Chapter 4 - Birth and Newborn Baby

Question 1

Stage 1: Dilation and Effacement of the Cervix

Answer 1

Dilation and effacement of the cervix: widening and thinning of the cervix during the first stage of labour This stage lasts an average of 12 to 14 hours with the first birth and 4 to 6 with later births

Question 2

Stage 1: Dilation and Effacement of the Cervix Contractions

Answer 2

Uterine contractions gradually become more frequent and powerful, causing the cervix to widen and thin Contractions start out about 10 to 20 minutes apart and initially last about 15 to 20 seconds They get gradually closer together, occurring every 2 to 3 minutes, lasting up to 60 seconds, and are much stronger at this point

Question 3

Stage 1: Dilation and Effacement of the Cervix Transition

Answer 3

Transition: climax of the first stage of labour, in which the frequency and strength of contractions are at their peak and the cervix opens completely It’s important to keep Mom as relaxed as possible here; if she pushes too soon, she may bruise the cervix and slow the progress of labour

Question 4

Stage 2: Delivery of the Baby Before Crowning

Answer 4

This stage lasts about 50 minutes for a first baby and 20 minutes in later births Strong contractions continue, and Mom begins to push with each contraction, forcing the baby out and down

Question 5

Stage 2: Delivery of the Baby Crowning

Answer 5

Crowning: we say the baby is crowning when the vaginal opening has stretched around the entire head

Question 6

Stage 2: Delivery of the Baby After Crowning

Answer 6

After crowning, the baby’s head, then upper body, trunk, and finally legs, emerge Baby is wet with amniotic fluid, and still attached to the umbilical cord Once the cord stops pulsing, it’s clamped and cut

Question 7

Stage 3: Birth of the Placenta

Answer 7

This stage lasts only about 5 to 10 minutes The placenta separates from the wall of the uterus and is delivered

Question 8

The Baby’s Adaptation to Labour and Delivery

Answer 8

During labour, Baby produces high levels of stress hormones o This sends a rich supply of blood to the brain and heart, preventing the periods of oxygen deprivation during the contractions from causing damage o Causes the lungs to absorb any remaining fluid and expand the bronchial tubes, which helps Baby breathe effectively after birth o Arouses Baby into alertness

Question 9

The Newborn Baby’s Appearance

Answer 9

The average newborn o Is 20 inches long o Weighs about 7.5 lbs o Has a large head in comparison to the trunk and legs o Has short, bowed, legs o Is likely to have a flattened nose and a misshapen head, if birth proceeded naturally

Question 10

Apgar Scale

Answer 10

A rating used to assess the newborn baby’s physical condition immediately after birth and five minutes later. 7 or higher is good physical condition. 4-6 means the baby needs assistance. 3 or below is serious danger and needs emergency care. o 77% of newborns receive a score of 8-10, o 17% score 3-7 o 6% score 0-2 Criteria: heart rate, respiratory effort, reflex irritability, muscle tone, colour

Question 11

Natural, or prepared, childbirth

Answer 11

Natural, or prepared, childbirth - an approach designed to reduce pain and medical intervention and to make childbirth a rewarding experience for parents Most natural childbirth programmes draw on methods developed by Grantly Dick-Read and Fernand Lamaze, both of whom believed that childbirth had become more painful for women due to the fear and tension we’d been taught to experience Mother who use natural child birth feel more in control, more positive and use less pain medication.

