当前在线人数12560
首页 - 博客首页 - 梦使宝贝@缘聚天涯 - 文章阅读 [博客首页] [首页]
简单介绍拉玛泽生产呼吸法(Lamaze)
作者:home99
发表时间:2008-06-19
更新时间:2008-07-02
浏览:6682次
评论:0篇
地址:10.
::: 栏目 :::
写给准妈妈1
宝宝护理与成长3
写给准妈妈3
为人父母3
英语学习
为人处世
休闲娱乐
理财话题
为人父母2
写给准妈妈2
实用资料
宝宝护理与成长2
为人父母1
其它
医药健康话题
写给新妈妈
宝宝护理与成长1
异国他乡

我是倾向于用epidural的,所以在这里绝对不是向JMs推荐要无麻药生产, 不过正确的呼吸法对于顺产还是应该有所帮助的。至少我生两个宝时护士给予了正确的指导才使DELIVERY特别顺利。对于拉玛泽生产呼吸法(Lamaze)我实在是没有经验, 而且也没机会去检验啦;只是在网上无意中看到的一些资料和评论, 据说在台湾还挺风行, 还有人称之为无痛或减痛分娩呼吸法。我想对于孕晚期特别是接近预产期而紧张的JM,以及打算不用麻药的JM,或者因某种情况来不及用麻药的JMs或许会有点用处, 所以决定贴出来,并附上我看到的一些有关分娩呼吸法的资料,供大家参考啊。

有JM从医院图书馆借来呼吸法的DVD,自己和老公一起练习呼吸方法,认为对缓解疼痛有帮助,在生产过程中没有用epidural.


拉玛泽生产呼吸法也称为拉梅兹分娩呼吸法,是指产妇通过刺激—反应的制约行为,学会如何自动使用神经肌肉控制运动、呼吸技巧,以达到分娩过程中减轻疼痛的目的的一种生产呼吸法。最早源于法国,由产科医生拉玛泽(Lamaze)先生研究发明这种利用呼吸分散注意力,以减轻分娩痛苦的呼吸法,并传至欧洲、南美洲、美国及亚洲各国。

拉玛泽生产呼吸法的基本原理是以俄国当时非常出名的“心理预防法”为依据,认为人类的大脑能被训练去接受并分析一个给予的刺激,并选择如何反应。基本上,孕妇在分娩前做好身心准备,不但对于分娩有正确认识和态度,于怀孕7个月后开始接受各种肌肉放松和呼吸技巧训练,且持之以恒的练习,以应用于分娩过程中,夫妻双方都能因为共同的练习过程,促进彼此间的感情,克服心中的恐惧,轻松顺利地生产,并拥有愉快的分娩经验。

一、拉玛泽生产呼吸法的优点
又称为“心理预防自然生产法”,这种分娩呼吸方法,从怀孕早期开始一直到分娩,通过对神经肌肉控制、产前体操及呼吸技巧训练的学习过程,有效地让产妇在分娩时将注意力集中在对自己的呼吸控制上,从而转移疼痛,适度放松肌肉,能够充满信心地在分娩过程发生产痛时保持镇定,以达到加快产程并让婴儿顺利出生的目的。其优点:

  1. 保障母体及胎儿健康。

  2. 增进夫妻感情。

  3. 减少药物的使用,将生产的疼痛降低至人体可以忍受的程度。

身心放松是秘诀 产科专家指出,“拉玛泽生产呼吸法”必须在身心完全放松的情况下,才能发挥最好的减痛效果。因此,平时丈夫应协助妻子做肌肉放松的练习,进行正确的运动及待产按摩放松技巧。

当子宫收缩时,全身肌肉必须放松,才能让足够的氧气输送到子宫,以供胎儿使用。此外,肌肉放松后,产妇才能集中精神运用呼吸技巧,以达到减缓疼痛的目的。

二、注意事项:
  经医生许可无拉玛泽禁忌症,可以自然分娩的孕妇,于怀孕7个月后在专业医护人员的指导下练习。

禁忌对象:

  1. 医生认为不宜进行运动者。

  2. 有高危妊娠状态,如以下情况:
妊娠合并症、并发症,如:前置胎盘,妊高症等;
自然流产史,习惯性流产史,有早产征兆,胆淤症等;

