chapter 4 Flashcards
Generations of Childbirth Customs
Pre 20th Century:
- birthing was a modest “female only” ritual
- use of midwives was predominant
- death rates high for mother and baby
- one out of four babies died in first year
- only 5%of births were in hospitals
Modern Generations: of childbirth
• dramatic reductions in death rate due to;
o antibiotics
o prenatal care
o blood transfusions
• 2005 99% of babies born in hospitals
• C sections reduced the number of mother and baby deaths
Humanizing Childbirth a Social Trend
• Home births have brought back intimacy of event
• Birthing centers and hospitals
o Soft lights
o Father or partner as coach
o Baby stays in room
• Hospital settings are trying to immolate this, fathers can be in the room during c section, baby being held by mother
Birth Process:
• Parturition- what brings on labor o 2 weeks before delivery o uterine contractions o cervix becomes flexible o stimulated by rising estrogen levels
Three Stages of Vaginal Childbirth:
- First stage is the longest the baby is still inside of the body, can be 12-14 hours, cervix has to dilate and reach 10cm for pushing
- Second stage: can last up to 1 hour, head is moving through cervix and through vaginal canal, second stage ends when body completely outside of the body
- Third stage is the delivery of the placenta and umbilical cord last 5 to 30 minutes can be up to 60 minutes
Cesarean Delivery:
• Up to about 30% of births in US
• Surgically removing baby from uterus through abdomen
• Now horizontal incision
• Harder to recover bc it cuts through all of your abdomen muscle and uterus
• Changing preferences among women and some physicians
• Common with:
o Mother bleeding vaginally
o First and or large babies
o Older moms
o Mothers with previous C-sections
• Once a mom has had a c section the next childbirth will also be c section
Unmediated Delivery
• Natural Childbirth: vaginal birth without the use of any type of medication, a prepared childbirth can be natural (Lamaze) mother receives training in fitness, breathing and relaxation
• Traditional cultures- Use of doula
o Experienced helper provides emotional support to mother
o Insurance wont cover it, it’s a coach
• Prepared childbirth:
o Lamaze is the most common controlled breathing
Medicated Deliveries:
• Local or regional anesthesia
o Blocks pain receptors in brain
o Induced labor means the child birth is no longer natural
• Relaxing analgesic
• Approximately 60% of women choose pain relief during labor
• Epidural: could be walking to very strong
• Huge push of all natural because 30 years ago the medications given to women affected the baby
Size and Appearance of the newborn
• Average neonate is o 20 in and 7.5 pounds • Fontanels: soft plates of head • Lanugo: Fuzzy prenatal hair • Vernix Caseosa: Oily protection against infection, dries and sloths off in a few days
Body Systems of the Newborn
• Meconium: first stuff pushed out of intestine: stringy waste in fetal intestinal tract • Neonatal Jaundice: o Yellowing of skin and eyeballs o Caused by immaturity of the liver o Half of all babies experience o Usually baby does not need treatment o Treatment is light
Apgar Scale
• Every baby gets this test, pulse, grimace, activity, respiration
Neonatal Screen tests
• Help detect correctable disorders
o PKU
o Galactosemia
o Hypothyroidism
One of the biggest problems for newborns
less than 5.5 lbs is low birth rate
-very low birthrate; 3.5 lbs
Childbirth complications
- Post maturity= pregnancy after 42 weeks
- Birth trauma
- Prematurity= pregnancy less than 37 weeks
- Low birth rate
Low birth weight
• 2nd and 3rd Preterm and low birth weight babies are the top to causes of infant death
preterm babies
- intravenous feeding , baby not sucking or mother not lactating
- Surfactant
- Isolette: controlled environment like an incubator
- Kangaroo Care : Skin to skin contact, mom sitting with baby, actually serves as a protective factor
Long-term of low birth rate
- Greater risk of neurological and cognitive impairment
- Lower academic achievement
- Social and behavior problems
Post maturity and still birth
- Before 20 weeks = miscarriage
* After 20 weeks = still birth, mother still has to give birth vaginally
Protective Factors for Development
• Individual Traits o Sociability o Intelligence • At least one supportive adult in child’s life • Child has a sense of meaning
Death During Infancy
• Primary cuases worldwide:
o Preterm delivery
o Sepsis or pneumonia
o Asphyxiation at birth
• Birth defects are leading cause in the US
• Improvement in US infant mortality rates likely due to SIDS (Sudden Infant Death Syndrome) awareness
SIDS
“Crib Death”
• No explanation
• Sudden death of infant under 1 year of age
• May have underlying biological defect (heart gene mutations)
• May be associated with sleeping on stomach
• Peaks at 2 to 3 months after 6 months it declines rapidly
Deaths from injuries:
• 90% of injury deaths in infancy due to:
o Suffocation (neglect cases)
o Motor vehicle accidents (car seat facing back)
o Drowning (don’t leave baby unattended by any kind of water) only takes 3 in of water
o Residential fires or burns