Question 12

Natural, or Prepared, Childbirth Typically, Mom and a companion participate in…

Answer 12

o Classes, in which they learn about the anatomy and physiology of labour and delivery o Relaxation and breathing techniques aimed at counteracting the pain of uterine contractions o Labour coach, in which Mom’s companion learns how to help Mom during childbirth by reminding her to relax and breathe, massaging her back, supporting her body, and offering encouragement and affection

Question 13

Natural, or Prepared, Childbirth Social Support

Answer 13

The social support that is a routine part of natural childbirth appears to make a large difference. Doula = birthing support person Mothers with more social support o interact more positively with their babies o are less likely to need a cesarean delivery o have babies with higher Apgar scores

Question 14

Natural, or Prepared, Childbirth upright, sitting position

Answer 14

During natural childbirth at a birth centre or home, Mom may give birth in an upright, sitting position The upright position makes pushing easier and more effective, shortening the duration Blood flow to the placenta is increased, providing Baby with a richer oxygen supply Permits for partner to sit behind and suport Mom’s ability to see the delivery can help her to tract the effectiveness of each contraction of pushing Baby out of the birth canal

Question 15

Natural, or Prepared, Childbirth Water births

Answer 15

Water births have become more popular Warm water supports Mom’s weight, relaxes her, and provides her with the freedom to shift positions as she needs Associated with a shorter labour, a lower episiotomy rate, and a greater likelihood of a medication-free delivery than are other methods

Question 16

Home Delivery

Answer 16

Home deliveries are common in some industrialized nations, but only about 1% of North American mothers choose this method Some home births are attended by doctors, but most are attended by certified nurse-midwives, who have degrees in nursing and additional training in childbirth For healthy women who are assisted by a well-trained doctor or midwife, home births appear to be as safe as hospital birth If attendants are not well-trained or Mom is at risk for complications, hospitals are safer

Question 17

Medical Interventions

Answer 17

Medical interventions are used sometimes in both industrialized and nonindustrialized cultures In North America, medical interventions are very common o This is partially because there are more multiple births and high-risk deliveries in the past (because of less miscarages) o But even births without risk factors are often highly medicalized here Types of medical interventions • Fetal monitoring – electrical insterments that track babys heart rate. • Labor and delivery medications • Instrument delivery – forceps, vacuum extractor - not used frequently anymore – risk of brain damage, head and eye bleeding • Induced labor – started artificially – synthetic oxytocin starts the contractions – number of ID has doubled (likely do to convenience) – it is done if baby or mothers health is threatened – contractions are longer, harder, and closer together (mother feels less control and more meds are used) – risk on inadequate oxygen to baby – higher chances of instrument delivery - • Caesarean delivery

Question 18

Common delivery medications

Answer 18

analgesics anesthetics

Question 19

Epidural analgesia

Answer 19

is the most common method used during labour, in which a regional pain-relieving drug is delivered via catheter into a small space in the lower spine Whereas older spinal block procedures numbed the entire lower half of the body, this newer technique affects the pelvic region only, so Mom can still feel contractions and can still push

Question 20

issues with the use of delivery medication

Answer 20

Epidural analgesia does weaken uterine contractions, so labour is prolonged Drugs cross the placenta, so exposed newborns tend to have lower Apgar scores, to be sleepy and withdrawn, to suck poorly during feedings, and to be irritable when awake There is controversy over whether or not there are long-term negative effects

Question 21

Cesarean delivery

Answer 21

a surgical delivery in which the doctor makes an incision in the mother’s abdomen and lifts the baby out of the uterus This accounts for about 19% of births in Canada Once a cesarean has been performed, later vaginal births are discouraged o A natural labour after a cesarean is associated with slightly increased rates of rupture of the uterus and infant death, particularly if labour is induced Note that recovery time following a cesarean is longer than after natural childbirth Also note that pain medication is necessary during a cesarean, and will affect Baby as well

Question 22

Cesarean delivery is commonly performed when

Answer 22

There is an Rh incompatibility There is premature separation of the placenta from the uterus Mom has an illness, such as herpes simplex 2, which can infect Baby during vaginal delivery Breech position – baby turned so that the buttock or feet would be delivered first – bad because: possibility of pinched umbilical cord which would deprive the baby of oxygen o This position can increase the risk of oxygen deprivation and of head injuries

Question 23

Birth complications are more likely when Mom is …

Answer 23

Is in poor health Doesn’t receive good medical care Has a history of pregnancy problems

