Signs that labor is approaching: Lightening The show Braxton-Hicks or prelabor contractions Regular contractions Rupturing of the amnio-chorionic membrane

What is a contraction? A contractions is a pain that is felt during labor when the muscles of the uterus tense

Difference between Braxton-Hicks and real labor contractions: As labor progresses the contractions come closer together. They continue rhythmically, an become stronger. That’s how a woman can distinguish between labor contractions and prelabor contractions. Prelabor contractions remain equal in intensity from the start. They occur irregularly, are not rhythmical, and stop if a woman changes position.

Why fill out hospital forms early? A couple might fill out the admittance forms early so they can get it out of the way. This makes admittance easier when the woman is in labor.

What is electronic fetal monitoring? Electronic fetal monitoring is the use of various electronic devices to measure the woman’s contractions and the baby’s response to them It is used to check how the baby is doing during labor and delivery.

The four types of medication for labor: General anesthesia – puts the mom to sleep for a period of time. Do not feel pain, but miss out on birth experience. Health risks involved! Regional anesthesia – takes away feeling in one region of the body (i.e. epidural) Local anesthesia – takes away pain in a small area Analgesics – dull pain, but do not take it away entirely; less side effects and risks

Epidural Very expensive Only administered by anesthesiologist Continuous feed line of medication that numbs from the waist down Not administered until at least 4 cm

Birth Decisions: Traditional childbirth Family-centered childbirth Lamaze method Prepared childbirth Leboyer method Breech delivery Cesarean delivery

C-Section (Cesarean Section) Delivery of a baby through a surgical incision in abdomen and uterus. Riskier and longer recovery Significantly high percentage (30%) in our country Sometimes scheduled in advance; or as a response to unforeseen complications Prolapsed cord Poor presentation Mother too small or baby too big Placenta previa or abruption Fetal distress STDs Previous C-section Toxemia

What happens when the baby is born? Baby is washed Baby is weighed and measured Apgar test is given or the Brazelton scale Identification bands are given Baby is given eyedrops Baby is given tests for PKU and anemia Circumcision

Test for newborn baby: Brazelton is more in depth and extensive Apgar is done to assess the need for immediate care, Brazelton identifies problems that might not need immediate medical attention

Reasons a baby might need immediate medical attn: The baby is born prematurely The baby had a low birth weight The baby was born addicted to illegal drugs The baby scored very low on an Apgar test NICU – Neonatal Intensive Care Unit

What is ‘postpartum’? The postpartum period is the time in which the mother’s body recovers and heals from pregnancy. It last about six weeks. The postpartum checkup is important because it helps the mother know how well she is recovering. It is also an opportunity for her to ask any questions she may have.

Water Birth Method Mother gives birth in a tub/pool filled with warm water Calming for mother and baby Why don’t they drown?! Natural Dive Reflex

Water Birth Conditions Everything has to be going terrifically for the baby to be born in water. Baby's heartbeat has to be reactive, Do not attempt if high-risk. More acceptable but still unconventional and considered risky; not recommended by the American College of Obstetricians and Gynecologists. Talk to caregiver about the risks and benefits. http://www.babycenter.com/2_live-birth-water-birth_3658855.bc When the baby moves, the heart rate goes up. And there's no areas where the baby's heart rate is going down and that your blood pressure's normal and everything's good! prenatal issues such as diabetes, high blood pressure, or preeclampsia; you plan to use any pain medication; or your labor will be induced

Midwifery Midwife – low risk pregnancy; emphasis on emotional and natural support Obstetrician – medical approach; can perform a caesarean section or other medical procedures (care of pregnant women and delivery of babies) Pediatrician – physician who specializes in the care of infants and children

If no lightening….

Inducing Labor Definition: To bring on (induce) contractions naturally or with medications WHY? You are one to two weeks past your due date Water broke and labor did not begin Placenta is failing to function properly Preeclampsia Illness threatens your health or the baby’s Previous stillbirth

Stage One: Dilation Dilation – cervix opens from 0 to 10 centimeters Effacement – cervix relaxes and thins Transition – the fetus begins “transitioning” or moving into the birth canal Mother starts to feel the urge to push

Stage Two: Delivery Begin to push Fontanels – soft spots that overlap to fit the skull through the birth canal. Crowning – when the widest point of the babies head is visible

Stage Two: Delivery cont. Forceps or the use of a vacuum might be used to aid delivery

Episiotomy Incision to prevent tearing Natural tearing takes a longer, less successful recovery

Stage Three: Afterbirth Placenta detaches and is expelled Umbilical cord, amniotic sac, and lochia also expelled 5-10 minutes of contractions and pushing Usually not difficult or painful

APGAR scoring Score given at 1, 5, 10 minutes after birth of the child Assists doctor to determine status of child Each component is worth 2 pts

APGAR cont. Respiration Color Heart Rate Reflex Muscle Tone 7 + is good, normal

Postpartum Period 1-3 days in hospital is normal Full recovery from pregnancy and birth can take several months, especially the first 6 weeks or postpartum period Involution – reproductive organs return to normal size Lochia – lining of the uterus sloughs off; bloody discharge Afterpains – contractions that help uterus return to normal cramps

Postpartum cont. Walking and getting up/around usually helps recovery Psychological effects “Baby Blues” Fathers’ emotions

Bonding Definition: A closeness for another person (love, caring, concern) Day-to-day interactions and affection Feeding, touching, playing Can you think of other examples?

Bonding cont. Having father present for birth is believed to improve his bond with the neonate Factors that negatively affect bonding Premature babies Vey expensive child (hospital/doctor bills) Colicky child Mother’s health Conflict within the couple Child appearance “Imagined Child”

“Failure to Thrive” Lack of touch and bonding can lead to the actual death of a child. Bonding is essential. Increased healthy bonding improves mental, physical, emotional development and beyond.