Lecture 4 Flashcards
Birthing Practices
- 99% of US births in Hospital
- 91% by physicians
- Most of the world are from Midwives
- US 8% midwives
US Certified Nurse Midwives
Deliver babies. More time with patient, emotional support, counceling education
Doulas
- No Medical care - do NOT deliver
- Support before, during and after birth (physical, emotional, educational)
- In US they work independently (part of a “birthing team”
Natural Childbirth
Goal: reduce pain by reducing fear
- education, breathing techniques, relaxation technique
Prepared Childbirth (Lamaze method)
- Similar to natural childbirth
- special breathing technique for last part of labor
3 Stages of Birth
Stage 1: 12-24hrs
Dilation and effacement of cervix
Stage 2: 45 minutes
Delivery of the baby. Begins when baby’s head moves through the cervix and birth canal. Ends when the baby emerges
Stage 3: minutes
Placenta (afterbirth), umbilical cord are dispelled
Effacement of the Cervix
- Cervix becomes thinner and shorter
- Starts a couple of weeks before delivery
Cooking up Placenta
- Can be dangerous, filled with toxins (lead, mercury)
- Can be cooked or made into pills
Cesarean Delivery
- Baby removed from uterus through abdomen
- baby is in breech or crosswise
- head too large
- vaginal bleeding
- US C Sections are increasing
Types of Breech
Complete Breech
Incomplete Breech
Frank Breech
APGAR Score
(NEWBORN HEALTH ASSESSMENT)
APPEARANCE, PULSE, GRIMACE, ACTIVITY, RESPIRATION
Sore:
- Heart rate
- Respiratory effort
- Muscle Tone
- Blue Color
- Reflex Irritability
Preterm and Small for date infants
Low birth weight - Under 5.5lbs
increased use PRGESTRIN for preterm
Very low - under 3lbs
Extremely low - under 2lbs
Premature baby 1st minutes
- 28weeks 2 days, 2.95lbs
- premature babies prone to infection and one germ can kill them
- plastic around the baby to protect body heat
- Blue light is used for jaundice
- Quiet in the nursery sleeping which is very import to health and development
Premature Baby 1st minutes contd.
New:
- BIOSENSORS - like stickers, monitor vital signs
- NTRAINER - pacifier like device, helps with breathing and sucking at same time
Preterm and small weight Consequences
- most premies grow up healthy and normal
- more developmental and health problems
- Norwegian Study : language delays, learning problems, behavior problems
Bonding
- Close connection, especially physical, between parents and newborn
- doctors suggest “rooming in” (kept in mother’s hospital room)
- Immediate Bonding: Not necessary for emotional health
Postpartum Depression
- mothers adjust physically and psychologically to process of childbearing
- last about 6 weeks
INVOLUTION: Uterus returns to pre-pregnant size 5-6 weeks
POSTPARTUM DEPRESSION (contd)
- hormonal changes
- Fatigue
- Inadequate rest
- inexperience or lack of confidence
- extensive demands may cause: anxiety, depression, coping difficulties
GETS WORSE WITHOUT TREATMENT - NOT the baby blues
Emotional and Psychological Adjustments
Postpartum Treatments:
- antidepressants, COGNITIVE THERAPY IS BEST
Depression affects:
- Mother/Infant interaction
- Risk of additional psych disorders
Baby Blues
Appears 2-3 days after birth, and only lasts 1-2 weeks
70% experience this
Father’s Adjustments
Considerable adjustments & Stress
- more focus on infant, feels neglected, unneeded, NO SEX
Father’s reactions
- Prenatal involvement can lesses feelings of depression
Infant Nutrition and Health
1st year:
triple in weight, increase 50% in length
- high calorie food (NO non-fat)
Healthy Infants Need
- Loving supportive environment
- Breast Milk
- Gradual Increase of chew and swallow (not too early, can choke)
- more fruits and vegetables
- Demand Feeding more popular (when baby cries, you feed them)
- Poor Dietary can cause overweight
Co-Sleeping
- Sharing bed common in many cultures
- Can be dangerous (crushing)
- STRESS and SIDS
SIDS (SUDDEN INFANT DEATH SYNDROME)
- Infant stops breathing, usually during night, without cause
- Highest risk of death
- Sleeping on back helps
- have a fan
SIDS Risks
Highest Risks:
- lower birth weight
- siblings with SIDS
- Sleep apnea
- Exposure to cig smoke
- Poor People
- Soft bedding
- Abnormal brain stem
- African American and Inuit Infants
Breast Milk
- Fewer Gastro infections
- Lower Resp tract infections
- Reduce effects of asthma
- Lower risk of diabetes
- Less SIDS
Infant Sensation & Perception
Sensation - what senses are coming in (sight, smell, taste, etc)
Perception - interpretation of what is sensed (color=blue)
Habituation
Babies get bored with same stimuli after time. Change the stimuli
Touch
Stimulates Growth
- failure to thrive syndrome (orphanage in romania)
Smell and Taste
Sense of Smell and Taste right away
Hearing
Can hear at 7 months in utero
Vision
Robert Frantz: Looking Chamber, prefer patterns
6 months, vision is like an adult, can’t see color initially
Infants prefer to look at normal human faces. Like pretty faces