  3. 内科合并症;如:心脏病、肝、肾脏疾病,甲亢,糖尿病等;

  4. 外科合并症,如:扭伤、摔伤等;

  5. 有不适症状,如:头痛、腹痛、出血或窦性心动过速,心律不齐等。

三、呼吸法:
* 廓清式呼吸
步骤
  1. 坐、躺皆可。
  2. 眼睛注视一个焦点。
  3. 身体完全放松。
  4. 用鼻子慢慢吸气至肚子。
  5. 用嘴唇像吹蜡烛一样慢慢呼气。
  
手指按摩法
  优点
  1. 协助手部的放松。
  2. 转移注意力。
步骤
  1. 将手轻轻放在下腹部。
  2. 吸气时,将手指轻轻从腹部外围往上做环行按抚。
  3. 呼气时,将手指轻轻从腹部中心往下做环行按抚。
  
* 胸部呼吸法
 运用时机 当孕妇无法做正常活动时,例如无法走路或说话时。
步骤
   1. 开始时先做一个“廓清式呼吸”,以坐或躺的姿势皆可。
   2. 眼睛注视一个定点。
  3. 身体完全放松。
  4. 用鼻子慢慢吸气至胸腔。
  5. 将嘴唇像吹蜡烛一样,慢慢呼气。
  6. 结束时,再做一个“廓清式呼吸”。 

练习  1分钟做6~9次,每次有60秒的收缩。
  
* “嘻嘻”轻浅呼吸
  运用时机 这类型的呼吸形式,通常在做胸部呼吸法无效时使用,于分娩的第二阶段(子宫颈扩张3~7厘米)时。
步骤
  1. 先做一个“廓清式呼吸”。
  2. 眼睛注视于一个定点。
  3. 身体完全放松。
  4. 在做“廓清式呼吸”时,将肺部的空气排出,吸一小口气,呼吸保持轻浅,呼出及吸入的气是等量的,以免换气过度。
  5. 呼吸技巧在于嘴巴微微张开,完全用嘴呼吸。
  6. 保持呼吸高位在喉咙,用发出“嘻嘻”的声音,保持用胸部高位呼吸。
  7. 若使用正确的呼吸技巧,照镜子时会发现喉咙会动。
  8. 继续轻浅呼吸,有规律感,吸气与呼气相等量,用呼吸的速度快慢强弱,配合收缩的强弱。
  9. 结束时,再做一个“廓清式呼吸”。

练习   在一次子宫收缩中,也许会有几次感觉最强烈的高点,因此呼吸速度可依需要调节,至少每次练习60秒收缩。
  
*  喘息呼吸
  运用时机 当“嘻嘻”呼吸无效时,通常运用于分娩中第一产程的末期,不要太早开始此呼吸法,否则在紧要关头就难以应付了。
步骤
  1. 开始时做一个“廓清式呼吸”。
  2. 眼睛完全注视于一点。
  3. 完全放松。
  4. 做4~6次喘息呼吸之后,用嘴呼气,技巧在于用力吹,速度要短要快,像吹袋子一样,但比“嘻嘻”式呼吸浅。
  5. 结束时,再做一个“廓清式呼吸”。

练习  此技巧也可用于加速或减速来配合强烈收缩。每次以90秒的收缩计算,假如有困难,先从45秒开始练习。

*  吹气
  运动时机  此技巧是用在当子宫尚未完全扩张,而您已经觉得很想用力,医生却告诉您还不要用力时。
步骤
  1. 开始一个收缩时,使用加速或减速的喘息呼吸法。
  2. 想用力时,继续短而有力地吹气,直到这种想法消失之后,再回复使用加速及减速喘息呼吸,慢慢地吸,慢慢地吐。

练习   每一次练习以90秒1次收缩计算,在90秒里,3次感觉强烈的顶峰收缩中有1次想用力。
  
*  用力推
  运用时机 有些产妇在分娩第二期,没有想用力的感觉,您也许会以为收缩的间隔较长,很快就过了,所以要把握收缩的机会,马上用力推。然而,在无收缩时完全放松是非常重要的,这会使您重新得力,以达成最后努力的结果。

