Birth

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CHAPTER 5

• Birth

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EXPLORING THE BIRTH PROCESSSTAGES OF BIRTH

• First stage lasts 12 to 24 hours with uterine
  contractions beginning.
• Second stage Babys head moves through cervix
  and birth canal baby is born.
• Third stage (afterbirth) is expelling of
  placenta, umbilical cord, and other membranes.

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The Fetus/Newborn Transition Baby undergoes
considerable stress during the birth process.
Large quantities of adrenaline and hormones are
secreted to protect the newborn.
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Childbirth Strategies and Decisions U.S.
mothers predominantly have their babies in
hospitals with physicians (99 percent).
Hospitals are becoming more sensitive to the
needs of the family by creating birthing centers
and attempting to re-personalize the process.
More midwives are involved.
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Delivery Methods

• Medicated Analgesia to relieve pain
• Natural Increased education on birthing without
  medication (Lamaze, Dick-Read)
• Cesarean Necessitated by babys position,
  mother condition, and/or physical capability
• Fathers More involved often the coach
• Siblings Attempts to be more sensitive to their
  needs educating parents on the impact.

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Low-Brithweight Infants weigh less than 5.5
pounds at birth. One in 13 babies born in the
United States is low-birthweight.

• Preterm infants born three weeks or more before
  full term
• Small-for-date infants birhtweight below normal
  some may be full term

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Long-Term Outcomes for Low-Birthweight Infants
Normal and healthy, but more apt to have
developmental problems. Brian weight is
correlated with cerebral palsy and/or increased
likelihood of brain injury. More likely to have
liver and lung diseases. More likely to have
learning disabilities. Some low-birthweight
deficiencies can be reversed.
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• Stimulation of Pre-term Infants Adverse effects
  of maternal deprivation reversed practice of not
  stimulating pre-terms. Very immature infants
  should not be stimulated. Behavioral cues may
  determine appropriate stimulation. Sensitivity
  to socioeconomic and cultural factors.

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MEASURES OF NEONATAL HEALTH AND RESPONSIVENESS

• Apgar scale is generally used to determine an
  infants immediate health status heart rate,
  respiratory effort, muscle tone, body color, and
  reflex irritability.
• Brazelton Neonatal Behavioral Assessment Scale
  27 evaluations to measure reflexes, responses,
  and general neurological development.

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• THE POSTPARTUM PERIOD
• The six-week period following birth in which the
  mother adjusts physically and psychologically to
  the birth process.

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Physical Adjustments

• Involution uterus returns to pre-pregnancy
  stage.
• Hormone production is interrupted and must
  recover.
• Exercise greatly aids quick return to physical
  strength and body tone.

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Emotional and Psychological Adjustments

• Emotional fluctuations caused by hormonal shifts.
• Depression, worrying, appetite change, crying
  spells, and sleep irregularities are all
  possible.
• Return-to-work factor must be considered.
• Fathers reaction to wifes attention to newborn.

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Bonding the close physical and emotional
contact between infant and parents

• Bonding may be thwarted by the use of drugs
  during delivery.
• Research is conflicted on the importance of
  bonding.