Chapter 4: Birth and the Newborn Baby Flashcards
3 stages of childbirth
1) Dilation and effacement of the cervix –> transition.
- contractions of the uterus cause dilation and effacement of the cervix.
- transition is reached when the frequency and strength of the contraptions are at their peak and the cervix opens completely
2) Delivery of the Baby
- pushing; with each contraction the mother pushes, forcing the baby down the birth canal, and the head appears
- birth of the baby; near the end of stage 2, the shoulders emerge, followed quickly by the rest of the baby’s body.
3) Birth of the placenta
Is the production of cortisol and other stress hormones during childbirth beneficial or harmful to the baby?
beneficial, promotes development of the lungs in preparation for breathing.
APGAR scale.
Appearance (color), Pulse(hear rate), Grimace (reflex irritability), Activity(muscle tone), Respiration(breathing)
Anoxia and what impairments are associated with it?
oxygen deprivation, can lead to cerebral palsy; impairment of muscle coordination.
Medical interventions
fetal monitoring - keep track of fetal heart rate
labor and delivery medication - epidural
instrument delivery - forceps and vacuum
induced labor - synthetic oxytocin to stimulate contraction and breaking bag of water.
cesarean delivery - surgical removal
Rh factor incompatibility. How does it occur? How is it detected? treated? 1st vs. 2nd child.
Mother is Rh negative and father is positive, first baby will get Rh positive. Mother will develop antibodies for Rh. So second child will be Rh positive and mothers antibodies will kill 2nd child RBC’s. treated by giving mother vaccines to fight against the antibodies, in emergencies, blood transfusion after delivery or before birth.
Main findings of Emmy Werner’s Kauai study regarding risk and resilience.
supportive home environment can lead to positive outcomes for babies with some birth complications. resilience is an important factor for combating complications.
What are newborn reflexes? what are their functions? When do they typically disappear?
Eye blink - doesn’t go away
rooting (find nipple)- stroke cheek near corner of mouth, head turns toward source of stimulation; 3 weeks –> becomes voluntary
sucking - finger in mouth, suck finger, 4 months become voluntary
swimming - place in water, paddle and swims; 4-6 months
moro (helped hold onto mother)- hold horizontally on back, let head drop slightly, produce loud sound against surface supporting the infant; infant will arch back, extend legs, throwing arms outward, and the bring arms to body; 6 months
palmer grasp (prepare for voluntary grasping)- 3 to 4 months
tonic neck (prepare for reaching) - turn head to one side while awake; fencing position, 1 arm extended in front of eyes, other arm is flexed; 4 months
stepping - hold underarms and let feet touch ground; stepping response; 2 months for heavy babies, sustained for light babies.
babinski (unknown) - stroke sole of foot; toes fan out curls as foot twist in; 8 to 12 months.
soothing baby, swaddling, why is it used?
Talk to baby, soothing sounds Hand on belly Restrain arms gently Pick up and hold on shoulder Rock gently or walk with baby Swaddle - restricting movement, increase warmth Pacifier Ride in carriage, car, swing Massage Combine methods Let cry for short time (self-soothe)
most/least developed sensory organs at birth?
most - hearing, least - seeing
Neonatal behavioral Assessment Scale (NBSA)?
Neonatal Behavioral Assessment Scale (NBAS)
evaluates a baby’s reflexes, muscle tone, state
changes, responsiveness to physical and social stimuli.
Neonatal Intensive Care Unit Network
Neurobehavioral Scale (NNNS) is an adaptation
of the NBAS, especially designed for use with
newborns at risk for developmental problems.
Clinical NBAS (CLNBAS)
– Now called “Newborn Behavioral Observation” (NBO)
Brief, structured assessment used by clinicians in
primary care settings with new mothers and their
families
Designed to be a helpful tool for pediatric
professionals who
– work with parents during the perinatal period
– Want a more relational or family-centered model of care to
replace the traditional pathology-seeking biomedical model
of care (Brazelton and Cramer, 1990; Stewart et. al. 1995)
NBO is flexible and can easily integrated into routine
home visits, as well.
NBO
Best understood as a relationship-building tool
Inherently interactive and family-centered, because
parents are involved as partners in the NBO session
throughout.
Designed to help the clinician and parent together, to
observe the infant’s behavioral capacities and identify
the kind of support the infant needs for his successful
growth and development
Can foster positive parent-infant interactions and
promote a more positive partnership between
clinician and parents
