Final Exam Flashcards
Umbilical cord
The cord that joins the fetus to the placenta, providing nutrients and enabling wastes to be eliminated
Urination
The act of urinating, or expelling urine
Uterine Rupture
A pathological condition describing a complete tear of the uterine wall. If a woman has had a previous c-section, there is a risk that the uterine can rupture during a subsequent labor, especially if medication is used to stimulate stronger contractions if the woman has an induction of labor
Uterus
The bag of muscles where the fetus develops. Also called the womb.
Vaginal Examination
A digital (with fingers) examination to assess cervical dilatation, length and position
Vertex presentation
A position adopted by the baby in the uterus, where the back or top of the baby’s head is presenting against the cervix.
Womb
The bag of muscle where the fetus develops. Also called the uterus
Xray Pelvimetry
Using X-ray, this technique measures the size of the woman’s pelvis to deterine whether or not a baby can fit through durig birth. This method was commonly used for breech babies but has come into disuse as there has been no evidence shown for its benefit.
Why has American Infant Mortality increased slightly in the last decade?
More babies being born prematurely to older women, more babies are being born to women carrying multiples.
What has replaced birth defects as the most common reason babies die?
Prematurity
About how many children annually are born too early in America?
400,000
What did a 1912 New York campaign promote that resulted in a decreased rate of newborn deaths?
Sending nurses to visit new mothers at home
For all the perils a woman might face, birth is more than how many times deadlier for the baby?
100
What were the two greatest causes of mothers dying in childbirth in the 1930s?
Infection and botched abortion
In the 1930s, which kind of drugs began fighting infections saving tens of thousands of women who would have otherwise died of puerperal sepsis?
Sulfa Drugs
According to Marshall Klaus, if mourning is impeded after the loss of a child, and not allowed to run its course, what kind of grief can result?
Pathological grief
In what kind of societies is there rarely any help for women in birth and many die?
Societies with poor living conditions and patriarchal societies.
At what time of the day do mothers prefer laboring?
through the night
Many women tend to give birth at what time in the day?
In the morning
What does CPD stand for, and what does it indicate?
Cephalopelvic Disproportion. Indicates a baby being too large to fit through the mom’s pelvis no matter what is done to help.
What is the average weight for an American and Britain newborn?
7 pounds 8 ounces
What is the average newborn weight for babies born in India?
6 pounds
What bone softening disease is responsible for deforming women’s pelvises, resulting in countless deaths for mother and baby?
Rickets
What two vitamin deficiencies contribute to Rickets?
Calcium and Vitamin D
What does the term midwife mean in Old English?
With women
In what year were midwives delivering only half of all American babies?
1910
By 1973, midwives were handling less than what percent of U.S. deliveries?
1%
What percent of births are midwives attending in the United States today?
About 10%
About how many nurse-midwives are currently practicing in the U.S. today?
6,000
How many lay midwives are estimated to still be working in the U.S. today?
2,000
Who was Raven Lang?
A famous lay midwife who started a birth center out of her Santa Cruz, California home.
Who was Mary Breckinridge?
An upper-class woman who rode horseback to help the poor of the Appalachian mountains and was the first American women to train as a nurse-midwife.
Who was Madame du Coudray?
A young, single, and childless woman appointed to train other midwives as the first national midwife.
In Southern America, plantation masters had their slave women give birth in:
Horse stalls, where babies often contracted tetanus
In Europe and Early America, there would be so much chattering and sharing of information during labor that “God-sibs” or sisters in God would become the basis for what word?
gossips
Which was NOT a popular place to give birth at home?
On a pile of straw in the living room
18th Century industrialization in Europe and America opened hospitals devoted solely to helping expectant mothers where only what kind of women checked in?
Impoverished and unmarried
What was childbed fever, how was it spread and what is it known as today?
Uterine infection, spread by doctors not washing hands, known as maternal sepsis
The epidemic of childbed fever was occurring mostly in women who had chosen to
Deliver in the hospital
When what became widely available, childbed fever became less deadly?
antibiotics
Who was the Scottish scientist that first proved that childbed fever was a result of doctors not washing their hands after examining sick patients?
