating the collected data to assess what it reveals about the habits and strategies of American publishers in acquiring and promoting titles from a diverse group of authors across the literary, non-fiction, children’s, mystery, romance, and SFF genres.
How to Add Colour Kanban Records in Odoo 17 NotebookCeline George
In Odoo 17, you can enhance the visual appearance of your Kanban view by adding color-coded records using the Notebook feature. This allows you to categorize and distinguish between different types of records based on specific criteria. By adding colors, you can quickly identify and prioritize tasks or items, improving organization and efficiency within your workflow.
Split Shifts From Gantt View in the Odoo 17Celine George
Odoo allows users to split long shifts into multiple segments directly from the Gantt view.Each segment retains details of the original shift, such as employee assignment, start time, end time, and specific tasks or descriptions.
No, it's not a robot: prompt writing for investigative journalismPaul Bradshaw
How to use generative AI tools like ChatGPT and Gemini to generate story ideas for investigations, identify potential sources, and help with coding and writing.
A talk from the Centre for Investigative Journalism Summer School, July 2024
3. UNICEF REPORT-2009
An Indian woman is 300 times more likely to die
in childbirth complications than USA/UK
Avoidable complications during childbirth are
killing 78,000 women in India every year
On an average,one woman die every 7 minutes
from complication of pregnancy and childbirth
In India,more than two thirds of all maternal
death occur in a handful of states ie.
UP,MP,Bihar Jharkhand,Orissa
Rajasthan,Assam,Chhatisgarh
In UP,one in every 42 women faces risk of
maternal death,compared to 1 in 500 women in
5. In bible labour pain is mentioned as “In
sorrow thou shalt bring forth the children”
– Genesis-3:16
Labour pain – sin, witch craft
Sir James Young Simpson – interpretation
of bible was wrong.
Queen Victoria – Chloroform - for the
birth of son Leopold
Entonox was introduced in 1881.
LABOUR PAIN - HISTORY
6. What is complementary therapy?
Complementary therapy is something
that complements conventional medical
treatment.
CARE = CARE
7. What are Alternative therapies?
Alternative therapies are those
which offer alternatives to
conventional therapies.
8. Therapies are as follows
1. Herbal medicine
2. Chinese medicine
3. Chiropractic
4. Naturopathy
5. Osteopathy
6. Acupuncture/Acupre
ssure
7. Homeopathy
8. Reflexology
9. Aromatherapy
10.Alexander
technique
11.Massage
14. Yogic medicine
15. Ayurvedic medicine
16 Spiritual healing
17. Iridology
18. Kinesiology
19. Meditation
20. Nutritional
medication
21. Music therapy
22. Gold therapy
23 Hydrotherapy
24. Energy healing
25. Crystal therapy
9. Complementary therapies are as
follows
1. Acupuncture 7. Birth ball
2. Acupressure 8.Aromatherapy
3. Reflexology 9. Water birth
4. Massages 10.DoulaServices
5.Music therapy 11.Yoga therapy
6. Hydro therapy 12.Homeopathy
11. PAIN
Pain is "an unpleasant sensory and
emotional experience associated with
actual or potential tissue damage
Questions to ask about pain:
P-Pattern (onset & duration)
A-Area(location)
I-Intensity(level)
N-Nature(description)
15. LABOUR PAIN PATHWAYS
The pain of the first stage of
labour is referred to the
spinal cord segments
associated with the uterus
and the cervix T10, T11,T12
and L1.
Pain of distension of the
birth canal and perineum is
conveyed by S2-4.
16. ACUPUNCTURE
Works by normalising the”flow”of
qi”vital energy”in the body.
Pain or illness=blockages of qi
12 main channels of energy and 8
extra channels.
17. REFLEXOLOGYREFLEXOLOGY
This therapy is related to acupuncture and
involves massaging various areas of the feet in order
to stimulate channels of energy which connect with
other parts of the body.
AIM
The body has its own powerful healing
response.Reflexology aims to stimulate this into
normal functioning and to maintain homeostasis.
18. There are approximately 7200 nerve endings on
the feet and these relate to various organs and glands
within the body. A mirror image of the body has been
mapped on the feet and pressure applied on specific
reflex points on the feet can affect the corresponding
part of the body.