Question 24

Cerebral palsy

Answer 24

Variety of impairments in muscle coordination caused by brain damage before, during, or right after birth

Question 25

Some examples of birth complications are…

Answer 25

Inadequate oxygen A pregnancy that ends too early or too late A baby who is born underweight

Question 26

Some potential causes of anoxia are

Answer 26

• Placenta abruptio(n), premature separation of the placenta • Placenta previa, a condition caused by implantation of the blastocyst so low in the uterus that the placenta covers the cervical opening; part of the placenta may detach during the third trimester as the cervix begins to dilate and efface

Question 27

Respiratory distress syndrome

Answer 27

a disorder of preterm infants in which the lungs are so immature that the air sacs collapse, causing serious breathing difficulties

Question 28

anoxia

Answer 28

Inadequate oxygen supply

Question 29

Oxygen Deprivation

Answer 29

Oxygen deprivation can also occur if Baby fails to start breathing within a few minutes after birth Cell death can occur for several hours after oxygen deprivation has occurred Researchers are experimenting with technology to cool the brain by several degrees for a few days after birth for anoxic newborns, as a way to reduce brain damage

Question 30

Long term consequences of Oxygen Deprivation

Answer 30

Anoxia during labour and delivery is associated with poorer cognitive and language skills in early and middle childhood Many children improve over time, with the severity of the effects depending on the severity of the deprivation

Question 31

Respiratory distress syndrome (hyaline membrane disease)

Answer 31

Common if born more than six weeks early. Poorly or underdeveloped lungs so the air sacs collapse causing serious breathing difficulties.

Question 32

Preterm and Low-Birth-Weight Infants

Answer 32

Babies who are born before 38 weeks or weigh less than 5 ½ are/were referred to as “premature” Low birth-weight infants can be preterm or small-for-date In some cases, both Many infants who weigh less than 1500g (3 1/3 lbs) experience difficulties that are not overcome, with problems growing stronger for babies that weight less There are often underlying problems that have prevented them from growing normally During their first year, they’re more likely to die, catch infections, and show evidence of brain damage By middle childhood, they have lower intelligence test scores, are less attentive, achieve more poorly in school, and are socially immature

Question 33

Preterm and Low-Birth-Weight Difficulties include

Answer 33

frequent illness, inattention, overactivity, sensory impairments, poor motor coordination, language delays

Question 34

Predicting Low-Birth-Weight

Answer 34

Low birth weight isn’t always predictable, but is most common among the babies of women who are undernourished and/or exposed to other harmful environmental influences Prematurity and low birth weight is also common among multiple birth children

Question 35

Preterm infant Small for date infant

Answer 35

Preterm infants are born several weeks before their expected due date. Small for date infants are below their expected weight considering the length of their pregnancy. Small-for-date babies are typically in more danger than are preterm babies

Question 36

Preterm babies and caregiving

Answer 36

Preterm babies often receive less sensitive caregiving than do full-term babies They are less responsive and more irritable, making interactions less rewarding for parents Preterm babies are less often held close, touched, and talked to gently Sometimes, mothers may poke their babies or issue verbal commands in an effort to obtain a higher level of response Note that parental education and resources, and sensitivity of caregiving, are paramount in determining long-term outcomes for these infants More likely for child abuse – this is also because poverty stricken mothers are more likely to have preterm or small for date infants

Question 37

In an isolette

Answer 37

Temperature is carefully controlled Air is filtered to protect Baby from infection Sometimes infants are fed through stomach tubes, assisted in breathing with a respirator, and receive medication through needles