Alexander Gordon
The obstetric ward’s obsession with sterility had changed birth so entirely that it lead to
Forms of torture in modern delivery rooms and the use of stirrups, cuffs and steel clamps to restrain laboring mothers
Despite the evidence to the contrary, women still believe hospitals are the safest choice and what percent of North American and British women today choose to deliver in a hospital?
98%
The first model birth center was opened in 1975 by Ruth Lubic, in an upper East Side NY town house. What was it called?
The Childbearing Center
What percent of women report giving birth without any pain?
2-3%
What was the name of the famous American obstetrician who devised the “forceps operation” because he believed giving birth felt like falling on a pitchfork and was painful for the baby?
Joseph B. Delee
What percent of women today ask for an epidural when pain in birth becomes too intense?
90%
What is the name of the English obstetrician who said birth “should feel like a normal and natural defecation,” and blamed fear and tension for women’s suffering during labor?
Grantley Dick-Read
By the early 1930s, hospital delivery rooms were so full of inhaled or injected drugs that mothers almost always gave birth while heavily medicated—this method persisted as late as the:
1970s
Where in the world can a birthing woman reach for a mask and inhale nitrous oxide or laughing gas?
the US and UK
What is the famous name attributed to the effects of the drug cocktail that combined morphine and scopolamine?
Twilight Sleep
Pain in birth is often greatest among what 5 groups?
First time mothers Young mothers Large babies Previous menstrual issues Unprepared for what to expect
Who was the first doctor to use diethyl ether during labor, on a woman with a pelvis deformed by rickets?
James Young Simpson
Define and describe the pain relief method known as TENS.
transcutaneous electronic nerve stimulation a handheld device the size of a camera sends buzzing impulses through wires taped to one’s back. The impulses were supposed to tell the brain to release natural opiates and endorphins
Who formulated his own method of drug-free births involving a mastery of certain breathing and relaxation techniques?
Fernand Lamaze
Who inspired the Hypno-Birthing Method, where one can achieve painless childbirth
Grantley Dick-Read
Who was the first doctor to diagnose anemia in pregnancy?
Walter Channing
Who pioneered the method of administering pain relief using a needle in the back?
Karl August Bier
Before surgery became routine to extract a stuck fetus, what procedure would have been performed during birth with a baby presenting headfirst?
Craniotomy
The latin for cesarean section is “ceaso matris utero” meaning?
“cut from mother’s womb”
A record high of what percent of babies arrive by cesarean section in the United States today, making the operation more common than the appendectomy or tonsillectomy?
32.8%
Which extraction procedure is still used today in some developing countries?
Symphysiotomy
Cesarean section rates should be within a national average of what percent?
5-10%
According to the World Health Organization, the cesarean rate should never exceed what percent?
15%
What American doctor gave German doctor Max Sanger the idea to use antimicrobial silver wire thread to close the uterus after a cesarean to prevent infection?
J. Marion Simms
Which city has the highest cesarean rate in the world at 98% and why?
Rio de Janiero, women want to keep vaginas intact due to men’s preference and their cultural treatment of women.
List the two reasons almost all breech babies in America are delivered by Cesarean.
a. Lack of familiarity with the procedure among OBs; b. fear of litigation
After a cesarean, the mother is more prone to develop what?
Placenta abnormalities, post-partum depression, infertility
What percent of births involve serious medical complications that are best managed with a medical and surgical approach?
5-10%
The most common reasons for C-section are what?
Failure to progress, fetal heart rate concerns, repeat cesareans, maternal and fetal health issues, breech babies
What is the Latin root meaning of the term “obstetrician”?
to stand before
What two countries are the only countries in the world where highly trained surgeons attend the majority of normal, low-risk births?
United States and Canada
What is a good question to ask to find out if an individual obstetricians or hospital is practicing modern maternity care?
What position do women give birth in?