In Labour
It can be used during labour to increase the
strength of contractions, to calmdown contractions if
they are extremely painful.
Research has proved that birth time has been
reduced and mothers recover more quickly after birth.
19. Following treatment,
mothers are advised to
wear comfortable shoes,
drink water/
decaffeinated drinks.
This is to promote the
detoxification process
and helps the body to
eliminate the toxins that
have been released.
Reflexology effect on the body can be as powerful as
that of strong drugs.
21. AROMATHERAPY
Essential oils form the base of aromatherapy and
influence the mind, body and spirit.
These oils are the concentrated extracts of plants
and their roots, stems, flowers and fruits.
Essential oils are concentrated and must be diluted
by mixing up with carrier oils before application. . Only a
few pure essential oils like lavender and tea tree can be
applied directly to the skin.
22. Massaging the oil onto the body is the most common
method of getting the benefit of aromatherapy oils,
since skin is the largest absorption organ that we
have.
Commonly used essential oils
1.Bergamot- Originally from Italy, is obtained from the
kind of the bitter orange. It is pale green in colour, with
sharp, orangey and refreshing fragrance.
It is a happy uplifting oil, works well against
tensions, headaches and anxiety.
23. 2. Chamomile
This is oil for women and children. It relieves cramps
and spasms and a good painkiller for dull aching pain.
German Chamomile is a great oil for children. Soothes
child’s colic or stomach upsets, alleviates nappy
rashes and skin irritation.
3. Eucalyptus
Versatile oil with origins in Australia. It helps to
relieve bad cold and fever. It is also an effective insect
repellent.
4. Tea tree
It has antibacterial, antifungal, antiseptic and
antiviral properties. Heals blemishes without any side
effects such as dryness, itching, stinging, burning or
redness.
24. Aromatherapy oils can be used for lower back
massage with
Jasmine
Juniper
Geranium
Clery sage
Rose
Lavender
Have been reported to provide subjective
benefits in labour
25. MUSIC THERAPYMUSIC THERAPY
Physical effects of music
Louder and faster noises tend to raise both heart rate
and blood pressure. Slower, soften and more regular
tones produce the opposite result.
It also relieves muscle tension and improves motor
skills.
Levels of endorphins are increased while listening to
music and levels of stress hormones are decreased.
It is used to create feelings of calmness, excitement or
romance.
27. BIRTH BALLSBIRTH BALLS
It is a large [65 cm in diameter]
air filled ball.
During pregnancy it can be
used as an exercise aid for
pelvic muscles.
Research on the use of the ball
demonstrates a significant
improvement in core muscle
stability, including the muscles
of the chest and abdomen,.
These muscles are instrumental
in the labour process for deep
breathing and pushing
28. The ball should be used with the
following precautions:
1. The woman should never use the
ball unless her support person is
with her.
2. The woman should always have a
firm support in front of her to hold
for securities.
29. Hydrotherapy
The use of hydrotherapy during labour, whether in a
shower or a tub, is a proven means of relaxation and
pain relief.
The warm water stimulates the release of endorphins,
relaxes muscles to decrease tension, stimulate large
diameter nerve fibre and to close the gate on pain,
and promotes better circulation and oxygenation.
31. Water birth is the process of giving birth in
a tub of warm water. Some women choose
to labour in the water and get out for
delivery. Other women decide to stay in the
water for the delivery as well. The theory
behind water birth is that the baby has been
in the amniotic sac for 9 months and
birthing into a similar environment is gentle
for the baby and less stressful for the
mother.
DEFINITION
32. WHAT ARE THE POTENTIAL BENEFITS OF
WATER BIRTH?
Benefits for Mother:
Water is soothing, comforting and relaxing.
In the later stages of labor, the water seems to
increase the woman’s energy.
The buoyancy lessens her body weight, allows free
movement and new positioning.
Buoyancy promotes more efficient uterine
contractions and better blood circulation
Immersion in water often helps lower high blood
pressure caused by anxiety.
Water seems to alleviate stress-related hormones,
allowing the mother’s body to produce endorphins,
which are pain-inhibitors.
33. Greater comfort and mobility.
Reduction of pressure on the abdomen.
Helps mother to conserve her energy.
Promotes deeper relaxation.
Water relaxes the pelvic floor muscles
Water minimises the pain
Water stimulates the touch and temperature nerve
fibres in the skin.