Question 38

Stimulation and preterm infants’ development

Answer 38

Stimulation can improve preterm infants’ development, but can also be overwhelming for some infants Stimulation becomes something of a balancing act Some NICUs suspend preterm infants in hammocks or place them on waterbeds, to simulate the gentle motion of being in the uterus Mobiles are sometimes used for visual stimulation Auditory stimulation may involve a tape recording of a heartbeat, soft music, or Mom’s voice In the absence of technology, kangaroo care is often used The infant is placed in a vertical position between Mom’s breasts or against Dad’s chest, under the parent’s clothing, and the parent’s body functions as an incubator o Improvements in oxygenation of Baby’s body, temperature regulation, sleep, feeding, alertness, and infant survival o Baby gets gentle stimulation in all modalities o Parents feel more confident about caring for their babies, interact more sensitively and affectionately, and feel more attached

Question 39

Parents of preterm babies and interventions

Answer 39

Parents of preterm babies may need interventions that teach them what to expect Teaching parents to recognize their baby’s needs and respond appropriately is linked to gains in mental test performance that allow preterm infants to ‘catch up’ with full-term infants Warm parenting that helps preterm infants sustain attention is helpful in promoting early cognitive and language development Preterm infants in stressed, low-income households, in which there is no intervention, are less likely to be within the normal range in intelligence, psychological adjustment, and physical growth, by age 3 The mothers of these infants are less affectionate, and less often encourage play and cognitive mastery in their children, than comparable mothers who receive intensive intervention

Question 40

Preterm and Low-Birth-Weight likelihood of long-term difficulties

Answer 40

Unsurprisingly, the likelihood of long-term difficulties is higher in cases of severe birth trauma Among mildly to moderately stressed children, the postnatal environment is a major factor In one study, mildly to moderately stressed children growing up in stable families did almost as well on measures of intelligence and psychological adjustment as those with no birth problems Those exposed to poverty, family disorganization, and mentally ill parents often developed serious learning difficulties, behaviour problems, and emotional disturbance There are, of course, exceptions The study discussed in the previous slide found a few children with serious birth complications and troubled family environments who were as competent and well-adjusted as adults as were controls These children relied on factors outside the family and within themselves to overcome stress o Some had attractive personalities that drew positive responses from relatives, neighbours, and peers o Some had grandparents, aunts, uncles, or baby-sitters who provided emotional support

Question 41

Infant mortality Neonatal mortality

Answer 41

The amount of deaths in the first year of life per 1000 live births The amount of deaths in the first month Best Countries • Singapore • Sweden • Japan • France • Finland Because of • Paid leave • Nurse visit programs • Free or cheap health care options • Social and economic supports • High quality medical care • Parenting support

Question 42

In the early 20th Century, it was believed that infants ….

Answer 42

In the early 20th Century, it was believed that infants couldn’t see or hear much, were largely insensitive to pain, and had relatively little to help them interact with the outside world

Question 43

Bonding after birth

Answer 43

Both parents are equally emotionally effected by the new birth They will stroke the baby, look in to the eyes, talk softly Hormonal changes: Mother – oxytocin near the end of pregnancy heightens responsiveness to the baby and helps with milk production Father – when holding the baby shows increase of prolactin, and estrogens and a drop in androgens Human bonding does not need to happen directly after birth like some animals but it could be important Parents can recognise their baby by touch, smell, and sight after a brief exposure Rooming in – this is where the baby stays in the mothers hospital room all or most of the time

Question 44

Reflex

Answer 44

Reflex - an inborn, automatic response to a particular form of stimulation Some reflexes have clear adaptive value Some reflexes form the basis for later motor development Testing infant reflexes can be an important diagnostic tool If reflexes are weak or absent, overly rigid or exaggerated, or don’t disappear when they should, this can signal brain damage

Question 45

List of infants reflexes

Answer 45

Eye blink reflex Rooting Reflex Sucking reflex Swimming reflex Moro Reflex Palmar Grasp reflex Tonic Neck Reflex Stepping reflex Babinski Reflex

Question 46

Eye blink reflex

Answer 46

– Survival reflex – permanent - if bright light is shined in baby’s eyes then the infant quickly closes eyes which protects from strong stimulation.