List the 5 different roles OBs attempt to juggle competently on a daily basis?
- All normal pregnancies, 2. All high risk pregnancies, 3. Women’s Gynecological health, 4. Women’s diseases, 5. Trained and competent surgeons
Which obstetrician allowed 28 men in to witness a birth, nearly causing a neighborhood riot and rushed the delivery breaking the baby’s thigh bone?
William Smellie
Which OB is known for his legacy of having women deliver lying down in bed rather than upright, on a birth stool?
Ambroise Pare
What can we learn as women advocates in birth from Dr. Mary Dixon-Jones, who urged against a craniotomy for a live birth, saving both mother and baby?
Speak up! it saves lives.
Who are the professional ancestors of obstetricians?
Barber-surgeons
What does Friedman’s Cervimetric Curve measure?
The average length of time of the three stages of labor.
Which obstetrician said, “A doctor, when called to a delivery must do something. He cannot remain a mere spectator”.
Walter Channing
In what year did most U.S. hospitals sponsor childbirth classes/prenatal courses?
1975
Which physicians devised a simple test to evaluate the condition of babies after birth whose mothers were anesthetized during birth?
Virginia Apgar
Which OB can we thank for adding stirrups to the birthing beds and for capitalizing on the practice of episiotomies arguing that they actually prevented tears?
Joseph B Delee
Whose ideas about birth helped launch the era of childbirth classes in the U.S.?
Fernand Lamaze
OB Grantley Dick-Read was known for:
a. theorizing that if women could let go they would experience less pain, stronger contractions
b. Believing breastfeeding was essential
c. Encouraging mothers to keep babies with them
d. Suggesting post-partum hemorrhage isn’t seen when mothers hear their babies cry.
Who introduced the idea of birthing pools and home-like birthing rooms in maternity hospitals?
michel Odent
Which OB invented a speculum to help see damaged tissue and devised a way to close fistulas without causing infection?
J. Marion Simms
American episiotomy rates were 90% in the 1970s and were what percent by 2000?
20%
Which obstetricians was haled as the dean of American midwifery and taught his all-male classes that “a woman has a head almost too small for intellect and barely big enough for love”?
Charles Meigs
In Colonial America, Doctors believed what procedure was the answer to prevent or treat various birth complications for a laboring woman?
Drawing her blood
Which obstetric tool had an L-shaped blunt hook and was used to help dislodge, but not destroy, a stuck baby?
The Lever
Which obstetric tools were not always the life-saving instruments many hoped them to be, causing maternal lacerations, infection, and damage to babies’ brains, eyes, noses, and facial nerves?
forceps
What percent of U.S. women today give birth assisted by a vacuum?
4%
What percent of U.S. women today give birth assisted by forceps?
1%
What coincided with the use of vacuum assisted deliveries becoming more popular in birth?
Widespread epidural use, which diminished the woman’s ability to successfully push
Which obstetric tool is least likely to cause maternal and fetal injury during birth?
Vacuum
True or Fale
The U.S. Food and Drug Administration states that, “Women should avoid unnecessary ultrasound and that 3-D pictures are unapproved use of medical advice.”
True
Labor induction is an ancient routine practice typically performed because of what two reasons?
The mother was ill or the fetus was dead
Today as many as what percent of hospital births are found to be artificially induced or augmented?
40%
What is the name of the fungus that was administered in ancient times and is still used today to help induce a woman’s labor and/or stop postpartum hemorrhage?
Ergot
Although doctors are likely to induce mothers who go past their 40 week due date, statistics show that how many of all healthy first-time mothers have pregnancies that last longer than 41 weeks?
Half
Which of the following fads are no longer routinely seen in hospital births today?
a. Shaving of pubic hair
b. Enemas
c. Use in incubator baby boxes
d. Women lying flat on their backs
A & B
Which of the fads in birth was thought to prevent infection but actually invited it?
Shaving
What is the name of the effect by which women naturally gravitate towards water to help ease their labor pain and further dilation?