步骤
  1. 开始时,做1~2次“廓清式呼吸”。
  2. 在待产室的姿势:双手握住膝窝处,肘部保持向外,将两膝抬起分开两腿,将骨盆底肌肉、腿、脚完全放松。
在产房的姿势:手握住床边的把手,脚放在拖架上。
  3. 长长吸一口气,然后憋气,马上用力。
  4. 由一旁的丈夫协助,下巴向前缩,略抬头。
  5. 用力使肺部内的空气压向下腹部肌肉。
  6. 完全放松骨盆底的肌肉,才不会有阻力阻碍宝宝产出。
  7. 用力时,尽可能憋气。
  8. 需要另一次换气时,保持原有姿势,马上把气呼出,同时马上吸满另一口气,憋气继续用力。
  9. 继续用力直到收缩完全结束。
  10. 当收缩结束,平躺,做2次“廓清式呼吸”,完全放松,继续深呼吸,以弥补用力时造成的缺氧。
  
练习 每次练习,至少有60秒用力,用力足够时,骨盆底会有种肿胀感。
  
练习情境很重要  当怀孕6~7个月时,可以和丈夫一起练习“拉玛泽生产呼吸法”,练习时须具备以下的条件:
  1. 舒适的环境。
  2. 柔和的灯光。
  3. 轻柔的音乐。
  4. 愉快的情绪。
  5. 眼光的定点,可以选择喜爱的图案或玩具。


            **附上几份相关资料**
* 一篇中文的报道文章

http://xdhlb.hebnews.cn/20060314/ca772235.htm
拉美兹生产呼吸法”对分娩影响研究

(2007-08-03 17:27:14)

宫缩疼痛使产妇对分娩产生惧怕和焦虑情绪,同时使体内儿茶酚胺增高,中枢神经系统功能紊乱,使子宫收缩受到影响,最终出现产程延长、酸碱平衡失调和胎儿窘迫等不良后果。因此,减轻和消除分娩疼痛是产科工作亟需解决的问题。我们在临床中应用了“拉美兹生产呼吸法“,对100例自愿自然分娩的产妇进行了研究,收到良好效果。

“拉美兹生产呼吸法”是一项对产妇实施人性化服务的有力措施。法国Lamaze曾在精神预防性无痛分娩基础上进行改进,提倡神经-肌肉教育法(neuromuscular education),根据其方法指导产妇进行呼吸技巧的训练,提高对疼痛的耐受力。

本次研究给予对照组给予常规护理,给实验组产妇呼吸减痛法书面资料,助产师讲解及示范练习要领。①廓清式胸部呼吸法:坐、躺皆可,眼睛注视一个焦点,身体完全放松,用鼻子慢慢吸气至肺,像吹蜡烛一样慢慢呼气,用于第一产程潜伏期;②“嘻嘻”轻浅呼吸:这种类型的呼吸形式,通常在做胸部呼吸法无效时使用,用于第一产程活跃期,呼吸技巧在于嘴巴微微张开,完全用嘴呼吸,保持高位在喉咙,用发出“嘻嘻”的声音保持用胸部高位呼吸;③喘息呼吸:当“嘻嘻”呼吸无效时,通常运用于分娩中第一产程的减缓期,做4次~6次喘息呼吸之后,用嘴呼气,技巧在于用力吹,速度要短快。像吹袋子一样,但比“嘻嘻”式呼吸浅;④吹气:用在当子宫口尚未完全扩张,而产妇已经觉得很想用力,医生却告诉还不要用力时。子宫开始一些收缩时,使用加速或减速的喘息呼吸法。想用力时,继续短而有力地吹气,直到这种想法消失之后,再恢复使用加速及减速喘息呼吸,慢慢地吸,慢慢地吐,应用于产程配合。

研究证明,“拉美兹生产呼吸法”通过不断练习各种肌肉放松和呼吸技巧,不但可以减缓生产时的疼痛,还可调动产妇的主观能动性,使其对分娩产生信心。当子宫收缩时,全身肌肉放松,可直接减轻宫缩时胎儿对盆腔底的压迫感,从而减轻大脑皮质对疼痛冲动的感应,提高产妇的疼痛阈值,将生产的疼痛降低至人体可以耐受的程度,缩短产程,提高自然分娩率。

(◇兰州军区兰州总医院陶慧白玮余慧云吴荞)

* History:
The Lamaze Technique was created a prepared childbirth technique developed in the 1940s by French obstetrician Dr. Fernand Lamaze as an alternative to the use of medical intervention during labor. Dr. Lamaze was influenced by Soviet childbirth practices, which involved breathing and relaxation techniques under the supervision of a \"monitrice\" or midwife. The Lamaze method gained popularity in the United States after Marjorie Karmel wrote about her experiences in her 1959 book Thank You, Dr. Lamaze.