Question 47

Rooting Reflex

Answer 47

– Survival reflex – becomes voluntary at 3 weeks – if baby feels stroke on cheek near corner of mouth then the infant turns head towards stimulus which helps the baby breast feed by finding the nipple. Will only happen if the baby is hungry and when touched by others and not by themselves.

Question 48

Sucking reflex

Answer 48

• Survival reflex – becomes voluntary at 4 months – if you place something in baby’s mouth then they will rhythmically suck which permits feeding.

Question 49

Swimming reflex

Answer 49

– Survival reflex – disappears at 4 to 6 months - if the baby is placed face down in water then the baby will paddle and kick in a swimming motion which would help if baby was dropped in water.

Question 50

Moro Reflex

Answer 50

– Evolutionary past reflex - disappears at 6 months - holding a baby horizontally on the back and allow the head to drop, or make a sudden loud sound against a surface supporting the baby will cause the baby to make a “embracing” motion by arching their back, extending their legs, throwing their arms outward, and then bringing arms back in to the body. Evolutionary past reflex. Probably helped baby hold on to mothers when they were carried all day. If they were dropped they may be able to grab back on.

Question 51

Palmar Grasp reflex

Answer 51

– developmental reflex – disappears at 3 to 4 months - if you place finger in infants hand then the baby will display a spontaneous grasp of the finger. This may prepare the infant for voluntary grasping.

Question 52

Tonic Neck Reflex

Answer 52

– developmental reflex – disappears 4 months - if you turn the baby’s head to one side while the baby is lying away on their back then the infant lies in the “fencing position” with one arm extended in front of the eyes on side to which the head is turned and the other arm is flexed. This may prepare the infant for voluntary reaching.

Question 53

Stepping reflex

Answer 53

– developmental reflex – disappears around 2 months correlating with the weight of the infant unless weight is not a factor by placing legs in water - if you hold the infant by under the arms and permit the baby’s bare feet to touch a flat surface then the infant will lift one foot after another in a stepping response. This may prepare the infant for voluntary walking.

Question 54

Babinski Reflex

Answer 54

– unknown reason for the reflex – disappears 8 to 12 months - if you stroke the soul of the baby’s foot from the toe towards the heel the toes will fan out and curl as the foot twist in. this has an unknown purpose.

Question 55

States of arousal

Answer 55

Degrees of sleep and wakefulness Newborns spend 16-18 hours a day sleeping, alternating between different sleeping states They also have different waking states, and alternate among those, and between waking and sleeping Note that there is considerable variation in sleep patterns from one infant to the next List - Regular, NREM sleep – 8 to 9 hours a day - Irregular, REM sleep – 8 to 9 hours a day - Drowsiness – time varies - Quiet Alertness – 2 to 3 hours a day - Waking activity and crying – 1 to 4 hours a day

Question 56

States of arousal Rapid-eye-movement (REM)

Answer 56

Rapid-eye-movement (REM) sleep - an ‘irregular’ sleep state in which brain-wave activity is similar to that of the waking state A newborn spends 8-9 hours per day in REM sleep Notice that newborns spend approximately 50% of their sleeping time in REM sleep This declines gradually during the first few years of life; it’s about 20% of sleeping time in children and adults Researchers believe that young infants need the stimulation provided by REM sleep to keep neurons active, since they have so little waking time The eye movements cause the vitreous to circulate, delivering oxygen to parts of the eye that don’t have their own blood supply; if the eyes were always still during sleep, visual structures would be at risk for anoxia

Question 57

States of arousal Non-rapid-eye-movement (NREM)

Answer 57

Non-rapid-eye-movement (NREM) sleep - a ‘regular sleep state in which the body is quiet and heart rate, breathing, and brain-wave activity are slow and regular A newborn spends 8-9 hours per day in NREM sleep

Question 58

Not normal sleep behavior

Answer 58

Normal sleep behaviour should be organized and patterned If a baby fails to fall into a predictable cycle of states, this may reflect central nervous system abnormalities In infants who are brain-damaged or who have experienced serious birth trauma, for instance, we often see disturbed REM-NREM cycles Babies with poor sleep organization are more likely to be behaviourally disorganized and to thus have difficulty learning and eliciting caregiver interactions that enhance their development