Aquadural Effect
Why have midwives adopted dolphins as assort of mascot?
They are the only mammals that support each other in birth.
Which is a term for a birth in which the mother and/or her partner do not want any medical assistance at all?
Unassisted Birth
What worldwide doula organization are maternal bonding experts Klaus and Kennel, along with other nationally respected childbirth experts, responsible for starting?
DONA, Doulas of North America
Why did some midwives cut the cord without first tying a string around it?
Believed blood would drain from the baby so it wouldn’t poison it. They believed it could prevent smallpox
What famous French Midwife tied to the cord tot he mother’s leg before the placenta was expelled?
Louise Bourgeois, out of fear the mother would choke
What was the death rate among newborns in Indian villages in 1965?
14% due to Tetanus, dressed the cord stump with a mixture of cow poop, straw, and dirt.
How long do doctors routinely wait to cut the cord? Why?
30 seconds or less. They are concerned that allowed too much blood flow from placenta can raise infant’s blood pressure.
Why is it helpful to the mother to wait until the cord stops pulsing?
Placenta shrinks as it pumps out blood, making it easier to deliver.
Delaying cord cutting how long for babies born before 27 weeks is helpful?
30 to 120 seconds
Who advised giving sneezing powder to the mother?
Hippocrates
What is the practice of eating the placenta?
Placentaphagy
Why do scientists believe animals eat the placenta?
so the scent will not attract predators, or new mothers are hungry and placenta is full of nutrients
What is the placenta full of that can help prevent postpartum hemorrhage?
oxytocin
Why do some women eat their placenta?
boost fertility
When did placentaphagy become part of radical home birth customs, and where?
1970s, San Francisco Area
Why was the placenta considered sacred?
nothing was killed to put it on the table and it gave life.
When and who fried his partners afterbirth and served it to dinner guests?
1998, Hugh Fearney-Whitingstall
What is the latin word from which placenta was derived?
“cake”
Who named the organ?
Gabriel Fallopio
How many days were women considered polluted in Europe?
40 days
What was the standard lying in time in hospitals in Europe and North American in 1937?
2 weeks
What caused doctors to send mothers home sooner?
WWII and a need for hospital space
What did the 1944 study report about the postpartum period?
If women were allowed to walk around within 3-4 days after birth they had no uterine prolapse or blood clotting, and were generally healthier.
Why are hospitals stays becoming shorter?
Insurance companies and women don’t want birth to be treated like an illness
What percent of a hospitals total revenue is acquired from maternity care services?
65%
Why did hospitals forbid mothers and babies from lying in together?
Fear of infection
What intricate antisepsis routines did they follow?
Washing the mother’s perineum with Lysol every 4 hours and cleaning her nipples with boric acid solution before and after feeding.
What did nurseries lead to?
Impetigo, diarrhea, and respiratory illnesses
When was the concept of rooming in introduced?
WWII era, hospitals crowding forced facilities to have mothers and babies together.
By 1958, how many hospitals allowed mother and child to remain together?
Only 300 out of 3,000 surveyed
Whose hunch about the lack of immediate contact between mothers and babies was correct?
Klaus
Why is contact good for babies?
Improves relationships, increases IQ scores, keeps families intact, and reduces the likelihood of child abuse.
When did the American Medical Association decide that bonding immediately after birth should be standard in U.S. Hospitals?
1970
How is bonding facilitated?
Immediate skin-to-skin contact, minimizing newborn crying, encouraging the baby to nurse.
What hormone is stimulated by breastfeeding?
Oxytocin
What 1990 initiatives recommended hospitals close nurseries and stop offering bottles and pacifiers?
UNICEF, “Baby Friendly Initiative”
What practices were alive toward newborns in the US in the 1930s?
holding them upside down by their feet and spanking them to get them to breath
When did this practice change and why?
1970s, Frederick Leboyer’s theory that newborns were acutely sensitive
Who was Frederick Leboyer
Wrote a book: Birth without violence; said doctors should cut cord only after it stopped pulsing. massage the baby as it lay skin to skin, immediate warm baths
What study found that Leboyer baths made little difference?
