Birth and the Newborn

Baby Chapter 5

Childbirth and Culture: How Birthing Has Changed Home Deliveries Midwives Reducing the Risks of Childbirth

Antibiotics Safe anesthesia Improved hygiene Drugs for inducing labor

Childbirth and Culture: How Birthing Has Changed Contemporary Settings for Childbirth

Hospital Home births with a trained nurse-midwife Homelike birth centers

Rooming-in policies “Demedicalizing” and “humanizing” the

experience

The Birth Process Labor Parturition

Begins about two weeks before delivery Uterine, cervical and other changes occur False contractions (Braxton-Hicks)

The Birth Process Stages of Childbirth

Dilation of the cervix Lasts 12 to 14 hours

Descent and emergence of the baby Lasts 1 to 2 hours

Expulsion of the placenta Lasts 10 minutes to 1 hour

The Birth Process

Electronic Fetal Monitoring Tracks the fetus’s heartbeat

during labor and delivery Externally or internally Telometry

Sends information remotely

The Birth Process Vaginal Versus Cesarean Delivery

Vaginal is the usual method Reasons for Cesarean

Labor progresses too slowly Fetus seems to be in trouble Vaginal bleeding Breech or transverse position of baby

The Birth Process Medicated Versus Nonmedicated

Delivery Natural childbirth

Lamaze method Medicated

Local Pedunal block

Analgesic Regional

Epidural or spinal

The Newborn Baby Adrenaline and Noradrenaline Are

Produced by the Baby’s Body During Birth Causes lungs to clear Mobilizes stored fuel to nourish cells Sends blood to the heart and brain May promote bonding with the mother

The Newborn Baby Size and Appearance

Neonates in the U.S. average about 7 ½ pounds and 20 inches long

Large head ¼ the body length Red skin Birthmarks Receding chin

The Newborn Baby Size and Appearance

Misshapen head (lasts about 1 week) Soft spots (fontanels) Lanugo Vernix caseosa

The Newborn Baby Body Systems

Most babies begin breathing soon after they are exposed to air If over 5 minutes →anoxia or hypoxia

Most other systems begin functioning 4 to 6 hours after delivery Nourishment Elimination of waste Temperature regulation

The Newborn Baby Medical and Behavioral

Assessment Apgar Scale

Appearance (color) Pulse (heart rate) Grimace (reflex

irritability) Activity (muscle tone) Respiration (breathing)

The Newborn Baby States of Arousal and Activity Levels

State of arousal is inborn Most new babies spend 75% of their

time asleep Alternates between quiet and active

sleep As the child grows into toddlerhood its

sleep time decreases Sleep schedules vary across cultures

States of Arousal

Complications of Childbirth- And Their Aftermath Low Birth Weight

Usually from inadequate prenatal nutrition

Preterm (premature) infants → under 37 weeks of gestation

Small-for-date 12.5 percent of U.S. infants are preterm 8.1 percent have low birth weight

(under 5 ½ pounds)

Complications of Childbirth- And Their Aftermath Low Birth Weight

Factors concerning having a low-birth-weight baby Demographic and socioeconomic factors

13.7 percent of African American babies have low birth weight

Medical factors predating the pregnancy Prenatal behavioral and environmental factors Medical conditions associated with the

pregnancy

Complications of Childbirth- And Their Aftermath Low Birth Weight

Immediate treatment and outcomes Feeding intravenously Place infant in an isolette Administering surfactant

Complications of Childbirth- And Their Aftermath Low Birth Weight

Long-term outcomes Adult-onset diabetes Increased risk of cardiovascular disease In extremely low-birth-weight infants:

Neurological Sensory Cognitive Educational Behavioral

Complications of Childbirth- And Their Aftermath Postmaturity

42+ weeks’ gestation Tend to be long and thin Complicates labor Risk of brain damage or death Induction of labor is common

Complications of Childbirth- And Their Aftermath Stillbirth

Death of a fetus at or after the 20th week of gestation

Perinatal death Death of a baby within 24 hours after

childbirth Women over 35 or under 20 have higher

risk

Complications of Childbirth- And Their Aftermath Can a Supportive Environment

Overcome Effects of Birth Complications? Infant Health and Development Program Kauai Study

Protective factors

Newborns and Parents Childbirth and Bonding

Mother-infant bond Ethological approach Evolutionary perspective

Imprinting Konrad Lorenz

Newborns and Parents What Do Newborns Need From Their Mother?

Harry Harlow’s experiment Comfort of close bodily comfort

Father’s Role Differs by culture Changed much since mothers began to work

outside the home