Question 59

Sudden infant death syndrome (SIDS)

Answer 59

The unexpected death, usually during the night, of an infant younger than one Remains unexplained after investigation Leading cause of infant mortality between 1 week and 12 months in industrialized nations The infants that die from SIDS often show physical problems from early on (low Apgar scores, prematurity, low birth weight, limp muscle tone, abnormal heart rate, respiration, disturbances in sleep wake cycle) At time of death infants have a mild repertory infection Research suggests that impaired brain functioning may play a part Most likely to occur between 2 to 4 months when reflexes are giving way to voluntary movements Autopsies reveal low levels of serotonin and other anomalies in areas of the brain for breathing and arousal Environmental factors include: maternal smoking, smoking of other care givers, parental drug abuse, poverty stricken areas Baby who die from SIDS more often sleep on stomachs, be wraped in warm clothing and blankets Babies who use pacifiers arouse more easily in response to breathing and heart rate irregularities

Question 60

awake infant states

Answer 60

Drowsiness; amount of time per day varies considerably Quiet alertness; 2-3 hours per day Waking activity and crying; 1-4 hours per day

Question 61

Crying

Answer 61

Although we don’t typically like to hear a baby crying, this is an important and adaptive response o It allows babies to let parents know when they food, comfort, and stimulation o The most common cause of crying is hunger o Temperature change, sudden noise, and painful stimuli also reliably evoke crying o Babies often cry if they hear another baby crying Parents usually gradually learn to interpret their babies’ cries Crying peeks at 6 weeks

Question 62

When feeding and diaper changing don’t quiet a crying baby, parents often can try…

Answer 62

Rocking the baby on their shoulder Swaddling Offering a pacifier, preferably sweetened with a sugar solution Talking softly or playing rhythmic sounds A car ride, walk in a carriage, swinging in a cradle Gentle massage

Question 63

Crying, as a diagnostic tool

Answer 63

Crying, like reflexes, provides a diagnostic tool The cries of brain-damaged babies and those who have experienced prenatal and birth complications are often shrill, piercing, and shorter in duration than are the cries of healthy babies Babies with colic also tend to have high-pitched, harsh-sounding cries Note that babies who react especially strongly to unpleasant stimuli are quite susceptible to colic It is harder for a baby with colic to calm down Training parents to identify the baby’s early warning signs of becoming overly aroused, and in using effective soothing techniques, can help

Question 64

Touch

Answer 64

Sensitivity to touch is well-developed at birth The newborn is particularly sensitive around the mouth, on the palms, and on the soles of the feet Those areas, and the genitals, are the first to become sensitive to touch during the prenatal period Infants are quite sensitive to pain at birth Male newborns are sometimes circumcised without drugs, and tend to respond with a high-pitched cry, and dramatic increase in heart rate, blood pressure, palm sweating, pupil dilation, and muscle tension Enduring overwhelming pain can actually result in increased pain sensitivity in the infant later

Question 65

Taste and Smell

Answer 65

Like adults, newborns Relax their facial muscles in response to sweetness Purse their lips when a taste is sour Show an archlike mouth opening when a taste is bitter These tendencies ensure that babies show preferences for their mothers’ sweet-tasting milk At about 4 months, they begin showing a preference for salty tastes over plain water, indicating readiness for solid food Newborns can learn to like tastes that they initially disliked For instance, babies allergic to cow’s milk formula, who are given a more bitter soy substitute do learn to prefer the taste that they come to associate with relief of hunger Certain odour preferences are present at birth as well The smell of bananas or chocolate induces a relaxed, pleasant facial expression The odour of rotten eggs makes an infant frown Newborns will often show preferences for odours that would have been present in Mom’s amniotic fluid (based on Mom’s diet) It’s notable that breastfed infants learn within the first days of life to distinguish their mothers’ breasts from another woman’s, based on smell alone