34. Water can reduce the need for drugs to artificially
stimulate labour.
Lowering of blood pressure.
Easier breathing.
Water causes the perineum to become more elastic and
relaxed
Being in the tub reduces the possibility of intervention
by birth attendants.
Skin to skin time is facilitated.
35. Initial breast contact is also easier to initiate
The cord continues to pulse strongly for an extended
period resulting in baby receiving his full blood volume.
Benefits for Baby:
Provides a similar environment as the amniotic sac.
Eases the stress of the birth, providing reassurance and
security.
As the laboring women relaxes physically she is able to
relax mentally, concentrating her efforts inward on the
birth process.
36. Recommended Criteria for the
use of a water pool
An uncomplicated pregnancy of at
least 37 weeks of gestation.
Established active labour (i.e. good
regular contractions; dilation of the
cervix and descent of the presenting
part).
37. Potential Advantages of Water Immersion
The buoyancy of water enables a mother to move
more easily;
Blood pressure is lowered;
Comfort & relaxation may be enhanced;
Maternal sense of control may increase, which in
turn enhances emotional well-being;
Pain may be diminished;
The need for pharmacological pain relief may be
reduced;
Length of labour may be reduced;
Improved perineal stretching may reduce trauma;
Operative births may be reduced.
38. Potential Disadvantages
Decrease in uterine contraction strength and frequency,
especially if used before active labour is established;
Neonatal water aspiration; at least two cases have been
recorded
Maternal hyperthermia may contribute to fetal hypoxemia;
Neonatal hypothermia is possible if water temperature is
too cool;
Cord immersion in warm water may delay vasoconstriction,
increasing red cell transfusion to the newborn and
promoting jaundice;
Blood loss estimation and assessment is difficult in the
water;
Maternal and Neonatal infection may be increased; not
supported by the evidence
39. Contraindications for birth in a
water pool
Pre-term labour;
Maternal infection with a blood borne pathogen
such as Hepatitis B or C or HIV 1 ;
A woman who has meconium-stained amniotic
fluid may use a water pool for immersion during
labour, as long as close monitoring of the fetal
heart takes place and findings are reassuring. She
should be asked to get out of the pool for the
birth of the baby to facilitate suctioning of the
oral and nasal pharynx once the head is born.
40. Caution should be used when
considering water immersion if
sedation has been administered to the
woman. Individual responses to
sedation vary; the woman must be able
to get in and out of the tub without
difficulty and be fully conscious and
aware of her surroundings while in the
water. She should never be left alone.
Risk of maternal water embolus;
Risk of acquiring blood born infection
or sustaining back injury for caregivers
41. Recommendations for the use of
water immersion for labour and birth
Midwives should discuss the potential advantages
and disadvantages of water immersion for labour and
birth with each woman prior to labour.
The woman's vital signs and the fetal heart rate must
be within normal limits.
The fetal heart should be monitored according to
accepted guidelines. Use of a waterproof Doppler
device is recommended.
The water temperature should be monitored and
maintained between 36 and 37.5 C to prevent hypo or
hyperthermia. The temperature may be monitored
with a floating thermometer.
42. The woman's temperature should be monitored and
she should leave the water if her temperature exceeds
37.5 degrees C.
The woman should be encouraged to maintain
adequate hydration and leave the pool to urinate at
regular intervals.
The woman should be asked to leave the water if
there are any concerns about her or her baby's well
being.
An alternative birth place should be set up close to
the pool.
The water should be kept as clean as possible. Stool
and blood clots must be removed from the tub
immediately. The tub should be drained, cleaned and
refilled if the pool is being used over a number of
hours or if contaminants cannot be easily removed.
43. The baby should be born completely
underwater with no air contact until the head
is brought to the surface, as air and
temperature change may stimulate breathing
and lead to water aspiration.
At birth the baby's head must be brought to the
surface immediately. Care should be taken to
avoid undue traction on the cord. There have
been reports of cord tearing. Some authors
recommend early clamping of the cord to prevent
polycythemia and reduce the risk of fetal blood
loss if the cord integrity is compromised.
44. Care should be taken to maintain the newborn's
temperature to prevent hypothermia.
The placenta is best delivered outside of the tub
to accurately assess maternal bleeding.
