11/23/2018 Labor and Delivery Chapter 6.1

The Beginning of Labor During last few weeks, time often seems to slow down for expectant mother Many women become anxious for baby to be born During this time they may feel lightening This occurs when the baby settles deep in the pelvis near the time of birth Because the baby has moved down, the pressure on the women’s upper abdomen is reduced, or lightened

Early Signs of Labor Many signs that the baby is on its way “Show” or “bloody show” Few drops if blood or a pinkish vaginal stain that occurs when the mucus that plugs the uterus during pregnancy dissolves Water breaks When women feel a trickle or gush of warm fluid from the vagina This indicates that the membrane, or amniotic sac, holding the fluid around the baby has broken Contraction Tightening and releasing of muscles of the uterus When the uterus contracts, it shortens and closes, pushing the fetus agains the cervix The uterus relaxes before the next contraction

Premature Labor Full-term pregnancy usually lasts 40 weeks Giving birth a week or two earlier is still normal Premature, or preterm, labor occurs when the fetus has been developing in the womb for 37 weeks or less

False Labor Some women feel what is called false labor hours or days before their real labor starts They begin to feel strong contractions and believe that labor may have begun Doctors look for three signs that may indicate false labor Contractions that are not regular or rhythmic Contractions do not get stronger over time Contractions end with light exercise, such as walking or stretching

Inducing Labor If necessary, the doctor can induce, or start, labor by artificial means This can be done by using medication or puncturing the amniotic sac Often induced for medical reasons or in emergencies If the baby has been slow to develop or is still in the womb after 42 weeks, the doctor may decide to induce labor Also if the amniotic sac has broken and labor does not begin on its own

Stages of Labor Three basic stages Stage 1 Contractions open the cervix Stage 2 The baby is born Stage 3 The placenta is expelled During these stages, the baby makes its way out of the mother’s womb and into the world The amount of time it takes to give birth depends on the mother and the baby Often takes longer for a mother’s first 6-18 hours for first 2-5 for a later child

The First Stage Officially begins when contractions are coming at regular intervals Contractions in the uterine muscle pull up on the cervix, slowly softening and thinning it allowing it to open Contractions increase in strength, length, and frequency Mother will use coping techniques with the help of their partner such as breathing techniques or exercises This is the stage the mother would receive medication if she wanted

The First Stage As the cervix dilates, the baby moves into the lower pelvis The first stage ends with a period called transition When the cervix becomes fully dilated to a diameter of about 10 centimeters (4 inches) This is the most difficult part of labor

The Second Stage Contractions during the second stage are more productive, pushing the baby through the pelvis and out of the vagina, or birth canal During this stage, it is safe for the woman to push When pushing, uses her muscles to expel the baby

How can a baby fit through such a narrow space?? Ligaments, or connective tissue, join the bones of the mother’s pelvis During labor, a hormone called relaxin allows this tissue to stretch like rubber bands Stretching moves apart the pelvic bones Also makes it possible for the walls of the vagina to stretch so the baby can safely pass through

The Second Stage Baby’s body is designed for this journey Soft skull lets the baby’s head become longer and narrower than usual Skull consists of five separate bones that move together and allow for the baby’s head to fit through the pelvis and vagina Sometimes opening of the mother is too small to accommodate baby’s passage so doctor may widen it with a surgical cut called an episiotomy

The Third Stage After birth, the mother may be able to rest briefly, and then may feel a few contractions and a desire to push Usually not painful and helps the placenta, the organ that develops in the mother and helps supply oxygen to the fetus, separate from the uterine wall Once the mother pushes the placenta out of her body, the birth process is complete

Cesarean Birth Not all births progress through the stages of labor If complications arise during pregnancy or labor, a cesarean birth or c- section may become necessary Delivery of a baby through a surgical incision in the mother’s abdomen Performed for several reasons Lack of normal progress during labor Baby is in distress or turned in the wrong direction Often planned for multiple births Because it is a surgery, it carries some risks Women who have had a cesarean birth may need up to six weeks to fully recover

Premature Birth Between 5-6% of all babies are born prematurely Babies born before 37 weeks of development and weighing less than 5 pounds, 8 ounces The earlier babies are born, the less developed their organs are and the lower their birth weight Mothers who have had other premature births, are carrying more than one baby, or have other medical problems are more likely to have premature babies Women can reduce their risks by eating well and getting proper prenatal care

Premature Birth Premature babies, or preemies, require special care They are not ready to live outside their mother’s body Their systems for controlling body temperature, breathing and feeding are not yet mature To help control the undeveloped body systems, a premature baby is usually placed in an incubator Special enclosed crib where the oxygen supply, temperature, and humidity can be closely controlled