Question 66

Hearing

Answer 66

Babies distinguish a variety of sounds early on At birth, they prefer complex sounds to pure tones Infants a few days old can distinguish between Tones arranged in ascending v descending order Different stress patterns in words Happy-sounding speech v negative or neutral Different languages, even if spoken by the same speaker Infants show an early preference for human speech, particularly their own mother’s voice They prefer infant-directed speech to adult-directed speech, and the preference for Mom’s voice is even greater in infant-directed speech Infants can distinguish phonemes, even those from languages to which they are not being exposed Newborns already show auditory localization This ability declines in the early months, and then increases again

Question 67

Vision

Answer 67

Vision is the least developed of the senses at birth, perhaps because of lack of practice during the prenatal period Visual structures in the eye and brain aren’t yet fully formed at birth Babies have poor visual acuity and poor ability to focus their eyes at birth Although even close-up objects appear blurry to the newborn, a preference for Mom’s face over that of unfamiliar women develops early Newborns still actively explore the environment by scanning it for interesting sights They track moving objects, but with slow and inaccurate eye movements Newborns often look at only one aspect of an object, often around the edges of an object Newborns prefer coloured to gray stimuli Their colour vision won’t be adultlike for 4 more months

Question 68

Neonatal Behavioural Assessment

Answer 68

Neonatal Behavioural Assessment Scale (NBAS) - a test developed to assess the behaviour of a newborn infant in terms of reflexes, muscle tone, state changes, responsiveness to physical and social stimuli, and other reactions

Question 69

Use of the NBAS across cultures

Answer 69

Use of the NBAS across cultures tells us that Asian and Native-American babies are less irritable than are Caucasian infants In these cultures, babies are more often swaddled, receive more close physical contact, and are nursed at the first signs of discomfort Zambian mothers carry their babies on their hips all day, providing a variety of sensory stimulation NBAS scores often improve for these infants over time

Question 70

The Neonatal Intensive Care Unit Network Neurobehavioural Scale (NNNS)

Answer 70

The Neonatal Intensive Care Unit Network Neurobehavioural Scale (NNNS) is based on the NBAS, but is specially designed for use with newborns born at risk for developmental problems Low birth weight, preterm delivery, and prenatal substance exposure are a few conditions that would warrant this

Question 71

The Transition to Parenthood

Answer 71

The time just after the child’s birth is one of adjustment Mom Needs to recover from childbirth Is undergoing massive hormone shifts May be trying to work out breastfeeding (which comes easier for some babies than for others) Dad Must find his place in this relationship Is probably trying to help support Mom’s recovery May sometimes feel ambivalent about the baby and his/her constant demands on Mom’s attention

Question 72

Changes in the Family System

Answer 72

For most couples, gender roles become more traditional after the birth of a baby It’s more common for Mom to take parental leave than Dad, so Mom spends more time at home with Baby, and Dad focuses more on the role of provider

Question 73

Changes in the Family System marital strain and satisfaction

Answer 73

For most new parents, the new baby doesn’t cause significant marital strain Marriages that are gratifying and supportive stay that way Troubled marriages, on the other hand, usually become more distressed after the baby is born Mothers’ marital satisfaction after the birth of a baby tends to remain stable or increase if their husbands are affection, express values and goals similar to hers, and show an awareness of her daily life Marital satisfaction may decline if expectations about division of labour in the home are violated In dual-earner marriages, a larger difference between Mom’s and Dad’s caregiving responsibilities is associated with a greater decline in marital satisfaction This is especially the case for mothers, who are likely taking on more caregiving responsibility Sharing caregiving predicts greater parental happiness and sensitivity to the baby

Question 74

Postponing parenthood until the late twenties or thirties

Answer 74

Postponing parenthood until the late twenties or thirties seems to make the transition easier It allows couples to pursue occupational goals and gain life experience Men are usually more enthusiastic about parenthood under these circumstances, and are more willing to be involved fathers Women whose careers are well underway are more likely to encourage their husbands to share housework and child care

