Chapter 4; Part 1 Flashcards
Stages of Childbirth:
Signs that labor is near…
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
The 3 Stages of Labor
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.
Baby’s Adaptation to Labor and Delivery
Healthy babies are equipped to with stand this trauma
High levels of infant cortisol and other stress hormones help!
The APGAR scale
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Approaches to Childbirth
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)
Elements of Natural or Prepared Childbirth
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
Approaches to Childbirth: Elements of Natural, or Prepared, Childbirth
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.
Home Delivery
Who should not have a home birth?
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.
Medical Interventions
Fetal monitoring Medication § Analgesics § Anesthetics Instrument delivery
Induced labor
Cesarean delivery
Fetal Monitoring
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
Analgesics & Anesthetics
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
Instrument Delivery
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
Induced Labor
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
Cesarean Delivery
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)
Why wait until 39 weeks?
Do it!
Birth Complications:
Oxygen Deprivation
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
Preventing Brain Cell Death from Anoxia
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.
Birth Complications:
Preterm and Small-for-Date Babies
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.
Preterm Infants
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.
Interventions for Preterm Infants
Isolette
Respirator
Feeding tube
Special infant stimulation
Kangaroo skin-to-skin contact
Parent training in caregiving
Influence of Early Intervention for Low-Income, Preterm Babies on Intellectual Functioning
at Age 8
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