Chapter 7 Childbirth

Essential Question How do today’s knowledge and practices envision childbirth as a natural process while also providing advanced medical care for the mother and baby? FamVeld/Shutterstock.com

Decisions Concerning Childbirth 7.1

Objectives After studying this lesson, you will be able to assess ways family members can be involved during pregnancy. describe the Pregnancy Discrimination Act and the Family and Medical Leave Act and explain how each law affects families during the birth or adoption of a child. differentiate among options for a birthplace. compare and contrast three methods of delivery.

Decisions Facing a Parent-to-Be Health care provider for prenatal care, delivery, and for baby Birthplace Support people for delivery and for after birth Name(s) Breast-feeding or formula-feeding Housing arrangements, clothing, and equipment Work and leave options

Explaining Pregnancy to Siblings Explain changes in the body or how a baby is born, if asked. Familiarize an older child with newborns. Assure child about what factors will be the same. Explain and make any changes in housing arrangements or routines. Engage older child as a special helper. Make sure older children receive at least one gift. Let child “introduce” baby to relatives and friends.

Employment Considerations Pregnancy leave—used if a mother-to-be cannot work during pregnancy due to health reasons Pregnancy Discrimination Act (PDA)—protects rights of working pregnant women Maternity/paternity leave—time away from work after the birth or adoption of a child Family and Medical Leave Act (FMLA)—used to take unpaid leave for family-related reasons

Delivery Considerations Choosing a birthplace: hospitals birthing rooms birth centers home Choosing a method of delivery: natural childbirth Lamaze method delivery with drugs Phattana Stock/Shutterstock.com

What Do You Think? How do social and economic factors impact childbirth options? szefei/Shutterstock.com

Time to Be Born 7.2

Objectives After studying this lesson, you will be able to identify and describe the signs of labor. explain important events that occur during each of the three stages of labor. differentiate among the most common procedures used for complications of childbirth. compare and contrast a mother’s and baby’s stay in a hospital room with a stay in a birthing room.

Signs of Labor Birth should occur about 266 days after conception. Lightening—the baby descending into the pelvis during the last few weeks of pregnancy Contractions—tightening of the muscles to move the baby out of the mother's body The mucous plug becomes dislodged or the amniotic sac breaks.

Did You Know? In about five percent of cases, the baby moves into breech birth position. Alila Medical Media/Shutterstock.com

Stages of Labor Body Scientific International, LLC

Complications of Childbirth Premature delivery Premature rupture of membranes Prolonged delivery Abnormal position for delivery Cephalopelvic disproportion Umbilical cord problems Asphyxia Meconium aspiration Postpartum bleeding

Procedures for Childbirth Complications Drug-assisted deliveries—increase or administration of drugs Vaginal-assisted deliveries—may be manual (using version) or operative (using forceps or vacuum extraction) Cesarean sections—baby is surgically removed

What Do You Think? Why do hospitals encourage a rooming-in arrangement after birth? How important is this arrangement for the mother? for the baby? nata-lunata/Shutterstock.com

Newborn Medical Care and Tests 7.3

Objectives After studying this lesson, you will be able to describe the first medical care babies receive at birth. differentiate between the Apgar test and Brazelton scale. give examples of newborn screening tests often performed within 24 to 48 hours of birth. evaluate the types of care and treatment needed at birth for premature and other high-risk babies compared to healthy babies.

The Apgar Test Assesses the neonate’s chance of survival at birth Administered one minute and then five minutes after delivery

Newborn Screening Tests Blood tests—check for anemia, jaundice, and developmental disorders Hearing test—checks neonate’s hearing Heart test—checks for heart defects, such as critical congenital heart disease (CCHD)

Brazelton Scale Used to test babies up to two months of age Identifies whether a baby has problems interacting with the environment handling motor processes controlling physical state responding to stress

First Medical Care of the Baby Male circumcision—removal of the foreskin from the end of the penis Well-baby checkup—routine medical visit to ensure signs of good health and proper growth Leonie Pauw/Shutterstock.com

Care for High-Risk Newborns High-risk newborns—newborns who are premature, low-birthweight, or who have another high-risk condition Neonatal intensive care unit (NICU)—provides immediate, specialized care for high-risk newborns Neonatology—branch of medicine concerned with care, development, and diseases of newborns

What Do You Think? Why is parental presence and involvement critical to the development of newborns in the NICU? Chaikom/Shutterstock.com

Postpartum Care 7.4

Objectives After studying this lesson, you will be able to describe physical care the mother receives during the postpartum period. compare and contrast mood disorders that mothers may experience in the postpartum period. identify common symptoms of paternal postpartum depression (PPPD). give examples of ways parents can meet their own needs while caring for their newborn.

Physical Care of the Mother Postpartum care—medical care received for the six to eight weeks following childbirth Typical side effects of delivery include mild cramping and vaginal bleeding some loss or thinning of hair facial blemishes or acne night sweats and frequent urination sore nipples and engorgement of breasts if breast-feeding extra soreness due to any delivery complication

Postpartum Mood Disorders Baby blues—mild mood disorder that goes away on its own Postpartum depression (PPD)—serious maternal depression Postpartum psychosis (PPP)—severe maternal mental illness characterized by delusions Paternal postpartum depression (PPPD)—paternal depression following birth

Meeting Parent Needs Getting enough rest Maintaining a healthful diet Staying physically active Staying organized Taking care of legal matters Socializing Tatiana Katsai/Shutterstock.com

What Do You Think? Parents across the world are awarded significantly more leave time upon the birth or adoption of a child than are parents in the U.S. What social or cultural aspects of the U.S. impact the expectation that a parent return to immediate productivity after childbirth?