Birth pools that are being used in hospital or
that will be used again by another birthing
mother should be cleaned between uses with a
chlorine-releasing agent to kill any blood born
pathogens.
As when caring for any mother or newborn, the
midwife is responsible for using her clinical
judgment, responding appropriately to problems
that may arise, and for documenting her actions.
45. Evidence:
Eight trials are included (2939 women). No
trials were identified that evaluated
immersion versus no immersion during
pregnancy, considered different types of
baths/pools, or considered the management
of third stage of labour. There was a
statistically significant reduction in the use of
epidural/spinal/paracervical
analgesia/anaesthesia amongst women
allocated to water immersion water during
the first stage of labour compared to those
not allocated to water immersion (odds ratio
(OR) 0.84, 95% confidence interval (CI) 0.71 to
0.99, four trials).
46. There was no significant difference in vaginal
operative deliveries (OR 0.83, 95% CI 0.66 to 1.05, six
trials), or caesarean sections (OR 1.33, 95% CI 0.92 to
1.91). Women who used water immersion during the
first stage of labour reported statistically
significantly less pain than those not labouring in
water (40/59 versus 55/61) (OR 0.23, 95% CI 0.08 to
0.63, one trial). There were no significant
differences in incidence of an Apgar score less than
7 at five minutes (OR 1.59, 95% CI 0.63 to 4.01),
neonatal unit admissions (OR 1.05, 95% CI 0.68 to
1.61), or neonatal infection rates (OR 2.01, 95% CI
0.50 to 8.07
47. PROFESSIONAL WATER BIRTH
ACCESSORIES POOL KIT
Electric Air Pump
Submersible Water Pump
Underwater Flashlight
Floating Thermometer
Handheld Water Mirror
25 Foot Water Hose
Protective Floor Plastic
48. Y-Adapter with Cap
Faucet Adapter
Debris Net
Anti-Bacterial Sponge
Detailed Instructions
2 sheets
6 towels , trays
Flash light & batteries Q-tips
6 old washcloths
Other towels and washcloths
Several pillows
49. A bowl or pot for the placenta (2 qt. size)
Paper towels
Large thick plastic trash bags (at least 4)
flannel-backed rubber sheet
Flash light & batteries Q-tips
Baby bathtub or small tub
A clean hose 6 baby receiving blankets
,Diapers
50. ACUPRESSURE IN LABOURACUPRESSURE IN LABOUR
It is an ancient healing art developed in
Asia over 5000 years ago (sushrut samhitta) that
uses the fingers to press key points on the
surface of the skin to stimulate the body’s natural
self-curative abilities.
The technique is based on the TCM system that
emphasizes the concept of holism, that is that
mind, body and spirit are integrated.
The belief of TCM is that channels of
energy called Qi (chi) run through out the entire
body. Qi flows through channels, or meridians,
improving blood circulation nourishing tissues
and promoting normal function.
51. Hegu- LI - 4
Location: This point lies between the
first and second metacarpal bones.
The highest point formed when the
thumb is brought to rest against the
index finger.
Uses:
1. To provide general pain relief in labour
2. To stimulate efficient uterine contraction.
3. To regulate uterine contraction.
4. During 2nd
stage of labour to aid body's effort to
move the baby down through birth canal.
52. Sanyinjiao – SP- 6
Location: 4 fingers width
(woman’s) above the tip of
the medial mallelous of the
border of the tibia.
Uses:
1.Aid in the dilatation of the cervix.
2.Aid in strengthening uterine contraction.
53. Ciliao BL - 32
Location: Centre of second sacral foramen, of the mid
point of posterior superior iliac and posterior midline.
Uses:
1.Aid in the descent of the baby
2.Produce a pleasant anaesthetising effect on the
uterine contractions.
54. Jianjing GB - 21
Location: when you draw an
imaginary line between the
bony prominence of the neck
(C7) and the top of the shoulder
joint (acromion process), this
point lies midway along the
curved line, at the highest point
of the shoulder muscle.
Technique: pressure is applied of the beginning of each
contraction.
Uses:
1.To aid in the descent of the baby at the first and second
stage of labour.
2.To stimulate uterine contractions.
55. Zhiyin UB - 67
Location: This point lies on the
little toe, just on the out side
aspect of the toe nail.