Question 75

The birth of a second child

Answer 75

Just as stressful as first time mothers The birth of a second child usually forces Dad to take a more active role in parenting, often caring for the firstborn while Mom is recovering from childbirth and coping with the man demands of a newborn Well-functioning families often show less traditional gender division when the second child comes Note that the birth of the second child may be difficult for the firstborn, and parents must help with the adjustment Preschool-age siblings may feel displaced and react with jealousy and anger

Question 76

Parental depression and child development

Answer 76

8 to 10% of woman experience chronic depression If it starts or increases after child birth it is called postpartum depression 3 to 5% of new fathers also report symptoms of depression Infants of depressed mothers have more trouble sleeping, they are less attentive to their surroundings, have elevated levels of cortisol (stress hormone), eventually emulate depressive symptoms, and can become violent or antisocial youth Parental depression is linked to marital dissatisfaction, predictor of child behavior problems, father – child relationship problems, lack of self-confidence, perceive others as threatening, lack self-control,

Question 77

How couples can ease the transition to parenthood

Answer 77

• Devise a plan for sharing house hold tasks - Begin sharing child care right after the baby’s arrival - Talk over conflicts about decision making and responsibilities - Establish a balance between work and parenting - Press for work place and public policies threat assist parents if rearing children

Question 78

Single mother families

Answer 78

1. Can be young, poor, unprepared – lots of consequences but also could be 2. old, secure adoptions – few consequences, can be just as good or even better then married couples

Question 79

Corticotropin-releasing hormone (CRH)

Answer 79

A hormone involved in stress response. The placenta releases this hormone this hormone as pregnancy advances. High levels of CRH trigger additional hormone augments the trigger uterine contractions. In the babies blood stream the CRH prepares the lungs for breathing

Question 80

Signs that labor is near

Answer 80

False labor or prelabor – is when the woman feels the upper part of the uterus contract. These are brief and unpredictable and can last for several weeks. Lightening – is when the babies head drops low in to the uterus. Placental hormone changes causes the cervix to soften and it no longer supports the weight as easily. This happens about 2 weeks before birth Bloody show – when labor is hours away the cervix begins to open, the plug of mucus that sealed it during pregnancy is releced, producing a reddish discharge. Soon after contractions become more frequent and mom enters the first stage of labor.

Question 81

episiotomy

Answer 81

An incision that increases the size of the vaginal opening.

Question 82

The second stage of labor typically lasts __________ for a first birth.

Answer 82

50 minutes

Question 83

The average newborn is _____ inches long and weighs ____ pounds.

Answer 83

20, 7

Question 84

Which of the following statements is true about fetal monitoring?

Answer 84

infant death

Question 85

Small-for-date infants are especially likely to suffer from

Answer 85

prenatal neurological impairments.

Question 86

Sixty-seven percent infant deaths in the United States take place within the first __________ of life.

Answer 86

Month

Question 87

A study conducted of infants on the island of Kauai, Hawaii, found that

Answer 87

as long as birth injuries are not overwhelming, a supportive home can restore children’s growth.

Question 88

The Moro reflex probably helped babies survive during our evolutionary past because

Answer 88

it helped infants cling to their mothers when they were carried about all day.

Question 89

When placed in a swimming pool, young babies will

Answer 89

swallow large amounts of water.

Question 90

Colic generally subsides between

Answer 90

3 to 6 months.

Question 91

Among newborns, what is a typical facial expression in response to sweetness?

Answer 91

archlike mouth opening

Question 92

How long does it take for a newborn’s color vision to become adultlike?

Answer 92

4 months

Question 93

__________ percent of babies in the United States are born to single mothers.

Answer 93

Thirty-nine

Question 94

soothing a crying baby TABLE

Answer 94

Question 95

Stages of Delivery TABLE

Answer 95