1980 Canadian study
What long lasting ideas emerged from Leboyer’s theories?
no longer holding babies by the ankles and spanking them, lights kept dim
What was the mortality rate among the 10,000 handfed infants in Dublin in 1775-1776?
99.6%, only 45 survived infancy
What complications came from allowing a child to suckle directly from an animal?
milk could be hard to digest
What problem did mothers face when they didn’t breastfeed?
potentially fatal breast infections from stagnating milk
What were some reasons a woman couldn’t breastfeed?
Clef palate, mother ill, forced to work, inverted nipples–these often led to a wet nurse
Of the 20,000 babies born in Paris in 1780, how many were nursed by the mothers?
Only about 1,000
Why was wet nursing desirable for the poor?
It usually paid more than any other work
What were milk banks?
An outlet for overproducers, first established in Vienna in 1909
What babies were milk banks for?
sick, orphaned, premature, multiple birth babies
What forced the closure of many milk banks?
AIDS in the 1980s
How many milk banks are there in the U.S. and Canada?
About a dozen
Who came up with formula?
1876, Henri Nestle, cow’s milk, flour, potassium bicarbonate, and malt. It was expensive and difficult for mothers to mix. He found a simplified way and tested it on a gravely ill infant who took to it.
What were “milk nurses”?
Women paid on commission to visit mothers in hospitals and sell formula.
What issues caused germs to breed in the formula?
Inadequate refrigeration, bad water, lack of proper bottle sterlization
What was summer complaint?
Potentially fatal diarrhea caused by formula contamination
What made it fashionable for women not to breastfeed as the 20th century progressed?
milk stations and hospital nursery policies
What percent of mothers were breastfeeding by 1956?
Only 20%
Who held the first La Leche League meeting in her Illinois home?
Mary White
Who spoke to a packed house in 1957 about breastfeeding as a part of natural childbirth?
Grantley Dick Read
When did breastfeeding rates begin to rise?
1972, 3% per year through the end of the decade
How did formula companies respond?
Marketing to the undeveloped world, arguing it fought malnutrition
When was “the baby Killer”?
A report published in 1974 whose cover featured the drawing of a malnourished black baby crying inside a bottle
What percent of US mothers breastfeed today?
70%
What are lactation consultants?
Professionals who teach mothers how to get a baby to latch on and promote her own milk production
The dropping levels of what hormones lead to the Baby blues?
Progesterone and estrogen
What percentage of women suffer from serious postpartum depression?
10-20%
What is postpartum psychosis?
Includes hallucinations and suicidal actions
When did postpartum depression begin to attract serious attention?
The 1960s-70s
What percentage of women in Uganda develop postpartum depression in 1988?
10%, compared to 13% of Scotland counterparts
Why were men banned from birth places?
women’s modesty, unclean and dangerous, what did they know that a midwife didn’t?
Why did sex aid labor?
prostaglandins, which help the cervix open and soften
When did men begin to be inviting to participate in prenatal classes?
1953, NYC hospital
In 1961, how many fathers remained with their wives?
half
How long did hospitals resistance to father’s last?
Into the 1960s
Who concluded that a spouse’s presence could be helpful, and when?
Dr. Robert Bradley, 1940s
What rate of births are unmedicated using the Bradley Method?
90%
When did hospitals permit most dads to come, with the exceptions of c-sections and those who weren’t married?
1970s
At the end of the 60s, how many men attended births of their children?
15%
What does Couvade mean?
To hatch; psychologists believe it shows if the dad is psychologically connected to his partner
What hormonal experiences are thought to lead to couvade?
Drop in testosterone and rise in estrogen
In 1960, how did men feel about birth?
They said they were happy to be there, though when question alone they said it is something they could have missed
Why did Michel Odent stay out of the delivery room for his children’s birth?
Hinder labor and may be contributing to c-section rates; might try to talk rationally to the woman in labor; might hinder the couple’s sexual relationship