Modern Lamaze childbirth classes teach expectant mothers a philosophy of birth rather than the technique created by Dr. Lamaze. Breathing techniques are no longer a hallmark of Lamaze, and often are not taught at all; instead \'breath awareness\' may be taught, as are many other ways to work with the labor process to reduce the pain often associated with childbirth, such as hot and cold packs, changing positions, the use of a \"birthing ball\" to remain in an upright position, and orgasm to induce or hasten labor.

* Lamaze Philosophy of Birth:
1.Birth is normal, natural and healthy.
2.The experience of birth profoundly affects women and their families.
3.Women\'s inner wisdom guides them through birth.
4.Women\'s confidence and ability to give birth is either enhanced or diminished by the care provider and place of birth.
5.Women have the right to give birth free from routine medical interventions.
6.Birth can safely take place in homes, birth centers and hospitals.
7.Childbirth education empowers women to make informed choices in health care, to assume responsibility for their health and to trust their inner wisdom.

* Lamaze’s six recommended care practices:
1.Care Practice 1: Labor should begin on its own
2.Care Practice 2: Laboring women should be free to move throughout labor
3.Care Practice 3: Laboring women should have continuous support from others throughout labor
4.Care Practice 4: There should be no routine interventions during labor and birth
5.Care Practice 5: Women should not give birth on their backs
6.Care Practice 6: Mothers and babies should not be separated after birth and should have unlimited opportunity for breastfeeding

* 还看到一篇关于Lamaze与另一种呼吸法Bradley比较的短文,大家有兴趣不妨看一下,说的是否有些道理?

Breathing Techniques...  Bradley or Lamaze?
- Bradley - Lamaze - Birth Coach

So you\'ve heard about the \"Bradley Method\" and also Lamaze Breathing Techniques, and probably you\'ve heard one is great while the other sucks. Like Mac vs. PC, people tend to grab onto what has worked for them (or what has not) and throw away the other system (not too bright, neither in computers or birthing techniques -- we need Pentium technology to constantly push the envelope, and also the Macintosh so that non-literate users can actually operate computers [plus aren\'t those new colors really, really cute?] and we need Lamaze for down-and-dirty hands-on tools that work, and also Bradley because you need the low-down about what drugs do to your baby, and to you, and where control should be, in your hands, or in the hands of the medical profession).

In my opinion, for a first pregnancy, take Lamaze classes first (first and foremost, you need the Lamaze Breathing Techniques). Lamaze is a little more laid back than Bradley, and offers the very best tool for ensuring a successful \"natural childbirth\" experience: the fabulous hee-hee-hooos; in other words, a great breathing technique for managing pain (these hee-hee-hoos are the best weapon against pain, and the best tool in keeping the delivery going, keeping both Mommy and baby healthy, seriously, learn and practice the invaluable hee-hee-hoooooos!!!).

If you can survive natural childbirth without resulting to drugs or dangerous spinal blocks (the epidural), then for your next pregnancy, TAKE THE BRADLEY CLASSES, by all means. Of the two methods, Bradley is the more complete, the more involved, offers the most hard truth, and urges natural, natural, natural -- and hey, you\'ve made it through the first pregnancy with Lamaze, you can definitely do it now with Bradley (statistically, first-timers with Lamaze are more likely to successfully complete the \"natural\" route, whereas first-timers with Bradley generally fall back on drugs).

Lamaze   As to the breathing technique. You NEED the hee-hee-hoooo (taking a short, fast inhalation of breath before each hee, and a longer inhalation before the hoo). It is about the best pain-management technique you have in your toolbox, outside of drugs. The many short breaths force a lot more oxygen into the blood -- much like a swimmer just before a race, hyperventilating.

