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