Uses:
1.To correct abnormal positions like occipito posterior
positions.
2.In all acute emergencies, difficult labour, and
malpositions of the fetus.
3.For spontaneous version of breech presentation into
cephalic. Apply pressure 1 or 2 minutes once or twice a
day. Immeidately afterwards get into knee chest postiion
for 15 minutes. Treatment can be started from 33 weeks
of getation.
56. Kunlun BL 60
Location : Level with
prominence of the
lateral malleolus
Uses:
1. To correct occiputo posterior position together
with Sp6
2. For progession of labour in occipito posterior.
57. To identify correct point
While applying the pressure there should
be a distinct feeling around or at the site of
pressure. This may be felt as tension,
numbness, warmth, aching or buring sensation.
N.B Do not use these points during pregnancy.
58. To induce labour : Points Li-4, Sp6,
BL32
L14 & Sp6 can be used in combination. Apply
pressure for 1 minute hourly or 2 hourly
intervals. BL-32 apply pressure and strokes
through to buttocks 5 minutes twice a day. Start
the treatment 1 week or 3-4 days before EDD.
59. Posterior Positions : Points – Kunlun Bl-60
in combination with Sp6. These points can be
used together. Apply pressure on BL-60 for 2
minutes followed by pressure on SP6 for 2
minutes. Preferably both legs are used
Or
BL-67 apply pressure for 2 minutes with end of
a ball pen or finger nail.
60. Pain relief in Labour : Points LI-4, SP6
Apply pressure with index finger or thumb for 1
to 2 minutes on one leg at a time. After 20 – 30
minutes apply pressure on the opposite leg.
Once the labour has become established (the
contractions are regular and efficient)
acupressure can be discontinued.
61. Un established labour or failure to
progress:
Point SP6 & LI4
Acupressure can be used for several minutes
on each point. Apply pressure on LI 14 on one
hand and SP6 on opposite leg. Ten minutes
later this combination can be repeated on the
opposite leg and hand.
62. Cervical Lip : Points Sp6 & BL32
When the cervix has not fully dilated and the
woman feels the urge to push, pressure on
these points can be used. Apply pressure on
BL-32 for upto 10 minutes. If possible apply
pressure in combination.
63. How Acupressure works?
The nervous system is stimulated to release
neurotransmitters in the body. Acupressure decreases
pain by to mechanisms
1.Release of endorphins
2.Gate control theory
64. Massage in labour
Women who have experienced skilful
massage during labour often say afterwards
how helpful and pain relieving it was.
Effleurage - it is a light, rhythmic stroking
techniques
Petrisage - kneading techniques
Uses
1. Soothing sensory input from
stroking and kneading activates the gate
closing mechanism at spinal level.
Tissue manipulation (deep sacral kneading)
to stimulate the release of endogeneous
opiates.
65. Back Massage
Back pain experienced in the lumbo
sacral region and it intensifies as labour
progresses.
Stationery kneading
Single handled or reinforced with one hand over
the other, applied slowly and deeply to the
painful area if often helpful.
66. Double handled kneading with loosely clenched fists
directly over the sacroiliac joints can give relief
67. Massage from the sacrococcygeal area, up and
over the iliac crests can be soothing.
69. The abodmen
Pain is most commonly experienced over the lower
half of the abdomen, particularly in the supra public
region.
Deep massage totally unacceptable
71. Double handled stroking ascending either side
of the midline and across to the iliac crests. This can
be synchronized with easy breathing.
72. Perineal massage
Midwives will massage a mother’s perineum
in the first and second stage of labour in an effort
to encourage stretching of the skin and muscle to
prevent tearing.
73. The doula’s most important role is to
provide nurturing, continuous support and
reassurance in helping the mother have
the birth how she wants. She will support
the mother throughout the labour.
DOULA SERVICES
ONE TO ONE LABOUR
SUPPORT
74. DOULA SERVICES
1. Smile Exercises
2. Establish eye contact
3. Use Mother’s name
4. Give your undivided attention
5. Match speech
6. Mirror the person’s body language
75. 7. Show that, without any shadow of doubt,
you respect and accept the person.
8. Don’t show any hesitance on your face
76. 9. Appreciation of good effort
10. Have Patient/ customer-friendly voice