Bradley   As to the breathing technique. Long, deep, relaxing breaths of air, a MUST for the intervals BETWEEN contractions. This technique does nothing for managing pain, but is necessary between contractions, to ensure the most rest and relaxation possible.

Use the techniques of both, if you desire a natural childbirth. Both techniques are necessary, the Lamaze breathing to BATTLE the contractions, and the Bradley breathing to REST between the contractions. You have to battle, and you have to rest, your success depends upon it. And also, read below, for either technique to work, Lamaze or Bradley, a very GOOD Birth Coach needs to present and in charge (not watching TV).

The \"Birth Coach\" is probably the most important factor (next to Lamaze breathing) when considering \"natural delivery,\" or even a low-drug birthing event. The Coach needs to soothe Mommy if she becomes agitated, needs to reassure her during especially powerful contractions, needs to keep time on the contraction as it makes a potent \"we can get through this one\" attitude if the coach can say: \"Okay, we\'re halfway through this contraction, okay, only about twenty seconds left to go, you can feel it letting up now, it\'s easier, you can start to relax...\" -- also, the coach needs to determine when to pick up the speed of the \"Hee-Hee-Hoos\" during larger contractions.

When the contractions are at their longest and most powerful, the \"hee-hee-hoos\" (double \"hee\") need to turn into \"hee-hee-hee-hoos\" (triple \"hee\") to better capitalize on oxygen and blood flow. As the contraction nears its strongest point, the coach needs to urge: \"Okay, we\'re switching to triples!\" while keeping a close watch on the time of the contraction (and also being extremely sensitive to Mommy, reading all her body language) so that when the contraction begins to ease the coach knows to switch back to doubles.

Lamaze breathing is beautiful, it works, it really works, but can\'t work without a very good Birth Coach. The Birth Coach needs to be there, in Mommy\'s face, the whole time, the whole nine yards, making certain that she is with the program.

Between contraction bouts the coach must ensure that Mommy is hydrated AND breathing deeply (the Bradley techniques, relaxing, and strongly and deeply filling the lungs with air, holding a moment, and slowly exhaling), and constantly encouraging her (\"You\'re doing great, I can\'t believe how well you made it through that one, you were so brave!\").

The Birth Coach should also practice intense eye contact with Mommy. During contractions she should be looking into the eyes of the Coach, not at a pleasant teddy bear, or a picture of the ocean -- these techniques are good, too, in their place (hint, between contractions, while practicing Bradley breathing, deep slow, oxygen-rich breaths, filling the lungs, this is when Mommy should be relaxing, looking at beautiful paintings, or woodcut of a teddybear mugging a penguin). But during contractions Coach and Mommy need to be eye-to-eye and stay that way.

Since this eye-to-eye closeness means the face of the Coach is going to be in Mommy\'s face, the Coach had better have fresh breath, keeping some Altoids (the curiously strong peppermints) close at hand, to pop into the mouth between contractions (not DURING contractions, as the Coach needs to be doing a lot of talking and coaching, and doesn\'t need the extra distraction of a mint bouncing around on the tongue). Along with keeping Mommy hydrated, the Coach better drink quite a bit of water too during the whole process, and had best keep the bathroom breaks as short as possible.

Mommy NEEDS to trust the Birth Coach, and the Birth Coach has to be confident enough to take charge. The Coach needs to be the bodyguard, the cheerleader, the wise commander, and the snap-judgment nurse\'s aide. The Coach should be proficient in various massage techniques, and should have strong arms so that Mommy can twist and squeeze to her heart\'s content. And EMPATHY, strong, strong EMPATHY, the Birth Coach better be sympathetic and empathetic, or else the job needs to go to someone else. For up to 30 hours straight, the Birth Coach needs to be sensitive to Mommy\'s needs, and not be shy about talking to nurses and doctors.

[上一篇] [下一篇] [发表评论] [写信问候] [收藏] [举报] 
 
暂无评论
 
用户名: 密码:
发表评论
评论:
[返回顶部] [刷新]  [给home99写信]  [梦使宝贝@缘聚天涯首页] [博客首页] [BBS 未名空间站]
 
Site Map - Contact Us - Terms and Conditions - Privacy Policy

版权所有BBS 未名空间站(mitbbs.com) since 1996