Chapter 4; Part 1

Question 1

Stages of Childbirth:

Signs that labor is near…

Answer 1

False Labor

Lightening:
When the baby’s head drops low into the uterus.

—Bloody Show:
Reddish discharge

Prelabor begins several begins several weeks before birth

Question 2

The 3 Stages of Labor

Answer 2

STAGE ONE:
Dilation & Effacement of the cervix. Contractions are forceful & regular.
Transition.

STAGE TWO:
Pushing starts to occur.
Birth

STAGE THREE:
The last few contractions when the placenta is delivered.

Question 3

Baby’s Adaptation to Labor and Delivery

Answer 3

Healthy babies are equipped to with stand this trauma

High levels of infant cortisol and other stress hormones help!

Question 4

The APGAR scale

Answer 4

….

Question 5

Approaches to Childbirth

Answer 5

Attitudes and practices molded by society

Western society:
Before late 1800s→home births
Post-industrial revolution→ hospital births
1950s–1960s→ movement toward natural childbirth
Today→birth centers (and some home births)

Question 6

Elements of Natural or Prepared Childbirth

Answer 6

Classes:
Reduces fear/anxiety

Relaxation & Breathing techniques:
Counteracts pain

Labor coach:
Great motivator, helps mother to relax, helps the mother become physically more comfortable

Social Support & Natural Childbirth:
Doulas

Question 7

Approaches to Childbirth: Elements of Natural, or Prepared, Childbirth

Answer 7

Positions for delivery might include sitting upright or using a birthing stool.

Water births are associated with shorter labors and a greater likelihood of a medication-free delivery than other approaches.

North American women choosing home delivery remain a small percentage.

Question 8

Home Delivery

Question 9

Who should not have a home birth?

Answer 9

Giving birth at home isn’t for everyone, of course.
Moms-to-be who are more likely to have complications during childbirth should give birth in a hospital.
This includes women with:
Medical conditions, such as high blood pressure or diabetes
A previous C-section or other uterine surgery.
Pregnancy complications, such as premature labor, preeclampsia, twins (or more), or a baby in the breech position at 37 weeks.

Question 10

Medical Interventions

Answer 10

—Fetal monitoring
—
Medication
§  Analgesics 
§  Anesthetics
—
Instrument delivery —

Induced labor —

Cesarean delivery

Question 11

Fetal Monitoring

Answer 11

Electronic instruments that track the baby’s heart rate during labor

Used in 85% of hospital births
—
Controversy: Linked to an increased number of c- sections and instrument deliveries

Question 12

Analgesics & Anesthetics

Answer 12

Relieves pain

Stronger painkiller that blocks sensations

Epidural is the most common form of pain killer
Can prolong labor
Newborns tend to have lower Apgar scores
Sleepier
Long-term side effects are controversial

Question 13

Instrument Delivery

Answer 13

Forceps: older technology; less used today due to the trauma they can cause to mother and child

—Vacuum Extraction: replacing forceps; much less likely to harm baby and mother

Question 14

Induced Labor

Answer 14

Started artifically (breaking the amnion or water), and giving the mother synthetic oxytocin (a hormone that stimulates contractions)

—Contractions are longer, harder, and closer together

Question 15

Cesarean Delivery

Answer 15

Cesarean deliveries, rare 40 years ago, now account for 31% of births in the US.

Cesareans are warranted in medical emergencies such as
— Rh incompatibility
— premature separation of the placenta from the uterus
— infection
— baby in breech position (1 in 25 births)

Question 16

Why wait until 39 weeks?

Answer 16

Do it!

Question 17

Birth Complications:

Oxygen Deprivation

Answer 17

Anoxia - oxygen deprivation at birth

Can lead to brain damage or later cognitive, language problems
v Cerebral palsy

Causes include:
v Squeezing by umbilical cord
v Placenta abruptio, placenta previa (1-2%) –> severe hemorrhaging
v Failing to breathe after birth
v Respiratory distress syndrome in preterm infants

Question 18

Preventing Brain Cell Death from Anoxia

Answer 18

Researchers are experimenting with ways to prevent secondary brain damage.

—Anoxic newborns placed in a head-cooling device shortly after birth for 72 hours substantially reduced brain injury and increased their assessment scores.

—Pre-cooled water blankets are also being used to reduce the rates of death and severe disabilities.

Question 19

Birth Complications:

Preterm and Small-for-Date Babies

Answer 19

Preterm
 Born weeks before their due date
 May be the appropriate weight for length of pregnancy

Small-for-Date
 May be born at due date or preterm
 Below expected weight for length of pregnancy
 Some small-for-date babies have weakened abilities to manage stress.

Question 20

Preterm Infants

Answer 20

7 more days in the womb—from 34 to 35 weeks can contribute greatly to infant health.

Babies born at 35 weeks show substantially reduced rates of illness and lengthy hospital stays compared to those born at 34 weeks.

Preterm infants born to isolated, impoverished mothers are at risk for unfavorable outcomes; most others can “catch up” developmentally.

Question 21

Interventions for Preterm Infants

Answer 21

Isolette

Respirator

Feeding tube

Special infant stimulation

Kangaroo skin-to-skin contact

Parent training in caregiving

Question 22

Influence of Early Intervention for Low-Income, Preterm Babies on Intellectual Functioning
at Age 8

Answer 22

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