Childbirth

The Role of the Family

Today’s Fathers-to-Be First few months of pregnancy: Husbands reassure their wives, help select a doctor and decide other aspects about delivery. Middle months: prepare nursery Final months: Husbands need to be supportive, as the mother-to-be is very tired and anxious for delivery. Many fathers see their babies being born.

Fathers act as “helpers” during labor Labor: the process that moves the baby out of the mother’s body Being involved in the delivery room has proven to strengthen marriages, along with the bond between father and baby.

Family Decisions Concerning Childbirth

Choosing a Birth Place-Hospital Hospital deliveries are most common. Labor take place in maternity room, and then mother is taken to delivery room shortly before baby is born. After baby is born, they spend short time in recovery room before returning to maternity room. If mother needs a surgical delivery, they will be taken to a surgical room.

Hospital cont… Many hospitals offer a homelike room in the hospital for low-risk deliveries. Furnished like a bedroom, but with hospital equipment. Nurse stay in the room during labor, doctor only comes in for delivery. Parents stay here until discharged.

Birthing Centers Some families think hospital deliveries treat childbirth as an illness rather than a natural process. These may choose to deliver in a birth center. Provides health care before labor and delivery services. Certified nurse-midwives (CNMs) have special training in delivering babies during normal, not high-risk pregnancies

Home Births Riskier because emergency services are not typically nearby. Many couples choose to have a midwife present to assist if any problems arise. Infant death rate is higher than those born in a hospital.

Choosing a Method of Delivery Delivery options may change during labor May start w/out drugs, but then ask for them to relieve pain. Some drugs may cross the placenta causing the baby to be sluggish and not an active participant.

Childbirth drugs Sedatives: reduce anxiety and are used in the early stages of labor. Analgesics: reduce pain but do not take it away. Anesthesia: blocks pain Has the most side effects

Natural Childbirth Method of delivery without drugs Woman is trained to breathe and relax in a way that helps the birth process. Father provides support. Some parents use a doula: female helper who reassures and guides the mother through labor. Some use midwives.

Lamaze Method Women may already to conditioned to fear childbirth, so in Lamaze training, the mother is taught to focus on something other than the pain. Mother and her coach (usually father) attend classes that prepare her mentally and physically. Breathing methods and exercises are taught. The woman may receive drugs.

The Last Weeks of Pregnancy Time to be Born

Contractions Contrations: Involuntary contractions in the uterine muscles. Lightening: a change in the baby’s position. The baby settles lower into the pelvis, uterus settles downward and forward. Baby typically rotates so the head is downward. Breech birth position: buttocks-first position. When lightening takes place, the mother can breathe easier, but may get leg cramps and may need to urinate more often.

False labor: Few irregular contractions. Regular contractions occur at more even intervals. As labor progresses, contractions increase in length and strength.

Other Signs of Labor Mother may feel a boost of energy due to an increase of adrenaline. The mucous plug in the cervix will become loose. Small amount of blood in mucous is called the show. This means labor will begin within 24 hours. Amniotic sac may break before labor begins Usually happens after labor starts

Signs of Labor

Stage 1: Dilation of the Cervix Contractions start at one every 15-20 minutes and last 30 seconds. Towards the middle of labor, they will last 45-60 seconds and will be 2-4 minutes apart. During the transition contractions last 90 seconds, and feel continuous. This causes the uterus to narrow, straightening the baby’s body and pressing the head against the cervix, cause the cervix to open or dilate.

If the amniotic sac has not broken, the doctor will break it when the cervix is fully dilated at 10 cm (about 4 inches). When the cervix is completely open, the first stage of labor ends. Average length of this stage is 8 hours for the first pregnancy (less for later pregnancies).

Stage 2: Delivery of the Baby Babies head enters birth canal. Sometimes an episiotomy is needed, which is an incision made to widen the birth canal and prevent tearing. The baby starts coming out head down, and then turns to the side as neck and shoulders come out.

Average time is 30-90 minutes for first pregnancy. Doctor suctions liquid out of mouth to help baby take first breath. Umbilical cord is clipped before the third stage begins.

Stage 3: Delivery of the Placenta About 5-10 minutes and up to 30 minutes after birth, the mother has a few irregular contractions. These cause the placenta to detach from the uterus and descend. Afterbirth: placenta and fetal membrane are expelled.

Complications of delivery

Common Techniques Used to Aid Delivery Version: manually rotating unborn baby into correct position for delivery. Pitocin: a drug used to speed up labor by causing contractions to start and strengthen. Forceps: curved instrument that fits around the sides of a baby’s head, aids in easing the baby down the birth canal during a contraction.

Cont… Vacuum extraction: suction is used to attach a cuplike device around the top of the baby’s head, allows the doctor to gently pull the baby down the birth canal.

Cesarean Births (C-Section) The mother’s abdomen and uterus are surgically opened, and the baby is removed. Recovery takes longer than for vaginal deliveries.

Reasons for C-sections Mother’s pelvis is small or not shape correctly Baby or mother is at medical risk Baby’s head is too large Contractions are weak or absent Baby is in an incorrect position for birth Multiple births Fear that uterine scar (from previous c- section) will rupture. Fear of transmission of herpes

Risks of C-sections Risks of major surgery Increasing need for surgical removal of the uterus (hysterectomy) with each c- section A low, but increased risk of stillbirth with next pregnancy Increased risk of complications from vaginal birth after previous c-section birth

Hospital Care

Mother and baby can expect to stay in hospital for 24-60 hours. Complicated or c-section deliver will stay longer Rooming-in: if baby is healthy, baby is placed in a bassinet in the room with mother.

Bonding

Bonding: developing a feeling of affection between parents and baby. 1st hour after birth is most important Bonding continues for the next few weeks as baby gets used to parents voices, touch, feel, etc.

Benefits of Bonding Increased chance of survival Better weight gain To Infant To Parents Increased chance of survival Better weight gain Less crying, more smiles and laughter Fewer infections Possibly higher IQ Better language development Less incidence of child abuse Faster recovery from delivery Longer breast-feeding More self-confidence as a parent Less depression after delivery Benefits of Bonding

Postpartum Care

Postpartum care is the care the mother receives during the 6-8 weeks following the birth of her baby. Body returns to prepregnancy state unless breast feeding.

Postpartum Mood Disorders Baby blues: mild and goes away on its own. Most common Postpartum depression (PPD): a serious form of depression Postpartum psychosis (PPP): an extremely severe mental illness PPD and PPP need immediate medical treatment